Hormonal Challenges of the Perimenopause

The term perimenopause means the years before, during and after menopause. Menopause is defined as the cessation of menstruation at average age 52. Others use the word premenopause to denote the 10 years or so leading up to the menopause. By that definition, 20 million American and two million Canadian women are now going through premenopause.

Dr Jesse Hanley, co-author of What Your Doctor Won’t Tell You About the Perimenopause, says that premenopause is not a natural phenomenon, but one created by our culture, lifestyles and environment. Woman’s health expert Dr Serafina Corsello states in The Ageless Woman: "I have witnessed a dramatic increase in both the length and intensity of this transitional phase. I now see women in their 30s beginning to show early menopausal signs."

From a naturopathic point of view, Dr Karen Jensen explains that most symptoms commonly attributed to perimenopause or menopause are actually the same as symptoms of stressed adrenal and thyroid glands, overtaxed and underfunctioning liver and poorly functioning digestive systems. Dr Jensen believes that these contributing causes can both be prevented and treated-allowing women to fully enjoy this stage of their lives.

Estrogen’s Storm Season

Dr Jerilynn Prior-professor of endocrinology at the University of British Columbia–has been one of few doctors to speak out about the perimenopause. Prior calls the perimenopause "the ovary’s frustrating grand finale." She says that midlife women increasingly hear the words "estrogen deficiency." Instead, "estrogen levels are higher than those of (the sexiest) 20 year old...[it’s] estrogen’s storm season," says Prior.

Many researchers now believe that estrogen fluctuates wildly during the perimenopause. Giving more estrogen would seem like a bad idea. Indeed, many doctors are wary about putting premenopasual women on hormone replacement therapy.

According to Prior, signs of high estrogen include "swollen and tender breasts, lumpy breasts, increased vaginal mucous and a heavy pelvic feeling almost like cramps." Heavy menstrual bleeding is also a sign of estrogen excess.

Toxic Misery

Both women and men are swimming in a sea of estrogen mimickers, or xeno-estrogens, which contribute to a chronic state of estrogen excess and progesterone deficiency. Harmful chemicals that contain xenoestrogens include: solvents, adhesives, pesticides, car exhaust, emulsifiers in soaps and cosmetics, nearly all plastics and meat from livestock fed estrogenic drugs.

"The more burdened the body is with toxins and allergies, and the more sensitive the brain is to hormonal fluctuations–the more tumultuous and lengthy is the menopausal transition," says Dr Corsello.

High levels of stress impact the whole hormonal system–especially the thyroid and adrenal glands. The adrenal glands become exhausted from making cortisol–a stress hormone–while the thyroid gland overworks to compensate. Also, high cortisol and estrogen levels can interfere with thyroid hormone function.

Balance is the Key

Balance can usually be achieved through the use of natural progesterone and a combination of measures to decrease exposure to xenoestrogens, improve the diet, reduce stress levels and support thyroid and adrenal glands function. Improving liver function is always important, as estrogen is broken down in the liver. Proper digestion and bowel function are necessary as poor bowel function allows undesirable estrogens to be absorbed back into the gut instead of being eliminated.

This is a time of enormous change for women as they transit into a new concept of themselves and their bodies. The needs of the perimenopausal woman may include periods of silence and reflection, understanding from her mate and kids, more time with her women friends and saying no to energy draining roles.