From about our mid-thirties to late forties, still very much our reproductive years, female hormones begin to shift significantly enough that we start experiencing uncomfortable physiological, mental and emotional symptoms. This phase of our lives can actually be considered pre-menopausal and is most often called perimenopause. Perimenopause, not to be confused with menopause, actually means “around” or “in front of” menopause. Perimenopause, also called the menopausal transition, is the time leading up to menopause, very often beginning between ages 45 and 55. It can last anywhere from two to eight years. It typically starts in the late forties to early fifties and often mimics maternal genetic patterns.
Estrogen is a hormone that plays a role in both the male and female reproductive systems. Females create more estrogen than males which is vital to their reproductive and breast health, among other functions such as cognitive, cardiovascular and bone health.
The female reproductive organs—breasts, ovaries, vagina and uterus—all depend on the presence of estrogen. Decreased estrogen and the breasts begin to sag. Decreased or insufficient estrogen and the uterus becomes atrophic. The uterus deflates and there is no more reason for menstruation to occur. Decreased or insufficient estrogen—particularly of estradiol—and the cells of the vagina and bladder are lacking the nourishment they need to keep things moist and to prevent against urinary infections and incontinence.
Estrogen—the particular estrogen called estradiol—helps dilate blood vessels, helping to keep the cardiovascular system healthy and blood pressure balanced. Reduced estrogen can also lead to increased heart palpitations—another symptom women will experience with more frequency as we age.
Estradiol boosts blood flow to the brain. This helps with nerve function and brain function. Estradiol helps to keep certain neurotransmitters in circulation, in particular, serotonin and acetylcholine, which help keep memory sharp, reduce anxiety and maintain normal sleep patterns.
Estradiol is also critical for our musculoskeletal health including health of bones and joints.
Estrogen is most associated with its role alongside progesterone in female sexual and reproductive health. Estrogen and progesterone work symbiotically to prevent the lining of the uterus from becoming too thick.
From around the age of 30, levels of progesterone and consequently, estrogen, start to fall.
Progesterone, one of our “feel good” hormones, is among the first to decline during our reproductive years.
Progesterone is meant to balance estrogen and it also protects the nervous system. It’s what keeps ample levels of circulating GABA(1) and allows for more restful sleep.
Progesterone is nature’s diuretic—helping to prevent water retention. And progesterone helps cells take-up the circulating estrogen receptors they need.
A condition called estrogen dominance occurs if progesterone production drops much more rapidly than estrogen. Estrogen dominance may also be considered progesterone deficiency.
Often, the female body produces too much estrogen compared to the amount of progesterone in the body and this is another factor resulting in estrogen dominance.
In severe cases where progesterone is very out of balance with estrogen, estrogen may work overtime in the female body causing cell overgrowths such as tumors in the uterine lining.
During perimenopause, hormone levels tend to fluctuate throughout the day causing an increase in our estrogen to progesterone ratio.
This creates a host of unpleasant, if not, distressing symptoms:
• the return of PMS
• breast swelling
• irregular periods
• water weight
• reduced sex drive
• and migraine headaches
Why Estrogen Dominance Is Not Just Restricted to Women in Their Forties
Estrogen dominance is practically the norm throughout our menopausal years, however today, it’s a cultural occurrence among women of younger age mainly because of the stressful lifestyles many women lead.
Our bodies produces the hormone cortisol in response to stress.When we do not have methods in place to help ourselves respond resiliently to stress, our bodies will produce high amounts of cortisol which will then deplete the body’s ability to produce progesterone. With estrogen left unchecked by progesterone, estrogen dominance occurs even in a woman who doesn’t seem of appropriate age to begin experiencing perimenopause.
High-dose oral contraceptives/birth control pills can be a factor causing estrogen dominance and so can hormone therapy medications.
Having a high percentage of body fat can lead to high estrogen levels because fat tissue secretes estrogen.
High alcohol consumption will also increase estrogen levels while at the same time reducing the body’s ability to metabolize estrogen.
Liver conditions may prevent it from breaking down estrogen and eliminating it from the body causing too much estrogen to accumulate.
If the body is not producing enough digestive enzymes, has too much bad gut bacteria, too little fiber in the diet or low levels of magnesium, all or any of these may prevent the liver from removing excess estrogen.
Synthetic xenoestrogens are chemicals found in the environment that act like estrogen once you’ve ingested them and these will increase estrogen levels. Xenoestrogens include Bisphenol A (BPA) and phthalates and they’re found in plastics, pesticides, household cleaning products and certain soaps and shampoos.
