Hormones are a key part to the delicate ecosystem that helps your body flourish, no matter how much they get blamed for just about every dysfunction in your body.

Does that mean you should ignore changes in your body or your hormones? What’s even considered normal? Last time in this series, we dove diving into the details of your 20s, and what you should expect for typical hormone function. Let’s chat today about the next portion of life: 30s and 40s.

What to Expect: Hormones in Your 30s and 40s

Women in their 30s and 40s can find this time of their life even more exciting and adventurous than their 20s. Although there’s a natural downward progression in hormone production, women can still find a balance that keeps them feeling “easy, breezy, cover-girl” and have the energy to take on the world whether in a career space or in their personal home life. 

What’s Normal in Your 30s and 40s

Let’s start by demystifying the word “perimenopause” (I can see some of you cringing!). Perimenopause is not a disease state or a disorder. In fact, it’s simply a word to identify a completely normal stage of a female’s life where the body slowly starts to make a transition in hormonal production. Perimenopause, on average, starts most prominently around the age of 40, but for some women they may notice this transition a little sooner or a little later. 

What’s the Cause for This Transition? 

For us to fully understand perimenopause, we have to go all the way back to when a woman is born. A female is born with all of her eggs she will ever have, which is typically around 1 million. Studies reveal that by puberty, a woman will have half that, and then from each month after puberty, she will continue to lose up to 1,000 eggs (1). And, note, because I can hear some of you asking, though all those eggs are typically released at one time, only one egg is matured and ovulated each month.

This process of ovulation plays a significant role in the production of both estrogen and progesterone levels, the main female hormones. During perimenopause, the level of estrogen will start to rise and fall unevenly. Your menstrual cycles may lengthen or shorten, and you may begin having menstrual cycles in which your ovaries don’t release an egg (ovulate).

When to See Your Doctor in Your 30s and 40s

The severity of these changes during perimenopause can vary from person to person. Although some mild changes can be expected, if you’re noticing the following, it might be time to do some further investigation.

• Your periods are very close together.
• You have spotting.
• You have periods that last longer than a week.
• Your periods are heavy.
• You have no period for a length of time.
• Hot flashes or night sweats.
• Vaginal dryness.
• Pain with sex.
• Difficulty sleeping.
• Mood swings.

Thyroid Screening

Feeling a combination of symptoms, such a low energy, constipation, dry skin, dry hair, brittle nails, cold intolerance, muscle aches, or brain fog? It might be time to check your thyroid and adrenals. 

If you haven’t been tested already, the American Thyroid Association (ATA) does recommend TSH (thyroid stimulating hormone) screening in all adults at age 35, with repeat tests every 5 years.

Breast Cancer Screening

Keep an eye out for any breast changes! Breast cancer is the most common cancer in American women.

The American Cancer Society (ACS) recommends women ages 40-44 have the personal choice to start annual breast cancer screening with mammograms (x-rays of the breast). Starting at the age 45 it is recommended to have a mammogram yearly. 

Always see a doctor for a breast exam if you notice:

• Swelling of all or part of a breast (even if no lump is felt).
• Skin dimpling (sometimes looking like an orange peel).
• Breast or nipple pain.
• Nipple retraction (turning inward)
• Nipple or breast skin that is red, dry, flaking or thickened.
• Nipple discharge (other than breast milk).

Colorectal Screening

In addition, colorectal cancer is the third most common cancer worldwide. Colorectal cancer symptoms can vary based on size and location.

The ACS recommends that people with average risk of colorectal cancer start regular screening at age 45. This can be done either with a sensitive test that looks for signs of cancer in a person’s stool (a stool-based test), or with an exam that looks at the colon and rectum (a visual exam).

Some commonly experienced symptoms that would indicate a good time to check in with your doctor, include:

• Changes in bowel habits.
• Changes in stool consistency. 
• Blood in stool.
• Abdominal discomfort.

Feeling great and have no complaints? It’s still recommended that you get a well-women’s examination yearly! Regular check-ins are a great preventative measure to your health. In addition, check out my previous post, under the section “Healthy Body & Mind”, to find routine biometric markers that are still relevant to check regularly.

Wanting to connect with a doctor who will hear ALL your concerns? Become a member at MIMC!

Sources

1. Wallace W, Kelsey T. Human Ovarian Reserve from Conception to the Menopause. PLoS ONE 2010; 5(1).

Dr. Danielle Vogler-Bos

Dr. Danielle Vogler-Bos is a Naturopathic Doctor, registered and licensed in both Minnesota and Arizona. Her passion is educating and empowering her patients to take back their health, partnering with them to find the root cause of their struggles, and helping them feel better, faster. After graduating from Gustavus Adolphus College with a Bachelors of Arts in Biology, Dr. Vogler-Bos earned her Doctorate of Naturopathic Medicine from Southwest College of Naturopathic Medicine, a fully accredited and nationally recognized institution in Phoenix, AZ.

During her clinical training, Dr. Vogler-Bos completed a rigorous internship gaining experience in the diagnosis and treatment of hormonal imbalances, thyroid disorders, and adrenal fatigue using both traditional naturopathic medicine and bio-identical hormone therapies.