Perimenopause

About 3 to 5 years before periods stop, hormone production often becomes erratic. At this time, the ovaries may actually produce too much estrogen. Sometimes, the estrogen production may be normal, but the other female hormone, progesterone, is produced minimally or not at all. Both situations result in an estrogen dominant state and can cause breast tenderness, heavy periods, bleeding between the periods and an increased risk of uterine or breast cancer.

Other times, the estrogen level may drop significantly and a woman may experience hot flashes, emotional liability, trouble sleeping, vaginal dryness, memory loss or other significant symptoms. This can have a profound effect on a woman"s sense of well being, and it also can carry medical risks such as an increased of loss of calcium from the bones (osteoporosis).

These symptoms of either estrogen dominance or estrogen deficiency are lumped together and collectively called perimenopause. Sometimes these symptoms are minor or nonexistent and no treatment is needed. Other times, the symptoms can be disturbing and medical treatment is helpful. A doctor often treats estrogen dominance by giving the patient progesterone or by using a low dose birth-control pill, which supplies both estrogen and progesterone.

Symptoms of a low estrogenic state can be treated with a low dose birth control pill or by using the same low dose estrogen and progesterone products that are used to treat full-blown menopausal symptoms. Some women elect no treatment or they turn to alternative remedies.

These symptoms can be complex and management should be coordinated with a physician. A woman should particularly keep in mind that symptoms of irregular and heavy bleeding could be associated with an increased risk of cancer and abnormal bleeding should be immediately reported to a physician. Management is usually straightforward and the risk can usually be eliminated with appropriate medication. If there are signs of estrogen deficiency, one has to realize that calcium can be lost from the bones and osteoporosis can result. Taking extra calcium is helpful, but usually additional management is needed and again it is very important to coordinate this with your physician.

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