This article is for educational and general wellness purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease. If you are noticing changes in your body or have questions about your health, please consult a knowledgeable healthcare provider.

"My perspective is that of an endocrinologist who, herself, suffered a long, perplexing and highly symptomatic perimenopause. I am also a clinician-scientist, doing epidemiological, clinical observational and randomized controlled trial research on perimenopause. In the early 1990s, despite my training and roles, I like Emily, struggled to understand the changes I personally experienced – I found the hormonal changes to be the opposite of what I had been taught and always thought; instead, estradiol erratically soared and progesterone progressively decreased. Before we get to that, however, we must first review how we got to a situation where Emily is seeking yet not finding help."

Let's take a look!

Research indicates how many women really experience changes around this time, with hot flashes, period inconsistencies, sleep disturbance and mood all being key areas — "About 80% of perimenopausal women experience vasomotor symptoms (VMS), 25% have menorrhagia, and about 10% experience mastalgia. The majority of women describe varying intensities of sleep, coping or mood difficulties."

However, as the lead researcher notes, the hormonal picture is often the opposite of what most women expect: "Women are more symptomatic because common knowledge inaccurately says that estradiol (E₂) levels are dropping/deficient. Evidence shows that with disturbed brain-ovary feedbacks, E₂ levels average 26% higher and soar erratically {...} Progesterone (P4) levels become insufficient or absent. The most symptomatic women have higher E₂ and lower P₄ levels."

The research authors describe this estrogen-progesterone imbalance as a significant area of ongoing study. If you're curious what this finding might mean for your own perimenopause experience, it's worth bringing to a knowledgeable healthcare provider who can look at your individual picture.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987489/