Perimenopause is a time of great fluctuation in hormone levels leading up to menopause.  Each woman experiences perimenopause symptoms in her own way.  Common symptoms of  include insomnia, hot flashes, heavy bleeding, decreased sex drive, momory loss, fatigue, depression, mood swings,  and weight gain.  There is ample evidence that women who have underlying excellent health habits go through this transition, with fewer symptoms.  If you're perimenopausal, and you're experiencing extreme symptoms, this is a good indication that there are imbalances beyond simple hormonal ones.  This is a good time to consider all the factors that must balance to create good health and well being.  I urge you to improve your nutrition, be sure to exercise, nurture your emotional health and consider whether there are also potential imbalances in your digestive, detoxification or immunological system.


During the transition to menopause many women request that their doctors provide them estrogen, thinking that this will relieve their symptoms.  Unfortunately,  with such widely varying hormone levels from day to day and minute to minute, adding more estrogen to the mix may do more harm than good.  There are no good studies to support any therapy for perimenopause.  As at menopause, the best strategy is to address the most troubling symptoms, without pharmaceuticals of possible.

A very popular book by Dr. John Lee promotes the use of natural progesterone by women during perimenopause and menopause.  This treatment, which has not been rigorously studied, does seem to help many women.  There is no evidence that natural progesterone is dangerous. 


There has been confusion about progesterone because the same studies discredited Premarin also showed Provera to be quite dangerous.  This was not news.  The dangers of provera were clear long before its use in Prempro.  Provera is a synthetic progesterone-like molecule that was intentionally made to be different from progesterone so that pharmaceutical companies could obtain a patent.  When taking provera, blood tests for progesterone are negative.  It is a progestin, but it is not progesterone.  To use the information about the dangers of Provera to indict natural progesterone, is, I think not wise.  We have no evidence that natural progesterone is dangerous.  Further studies are  underway.  The Prempro was a huge fiasco prepetrated on women by a drug company.  Overreacting to the information will not help.


Again, before beginning any treatment for menopause or perimenopause, it is wise to consider whether there are other factors underlying the symptoms.  Life transitions are a good time to increase your awareness of the many you can optimize your health by making good choices over time.



Natural progesterone

Hormone Replacement:  Estrogen, etc

Supplements for lessening symptoms

Studies on Supplements and Menopause