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Why do oestrogen levels fluctuate
during perimenopause?
Oestrogen levels do not decline steadily during perimenopause but, instead, rise and fall unpredictably.
These fluctuations can trigger a range of symptoms, including heart palpitations, which many women find unsettling.
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As a result of the shifting levels, symptoms can vary significantly over time.
How ovarian function changes in perimenopause
The ovaries are responsible for producing oestrogen. During perimenopause, they become less consistent in how they respond to signals from the brain. This leads to uneven hormone production.
How follicle development affects oestrogen
Each cycle, the ovaries prepare follicles that contain eggs. During perimenopause, this process becomes less reliable, which affects oestrogen production and often leads to period changes.
How brain signals affect oestrogen levels
Hormonal changes often begin with signals from the brain, such as FSH, trying to stimulate the ovaries. As the ovaries respond less predictably, oestrogen levels can swing higher or lower than expected.
Oestrogen fluctuates rather than declines
Oestrogen does not simply decrease during perimenopause. Levels can sometimes be higher than usual and at other times lower, creating a pattern of ongoing fluctuation.
How oestrogen fluctuations affect the body
These ups and downs in oestrogen can affect many areas of the body, contributing to various physical symptoms and changes that may feel inconsistent.
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In addition, these fluctuations can affect cognitive function — contributing to brain fog, memory lapses and reduced concentration — and may even exacerbate ADHD symptoms.
When to see a doctor
If you are finding that these fluctuations are difficult to manage, a perimenopause consultation can help provide clarity and will give you an opportunity to explore perimenopause treatment options.
Key points
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Oestrogen levels fluctuate during perimenopause rather than steadily decline.
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The ovaries respond less consistently during perimenopause.
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Follicle development becomes less predictable.
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Brain signals and ovarian response may not align.
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Hormone fluctuations can lead to changing physical and cognitive symptoms.
Medically reviewed by Dr Susana Rodriguez, menopause clinician at ClaraSana Women’s Health, Perth.
Our content is based on up-to-date Australian guidelines & may differ from information on other sites.