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Why is Menopause so Confusing?

Updated: Nov 8, 2023

“How do I know if I am in perimenopause?”

This is a frequent question that I get asked.

There are several reasons that menopause is confusing, but the four facts that many women do not realise are:

  • Oestrogen and progesterone do not decrease in a neat linear fashion.

  • Oestrogen and progesterone do not just function in the uterus.

  • Oestrogen and progesterone do not operate in isolation.

  • Many symptoms associated with menopause could also be caused by other illnesses.

1. The decline of oestrogen and progesterone is not linear.

hormonal fluctuation diagram

It is actually the opposite.

I like to show the above diagram because it explains the madness of what is happening.

Usually, progesterone starts to decrease first, which can produce its own array of symptoms, such as heavy or irregular periods, anxiety, depression and insomnia, and headaches, to name a few. This is followed at some point by the random yo-yoing of oestrogen.

The balance between both oestrogen and progesterone is critical. Low progesterone can give rise to progesterone symptoms or make the oestrogen seem unusually high and create symptoms associated with what is known as oestrogen dominance.

But because the hormones go a bit awol and fluctuate, as shown in the diagram – so do our symptoms. One minute you can be battling hot flushes, and then it is all change and insomnia arrives.

It IS very confusing, and not remotely surprising that many women feel as if they are going mad. That is until you understand that this is what is happening. Then it 'simply' becomes annoying, rather than you losing the plot.

2. There are oestrogen and progesterone receptors ALL over the body.

Particularly oestrogen. These lovely hormones have an essential function in many areas – so when we have lower or higher levels – this impacts everywhere. The diagram below shows where oestrogen receptors can be found and how this links to different symptoms.

3. Oestrogen and progesterone do not just whizz around our bodies on their own in isolation.

They have many interactions with other hormones such as thyroxine, cortisol, and neurotransmitters such as our feel-good hormone serotonin. So when they start to go wonky – this affects absolutely everything. It is not surprising that problems can take a while to diagnose correctly.

4. Many menopause symptoms can overlap with other health conditions.

For example, symptoms such as fatigue, mood changes, and weight gain can be attributed to menopause, but they can also be caused by other factors such as stress, thyroid disorders, or depression.

If you are around 45 and onwards, there is a good chance that these symptoms may be linked to menopause. I often encourage women to go to their GP and have a proper check-up. This way, anything more exciting can be ruled out.

If you are younger, then it may well be more confusing. Please do go to your GP and ask for tests. Premature and early menopause are increasingly common and the sooner you can get a clear diagnosis the better.

Functional tests can also work out what is happening to oestrogen, progesterone, testosterone, and cortisol. These can be valuable depending on the symptoms and the desire for facts. Much can be done without these tests through diet and lifestyle changes.

Please do message me if you are

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