At the age of 47, I am surfing the high and low tides of perimenopause. And let me tell you something sisters- it’s a really rocky ride at times and I feel like I’m white-knuckling it. I’ve talked to countless women about this stage of life and I have come to realise that we are unique in how we experience it. The biggest clue to figure out what it’s going to look like for you is to ask your mother how it was for her. The medical professionals I’ve spoken to tell me that biologically, we follow in our mother’s peri/menopausal footsteps. For me, it’s an unfortunate torch to carry as my own mother went through somewhat of a personal hell for nearly 20 years!
The impetus for this piece of writing is to supply you, my dear readers, with what I have found to be the best resources to get you through this phase of life as calmly and confidently as possible. I have literally scoured the literature on this topic and read any book I could find on perimenopause and most of them were a huge disappointment.
For those of you who have been through perimenopause already and learned some invaluable lessons along the way, I strongly urge you to send your bits of wisdom my way so I can pass them onto other readers who are in the thick of it and needing some guidance. I will keep your identity anonymous and thank you in advance on behalf of the rest of us who are trying to figure this whole stage of life out and how to best navigate it. Please send your stories/tips/wisdom to me by email: estherATestherkane.com
Below I provide past writings on the subject I tackled in case they may be of use to you now:
Esther’s New Top Picks to Help You Navigate Perimenopause
As I stated earlier, I’ve scoured the literature for a few years now trying to find the best information women need to prepare themselves for perimenopause and was constantly disappointed. That is, until I found Estrogen’s Storm Season: Stories of Perimenopause by Dr. Jerilynn Prior which I consider the only book a woman needs to safely and successfully navigate the rocky storms of perimenopause. This book is actually a novel about eight perimenopausal women- from all walks of life- who meet a female doctor who specializes in perimenopause and offers her clinical expertise to help alleviate the various symptoms women are experiencing such as: night sweats, excessive menstrual bleeding, nausea, infertility, migraines, weight gain, and sore, swollen breasts.
Jerilynn C. Prior BA, MD, FRCPC (former ABIM, ABEM) is a Professor of Endocrinology and Metabolism at the University of British Columbia in Vancouver, BC. She has spent her career studying menstrual cycles and the effects of the cycle’s changing estrogen and progesterone hormone levels on women’s health. She is the founder (2002) and Scientific Director of the Centre for Menstrual Cycle and Ovulation Research (CeMCOR). CeMCOR is actively researching women’s health and has a very accessible, informative website that receives on average between 3500-7000 page views per day (www.cemcor.ca). She is also Director of the BC Centre of the Canadian Multicentre Osteoporosis Study (CaMos – www.camos.org) that is studying osteoporosis, fractures and bone mineral density and has followed over 9000 adult women and men across the country for over 19 years, plus about a 1000 younger women and men aged 16-24 for two years.
Dr. Prior has studied women’s menstrual cycles, perimenopause, menopause and the causes for and treatment of osteoporosis. She has shown that regular cycles (with enough estrogen) commonly do not produce sufficient progesterone (anovulation or short luteal phases). She first discovered and has since proven by meta-analysis that more versus fewer ovulatory disturbances within regular cycles are related to significant spinal bone loss in healthy women ages 20-45. She has shown in controlled trials that the ovarian hormone, progesterone, is effective treatment for menopausal hot flushes and, given cyclically increases bone mineral density in healthy women with hypothalamic amenorrhea.
She also proved in a randomized controlled trial that progesterone is effective for menopause hot flushes/flashes and night sweat treatment and has short term cardiovascular safety. Dr. Prior is internationally known for her cumulative studies that now support progesterone as causing women’s increased bone formation through progesterone-specific osteoblast receptors.
The most important part of Dr. Prior’s work is this:
I hear countless stories from my clients going through menopause who are prescribed synthetic estrogen for their symptoms. According to Dr. Prior’s findings, what these women need instead is bioidentical progesterone, not more estrogen. Dr. Christiane Northrup, who has written my other favourite books on women’s health agrees when she states:
The conventional view of what happens at perimenopause is that estrogen levels plummet. This is a gross oversimplification and too often leads to treatment that can make mildly uncomfortable symptoms worse. In natural menopause, the first hormonal change that occurs is a gradual decline in levels of progesterone, while estrogen levels remain within the normal range or even increase. Because progesterone and estrogen are meant to counterbalance each other throughout the menstrual cycle, with one falling while the other rises and vice versa, an overall decline in progesterone allows estrogen levels to go unopposed—that is, without the usual counterbalance. The result is a relative excess of estrogen, a condition that is often called estrogen dominance—which is precisely the opposite of the conventional view.
