Marla Ahlgrimm: Understanding Perimenopause

Marla Ahlgrimm | December, 22, 2011 | by
According to Marla Ahlgrimm, pharmacist and founder of Women’s Health America, a woman may experience physical and emotional symptoms as her hormone levels change beginning in her mid-thirties. Perimenopause is the time around menopause. Peri, which means “enclosing” or “surrounding,” is paired with menopause to encompass the years leading up to menopause, when a woman’s monthly cycle stops. As a woman ages, says Marla Ahlgrimm, subtle shifts in hormone levels occur that she may not even notice at first.


Marla Ahlgrimm, an expert in women’s hormonal health, explains that during the perimenopausal transition, a woman’s ovaries begin to produce decreasing amounts of estradiol and progesterone. She may notice the symptoms of sleep disturbances, hot flushing, stress incontinence and experience an increased rate of bone loss, adds Marla Ahlgrimm. While some women experience these changes over many years as they as they approach menopause, others experience intense symptoms that only last a few months, according to Marla Ahlgrimm, R.Ph. Every woman experiences hormonal changes in her own unique way.


A woman will likely continue to menstruate during perimenopause, Marla Ahlgrimm, pharmacist, explains. However, the menstrual cycle may not be as predictable as in her earlier years and she may even find she skips some periods altogether. Marla Ahlgrimm, a licensed pharmacist, also reminds patients that PMS symptoms can increase during this time, including mood swings, anxiety, irritability, and premenstrual depression.


For women experiencing hot flushing and sleep disturbances, Marla Ahlgrimm explains that the decline in estrogen may effect the chemicals in a woman’s body that control temperature and sleep. Scientists have theorized that the hypothalamus, the part of the brain that stimulates the release of sex hormones near the brain’s temperature and sleep control center, may be the cause of certain symptoms, Marla Ahlgrimm explains. In fact, sleep quality is the most sensitive indicator of falling estrogen levels. Sleep disturbances, says Marla Ahlgrimm, can occur 10 years before menopause.


Another symptom of perimenopause is vaginal dryness. According to Marla Ahlgrimm, R.Ph., estrogen decline causes vaginal tissues to become thinner and less moist.  Vaginal pH increases as estrogen levels fall changing the normal flora of the vagina, increasing the risk of vaginal irritation or infection. Marla Ahlgrimm, co-founder and president of Madison Pharmacy Associates, says that pain and irritation due to vaginal dryness may play a role in a woman’s loss of interest in sex. Depression and fatigue due to changing hormone levels may play a part as well.


During perimenopause, a woman may notice an increase in facial hair growth and acne. As estrogen and progesterone levels fall during the perimenopausal transition, a woman’s testosterone level stays the same creating an imbalance between the female hormone, estrogen, and the male hormone, testosterone, according to Marla Ahlgrimm, R.Ph.


Rate of bone loss may also increase as estrogen levels decline. When estrogen levels are low, bone breakdown occurs faster than bone building, resulting in osteoporosis if the imbalance continues, Dr. Marla Ahlgrimm warns.


Estrogen has a positive effect on the heart, according to Marla Ahlgrimm. As this hormone decreases, HDL, the good cholesterol decreases and LDL, the bad cholesterol, increases over time predisposing a woman to the effects of heart disease.


The Good News


Many of the troublesome symptoms of perimenopause as well as bone loss and heart disease can be managed with diet and lifestyle changes along with low dose, natural hormone therapy around the time of menopause.


The information in this article has been previously published and is provided as a reference resource by Marla Ahlgrimm, R.Ph. The businesses referenced above were sold in 2011. Marla Ahlgrimm is also the co-founder and President of Cyclin Pharmaceuticals, Inc. The company sells proprietary products for the women’s health market as well as ProCycle PMS and ProCycle Gold products. For more information, go online to

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Contact Marla Ahlgrimm, R.Ph.