Resources:
Hormone fluctuations throughout life span
Progesterone and GABA relationship
hormone changes throughout menstrual cycle and ovulation
FAQ about perimenopausal and post menopausal bleeding
Perimenopausal transition management guidelines
Disclaimer:
The following information is for educational purposes only and not intended to diagnose, prevent or treat any diseases or conditions. Please consult your doctor before incorporating any of this information into your care. The information presented on this podcast is not medical advice.
AI generated summary of my audio
Perimenopause – Part 1
Before adolescence:
Estrogen and progesterone are low.
Ovaries are inactive hormonally.
Puberty onset:
Ovaries begin producing estrogen.
Estrogen fluctuates (highs and lows), but overall levels are lower than in mature cycling years.
Irregular cycles are common at first (including skipped periods).
Ovulation establishment:
Once enough estrogen is produced, ovulation begins.
Ovulation is required to complete a menstrual cycle.
Stress, illness, and nutrition influence cycle regularity.
Normal reproductive years:
Follicular phase: Estrogen rises to trigger ovulation.
Luteal phase: Progesterone is produced after ovulation (from the corpus luteum).
Progesterone ideally dominant relative to estrogen in the luteal phase.
Adrenal glands make small amounts of progesterone.
Early perimenopause (up to ~10 years before menopause):
Ovulation becomes inconsistent.
Progesterone declines first.
Estrogen may fluctuate widely.
Cycles may be heavy, light or irregular.
Common symptoms during transition:
PMS (often linked to low progesterone relative to estrogen)
Mood changes
Temperature shifts (hot flashes/night sweats)
Skin changes
Immune shifts or changes in autoimmune conditions
Menopause definition:
Diagnosed clinically after 12 months without a period.
Hormone testing does not reliably predict timing. Only data for current cycle.
Bleeding after menopause:
Any bleeding after 1 year without a period requires evaluation.
May involve pelvic ultrasound or hysteroscopy.
Concern includes endometrial cancer.
Clinical approach:
Perimenopause is symptom-based rather than lab-based.
Treatment focuses on supporting quality of life.
Progesterone support may be considered first in some cases.
Hormonal and non-hormonal tools are available.
Key takeaway:
The transition is dynamic and can last years.
Loss of consistent ovulation (and progesterone) is the earliest hormonal shift.
Care is individualized and guided by symptoms.
