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"Before the Change: Taking Charge of Your perimenopause by Ann Louise Gittleman, Ph.D. Wonderful advice on diet and lifestyle for the premenopausal woman by the First Lady of Nutrition! Pregnancy and Postpartum Books Natural Guide to Pregnancy and Post-Partum Health by Dean Raffelock, D.C., C.C.N., and Robert Roundtree, M.D. This is the book I give everyone in my life who is either pregnant, thinking about becoming pregnant, or has just had a baby. It's that important. Reflexology Online Resources www.americanacademyofreflexology." - Jonny Bowden, Ph.D., C.N.S., The Most Effective Natural Cures on Earth: The Surprising, Unbiased Truth about What Treatments Work and Why (Get the book.)

"Some doctors think that women should be introduced to HRT during perimenopause, but there are many others who think that this is unnecessary and, with the correct diet, stress management, and exercise, women do not need to opt for replacement therapy at this early stage unless there are profound reasons for doing so. Discuss this issue with your doctor. Also discuss how long you should continue taking HRT. The uncomfortable symptoms of menopause and perimenopause often last for only a short time, so you may not need to remain on the therapy for a prolonged period." - Phyllis A. Balch, CNC, Prescription for Nutritional Healing, 4th Edition: A Practical A-to-Z Reference to Drug-Free Remedies Using Vitamins, Minerals, Herbs & Food Supplements (Get the book.)

"During perimenopause, several biological changes occur: • The number of ovarian eggs (oocytes) reaches very low levels • The menstrual cycle begins to vary, usually shortening from one menses to the next. • The levels of FSH in the body increase. This rise is one of the first signs of an aging reproductive system. Health-care practitioners often measure FSH levels to determine if one's symptoms are related to menopause. There are two problems with this test, however: varying patterns of FSH may occur even in the same woman, and the FSH is often normal even in a perimenopausal woman." - Tori Hudson, N.D., Women's Encyclopedia of Natural Medicine: Alternative Therapies and Integrative Medicine for Total Health and Wellness (Get the book.) "On the other hand, some women mistakenly think that if they are in their mid- to late 40s or early 50s, having some perimenopause symptoms, and haven't menstruated for a few months, they cannot become pregnant. On the contrary, unplanned pregnancies are common during this time period. If pregnancy is not desired, contraception must be used until you have not had a menses for 12 consecutive months, or until levels of FSH are consistently above 30 IU/L. Insomnia/Sleep Disturbances. Sleep problems are especially common in perimenopausal women, increasing after age 40 and plateauing by age 50." - Tori Hudson, N.D., Women's Encyclopedia of Natural Medicine: Alternative Therapies and Integrative Medicine for Total Health and Wellness (Get the book.) "The average age of onset of the perimenopause or menopause transition is age 47.5. For most women, this transition lasts about four years. Only a very small number of women stop having their menses abruptly. Most of us experience the irregular pattern of bleeding. Postmenopause begins after the time of the final menstrual period, whether it was a natural or medically induced menopause, and continues until the end of life. It is defined as stage +1 (early postmenopause) and stage +2 (late post-menopause)." - Tori Hudson, N.D., Women's Encyclopedia of Natural Medicine: Alternative Therapies and Integrative Medicine for Total Health and Wellness (Get the book.) "At times, the bleeding can become too chaotic, and, of course, there are other causes of abnormal bleeding other than perimenopause such as a uterine polyp, hypothyroid, uterine fibroids, and endometriosis, to name a few. Chapter 1, on abnormal bleeding, is an important chapter to read to help understand these distinctions. Normal menstrual blood loss is approximately 40 mL. Blood loss greater than 80 mL is considered heavy, especially if there are blood clots or if you become anemic." - Tori Hudson, N.D., Women's Encyclopedia of Natural Medicine: Alternative Therapies and Integrative Medicine for Total Health and Wellness (Get the book.)

"Studies have shown that in the perimenopause the incidence of negative changes was somewhat higher than in the postmenopause, the latter bringing relief of discomfort and a more positive mental outlook. perimenopause terminates with the cessation of menstruation. 11 See: www.newtreatments.org/depression 12 Dahl, 1950; Nida and Broja, 1957; Goldsmith, 1963; Goldsmith et al., 1970; Goldsmith, 1971). The use of estrogen-containing oral contraceptives has been shown to reduce the serum levels of magnesium (in users versus nonusers) by 16% (Goldsmith et al., 1966), 28% (DeJorge et al." - Mark Sircus, Transdermal Magnesium Therapy (Get the book.)

