Perimenopause and Natural Progesterone
Years before the end of your periods, a woman goes through a transitional time that is called perimenopause. This transition - puberty in reverse - occurs as your hormones are gearing down from the high levels needed to reproduce. This transition can take between one and 10 years, but averages about three years. After a full year without a period a woman is proclaimed menopausal.
Hormonal changes are responsible for the onset of perimenopause. As a woman reaches the end of her childbearing years, production of her ovarian hormones begins to fluctuate. During perimenopause, many cycles are annovulatory (do not include ovulation) and estrogen levels can sharply rise and then quickly drop. This causes menstrual periods to become shorter, then more and more irregular until they stop.
In the United States, the average age of menopause is 51.
What are some of the symptoms of perimenopause?
The variations in hormones that occur during perimenopause are responsible for many of the symptoms. Luckily most of the symptoms typically only last for a few months. About one-third of women have no symptoms, while a third have mild ones and a third have severe ones. Overall, many women feel unstable during this time with temperature control (hot flashes), heart rates (palpitations), energy (fatigue), moods (irritability) and even thinking (fuzzy thinking).
Here are some of the commonly mentioned symptoms:
- Fatigue
- Insomnia
- Irregular menstrual periods
- Heavy bleeding
- Irritability
- Hot flashes and night sweats
- Memory difficulties (fuzzy thinking)
- Mood swings
Although perimenopause is perfectly normal, some symptoms should probably be checked to make sure that they are not the sign of something else. This is particularly true for persistent heavy bleeding, persistent palpitations (especially when accompanied by chest pain or shortness of breath), severe depression or fatigue.
Extreme variations in hormones make testing hard. The FSH test, which checks the blood level of the follicle stimulating hormone (FSH), is only valuable after you have been without a period for a year, by which time you will have probably figured out that you are in menopause.
Premature menopause
Premature menopause is technically defined as menopause that occurs before the age of 40. You stop ovulating and your periods stop completely years before the "normal" age of menopause. When you’re going through early menopause, you’ll notice symptoms that are the same as those for women in perimenopause — hot flashes, changes in your period, night sweats, mood swings and the like. But you’ll notice these symptoms at a much younger age — in your 20s, early 30s, even late teens. Your estrogen levels drop; your FSH levels rise in an effort to jumpstart your ovarian function — but you stop ovulating and, ultimately, your periods stop altogether decades earlier than usual.
The role of progesterone
Progesterone has a comprehensive role in a woman’s body. And when levels drop, your body is going to react in a big way. We now know that if we allow estrogen to dominate the hormonal environment, there is significant risk of breast cancer and reproductive cancer. So one of progesterone’s most important roles is to balance or negate the effects of estrogen.
At menopause, a women’s estrogen level will drop by 40-60% (or can be lower in cases involving thin women). Just low enough to stop the menstrual cycle. Progesterone levels, however, may drop close to zero in some women.
This wouldn’t have bothered a woman at the turn of the 20th century who rarely lived beyond her reproductive years. But these days a woman can expect to live to 85 years and beyond. She needs to give some thought to how she’s going to rejuvenate her ‘ageing’ endocrine system. Natural hormone replacement will become a vital anti-ageing tool for both men and women, and progesterone supplementation is a good place to start.
