I just discovered this Canadian website from the Centre for Menstrual Cycle and Ovulation Research (CeMCOR). It’s fantastic. I wish I had discovered known about the organisation years ago.

This section for health care providers shows their (radical) approach, followed by their Mission and Values statements:

The purpose of this health care provider section is to re-frame knowledge about women’s reproduction to an approach that is life cycle based, ovulation-focused and woman-centered. Those providing medical services related to women’s reproduction have been trained largely by gynecologists and given a pelvis-based and surgically focused knowledge that may or may not be practical for and acceptable to women. In addition this section provides practical tools and handout materials for women’s reproductive care.

Because reproductive medical education, journals and textbooks continue to be dominated by a gynecological approach, some of the CeMCOR’s research may not yet be published. Hence the information may vary from current standard recommendations and recommendations provided may or may not be supported by published Level 1 or 2 evidence. However, in each instance the physiology, epidemiology and, sometimes, randomized double blind controlled trial evidence for the approach will be provided with peer-reviewed references.

Our Mission

To create and share a scientific, holistic body of knowledge focused on normal patterns of hormones in the population and changes in women’s menstrual cycles and ovulatory characteristics across the life cycle.

To perform studies, analyze data, publish and teach about the science of menstrual cycle and ovulation physiology and the expressions of these in women’s experiences.

Our Values

  • Affirm women’s accurate self-knowledge on personal health issues as they progress through the natural stages of their lives.
  • Produce quality science that is hypothesis-driven and evidence-based.

Our Vision

To reframe scientific knowledge of the menstrual cycle and ovulation in a woman-centred context.

This following paragraph describes a myth I have been misled by for maybe 5 years. They have a great page talking about 2010 study on taking bio-identical progesterone for hot flashes. The whole website looks very interesting with good research, evidence based recommendations and an open mind towards the bio-identical hormones.

The myth of perimenopause is that it is a time of dropping estrogen levels and estrogen deficiency. This idea arose because a separate phase of perimenopause as distinct from menopause was not described until recently and because hot flushes commonly begin in perimenopause. In reality perimenopause estrogen levels average about 20-30% higher than premenopausal values and often swing widely.

Here is the article on their website: Perimenopause | CeMCOR.

Here is another article:

Progesterone (not Estrogen) for Hot Flushes in Perimenopausal and Menopausal Women

and here is a Q & A about sleep and progesterone that is very interesting too.

Here is a snippet (I just keep finding more and more I want to post. Their website is worth a good deep broad read.

In the normal course of events a 47-year-old woman seeing her doctor about night sweats, heavy flow and PMS would likely be given combined hormone (estrogen/progestin) therapy or the oral contraceptive pill. (She might even be told that she is too young to be menopausal and scheduled for a D & C). She is not likely to be told that there are many things she could do to help herself. She could find and talk to other women who have come through the perimenopause; she could get more information about perimenopause at community seminars and read about perimenopause. She could also help herself by exercising regularly. Walking (or more strenuous exercise) for 30 minutes a day may not alleviate all premenstrual symptoms but will help reduce stress, control weight, allow more sound sleep, possibly relieve hot flushes and be good for both bones and heart. The hot flushes can also be helped by a daily dose of vitamin E (400-800 IU) and even more so, by relaxation training. Finally, she could use vitamin B6, oil of evening primrose and herbal remedies like black cohosh to see if they help.

And here is the link for another fascinating article that I found the snippet in:

Perimenopause is a time of “Endogenous Ovarian Hyperstimulation”

Oh and PS … one more. This is a description of the research conducted by one of the members of their board of scientific advisors, Susan I. Barr, PhD, RDN, FDC, FACSM is Professor of Nutrition at the University of British Columbia. Just to show you how totally brilliant they are.

Her research interests focus on cognitive dietary restraint (the perception of constantly limiting food intake), and she has demonstrated important associations among high levels of dietary restraint, menstrual disturbances, and bone health in young women of normal weight.

I cannot stop browsing this website. SO MUCH EXCELLENT INFORMATION!

For the past year or so I have been using the word perimenopause. I have been surprised how many women and even a doctor woman looked at me funny and said “don’t you mean menopause?”. It’s as if the entire population is under the impression that menopause is some kind of event, without realising how young it can start (35) and how long it can take (10 years). It’s a process, people!

So here on the CeMCOR is more excellent information. This time it’s about naming and how important it is for people to understand the process and use the proper words. I have to say their naming position is the same as mine and it’s great to have such authoritative back-up. So great to find it all in one place and taken seriously.

So our new Naming position statement says don’t call it “menopause” until you’ve not had a period for a year. And do call it “perimenopause” if things are variable and changing even if you are still having regular flow2.
Three of nine changes
can confirm for you that you are perimenopausal even if your flow is still regular:2

1.Shorter cycles (25 days or less);
2.Increased cramps;
3.Heavier flow;
4.Increased trouble sleeping-especially waking up in the middle of sleep;
5.New or increased migraine headaches;
6.Night sweats-especially if they tend to occur before or during flow;
7.An increase in or new premenstrual mood swings;
8.New sore, enlarging or nodular breasts; and
9.Weight gain without changes in what you eat or the exercise you do.

If women can learn to call themselves perimenopausal, they will be saying they know that perimenopause is not the same as menopause –perimenopause is a midlife transition with higher and erratic estrogen levels. Menopause is a fairly stable life phase with normally low estrogen and progesterone levels that begins one year after their last menstrual flow.

Furthermore, by naming themselves accurately they will be able to tell whether a medication that is proposed for them has been tested and proven effective in perimenopausal women. Usually symptomatic women are treated with oral contraceptives (that are proven reasonably safe and useful for premenopausal contraception), or offered hormone therapy that has only been tested and shown effective for hot flushes/flashes in menopausal women.

So. . . I like the word perimenopause and think if women understand and own it they will be on their way out of a midlife muddle.

– From Midlife Muddle – Own the Power of Naming by Dr. Jerilynn C. Prior, Scientific Director, Centre for Menstrual Cycle and Ovulation Research