Oestrogen = oestradiol, oestrone and estriol

• So there are three kinds of oestrogen naturally produced in our bodies.  Before menopause, the primary role of oestradiol is to stimulate growth in the breast, ovaries and uterus and to participate in the growth of egg-bearing follicles. It also is a major influence in stimulating maternal behaviour. In other words it promotes child birth and child care. After menopause, oestrone becomes the predominant oestrogen. No one knows exactly why this happens, but obviously it has nothing to do with procreation. It is likely that oestrogen's ability to protect heart and brain function as well as bone strength and is part of its purpose in this phase of life.

When we have a deficiency of oestradiol we get a variety of the above symptoms.

In Chinese Medicine theory the above list are all symptoms of Kidney Yin deficiency, which means that the Yin of the body is drying up hence the drying symptoms, then the Kidney Yang which is the fire element of our body has nothing to cool it down leaving us feeling hot. So at night when the Yin of our body is supposed to be nurturing and cooling us down and containing the Yang, it's not strong enough and then we feel the flare up of the Yang (hot flushes). This is why at night the flushes can be worse, it can also flare up if we are drinking alcohol or hot spicy foods at the end of the day. This will then keep us awake and stir up our adrenals that are already not coping due to the low oestrogen in our bodies.

• There is one area in which supplemental oestriol is known to be particularly effective: urogenital symptoms. Applied locally in the vagina, it relieves urinary frequency, vaginal dryness and other conditions associated with thinning of these tissues.

Perimenopause is a very interesting phase and education on how and why it is happening to us can so help us understand why we have these symptoms. Then we can seek help to support us through this stage where the body is resetting itself. This may take several modalities working together to get the result we are looking for, so try a few out and see what works for you.

Best, Tabitha

*pages 141- 142, Dr Christiane Northrup, The wisdom of Menopause.