Dr Natalie Crawford

So when estrogen levels normally get low during the cycle, the brain doesn't like it, the hypothalamus.

So the gland in our brain starts looking for estrogen.

It likes estrogen.

And when the estrogen levels are high, it's happy.

And so when estrogen levels decline naturally in a cycle, it says, whew, where's my estrogen?

And it sends a signal to a second gland in the brain called the pituitary, and that makes the LH and the FSH.

So it's the loss of eggs and the loss of the group of eggs to respond to these signals.

So here we go.

We're beginning perimenopause.

We've reached a critical threshold level where our ovaries cannot respond.

And that might be, I don't know, a millionaire.

So, and in the brain, as we talked about those neurotransmitters, there are not only is estrogen changing and the amount that we're producing actually in perimenopause quite often, we'll have much higher estradiol levels than we did in our premenopausal years where we had that kind of

predictable ebb and flow of our monthly hormones.

There's also independent FSH receptors outside of, so these hormones that are pumping out to talk to the ovaries are also backtalking to different parts of the brain.

So the first symptoms that patients feel, and they've done a great study on this, is I don't feel like myself.

I don't feel like myself.

And they even call it IDFLM.

And so you can't put your finger on it.

Periods are regular, but your environment hasn't changed.

Your normal stressors haven't changed.