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What Is Pre/Perimenopause All About?

It can be a confusing time as hormones change and various symptoms start to appear. Is it pre/perimenopause or menopause itself?


Your doctor may tell you that you in menopause, or premenopausal or even perimenopause but what exactly does that mean? There is a vast range that can apply as a woman’s hormone balance can begin to shift at anywhere from her mid thirties to late forties.

This can all depend on a number of factors including:

*  heredity

*  environment

*  how early or late she began menstruating

*  whether she had children, how many and at what age

*  lifestyle factors such as diet and exercise

*  how exhausted she is from trying to juggle career and family

*  being exposed to toxins in the workplace

Hormone balance is intimately connected to stress levels, nutrition and the environmental toxins encountered daily.

The ability of the follicles to mature an egg and release it may begin ‘sputtering’ so to speak a decade before actual menopause, creating menstrual cycles in which a woman does not ovulate, called anovulatory cycles.

If she isn’t ovulating she isn’t producing progesterone from the ovaries and she may begin experiencing menopausal symptoms such as weight gain, water retention and mood swings.

Menstrual cycles can continue even progesterone being produced so most women aren’t aware that the lack of progesterone is causing their symptoms. This is known as perimenopause or premenopause.

It used to be true that the majority of women began menopause in their midforties to early fifties but now things appear to have changed. Women now may have anovulatory periods starting in their early thirties and yet do not experience cessation of periods (menopause) until their fifties.

During this time the ovaries continue to produce oestrogen sufficient for regular or irregular shedding, creating what the late Dr John Lee termed ‘oestrogen dominance.’

Some women may go for years with irregular cycles and slowly wind down, or may just suddenly stop menstruating one month and never menstruate again.

They may be overwhelmed with unpleasant symptoms or hardly notice what has happened, other than not having to worry about birth control or buy tampons every month.

How menopause is experienced is as individual and unique as you are

Also, as you approach the menopause your periods can be closer together or get longer or heavier. This is really common and due to the way that your hormonal balance is starting to change.

At this point, your progesterone levels will be falling faster than your oestrogen, so your oestrogen just keeps triggering a menstruation and a bleed.

When oestrogen surges women undergoing these changes may notice:

  • Breast swelling and tenderness
  • Mood swings
  • Sleep disturbance
  • Water retention
  • Tendency to put on weight

These may be the symptoms of oestrogen dominance, caused mainly by lack of ovulation and therefore a lack of progesterone, while their oestrogen levels are still in the ‘normal’ range.

Their doctors may check their oestradiol levels and their FSH and LH levels, but rarely does it dawn on them that their patients’ progesterone levels are too low.

Restoring hormone balance can help women through perimenopause and support them as their symptoms change during menopause itself.

What each woman needs is different, for the majority simply increasing their progesterones levels is all that is needed, but some women a small amount of oestrogen is helpful if her own natural levels are insufficient and resulting in symptoms such as vaginal dryness.