Hormone Balance And Menopause

Women live their lives in a state of hormonal flux and flow. From the beginning of menarche to the end of menopause, our hormone balance changes continually. We experience a different hormone balance during the first half of the menstrual cycle—when our bodies prepare for pregnancy—than the second half—when our bodies prepare to release another egg. Pregnancy causes our hormones to change continually as our bodies nourish a growing baby and prepare for birth and lactation. Lactation requires yet another change in hormone balance. And so it continues from menarche til the end of menopause.

Somewhere in the 4th or 5th decade of life, a woman's body gradually becomes less able to maintain this delicate, ever-changing hormone balance. The primary reason for this is the declining number of egg-containing follicles, which secrete a form of estrogen called estradiol. Our bodies respond to the diminishing level of estradiol by secreting more follicle-stimulating hormone (FSH). At some point, we stop responding to FSH, and stop releasing eggs. One indication that menopause is complete is the absence of menopause for a year. FSH levels will also usually be elevated.


Most of the symptoms of peri-menopause are caused by the uneven flux of hormones. Estrogen and progesterone are still being excreted, but not in a predictable, rhythmic way. A sudden surge in estrogen production can cause hot flashes, confusion, irritability and other symptoms.

When the process is complete, and hormone levels have stabilized, the symptoms go away. We still release some estrogen and progesterone from tissues other than our ovaries, but we do experience problems associated with low estrogen levels, such as thinning bones and increased risk for heart disease.

Hormone Balance During Peri-Menopause

One theory, proposed by Dr. John Lee, is that the symptoms we experience during menopause are from estrogen dominance, not estrogen deficiency. We do have estrogen deficiency, but we have an even greater deficiency in progesterone. He pioneered the use of bioidentical progesterone cream to manage menopausal symptoms.

Many women find that using progesterone cream decreases the hot flashes and other symptoms of menopause. Bioidentical progesterone breaks down very rapidly when taken by mouth, but it is well absorbed through the skin.

Progesterone cream opposes the estrogen and normalizes the hormone balance between estrogen and progesterone. Even though hormone levels are low, they are in better balance so you have fewer symptoms.