Estrogen, Progesterone & Testosterone: Know the Players

By: Dr. Mary Knudsen ND

Perimenopause and menopause can feel like an unpredictable rollercoaster, but understanding what’s happening with your hormones can help you stay in control and feel your best.

Perimenopause: Hormones on a Rollercoaster

Perimenopause is your body's "transition zone" before menopause — and your hormones can be all over the map.

Estrogen:

Estrogen doesn’t just gradually decline — it’s more like a wild ride with sudden spikes and dips. Those unexpected surges can bring on hot flashes, mood swings, and breast tenderness. Over time, estrogen levels trend downward, but the journey can feel bumpy.

Progesterone:

Progesterone tends to take an earlier and steadier dive. Since this hormone plays a key role in calming the brain, its decline can leave you feeling more anxious, irritable, or struggling to get restful sleep.

Testosterone:

While less prominent in women, testosterone also dips as you age. This can leave you feeling less energized, less motivated, and may even lower your libido.

Menopause: Finding a New Normal

Once you’ve gone 12 months without a period, you’ve officially reached menopause — and your hormones settle into their new baseline.

Estrogen:

Estrogen levels are now consistently low, which can lead to vaginal dryness, bone loss, and a higher risk of heart disease.

Progesterone:

Since ovulation has stopped, progesterone levels remain low, which can affect mood and sleep.

Testosterone:

Testosterone continues its slow decline, sometimes contributing to lower muscle tone, reduced motivation, and changes in sexual desire.

How Hormonal Changes Affect Your Body

These shifting hormones can show up in surprising ways:

• Brain: Estrogen’s ups and downs may contribute to mood swings, anxiety, and those frustrating "brain fog" moments.

• Skin and Hair: With less estrogen supporting collagen production, your skin may feel thinner, and your hair may lose some of its fullness.

• Bones: Lower estrogen can speed up bone loss, increasing your risk of fractures.

• Metabolism: With estrogen playing a key role in metabolic regulation, weight management can become trickier.