Perimenopause is the period of time before menopause when your body starts to change its hormone production. I say "change" because it is not just a decrease but also a hormonal imbalance between estrogen and progesterone. Perimenopause can start years before menopause, and women become aware of it when problems like irregular periods, heavy bleeding, or fibroids start.
Lot's of things happen during perimenopause, but the most crucial element is that you are running out of viable eggs, and you may not ovulate every month. Without ovulation, there can be no progesterone production in the second half of your monthly cycle from the follicle that releases the egg. You may not notice an annovulatory cycle and may just have a heavy period. The heavy period is occuring because there was no progesterone to oppose the estrogen and stop the growth of the lining of your uterus. The lining finally just gets too thick and heavy and basically tears off instead of shedding in a normal way. Maybe the next month or the next few months, you ovulate and things work fine. However, during perimenopause you ovulate less and less, causing the lining of your uterus to get thicker and bleed more.
Because of the annovulatory cycles, you have less and less progesterone, but your ovaries are still producing a a good bit of estrogen. In other words, the progesterone production stops a lot more suddenly than the estrogen. Over time, I believe this estrogen dominance state also causes fibroids in addition to irregular or very heavy bleeding with clots. I also think it plays a role in breast, uterine, and ovarian cancers.
It seems women have years of hormonal imbalance to deal with before menopause often with terrible consequences. I have to ask why. Does this happen to aboriginal women, or women from non-industrialized countries? Did it happen to our grandmothers or great-grandmothers? Who really knows. I also have to wonder why women in poor and undeveloped countries seem to be able to reproduce rather easily even though they live under primitive conditions with inadequate food and clean water. Meanwhile, women in developed countries are having more and more fertility and pregnancy difficulties. I'm guessing this has something to do with all the toxins and stresses we are exposed to in our more affluent, modern lifestyles. Maybe we are suffering the consequences of taking birth control pills, the high dose of estrogen given to some of us to stop our breast milk from coming in, or from all the chemicals and xenoestrogens (toxic substances that mimic estrogen in everything from pesticides to carpeting to toothpaste) we are exposed to. Whatever the cause, the problem is real and requires a solution.
During my perimenopause, I had terrible bleeding problems and fibroids and found that using a good over-the-counter progesterone cream worked amazingly well. I'm convinced I would have had a hysterectomy by now if I had not discovered the progesterone cream.