"Because estrogen is lowest during your period and the week after, symptoms of low estradiol tend to occur here first, during perimenopause. So, in addition to PMS symptoms from your waning progesterone, you may over time start to develop menstrual headaches, depression, fatigue, or sharp menstrual cramps during and immediately after your period. You may notice that where you used to feel great once your period came, you are now tired and depressed throughout your cycle. Some women feel like they have entered a state of constant PMS." - Phuli Cohan, The Natural Hormone Makeover: 10 Steps to Rejuvenate Your Health and Rediscover Your Inner Glow (Get the book.) "This is why it's important to recognize your symptoms early during perimenopause and treat underlying progesterone and estrogen deficiency promptly. Symptoms of Low Estrogen The low estrogen symptoms described above can arise at any age. Symptoms usually start when your estradiol level falls too low. I have a saying: "Never argue with a woman who has an estradiol level below 60 pg/ml, you won't win. And you will regret ever trying." - Phuli Cohan, The Natural Hormone Makeover: 10 Steps to Rejuvenate Your Health and Rediscover Your Inner Glow (Get the book.) "It is believed that an imbalance between norepinephrine and epinephrine (too much norepinephrine and not enough epinephrine to balance it) is largely responsible for hot flashes, palpitations, insomnia, and anxiety commonly seen during perimenopause and menopause. That is how antidepressants (SSRIs) work to help menopausal symptoms: they "raise" serotonin. But these treatments, though effective and useful temporarily, are not treating the root cause, low estradiol." - Phuli Cohan, The Natural Hormone Makeover: 10 Steps to Rejuvenate Your Health and Rediscover Your Inner Glow (Get the book.) "During perimenopause, your period will help to tell you about how your estrogen levels are doing. As your estrogen falls, usually your menstrual blood flow becomes less heavy and darker, and you bleed fewer days, usually only two or three. Often when this happens, women notice new symptoms such as headaches and sharp cramps. But some women, particularly those who are anemic or have fibroids or low thyroid problems, can bleed heavily despite low levels of estrogen. Skipping Cycles If you start to skip cycles, things can feel very confusing, particularly if you've always been regular." - Phuli Cohan, The Natural Hormone Makeover: 10 Steps to Rejuvenate Your Health and Rediscover Your Inner Glow (Get the book.)

"Levels drop in PMS and in perimenopause, leading to increased anxiety and insomnia.There is evidence that natural, bioidentical (hormones identical to those produced by the body) progesterone reduces this anxiety and stress through its action on GABA receptors, the relaxing neurotransmitter—your body's natural Valium.50 Testosterone is also a wonderful brain-boosting hormone that improves mood, memory, motivation, and overall cognitive function. It drops significantly in women and men with age and has an enormous impact on quality of life." - Mark Hyman MD, The UltraMind Solution: Fix Your Broken Brain by Healing Your Body First (Get the book.) "Women are defective, flawed, broken, and destined to suffer throughout their reproductive life from the curse of mood and behavior swings that are the result of the three Ps: Puberty, PMS or premenstrual syndrome, and perimenopause (the years leading up to and just after your final period). This is the "genetic flaw" that supposedly threatens them. As they age, men, if you believe all the television commercials, supposedly need the little blue pill (Viagra) just to be men again. Is this just a "normal" part of being a woman or a man? Is it the product of some defective, mutant gene?" - Mark Hyman MD, The UltraMind Solution: Fix Your Broken Brain by Healing Your Body First (Get the book.) "Sex Hormones: Puberty. PMS, perimenopause, and Andropause "Seventy-five percent of women are found to have a mutant gene that threatens their relationships, work, and well-being." "Over half of aging men will lose their sexual function, their testosterone levels will drop, and their estrogen levels will rise, making men more like women." These are the beliefs that most of us unconsciously accept." - Mark Hyman MD, The UltraMind Solution: Fix Your Broken Brain by Healing Your Body First (Get the book.)

"In reality, hormone levels may begin to change in the 30s, as a woman enters a period called perimenopause. In the decades leading up to menopause, small hormonal imbalances can exist, so by the time menopause sets in, a woman may have already experienced close to 20 years of hormonal imbalance Hormone replacement actually can cause the body to slow down the production of its own natural hormones, including melatonin, DHEA, progesterone and human growth hormone (HGH). HRT does not treat the cause of any problem, it only addresses ?and perpetuates ?the symptoms." - Mark Sircus, Transdermal Magnesium Therapy (Get the book.)

