What is Perimenopause?
Perimenopause is the transition phase to menopause that can begin between ages 35-45, lasting 4-10 years. During this period, hormone levels fluctuate significantly.[1]
Contrary to what many women think, progesterone is typically the first hormone to decline during perimenopause, while estrogen may remain normal or even elevated initially.[2]
Symptoms of Progesterone Deficiency
The most common symptoms include:
- Sleep disturbances: difficulty falling asleep or night wakings
- Mood changes: anxiety, irritability, depression
- Irregular cycles: heavy bleeding or spotting between periods
- Fluid retention and bloating
- Headaches and migraines
- Breast tenderness
- Brain fog and difficulty concentrating
Bioidentical Progesterone vs. Synthetic Progestins
There's a crucial difference between bioidentical progesterone (molecularly identical to what ovaries produce) and synthetic progestins used in contraceptives.[3]
Bioidentical progesterone offers:
- Better cardiovascular safety profile
- Positive effects on nervous system (neurosteroid)
- No increased breast cancer risk like some progestins
- Anxiolytic and sleep-promoting effects
The KEEPS study and other clinical trials have demonstrated superior safety profile of micronized progesterone.[4]
Clinical Benefits of Progesterone
Sleep Improvement
Progesterone and its metabolites, especially allopregnanolone, act on GABA-A receptors in the brain, producing natural sedative effects.[5]
Emotional Stability
As a neurosteroid, progesterone has natural anxiolytic properties. It helps reduce anxiety and stabilize mood.
Endometrial Protection
When estrogen is used in hormone therapy, progesterone is essential to protect the endometrium.[6]
Bone Health
Progesterone stimulates bone formation through osteoblasts, helping maintain bone mineral density.
Are You a Candidate?
You might benefit from evaluation if:
- You're between 35-55 years old
- You experience new sleep disturbances
- You notice mood changes or anxiety
- Your cycles have become irregular
- You feel "not yourself"
At Long Life Clinic we perform a complete hormonal analysis including the DUTCH test that evaluates not just hormone levels but also how your body metabolizes hormones.