PERIMENOPAUSE TO MENOPAUSE

Perimenopause:
Perimenopause should be used to include the period immediately or prior to the menopause with endrocrinological, biological, and clinical features of approaching menopause, and at least the first year after the menopause. Most women are anovulatory 18 months to 5 years before menopause. Thus, these women have little to no progesterone production during this period of time, thus they have a state of unopposed estrogen.

Symptoms: Hot flashes; irritability; sleep problems; irregular bleeding and general psychological changes.
As the woman transitions through the 5 years, she is first progesterone deficient with normal estrogen level and regular cycle. Then, estrogen production slows, usually in estriol and then estrone and estradiol. Usually she has symptoms of sleep disturbance when the estrogen levels start to drop. At the same time dhea levels are also dropping.

Treatment: In the first stage, the woman is only progesterone deficient, use progesterone therapy from mid-cycle to the first day of her bleed. Progonol: ½ tsp- twice daily or ProgonB: 4 pellets-twice daily. This should manage all her symptoms. Then there will come a time that she starts to have sleep disturbance, hot flashes and possibly some minor vaginal dryness. This is a sign of estrogen production starting to lower. Use Progonol or ProgonB for the morning dose and change the evening dose to Transitions. The Transitions dose at bedtime should be ½ teaspoon. This can be applied on the face and neck, if the woman would also like to the benefit of reduced facial wrinkles. If this dose of Transitions does not correct the sleep disturbance, then add a dose of PhytoB, 2 pellets at bedtime will do the job.