"During perimenopause, thyroid hormone levels may decrease along with estrogen levels. It's often difficult to accurately measure T3 and T4 levels because of natural shifts in hormone levels. Sometimes a physician will base a diagnosis on clinical symptoms, such as those described in the previous paragraph. Although low thyroid activity (hypothyroid) is not a common cause of depression, it could be a factor, particularly in middle-aged women. It's important, however, to consider whether lifestyle issues, such as self-esteem and changing physical appearance, might be causing depression." - Jack Challem, The Food-Mood Solution: All-Natural Ways to Banish Anxiety, Depression, Anger, Stress, Overeating, and Alcohol and Drug Problems--and Feel Good Again (Get the book.)

"Anita Flegg, 43, of Ottawa, Canada, also found that reducing her sugar intake helped her through perimenopause. "I was able to go off the estrogen treatment I had been on for five years, and my symptoms never returned," marvels the electrical engineer, who became so intrigued by the subject that she self-published Hypoglycemia: The Other Sugar Disease. Moreover, Ruth M., 53, of Great Britain, credits her having "come through menopause without hot flashes or insomnia" to cutting out sugar, taking evening primrose oil, eating more nuts and seeds, and adopting an Ayurvedic-type diet." - Connie Bennett, C.H.H.C. with Stephen T. Sinatra, M.D., Sugar Shock!: How Sweets and Simple Carbs Can Derail Your Life-- and How YouCan Get Back on Track (Get the book.)

"For example, it is thought that women who smoke generally experience menopause earlier than women who do not. The perimenopause, the period leading up to menopause where periods start to become irregular, generally starts when a woman is in her 40s. Menopause can go on for many years, but once a woman has not had a period for one year she is considered to be "postmenopausal." Menopause is triggered when the ovaries no longer respond to the controlling hormones released by the pituitary gland." - Marshall Editions, 1000 Cures for 200 Ailments: Integrated Alternative and Conventional Treatments for the Most Common Illnesses (Get the book.) "In women, libido can be affected by changes in hormonal levels, menstrual cycle, pregnancy, childbirth, perimenopause, and menopause. Some women may also experience pain and discomfort during sex, which can contribute to a low libido. In men, a low sex drive may be associated with prostate problems, the disorder known as hyperprolactinemia, where too much of the hormone prolactin is produced by the pituitary gland, and low testosterone levels. Psychological factors that affect both sexes, such as stress, emotional worries, fatigue, depression, and low self-esteem, also influence sex drive." - Marshall Editions, 1000 Cures for 200 Ailments: Integrated Alternative and Conventional Treatments for the Most Common Illnesses (Get the book.) "To treat perimenopause: Mix 15 g of Shen Di Huang (Chinese foxglove root), 10 g of Shan Zhu Yu (Asiatic cornelian cherry fruit), 15 g of Shan Yao (Chinese yam), 15 g of Fuling (poria), 12 g of Zi Xie (water plantain rhizome), 12 g of Dan Pi (cortex of peony root), 12 g of Niu Zhen Zi (privet fruit), and 12 g of Wu Wei Zi (schisandra fruit). • To treat kidney Yang deficiency: Symptoms may include chills, dizziness, cold hands and feet, and loose stools." - Marshall Editions, 1000 Cures for 200 Ailments: Integrated Alternative and Conventional Treatments for the Most Common Illnesses (Get the book.)

"Between the ages of forty-five and fifty-five, I was diagnosed Y/N with low thyroid and also went through perimenopause. A brother, a sister, or a parent was diagnosed with diabetes. Y/N Interpretation: If you answered "yes" to any of these questions, there's a good chance that you have, or are at risk of developing, prediabetes. If you answered "yes" to more than five of the questions, you have a very high risk of being prediabetic. The Overweight and Obesity Quiz for Women I know that I am overweight. Y/N I was told by my doctor that I should lose some weight." - Jack Challem, Stop Prediabetes Now: The Ultimate Plan to Lose Weight and Prevent Diabetes (Get the book.)

"During perimenopause,10 there are wide fluctuations in the hormones estrogen, testosterone, FSH, LH, and progesterone and it is these widely fluctuating hormone levels that can cause many problems, the least of which is hot flashes. Estrogens are primarily responsible for the conversion of girls into sexually-mature women in the development of breasts, the further development of the uterus and vagina, broadening of the pelvis, growth of pubic and axillary hair and play a role in the increase in adipose (fat) tissue." - Mark Sircus, Transdermal Magnesium Therapy (Get the book.)

