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Post image for 35 Symptoms of Perimenopause: Heavy, Flooding, Periods

When the average woman thinks of perimenopause symptoms she usually thinks of the proverbial night sweats and hot flashes.

Perhaps even a few mood swings thrown in for good measure.

What many do not know, however, and are often surprised to find out, is that heavy, flooding periods with painful cramping and large blood clots are a common complaint for many women in perimenopause.

Sometimes the bleeding is so heavy and so severe it is thought to be symptomatic of something more serious, such as cervical cancer, endometriosis or uterine fibroid disease.

While it’s always a good idea to have heavy, cramping periods checked out by your physician, if you are of perimenopause age and are experiencing heavy, flooding, cramping periods, there is a good chance it is the result of low progesterone levels common during perimenopause.

Dropping Progesterone Levels during Perimenopause Create Estrogen Dominance

During a woman’s normal menstrual cycle the two hormones primarily at work are estrogen and progesterone. At the beginning of the cycle, estrogen is the dominant hormone and works to prepare the body for fertilization by promoting the buildup of the inner lining of the womb, called the endometrium.

At approximately mid-cycle, around the 14th day, ovulation occurs and the levels of progesterone rise to prepare for implantation of an embryo.

If fertilization and implantation does not occur, progesterone levels drop and trigger menstruation. Provided there are no significant health issues, most women will experience this same cycle hundreds and hundreds of times during her years of fertility, usually without a hitch.

However, once a woman begins to enter perimenopause, this well oiled and fine tuned cycle is radically disrupted when her progesterone levels begin to fall, creating what is called an estrogen dominant environment.

Subsequently, it is the estrogen that is responsible for the long list of commonly known symptoms of perimenopause which includes heavy, flooding, cramping periods.

Bio-identical Progesterone For Heavy, Flooding, Cramping Periods of Perimenopause

If an estrogen dominant environment is the culprit for the majority of symptoms women experience during perimenopause, then it is only logical that in order to combat the symptoms of estrogen dominance, a woman should introduce more progesterone to correct the imbalance.

While the debate still rages among some physicians over the safety of synthetic hormones versus bio-identical hormones, more and more physicians are recommending bio-identical progesterone rather than the synthetic form called progestins. Fortunately, few will argue or disagree that progesterone does help with heavy, flooding, cramping periods associated with perimenopause.

How Much Progesterone Should You Use?

The basic recommend dose of progesterone for use during perimenopause would contain 450 to 500 milligrams of progesterone per ounce. However, with extreme symptoms such as the heavy, flooding periods, some physicians recommend as much as 1500 milligrams per ounce of progesterone for approximately 3 months in order to get your symptoms under control. Once the symptoms are managed and controlled you can cut back to 750 milligrams per ounce or even go as low as 450 to 500 milligrams.

How long should you use Progesterone?

If you are getting close to actual menopause, you might be concerned that if you used hormones such as progesterone that it will prolong perimenopause or interfere with actual menopause. However, this is not the case. Women can safely use low levels of progesterone to manage symptoms without promoting monthly cycles.


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One of my more popular blogs here has been “Dry, Itchy Skin in Perimenopause.”  Apparently, we’re all itchy and scratchy when hormone imbalance hits. Go figure. For me, the biggest issue has been an itchy scalp.  However, in the interest of full disclosure, I’ve always had issues with an itchy scalp.  As long as I can remember. [...]

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Today’s post is a guest post by Dr. Joseph Mazzei, a Chicago based doctor for BodyLogicMD, a medical group which sponsors The Perimenopause Blog. I asked Dr. Mazzei if he could give his opinion on estrogen therapy since it is starting to make its way back into the news once again.  In this post, Dr. Mazzei [...]

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