Perimenopause, that period of time when the ovaries are beginning their decline. It is the most difficult period to treat, because the level of hormones varies from day to day and sometimes, moment to moment. Think of a flickering light bulb–sometimes, the light is very bright, but most of the time, dim. The menstrual cycle can become heavier and closer together. Why? The falling level of estrogen does not allow the endometrium to thicken and instead, it is thin and easily shed. A recent study found that depressed women had lower levels of estrogen. Another study matched women who were clinically depressed with a control group without symptoms of depression. The depressed women had a higher rate of early perimenopause symptoms(defined as change of 7 days or more in the menstrual cycle, change in the amount of flow, or no period for up to 3 months). Usually, this period of a woman's life can be eased with either low dose birth control pill to boost and stabilize the estrogen or simply estradiol cream and sometimes a small amount of progesterone cream applied towards the end of the cycle. What about dong quai, chaste berry, black cohosh? These are herbs, some in use since the time of Hippocrates. For the most part, they are plant estrogens which bind to the estrogen receptors in the body. Symptoms of hot flashes may be much reduced, menstrual irregularities improved, but the BONE LOSS, WRINKLED SKIN/DECREASING COLLAGEN, and LOSS OF VAGINAL TONE & LUBRICATION continues. One study actually showed that soy protein increased bone loss!