By: Serafina Corsello, MD
Last Reviewed on: June 25, 2002
Treatment for Perimenopause
Pharmaceutical Grade Natural Hormonal Replacement Therapy
Other Menopausal Symptoms
Before reaching menopause, a potentially liberating stage of life, women go through perimenopause?the transition time between regular menstrual cycles and their complete cessation. On the average, women move into menopause around ages 50 to 52. If all is well, perimenopause should not exceed one year. Over the course of my lengthy clinical practice, however, I have witnessed a dramatic increase in both the length and intensity of this transitional phase.
In my practice, I use natural remedies and stress management to facilitate smooth sailing through this tumultuous period. I think that women, by nature, have a tremendous amount of creative energy. For many, a good portion of that energy is channeled into birthing and raising children during the reproductive years. When reproductive capability ceases, and perimenopause and menopause begin, women have the opportunity to redirect their creative energy.
Perimenopause is marked by a disruption of the hormonal feedback loop (the relationship between ovarian hormones and the brain signals), which inevitably increases as we age. The ovaries begin to receive confusing messages and go through bouts of estrogen overproduction. Concurrently, progesterone rapidly declines as the frequency of anovulatory (without ovulation) periods increases. Follicle stimulating hormone (FSH), one of the hormones responsible for ovulation, spikes irregularly, as if a whirling dervish is trying to awaken the last few eggs to their final hurrah.
One of the earliest symptoms of perimenopause is a change in the character of the menses (monthly periods). Subtle emotional shifts may begin to occur. Family, work, and other stressors that were previously manageable now trigger irritable responses. Some women begin to have insidious recall or short-term memory difficulties that threaten their livelihood. Sleeping patterns may be disrupted, the sex drive may dwindle, and vaginal dryness can lead to painful intercourse. Unexpected weight gain while maintaining the same eating habits may add to the distress of this often unrecognized early transitional stage.
These bursts of estrogen in response to the FSH spikes can cause unpleasant premenstrual-syndrome-like symptoms?mood swings, anxiety, irritability, depression, acne, and carbohydrate craving. An overproduction of estrogen leads to excessive insulin production, which in turn is responsible for inexplicable weight gain. If uncontrolled, this hyperinsulinism can lead to type 2 diabetes. With falling progesterone levels unable to balance the estrogen bursts, the result is further estrogen dominance. Estrogen dominance can lead to increased incidence of breast, uterine, and ovarian cancer.
When we stop ovulating, we no longer form a corpus luteum?the site of progesterone production. The corpus luteum is the cholesterol accumulation that occupies the space left by the exiting egg. It is from cholesterol that all hormones are produced. As ovulation becomes less and less regular, progesterone levels decline rapidly.
Since progesterone plays a role in many important body functions, including glucose metabolism, mineral balance, cell division, good thyroid function, mood stability and bone metabolism, inadequate levels can have many consequences in midlife. Symptoms can be very surprising?such as midlife asthma. Since progesterone is an involuntary muscle relaxant, declining levels of the hormone can result in constricted breathing in women who either have allergies or an inherent lung weakness.
Testosterone is most often associated with men, but women do produce a small measure of testosterone, and their testosterone levels begin to decline in midlife. Low testosterone levels play a major role in osteoporosis, decreased libido, and loss of initiative and drive. Fifty percent of postmenopausal women have substantially decreased testosterone levels.
The thyroid gland is to the body what the starter is to the car. By midlife, the thyroid has been subject to much wear and tear, becomes less efficient, especially because progesterone, the thyroid?s hormonal assistant, is low.
A sluggish thyroid worsens both the weight gain and fatigue associated with menopause, and fat distribution begins to takes on more of a male pattern, with accumulation of fat at and above the waistline (apple shape). Besides the loss of the appealing feminine waistline, an apple shape is associated with a greater risk of heart disease.
Treatment for Perimenopause
In my practice, I approach the midlife transition in two phases:
Hi, I am new to forum and have found it most intresting. I am 41yrs old and have just had surgery for a bowel obstruction, which resulted in them taking one of my ovaries as it was attatched to the bowel and had many cysts. My other ovary has been out of action for 6 years, it to had many cysts,one of which was removed by surgery. Anyway waffling on... Since my surgery at the begining of may I have had many symptoms that include:-
Hot flashes...all day and all night, Sleep disturbance...get about 4 hours nightly, Headaches, Depression, Joint ache, Thirst...cant get enough of fluid and am trying to make it water or herbal tea! I have not had a period scince around the 20th April. I have been trying to find out the best treatment for the above...blood tests have been positive for menopause....my mother was also 40 when she had the menopause although she herself had NO stmptoms.
I am still trying to way up whether to use medical or homeopathic hrt?
I am doing some reading around menopause symptom control and would recommend starting with natural remedies before HRT, try supplements like red clover blossom, black cohosh, agnas castas, sage extract, avoid spicy foods, eat naturally occuring soya (not modified) and keep well hydrated! If these don't work then you can try medical HRT but I would definitely advise to read about them deeply first.
I am looking for people or companies who produce information pamphletts about these natual remedies - if you know of any let me know on ali78*tesco*****