Perimenopause is an interesting time in a woman's life.
Hormones are still being produced by the ovary, but usually not in the same pattern as normal. They are fluctuating. The estrogen levels are peaking and dropping more drastically; higher levels and lower drops. This causes decreased blood flow to the brain, per PET scan studies. The brain is truly not working as well as it should.
- For many months, progesterone is inadequate because one is not ovulating every month. Progesterone is needed for lighter menses and is needed for sleep and anxiety.
- Women will have menopausal symptoms and emotional swings. Many do not feel well; they complain of extreme anxiety and possible depression, feel off balance, not themselves anymore.
- The options for treatment involve life changes, dietary changes, and, of course, hormones
- Hormonal options include adding estradiol and progesterone supplementation vs hormonal contraceptives.
- Hormone contraceptives (H.C.) are hormone manipulators: they control the ovarian fluctuations.
- H.C. creates consistent estrogen and progestin levels, eliminating the hormonal fluctuations that cause mood swings and other side effects.
- H.C. is safe during this time unless one has contraindications to it. But all women can use progestin-only hormonal contraceptives and add transdermal estrogen to it for symptom control.
- H.C. decreases cancer risk of ovarian/breast, and uterine.
- Perimenopausal use of hormones does not increase one’s risk of breast cancer or other disease processes. Hormone supplementation can decrease the risk of CVD, dementia, and bone loss. It improves the quality of life and decreases inflammation associated with hot flashes and night sweats.
Potential side effects from progesterone/estrogen:
1. progesterone: bloating/fatigue/irritability/
2. estrogen: headache, edema, breast tenderness, moodiness