Fifty percent of women beyond the age of 35 are no longer ovulating consistently each month. This fact is important because women rely on their ovaries to produce both estrogen and progesterone. It is only with ovulation that progesterone is released in the latter half of the menstrual cycle to balance out estrogen. Prior to menopause, the ovaries continue to produce estrogen throughout the month. In addition, we are exposed to environmental estrogens known as xeno-estrogens that are found in pesticides, plastics, personal care products, the food we eat and the water we drink. In other words, we are exposed to considerable amounts of estrogen at all times.
Estrogen needs to be balanced by progesterone. Progesterone comes from the ovaries with ovulation, and continues to be produced for the latter two weeks of a menstrual cycle. So, if a woman is not ovulating reliably in peri-menopause (the years leading up to menopause), in many cycles she will be estrogen-dominant – or, from another perspective, progesterone-deficient. This can manifest itself in the form of heavy or painful periods, breast tenderness, irritability, anxiety, foggy thinking and sleeplessness. These symptoms are often exaggerated in the one to two weeks leading up to menstruation and often dissipate within one or two days of menstruation starting. Fortunately, with physiologic dosing of bio-identical hormones, these symptoms can be significantly reduced, and in most cases eliminated.
During the transition to menopause, many women also begin to experience thinning tissues in the vagina leading to symptoms like painful intercourse, vaginal dryness or irritation, increased bladder urgency and frequency, burning with urination and recurrent urinary tract infections. These symptoms can also be reversed or significantly reduced with new state-of-the-art treatments.
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