Second Puberty: What Happens on Our Way Through Perimenopause

Sleep problems, mood swings, and crazy heavy periods. Is this menopause already? And you’re only 42? No, menopause may still be a decade away. This is perimenopause or “second puberty” which is the 2–12 years of hormonal change that precede menopause.

Just like first puberty, second puberty can bring challenging physical and emotional symptoms. But the added challenge with second puberty is that the symptoms are, to some extent, “unspeakable.” They signal to a society that doesn’t value older women that you are a woman growing older.

If this sounds familiar, I’m there with you. As a natural hormone doctor and a woman in my late 40s, I’ve stood face-to-face with perimenopause and the stigma around it, and I can tell you that it’s going to be OK. You still have power. You still have health.

Here’s what you need to know about this new life stage.

The Symptoms of Perimenopause Won’t Last Forever

If you’re suffering symptoms in your 40s, please know that they are temporary. Eventually, your symptoms will end and you will reach the kinder, calmer phase of life called menopause, when your mood should be at least as good as it was when you were younger—and maybe even better.

For example, one study tracked 400 menopausal women over 20 twenty years and discovered that mood scores steadily improve with age and that most women report feeling “pretty fantastic after menopause.”

You Have Permission to Slow Down

Knowing that perimenopause won’t last forever, you now have permission to slow down and be kind to yourself during these few vulnerable years. For example, you might want to look at temporarily cutting back your work hours, or hiring someone to help you at home. Sign up for that yoga class or book a weekly massage, and consider it an investment. Being in my late 40s finally convinced me to start meditating regularly.

Magnesium Is Your New Best Friend

As I share in my book Period Repair Manual, magnesium is my favorite natural prescription for perimenopause. It calms the brain and promotes sleep and has been proven to ease the symptoms of the menopause transition. The best type is magnesium glycinate because it’s the most absorbable and the least likely to cause digestive side effects. For best results, I give magnesium together with vitamin B6. Unless you have kidney disease, magnesium is safe for long-term use.

You Don’t Need Estrogen

Contrary to what you may have been told, your estrogen is not on a slow, gradual decline in your 40s. It would be a lot nicer if it were because then you could experience a slow, gradual transition to menopause. Instead, your estrogen is doing the worst possible thing: it’s fluctuating wildly. It’s soaring to twice what it was before and then crashing down again to almost nothing. And it’s doing that again and again, cycle after cycle.

The solution to the high estrogen of perimenopause is not to take more estrogen in the form of hormone replacement or the Pill.

You Might Need Progesterone

The best treatment for perimenopause is progesterone, which is the wonderful, soothing counterpart to estrogen. Progesterone is the hormone we lose most dramatically in perimenopause, and it’s the hormone that can deliver the most relief.

Natural progesterone (also called micronized progesterone) makes periods lighter. In that way, it’s just as good as progestin drugs such as the levonorgestrel in the hormonal IUD. But natural progesterone delivers other benefits that progestins cannot. For example, progesterone has been demonstrated to relieve hot flashes, stabilize mood, and improve the sleep disturbance of perimenopause.

Natural progesterone is available as either a topical cream or the capsule PrometriumⓇ.  

Yes, You’re Getting Older (and That’s a Good Thing!)

In a society that values young women, some of us entering menopause can feel a loss of power and worth.

It doesn’t have to be that way. As I approach menopause myself, I’m waking to a new kind of power—one of wisdom and a strong desire to help others. I also feel a camaraderie with other older women. By 2030, there will be 1.2 billion menopausal women in the world.

Surely, we can be a force for good. Join us.

Featured image by Aline de Nadai

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  • I’m a breast cancer survivor am I’m in treatment induced menopause and taking tamoxifen. That’s interesting about the progesterone as they’ve just increased my antidepressants to stablise my mood and I take nothing for the hot flushes, they mainly happen in the afternoons, and I take vagifem low dose for the dryness. The gift that keeps on giving! Am I on the right track or would you recommend the progesterone? I’m only 36. I’m considering having a full hysterectomy next year so I don’t have to be on tamoxifen for the next 5-10 Years putting me in a state of menopause and then when I stop, it will almost be time to go through it again naturally anyway…I don’t want 20 Years of menopause if one can avoid it. Your advice would be appreciated. Many thanks

  • Thank you. I’m right here with fluctuating oestrogen and low progesterone and yep suffering terribly and at the same time I’m in a critical and high stress junction in my biz. Worst timing or perfect. It truly feels like I have time travelled to the 80s doing that wild PMS again. I’ve implemented most things except slowing down but I do go to bed at 8:30pm but don’t sleep yet. Sweet relief is on my door step and deep learnings are surfacing. Thank you for your research and passion xx


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