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The Relationship Between Perimenopause and Thyroid Health

In this blog post I interviewed Bridgit Danner, who is a licensed acupuncturist and functional health coach, and she has a lot of experience working with women’s hormones.  She is also the host of Women’s Wellness Radio, which is a weekly podcast, and I would check this out when you get the chance.  Recently I read an article by Bridgit where she discussed perimenopause, and it made me realize that I haven’t had a recent article or blog post on this topic.  As a result, I asked Bridgit if she would be willing to do a brief “blog post interview” on this topic, and I’m so grateful that she agreed to do this.

Dr. Eric: Can you please explain what perimenopause is?

Bridgit: Perimenopause is characterized by menstrual irregularity, as there are changes in the length of the menstrual cycle, and there can also be changes in the level of discomfort associated with menses.  This is essentially the opposite of puberty.  In puberty the ovaries are “waking up” in order to start your reproductive years, and during this time your brain and ovaries learn to work together to coordinate a monthly cycle.  But with perimenopause, this brain-ovary relationship starts to shut down.

Dr. Eric: When does perimenopause usually begin?

Bridgit: Perimenopause begins several years before menopause, and it usually starts in a woman’s early 40s, although in some women it will begin in their late 30s.  During this time the ovaries will begin to make less estrogen, and it will last until the ovaries stop releasing eggs.

Dr. Eric: How long does perimenopause usually last for?

Bridgit: Perimenopause is a long gradual process that occurs over many years.  You may notice symptoms for many years, or just for a few years before menopause, or you may not have many symptoms at all, besides your period becoming less frequent.  Perimenopause ends when the woman has gone 12 months without having her period.

Dr. Eric: What are some of the common symptoms associated with perimenopause?

Bridgit: With perimenopause you may notice that your PMS worsens, and you may have spotting in between periods.  Eventually women will experience irregular and missed periods, and these irregular cycles can result in heavy menstrual bleeding.  Sometimes these symptoms will disrupt sleep, and other common symptoms can include hot flashes, brain fog, headaches, heart palpitations, mood swings, and anxiety.

Dr. Eric: How can perimenopause affect thyroid health?

Bridgit: While both estrogen and progesterone decline in perimenopause, the decline of progesterone is more dramatic, which leads to a condition known as estrogen dominance.  This estrogen dominant state can affect thyroid transport and conversion.

With regards to autoimmune thyroid conditions, estrogen seems to inhibit Th1 cytokines while stimulating the production of Th2 cytokines.  Hashimoto’s Thyroiditis is considered to be a Th1-dominant condition, whereas Graves’ Disease is a Th2-dominant condition. As a result, estrogen dominance will typically exacerbate Graves’ Disease.  And while estrogen dominance might actually benefit the immune system in those with Hashimoto’s, ideally you still would want to have a healthy balance of estrogen and progesterone.

Dr. Eric: Can you give some natural treatment tips to women who are in perimenopause?

Bridgit: Many of your readers probably know that having a healthy gut is important for a healthy immune system, and since some of the conversion of T4 to T3 takes place in the gut then this is another reason why improving the health of your gut is essential.  But many don’t realize that having optimal gut health is essential for healthy estrogen metabolism, which can help in cases of excess estrogen.

How can you improve the health of your gut?  Eating well is important, including fermented foods like sauerkraut and kimchi, eating a good amount of fiber from vegetables, berries, spices, etc.  Sugar can feed both yeast and bacteria, and so reducing your sugar intake is essential.  Glyphosate, which is in genetically modified foods and non-organic foods, can kill off your friendly bacteria, and so you should try to avoid these foods.

While estrogen dominance can involve high estrogen levels, a woman can have an estrogen dominant state by having low progesterone levels, and so doing things to boost progesterone can also be beneficial.  Maca root is an adaptogenic herb that can help to boost progesterone levels, and I’ve been very impressed with how taking 1 -2 tablespoons of hemp oil a day helps with my own perimenopausal hormones.  Borage oil has gamma linoleic acid, and this can also help with hormone production.

I also mentioned how estrogen dominance can cause an imbalance of the Th1 and Th2 pathways, and while fixing the estrogen dominance condition is necessary, doing other things to balance the immune system can be helpful.  For example, taking fish oil supplements (make sure you find a good brand) will help to balance the immune system and decrease inflammation.  Since vitamin D is commonly deficient in those with autoimmune thyroid disease it’s important to get your levels tested, and ideally get the levels to around 60 to 80 ng/dL through both sunshine and vitamin D3 supplementation.

Dr. Eric: Thank you so much for sharing this information on perimenopause.  Please tell others how they can learn more about you, including how they can sign up for your podcast.


Bridgit: My website is www.bridgitdanner.com [2], and they can also subscribe to my “Women’s Wellness Radio” podcast on iTunes, or you can listen and watch interviews at my blog, http://www.bridgitdanner.com/blog [3].