To read her full article, Estrogen Dominance: A True Balancing Act click here.
Cyclic Progesterone Therapy: What Most MD’s Aren’t Telling You About
One of the biggest allies in my finding equilibrium with major hormone shifts has been bio-identical progesterone prescribed by my naturopath, Dr. Sheree Chappell, who specializes in women’s hormones. We owe this God-send to Dr. Prior and her research. You can get all the information you need from Cemcor’s website by visiting this link.
Beware of Synthetic Hormones: The Women’s Health Initiative and the work of Dr. Christiane Northrup, MD
I strongly urge you to read up on the massive ground-breaking study called The Women’s Health Initiative (WHI) which was initiated by the U.S. National Institutes of Health (NIH) in 1991.
One of the major findings was that synthetic hormone replacement therapy was dangerous and in the long-term, caused multiple health problems for post-menopausal women. I will end this piece with more on synthetic versus bioidentical hormones from one of the most respected experts on women’s health, Dr. Christiane Northrup. The following comes from a blog post she wrote called Natural Hormones:
Today’s topic is natural hormones versus synthetics. Now, this is an area of tremendous confusion, not only for the average person, but also for a lot of health care practitioners. People just don’t know the difference between a natural hormone and something that is not natural to the female human body. I’m going to give you the most common examples. Premarin is a natural hormone for a horse. It is the most common form of hormone replacement, and it is made from the urine of pregnant horses. So it’s a natural hormone, if your native food is hay.
Now, progesterone is found in the human female ovary. It’s also made by the brain. It’s even made by some nerve cells. Unfortunately, in most hormone replacement, the molecule that’s used is not natural bioidentical progesterone, but instead something known as medroxyprogesterone acetate, MPA.
This is what was used in the huge Women’s Health Initiative study that used a combination of Premarin and Provera, that’s medroxyprogesterone acetate, in the form of Prempro. Prempro is then the urine of pregnant horses combined with a synthetic progesterone known as MPA. And unfortunately, the way nature designed the female body, and the male body for that matter, is that the hormones need to match exactly what Mother Nature created over millennia.
The way a hormone works is it sits on a receptor site in your cells, and it begins a cascade of protein synthesis starting with the cell membrane, where the hormone sits on the cell membrane. If it doesn’t match the three-dimensional structure of a native hormone, the effects will be different than what nature intended. And this is one of the reasons why the Women’s Health Initiative study showed that hormones were dangerous. They are dangerous, if you’re not using the same hormones that your body would ordinarily make. I want to share with you some of the latest research on natural progesterone.
It’s just been found that natural progesterone works by relaxing the smooth muscles in the arteries of the body, particularly those in the coronary arteries, and can actually be used to relieve chest pain. Now that is a pretty exciting thing to know. So natural progesterone, very small doses, 20 milligrams, which comes in a transdermal cream, can actually be used to reduce angina, or chest pain in women, and this is a very common symptom in perimenopausal women. I had it myself.
Researchers pause at that when the body’s production of natural progesterone falls below a certain level, women who are under stress will actually require some progesterone to keep the coronary arteries working smoothly, and to keep them from going into spasm, because that’s what causes the chest pain. And this is a setup for heart disease, the number one killer of women. The Women’s Health Initiative, using Prempro, the synthetic stuff, showed that this hormone combination actually increased the risk of heart attack and stroke.
I don’t believe we’d find the same thing, if we were really using natural hormones. These are widely available by prescription, and there’s all different kinds of them. The patches are almost all natural estrogen. You can get progesterone as a vaginal cream, as a capsule, and it’s also available as a skin cream.
Watch for more and more research on this exciting area, and please, when you get your prescriptions filled, or if you’re thinking about using hormones, make sure you’re using those hormones that are exactly like the ones your own body would produce.