"In fact, disturbed sleep is one of the primary complaints that causes women to seek treatment for menopause and perimenopause. It's estimated that about two-thirds of women who visit the Yale Mid-Life Center are afflicted with insomnia.3 Although levels of both estrogen and progesterone diminish as a woman approaches menopause, progesterone usually falls off more rapidly. The resulting imbalance is known as estrogen dominance, a condition that women's health expert John R. Lee, MD, describes as "toxic to the body." - Herbert Ross, DC with Keri Brenner, L.Ac., Alternative Medicine Magazine's Definitive Guide to Sleep Disorders: 7 Smart Ways to Help You Get a Good Night's Rest (Get the book.)

"The time period prior to menopause is referred to as perimenopause, while the time period after menopause is referred to as postmenopause. During the perimenopausal period, many women have irregular periods. Signs and Symptoms The most common complaints of perimenopause and menopause are hot flashes, headaches, atrophic vaginitis (vaginal dryness and irritation due to lack of estrogen), frequent urinary tract infections, cold hands and feet, for-getfulness, and inability to concentrate. In the United States, 65 to 80 percent of menopausal women experience hot flashes to some degree." - Michael Murray, N.D. and Joseph Pizzorno, N.D., The Encyclopedia of Healing Foods (Get the book.)

"The uncomfortable symptoms of menopause and perimenopause often last for only a short time, so you may not need to remain on the therapy for a prolonged period. On the other hand, if you are taking hormone therapy because of long-term concerns such as osteoporosis prevention, a different duration may be necessary. Consult your physician. A study conducted by the Women's Health Initiative (WHI) and sponsored by the National Institutes of Health (NIH), beginning in 1993 and involving 16,600 women aged fifty to seventy-nine, examined the benefits and risks associated with HRT." - Phyllis A. Balch, CNC, Prescription for Nutritional Healing, 4th Edition: A Practical A-to-Z Reference to Drug-Free Remedies Using Vitamins, Minerals, Herbs & Food Supplements (Get the book.)

"Menorrhea, or excessive menstruation dependent upon perimenopause or subnormal levels of reproductive hormones, is often diminished by Ratany, albeit symptomatically. The plant serves as a tissue and capillary bed constrictor and does not affect circulating hormone levels. Colliquative sweating may be lessened with Ratany. The addition of Sage may augment the effectiveness of treatment. Topically Ratany is applied to weepy sores, cuts, rashes, and stings to astringe, lessen inflammation, and facilitate healing." - Charles W. Kane, Herbal Medicine of the American Southwest (Get the book.)

"Symptoms of perimenopause are often mistaken for those of premenstrual syndrome (PMS). Both PMS and perimenopausal symptoms are a result of an imbalance between estrogen and progesterone—specifically, rising estrogen and diminishing progesterone. If your menstrual cycles have changed—for example, if your periods are lasting for a longer or shorter time than they used to, or if they are irregular when they were not irregular before—it is more likely that you are perimenopausal rather than premenstrual." - Phyllis A. Balch, CNC, Prescription for Nutritional Healing, 4th Edition: A Practical A-to-Z Reference to Drug-Free Remedies Using Vitamins, Minerals, Herbs & Food Supplements (Get the book.)

"The symptoms occurring during perimenopause can be severe and may correlate with naturally decreasing levels of DHEA which hit peak levels around the age of twenty and then decrease as we age. Since DHEA is one of the primary bio-markers for aging, the long range effect of large doses of magnesium in a usable form is to significantly raise DHEA levels and thus produce true age reversal results. Dr. Norman Shealy, who is an expert on anti-aging, has done studies regarding magnesium and aging, refers to DHEA as the Master Hormone." - Mark Sircus, Transdermal Magnesium Therapy (Get the book.)

"Many women don't realize that they may start having some symptoms of menopause long before what is still referred to as "The Change" is due; this phase of changing hormone levels and its symptoms is called perimenopause. These symptoms, which include insomnia, night sweats, fluctuating moods, little interest in sex, and memory loss, are indications that levels of the basic female hormones are shifting or out of balance." - Herbert Ross, DC with Keri Brenner, L.Ac., Alternative Medicine Magazine's Definitive Guide to Sleep Disorders: 7 Smart Ways to Help You Get a Good Night's Rest (Get the book.) "Hormone fluctuations influence body temperature and as a result can cause insomnia indirectly because of the increased frequency of hot flashes and night sweats during perimenopause and menopause.8 In a recent study, over 81 percent of women with severe, frequent hot flashes showed signs of insomnia, including unsatisfying sleep patterns and problems falling asleep. Therefore, treating hot flashes could be an important way to ease the symptoms of insomnia for menopausal women." - Herbert Ross, DC with Keri Brenner, L.Ac., Alternative Medicine Magazine's Definitive Guide to Sleep Disorders: 7 Smart Ways to Help You Get a Good Night's Rest (Get the book.)

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