Estrogen dominance, is it a real thing? Perimenopause

[FrameyMcFrame]

I've been reading a lot about menopause and perimenopause and keep coming across this term online and in books. It seems the idea is that fluctuations of estrogen rather than low levels of estrogen cause symptoms, plus very low progesterone...So someone in peri may have high estrogen with fluctuations and not enough progesterone which is causing their symptoms. Dr Lee's book, What your Doctor may not tell you about Premenopause (which was recommended on MN) talks a lot about it too. Just wondering if anyone has more understanding of this?
I get the idea that if you don't ovulate in a cycle then progesterone is not released in the second part of the cycle. But lots of symptoms of peri point to low estrogen not too much...

[PollyPerky]

Sorry to disillusion you, but the whole oestrogen dominance thing is a complete red herring. The John Lee book is very outdated and discredited by medics- not sure why or where MN are recommending it?- because it 's based on the belief that you have to increase progesterone to 'balance' oestrogen and this led to the sale scam of 'natural progesterone cream'. This is more 'popular' in the US where there are claims made that this cream can work all kinds of miracles, which is can't. The ingredient in the cream cannot be converted chemically in the body to progesterone we can use- and if it was, it would be licensed, like BP progesterone, which comes with a warning list of potential serious side effects. All peri symptoms are caused by declining ovarian function which means no eggs left, no ovulation, erratic periods and all the symptoms of meno.

[FrameyMcFrame]

I'm not disillusioned at all, I was finding it hard to understand how it could work! I bought the book about a year ago after I read a thread on MN recommending it. But since have read a lot of conflicting information and opinion about it, there's still a lot of people out there on the internet propounding this theory!

[PollyPerky]

Sorry! Maybe picked up your post wrongly. Yes, there is no independent research at all for Lee's theory. If you google, there is something called Skeptoid - a site- and there's an interesting feature there about him. TBH you only have to look at the simple facts: meno symptoms, use HRT (mainly oestrogen for the month) = symptoms clear.

[whatevva]

What happened to me ( I was charting my cycles ) was that I seemed to go through all the motions of ovulation (cervical mucus etc), then nothing would happen, there was no temperature rise (therefore no progesterone, as that is what it is measuring) or there was some half-hearted ovulation going on then 'whoosh' - a 'period' just a week later. This was probably 'oestrogen withdrawal bleed' where the oestrogen levels have dropped suddenly. As time went on, there was less definable ovulation-type stuff going on and even more random 'periods'.

I suppose you could call it 'oestrogen dominance' if you want, as there was very little progesterone happening. I expect some people may have a problems with over-production of oestrogen during this time, but things work on feedback loops so once your oestrogen levels have risen to the required amount for a few days and nothing happens, they stop. I do not have hot flush problems, but I was getting huge uro-genital problems due to low oestrogen. Cyclical hrt sorted it immediately for me.

You do need progesterone in the second half of your cycle, if you are producing oestrogen in the first half. It changes the lining so that it is more receptive to a fertilised ovum, but also the structure changes so that it comes away properly and all together when you have your period. If you are not producing enough, then bits break off when it thickens too much, and causes bleeding, which heals, until another bit breaks off. The blood vessels do not spasm properly to stop the bleeding. This is why things like Mirena can be helpful in perimenopause.

Articles about oestrogen dominance get all 'wafty' and talk about 'balancing' and 'oppposing' but really, you just need enough of each to do the job properly.

Some women are better with more progesterone as it can be sedating (think calm pregnancy) and some women can't tolerate it (think pmt). No one size fits all.