Not quite menopause. Throwing blankets off at night, keeping awake. Fatigue and irritation punctuated throughout the day by heat dissipating from every pore, clouding thoughts, reinforcing forgetfulness. Hair falling out so stubbornly fast. Clothes choosing when to fit. Flooding periods coming sporadically, unexpectedly. They call it “the change of life” – but I feel like a different person altogether. What is happening?
In perimenopause, the physiological landscape is subject to tremendous change with estradiol and progesterone at the heart of the transition. Progesterone levels fall quickly – no ovulation – no corpus luteum – no progesterone. Estradiol, on the other hand, does not give up so easily. Estradiol levels continue to rise and fall – reliable, steady, wave-like – a biological rollercoaster – approaching the halting rhythms of reproductive senescence. In the context of very low progesterone, these dramatic peaks and troughs in estradiol levels, give rise to systemic consequences and unrelenting symptoms of the menopausal transition.