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Estrogen's Storm Season: Stories of Perimenopause: Dr. Jerilynn Prior.


This book is for "the woman who no longer recognizes herself" as she is buffeted by the hormonal storm that precedes menopause. According to Dr. Jerilynn Prior, such chaos may be experienced by one in five women, and can last up to a decade or more. The book sets out to re-frame perimenopause, a condition sexist medicine misunderstands, misdiagnoses and mistreats. Prior has been a key contributor to this work: she is author or co-author of 25 of the 138 scientific references cited, and is founder and scientific director of the Centre for Menstrual Cycle and Ovulation Research (CeMCOR) at UBC.

The book is narrated by a fictional alter ego, "Dr. Kaily Madrona," a specialist in women's reproductive health. The book is written as a series of connected stories about eight women experiencing "midlife miseries." The composite characters span a range of ages and life conditions, motherhood statuses, sexualities and ethnic identities.

One of Prior's key objectives is to challenge the conventional medical view that dropping estrogen levels are the cause of women's symptoms. She believes that the corresponding treatment of estrogen replacement actually exacerbates symptoms. Prior also underscores that perimenopause and menopause are distinct and different phases of female reproductive development. The book provides useful information on a range of symptoms that includes hot flashes, constipation, sleep problems, disordered eating and lowered libido. Readers also learn that the average age in North America for menstrual disruption is 48, an average period uses about eight soaked pads or tampons; and ibuprofen for cramping has advantages over other pain relievers, including decreasing menstrual flow.

These insights, however, don't fully compensate for the stilted tone which aims to popularize medical education through stories--"'The low-dose cyclic Provera,' I say slowly, consciously trying to be calm and positive, 'was simply not strong enough to counterbalance effects of the high estrogen your body is making in perimenopause.'"

To make things weirder, the fictitious Madrona regularly tells her eight patients that she was a student of the esteemed Dr. Jerilynn Prior and cites scores of Prior's studies and reports, recommending several times a chapter that the character visit CeMCOR's website ( The self-promotion makes some sense once you realize the book was self-published by CeMCOR.

The history of medicine is full of well-known reversals. (Recall the 19th-century wandering uterus that made women unfit for higher education?) In an aging society, older women's health concerns will likely come under closer scrutiny. Prior's may be an opening--if far from the final--shot in that rethinking.

Susan Prentice is having a peaceful perimenopause in Winnipeg.


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Author:Prentice, Susan
Article Type:Book review
Date:Sep 22, 2007
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