Peri-Menopause is defined as the period of time (ranges from 6 months to several years) that immediately precedes true menopause. And, as most women find out, it can often be more symptomatic than the actual experience of menopause itself.  If any of these symptoms sounds familiar, you may be peri-menopausal:

• Decreased sex drive
• Irregular or otherwise abnormal menstrual periods
• Bloating (water retention)
• Breast swelling and tenderness
• Fibrocystic breasts
• Headaches (especially premenstrually)
• Mood swings (most often irritability and depression)
• Weight and/or fat gain (particularly around the abdomen and hips)
• Cold hands and feet (a symptom of thyroid dysfunction)
• Hair loss
• Thyroid dysfunction
• Sluggish metabolism
• Foggy thinking, memory loss
• Fatigue
• Trouble sleeping/insomnia
• PMS

And, even more surprising to hear is that peri-menopause is a condition of estrogen dominance, and not estrogen defeciency.  The defeciency side of the coin doesn’t usually come into play until much close to menopause.  In the early years, progesterone defeciency is the real culprit.  Why?

It’s all about the eggs…

It’s no surprise to hear that our eggs lose their youthfullness as we age, but so do the follicles that the eggs grow in.  And, it’s the  follicle remnant (corpus luteum) that produces progesterone in the second half (luteal phase) of our menstrual cycle.  As we age, the amount of progesterone produced decreases. So, in a peri-menopausal woman, you may have a normal follicular phase (first half of the cycle) but  a shortened (or absent) luteal phase, leading to an imbalance between estrogen and progesterone.  What needs to be deciphered is whether or not it’s a “true” estrogen dominance (high estrogen, normal progesterone), or if it’s a “relative” defeciency, where estrogen is normal but progesterone is defecient.  The best way to determine this is by using saliva hormone testing.  Conventional blood work will tell us if your hormone levels fall outside of the normal reference ranges, but it won’t tell us the relationship between the two at a given point in your cycle, nor does it break down estrogen into it’s 3 forms: estone, estradiol, and estriol.  This is important information, as it can lead to more effective treatment. But, we don’t always have to proceed with saliva hormone testing, especially if the symptom picture is clear.

Will you need progesterone cream or supplements?

Maybe, but probably not.  In my experience, the vast majority of patients with estrogen dominance respond very well to dietary interventions, functional medicine and carefully chosen herbs.  There are a variety of herbs that can help treat estrogen dominance and/or progesterone deficiency, and are my preferred treatment of choice.

What can I do NOW?

Keep in mind that it can take up to 3 months for any therapy to take full effect. However, most of my patients begin to feel better long before that, often in as little as 3 weeks.  Here’s what you can do to get things started:

• Exercise.  Numerous studies have found that women who exercise for 30 minutes/day fare better than their sedentary counterparts.
• Reduce alcohol, sugar and red meat consumption.
• Add beans and legumes to your diet, 3-4x/week
• Learn to love flax!  Try to get 2 tbsp/day
• Reduce exposure to xenoestrogens (chemical estrogens). This includes pesticides and plastics. Click here for more information about plastics.
• Keep stress in check. Too much stress, resulting in excess amounts of cortisol, insulin, and norepinephrine, which can lead to adrenal exhaustion and can also adversely affect overall hormonal balance

If you are interested in Naturopathic care, please feel free to call or email with any questions you may have.