Estrogens during perimenopause

Understanding the role of estrogen during perimenopause is essential for anticipating the changes your body will undergo. During this transition, fluctuations in these key hormones affect your energy levels and mood. Discover how to navigate perimenopause with peace of mind by understanding these biological mechanisms and their solutions.

The three main types of estrogen

We often talk about "estrogens" in general terms, but there are actually three main types, which have different roles and origins.

Estradiol (E2) is the main estrogen in women of childbearing age. It is produced by the ovarian follicles during the menstrual cycle and is the most biologically potent, with numerous effects on the body. Its decline during premenopause and sharp drop during menopause can cause many symptoms such as hot flashes, sleep disturbances, vaginal dryness, fatigue, and mood swings.

Estrone (E1) is mainly produced by adipose tissue and the adrenal glands. After menopause,estrone (E1) becomes the main form of estrogen in the body, but its hormonal activity is weaker than that of estradiol. It therefore only partially compensates for the decline in estradiol. 

Estriol (E3) is a specific estrogen produced mainly during pregnancy by the placenta. Its estrogenic activity is weaker.

The role of estrogen in women

Estrogens are not simply "reproductive hormones"; they are true multitasking messengers that influence almost the entire female body. Produced mainly by the ovaries, they circulate in the blood and bind to receptors located in the brain, bones, heart, skin, and, of course, the reproductive system.

Estrogens, and in particularestradiol, play an essential role in many of the body's mechanisms, far beyond fertility.

• First, they help regulate the menstrual cycle by promoting the thickening of the endometrium in order to prepare the uterus for a possible pregnancy.
• They also contribute to bone health by slowing down bone tissue degradation and supporting the activity of cells responsible for bone formation (osteoblasts). This is one of the reasons why the risk of osteoporosis increases after menopause.
• Estrogens also play an important role in cardiovascular protection. They promote proper dilation of blood vessels, improve blood circulation, and help maintain a more favorable lipid profile (cholesterol levels).
• They also play a role inemotional balance by influencing the production and action of certain neurotransmitters such as serotonin and dopamine, which are involved in mood, motivation, and general well-being.
• Finally, estrogen contributes to healthy skin and mucous membranes by stimulating collagen production, promoting tissue hydration, and supporting skin elasticity.

How does estrogen change during perimenopause?

Contrary to popular belief, the decline in estrogen is not linear. Premenopause is characterized more by hormonal instability. It often resembles a roller coaster ride: the body, sensing that the ovaries are slowing down, sends increasingly strong signals (via the FSH hormone) to try to stimulate estrogen production.

It is therefore not uncommon to experience phases of hyperestrogenism (too much estrogen) alternating with phases of hypoestrogenism (not enough). It is this hormonal chaos that defines hormones during premenopause and explains why you may feel different from one cycle to the next. As you approach menopause, production will eventually decline permanently.

Symptoms of declining estrogen levels

When estrogen levels begin to drop significantly, the body sends out various warning signals. Every woman is unique, but some signs are unmistakable:

• Hot flashes and night sweats: a lack of estrogen disrupts the body's temperature regulation center.
• Mucosal dryness: this often manifests as vaginal or ocular dryness, as well as a loss of skin elasticity.
• Mood disorders: irritability, anxiety, or depressive episodes are common.
• Fatigue and sleep disorders: difficulty falling asleep or waking up early due to hormonal decline.
• Joint pain: Estrogen has an anti-inflammatory effect, so a decrease in estrogen levels can cause joint sensitivity.

Natural solutions to support estrogen

It is entirely possible to support your endocrine system through gentle methods and a healthy lifestyle.

1. Diet: focus on phytoestrogens (organic soy, legumes) which mimic the action of estrogen in the body in a mild way. Consume omega-3s (small oily fish, rapeseed oil) to support the nervous system.
2. Herbal medicine: certain plants are valuable allies. Red clover and sage help regulate hot flashes, whileblack cohosh acts on overall hormonal balance.
3. Stress management: The drop in estrogen can make the body more sensitive to stress and fluctuations in cortisol, the stress hormone. Practices such as yoga, meditation, or cardiac coherence can help to better regulate stress and support overall balance.
4. Exercise: Regular physical activity helps maintain bone density and improves hormone receptor sensitivity.

When should hormone therapy be considered?

Despite all the natural remedies available, some women's quality of life remains severely impacted. If symptoms (severe insomnia, depression, debilitating hot flashes) prevent you from leading a normal life, it's time to seek medical advice.

HRT (Hormone Replacement Therapy), or replacement therapy, may be considered. Today, doctors often favor " bioidentical" hormones (whose structure is identical to those produced by the body) administered transdermally for estrogen and vaginally or orally (ovules) for progesterone.

The important thing is to discuss it with a healthcare professional (particularly a gynecologist) to assess the benefits and risks based on your medical history. There is no inevitability: perimenopause is a transition, not a disease, and there are solutions for every woman.