Dr. Mary Claire Haver

is perimenopause.

Let's start with some basic definitions so we're all on the same page.

So perimenopause is more than just the waiting room, right, for your menopause.

It is its own distinct hormonal and biological transitory state.

So if you think of back when you were premenopausal,

pre-menopausal, okay?

Menopause had not entered the chat, all right?

You're steadily losing your egg count supply, and we can talk about that in a minute, but you are still ovulating on a fairly regular basis.

Now, for those of you who don't ovulate regularly or you're on suppression for birth control pills or whatever, you have to take this as a caveat, or those with PCOS may not ovulate regularly.

But for the 80% of you that do, when our estrogen supply

drops after ovulation, the brain says, hey, where's this estrogen I've been looking for?

And it starts sending signals out in the form of something called LH and FSH from the pituitary gland that then go and bind to the cells around our individual eggs.

And that starts producing estradiol again.

And the whole process repeats itself over and over again, month after month after month, until we hit perimenopause.

The length of perimenopause can be 7 to 10 years.

So your brain realizes the egg supply count is getting low.

That is perimenopause.

The first symptoms people typically have, they feel like something's not right.

It's usually mental health changes looking like increasing anxiety or depression or new onset anxiety and depression with no real precipitating factors.

Or I just don't feel like myself.