Friday, August 26, 2016

Could you be in perimenopause?

Before you go through menopause, there is a period of time (up to 10 years!) where things start to change. The changes can be subtle or not so subtle. We call this phase of life "perimenopause", and it can be one of the most difficult transitions in a women’s life. Sadly, some women are told to tough it out and that it will pass. And often women are told that they are too young to be in perimenopause.

Addressing the hormonal symptoms of perimenopause can dramatically improve quality of life for many women. Lets talk about what is going on.

While estrogen levels start to decline around the time of menopause (average age of menopause is 52), progesterone levels start to decline much earlier.  In fact a your progesterone production may decline by as much as 80% between age 30 and 40.  This is one of the reasons that women in their forties have a harder time getting pregnant.

Progesterone is produced in two main places in your body. It is produced in the ovaries and in the adrenal glands. The majority of progesterone is produced in the ovaries after ovulation.  It helps to prepare the uterine lining in case of a pregnancy and is very important throughout pregnancy (it is “pro-gestational”).  

When a woman is in the second half of her monthly cycle, she is producing between 20 and 25 mg of progesterone a day. During pregnancy, production of progesterone spikes to between 300 and 400 mg per day.

When progesterone levels start to decline because of age, and symptoms of hormone imbalance become noticeable, we call this “perimenopause”.  

Progesterone deficiency is the most common hormonal problem we see in peri-menopausal women, but younger women can have this problem as well.  Because progesterone levels naturally vary over the menstrual cycle, the symptoms vary as well.  

Typically the week after a period is a “good” week; you are eating your broccoli, exercising regularly, and cleaning out your closets.  Then as you get closer to your period,  symptoms get worse and worse including irritability, anxiousness, and interrupted sleep.   You may feel more negative, critical, impatient, and easily frustrated - and this can affect how you behave towards your family and co-workers!

In fact, this variation in symptoms is a big clue that hormones are the problem.  If your mood symptoms or insomnia are exactly the same on every day in your cycle, it is less likely that hormones are the cause.

Progesterone has mainly been studied for its effects on the uterus but it turns out that progesterone has far more roles to play.  Women have progesterone receptors on cells in all parts of our bodies, and surprisingly the cells with the most progesterone receptors are our brain cells.  Anyone who has experienced PMS symptoms with mood swings and irritability may not be surprised after all!  

Research is showing that progesterone has important neurological effects.   It acts as a natural anti-anxiety compound, helps with sleep and is calming - sort of like nature’s version of valium or a glass of red wine.

Here is a checklist of symptoms that you may experience if you progesterone levels are declining:

Insomnia (especially wakening in the night)
Night sweats
Anxiety
Irritability
Mood swings
Weight gain
Increased PMS
Pre-menstrual headaches
Heavier periods
Shorter cycles (periods coming less than 28 days apart)

If this sounds like you, please know that there is help! You can feel like YOU again.

You can find more information at our website www.signaturewellness.org or contact the office at 704-752-9346

Yours in health
DrM