Perimenopausal Symptoms of Estrogen DominanceDuring menopause, the ovaries continue to produce estrogens while they produce less progesterone.
Common symptoms of estrogen dominance include:
• weight gain (around waist and hips)
• mood swings
• hot flashes
• low sex drive
• fluid retention
• hair loss
• fibrocystic disease
• night sweats
• vaginal dryness
• foggy thinking
• memory lapse
• heart palpitations
• bone loss
• sleep disturbances
• sensitivity to chemicals
• cold body temperature
• sugar cravings
• increased triglycerides
• increased facial and body hair
• tender breasts
• bleeding changes
• uterine fibroids
During perimenopause, the ovaries still continue to produce hormones(2) however with progesterone decrease always in play. Hormones in the female during perimenopause are winding down, vacillating, playing with the female body like a yo-yo, and all leading to the moment of full menopause(3)—the full pause or cessation of menses which is a singular occurrence and actually a moment or a day in time.
Susan Love, M.D., author of Dr. Susan Love's Menopause and Hormone Book: Making Informed Choices All the Facts about the New Hormone Replacement Therapy Studies, describes perimenopause this way:
“Remember the highs and lows of puberty? Your face broke out. You slept half the day. Your brain didn’t seem to work the way it used to. You didn’t know what was going on with your body. Well, with perimenopause it happens all over again.”
How to Begin Easing the Symptoms of Perimenopause
• Get good nutrition that can help restore hormonal balance naturally, help manage your weight and digestion and boost your energy and mood. (We will soon have exciting news about a revolutionary supplement product you can take that will keep you in balance!)
• Be sure you’re consuming foods rich in calcium and vitamin D. Take in sunlight for vitamin D. Eat lots of fruits and vegetables.
• Consume foods rich in phytoestrogens or plant estrogens. These include: soy beans, tofu, tempeh, soy beverages, flax seed, sesame seeds, wheat, berries, oats, barley, dried beans, lentils, rice, alfalfa, mung beans, apples, carrots, wheat germ, and ricebran.
• Consume well-prepared and not processed foods high in refined sugar.
• Curtail your alcohol consumption and do not smoke.
• Exercise. Though exercise may not directly lessen your symptoms, it can improve energy levels, sleep patterns, mental well-being, muscle strength and bone density while it reduces muscle loss. All of these benefits will support your physical, mental and emotional well-being as you go through perimenopause.
• Sleep. Your sleep may become disrupted during perimenopause and may continue past menopause perhaps indefinitely. It’s important to find the natural methods that work best for you that encourage good sleep. Six hours or less per night is probably not going to be enough.
• Get yourself naturally to a healthy weight and remain there.
• Systemic estrogen therapy (hormone therapy) which comes in pill, skin patch, spray, gel or cream form is believed by the medical profession to remain the most effective treatment option for relieving perimenopausal hot flashes and night sweats.
1. GABA: gamma-aminobutyric acid, the chief inhibitory neurotransmitter in the developmentally mature mammalian central nervous system; its principal role is reducing neuronal excitability throughout the nervous system.
2. Testosterone is an important hormone also for women as well as men for: increasing muscle mass, boosting libido, helping to build the bones, supporting cardiovascular health, keeping the mind sharp, and the mood more elevated improving carbohydrate metabolism and insulin sensitivity, which is one reason why men who are not as estrogen dominant can eat more carbs and not gain weight like women can.
3. The average age in the U. S. that women experience menopause is about 51 years of age. Premature menopause occurs in about one in every one hundred women with causes related to genetics, chemotherapy, radiation or autoimmunity.
• Love, Susan M., and Lindsey, Karen. Dr. Susan Love's Menopause and Hormone Book: Making Informed Choices All the Facts about the New Hormone Replacement Therapy Studies. United States, Harmony/Rodale, 2003.
• Santoro N. Perimenopause: From Research to Practice. J Womens Health (Larchmt). 2016 Apr;25(4):332-9. doi: 10.1089/jwh.2015.5556. Epub 2015 Dec 10. PMID: 26653408; PMCID: PMC4834516.
• Burger H, Woods NF, Dennerstein L, Alexander JL, Kotz K, Richardson G. Nomenclature and endocrinology of menopause and perimenopause. Expert Rev Neurother. 2007 Nov;7(11 Suppl):S35-43. doi: 10.1586/14737175.7.11s.S35. PMID: 18039067.