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Published in Healthy & Natural Journal February 1, 1998

Editor's note: To launch our new monthly feature, "The Female Frontier," we asked one of our favorite people in the industry, Ann Louise Gittleman, to talk about perimenopause. For the millions of women like me who are 30 something and beginning to feel their bodies change, Ann's enlightening article will allay fears and bring a knowing smile. No, you're not going crazy, you've just entered...the perimenopause zone...

Surprisingly, perimenopause can occur in some women as early as their mid-30's and early 40's. In others, perimenopause may occur as late as their mid-40's. There are about 34 million women in America currently going through perimenopause, and it can last anywhere from five to 10 years before the actual cessation of menstruation for at least one year, which is officially known as the "menopause." While the ages of perimenopausal women may vary as well as the length of time that women are in the perimenopausal stage of life, the symptoms (once recognized) may even be more confusing.

To confound the situation even more, many of the symptoms of perimenopause and premenstrual syndrome (PMS) are similar; bloating, weight gain, food cravings, headaches, depression, irritability, lack of energy, and loss of concentration.

Here is a little perimenopause biochem 101 for you to get a better handle on the progesterone connection to your perimenopausal symptoms. Remember that your menstrual cycle will normally last from about 25 to 28 days. The cycle actually begins when your brain sends a message to the ovaries to stimulate egg follicles. Only one egg fully ripens and actually moves in its follicle to the outer surface of the ovary. Upon ovulation the follicle will burst, and the released egg travels down the fallopian tube to the uterus.

As the egg was initially ripening in the ovary, the lining of the uterus walls becomes thickened and develops a strong network of blood veins. This occurrence was in expectation that the fertilized egg would eventually become implanted on the lining. Remember, only a fertilized egg becomes implanted. In the absence of a fertilized egg, the uterine lining is shed and menstruation begins.

The cycle then starts all over again. For a week or so after your period, estrogen is the dominant hormone. It stimulates the buildup of the uterine lining.

Now for some unknown reason which we suspect is due to stress or the environment, women in their mid-30s onward often stop ovulating on a regular basis. When this occurs, there is no empty follicle to become the corpus luteum. Therefore progesterone is not secreted by the ovary in sufficient amounts to counteract the effects of estrogen, and unfortunately, a hormonal imbalance and many symptoms can result. This condition is referred to as estrogen dominance.

Based upon the pioneering research of Dr. John Lee, an expert in female hormones from Sebastopol, Calif., here is a comparison of the effects of estrogen and progesterone. Estrogen is known to stimulate uterine lining growth, stimulate breast cell growth, add to body fat, promote water retention, promote depression, cause headaches, counteract thyroid hormones, promote blood clotting, diminish sex drive, upset blood sugar balance, lower cell oxygen levels, raise the risk of uterine and breast cancer. Progesterone, on the other hand, counters estrogen's effects by stabilizing uterine cell growth, stabilizing breast cell growth, helps burn body fat as fuel, acts a diuretic, serves as a natural antidepressant, assists in supporting thyroid hormone, stabilizes blood clotting, increases sex drive, stabilizes blood sugar balance, normalizes cell oxygen levels, and acts as a preventative to both uterine and breast cancer.

The basic characteristics of estrogen dominance seem to be identical to perimenopausal symptoms. These include the all too familiar bloating, breast swelling, depression, hypothyroid symptoms, fat deposition on the hips and thighs, mood swings, irregular periods, low sex drive, sugar cravings, tiredness, water retention and weight gain.

Ease discomfort naturally

Thankfully there are many natural options available to smooth out discomforting perimenopausal symptoms. These solutions include dietary management, dietary supplementation and natural progesterone creams or micronized progesterone supplementation that help build up progesterone reserves once again.

First and foremost, it is important to understand that the mineral zinc has been associated with elevated progesterone levels while the mineral copper has been associated with high estrogen levels. These two minerals are antagonistic to one another. A zinc rich diet, which includes free range eggs and even moderate amounts of organically grown beef, may be in order at this time of life. For those women suffering from perimenopausal symptoms who are strict vegetarians or vegans who may not be getting enough zinc in their diet, it is suggested that between 15 to 35 milligrams of zinc be taken on a daily basis. Sometimes even more, even up to 50 milligrams a day, can be required.

Unfortunately, due to a variety of zinc depleting factors, such as high sugar intake, a high carbohydrate and fruit diet, stress, oral contraceptives and even mineral deficient top soil, the zinc/copper balance in many women has been turned upside down in favor of copper. It has been my experience through tissue mineral analysis that many women have been overloading on carbohydrates, from the processed white flour variety to even the complex carbohydrates like brown rice, potatoes, whole grain breads and pasta, without sufficient quality protein and healthy fats for balance. These women have become copper toxic.

The resulting copper overload may contribute to estrogen dominance because there is not sufficient zinc in the diet to help assist in raising progesterone levels. It is also important to remember that protein is necessary to support the detoxification of excess estrogen in the liver.

Poor eating habits resulting in mineral imbalances as well as certain vitamin deficiencies may also be creating a hormonal imbalance that mirrors perimenopausal symptoms. For example, women need extra vitamin B6, which is not only known to increase progesterone levels in the system but also helps to decrease water retention. It also increases the production of the neurotransmitter serotonin in the system, which is calming and helps balance moods. Vitamin B6 is one of the most deficient vitamins in the female diet according to the most recent USDA eating surveys. A supplement from 50 to 200 mg. Of vitamin B6 in conjunction with a yeast-free B complex tablet may be extremely helpful. The mineral magnesium may also be necessary in quelling perimenopausal symptoms. An intake ranging from 500 to 800- mg. A day can often provide relief in alleviating irritability, insomnia and anxiety.

Topical progesterone

The use of progesterone itself in the form of a topical skin cream or micronized tablet is recommended. Progesterone creams are transdermal so they can be easily absorbed in to the system via the skin. There are several progesterone creams that are now on the market made from wild yam. It is important when choosing a progesterone cream that the labels are checked to make sure that the cream actually contains biologically active progesterone itself, and not just a precursor, such as diosgenin. Certain wild yam creams have not been converted in the laboratory to actually contain progesterone itself. The internal progesterone supplements can be ordered from a natural compounding pharmacy through a physician.

All in all, it has become quite apparent that perimenopause has dawned upon an increasing number on unsuspecting women because many of them feel that they are too young to be going through any hormonal change at all. It is important to acknowledge the various symptoms as red flag signals that are not isolated conditions within themselves, but as part of a bigger picture - the perimenopause stage of life. It is my hope that once women start to recognize the symptoms, they will be able to take control of this new right of passage by adopting the proper diet and mineral supplementation, as well as balanced exercise and stress relieving measures. Perimenopause need not be a time of life to merely survive the symptoms, but can be a time for women to actually flourish and thrive throughout this vital season of life.

"...it has become quite apparent that perimenopause has dawned upon an increasing number of unsuspecting women because many of them feel that they are too young to be going through any hormonal change at all."

This information has been reprinted with permission from Healthy & Natural TM Journal. Copyright 1998 by Healthy & Natural TM Journal. To find out about Healthy & Natural TM Journal please call 1-800-883-8894, or visit our website:www.healthyandnatural.com

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