Perimenopause is the two to twelve years before menopause. It can cause heavy periods, mood swings, insomnia, and night sweats.
Menopause is the life phase that begins one year after the last period. It can cause hot flushes, weight gain, and insomnia.
Perimenopausal and menopausal symptoms can be relieved by natural treatments such as magnesium, taurine, progesterone, and transdermal estrogen.
Step 1. Magnesium plus taurine
Magnesium boosts GABA which is the brain’s main calming or inhibitory neurotransmitter. Together with the calming amino acid taurine, magnesium can improve sleep, mood, and hot flashes. I recommend 300 mg magnesium plus 3000 mg of the amino acid taurine.
A 2017 paper called “Magnesium in the gynecological practice: a literature review” found that magnesium is an effective treatment for the symptoms of menopause and perimenopause and works by “normalizing the action of hormones (mainly progesterone) on the central nervous system.”
👉🏽Tip: For additional relief, consider adding 50 mg of vitamin B6, which is another good way to boost GABA.
For mood and sleep and hot flashes, magnesium could be as much treatment as you need. Try it for a few weeks, and then if you’re still suffering, stay magnesium, but look at adding the next step, progesterone.
Step 2. Progesterone or Prometrium for perimenopause
Natural progesterone or micronized progesterone is entirely different from the progestins used in birth control or conventional hormone replacement (HRT). It’s not a drug. It’s the beneficial hormone you used to make in your twenties and thirties.
Progesterone has many benefits.
- It makes periods lighter so progesterone can be used together with turmeric and other treatments to relieve the crazy heavy periods of perimenopause. For very heavy periods, a progesterone capsule such as Prometrium is preferable to a cream. (For a full discussion of heavy periods including the very important treatments of iron and stopping dairy, read Chapters 9 and 10 in Period Repair Manual and my blog post about heavy periods.)
- It relieves hot flashes—even on its own without estrogen. Progesterone works best in combination with magnesium and taurine.
- It improves mood and sleep because progesterone soothes the GABA receptors in the brain. For mood, a progesterone capsule generally works better than a cream.
- It helps to remove histamine from the body thereby relieving the mast cell and histamine problem that can flare during perimenopause and menopause.
- It stabilizes the HPA or adrenal axis and improves your ability to cope with stress.
👉🏽 Tip: Consider Prometrium or Utrogestan for perimenopause symptoms.
Magnesium + taurine + progesterone could be enough to relieve symptoms. Try that combination for a few weeks, and then if you still have symptoms, talk to your doctor about adding estrogen.
Step 3. Estrogen
Estrogen is a lot safer than you’ve been led to believe and can be incredibly helpful for sleep and mood and hot flashes. Most of the cancer risk from conventional hormone replacement was from the synthetic progestin, not estrogen.
If you do decide to add estrogen, choose one that is:
- Low-dose such as Vagifem (10 mcg estradiol) or Estradot 25 or 50 (25 or 50 mcg estradiol).
- Body-identical, which means it is identical to human estradiol or estrogen. Fortunately, most (not all) modern conventional estrogen products are body-identical. That includes brands like Vagifem, Estradot, and Sandrena gel. If you’re not certain if your estrogen prescription is body-identical or not, ask me in the comments.
- Transdermal, which means you absorb estrogen through your skin from a cream, gel, or patch. It’s better and safer when taken this way.
You can take progesterone without estrogen. But if you take estrogen, you should take progesterone because it has many benefits for sleep and mood and breasts. That’s true even if you don’t have a uterus.
For more information, see my perimenopause book Hormone Repair Manual.