#1 It’s fluctuating hormones not just declining hormones that cause the upheaval in our lives.
Many of us experience new things as hormonal patterns start to change in the form of middle-of-the-night waking, increased irritability, and feeling less able to cope. These are in addition to the more classic things like night sweats, hot flashes, and vaginal dryness.
For so long most hormone-related symptoms were blamed on declining estrogen. But in 1996, Dr. Nanette Santoro changed this long-standing narrative when she and her co-authors published data that showed chaotic estrogen patterns in perimenopausal women with peaks that were at times higher than they’d been during the more regular reproductive years. Unfortunately, it takes a long time for new ideas to make it to the mainstream. Many articles still talk about declining estrogen when talking about the menopausal transition.
Below is the key graph from that study. E1 is estrogen and PDG is progesterone. As the key shows, the closed circles are the reproductive women (ages 19-38), and the open circles present data from the perimenopausal women (ages 43-52). Note how much higher estrogen is and how much lower progesterone is in the perimenopausal women.
Click here to learn more about hormonal changes. Before founding WLB, my co-founder and I never gave any thought to how hormones worked in our bodies for most of our lives. But during this reproductive transition, more knowledge has really helped us better understand what’s going on and what we might do about it.
#2 Sleep is high on the list of challenges women deal with and the article suggests that while it’s likely related to fluctuating estrogen, the biological underpinning is not yet known.
It also mentions the contribution of declining progesterone — a fact that has been shown scientifically (in Dr. Santoro’s data above) but is often left out.
#3 A range of mood changes and forgetfulness are mentioned.
And again, we are glad to see acknowledgment that “Experts aren’t sure why these changes happen, but they likely have to do with the dropping hormone levels”.
#4 The lack of value of a single-point-in-time measurement of hormones.
This is really important. It is enticing to want to know some definitive answers about what is going on hormonally during this out of control time or to know how much longer it will go on. But as the article notes, hormones fluctuate minute-to-minute so measuring a level isn’t helpful during the menopausal transition.
Menopause is a point in time — your final menstrual period — so you don’t really “go through” menopause. What you go through is a transition to that point in time, which signals the end of the transition. To make things even more confusing, this point-in-time can only be identified in hindsight – you don’t know that a given period is your last until you’ve gone 12 months without another one. This makes it a pretty misleading definition.
As in this article, the term menopause is frequently used to describe anything and everything related to this life transition. In efforts to make this phase of our lives less, not more confusing, WLB tries to use precise and consistent definitions.
We use the term “the menopausal transition” to talk about the whole time that our bodies are changing from a reproductive phase to a non-reproductive phase and all of the various, often disruptive things that can entail.
