Paul Saladino· MD
what's happening is those little follicles remember we said you were only born with a certain number of follicles those number of follicles in the ovaries start to really diminish... the hormones are becoming very erratic estrogen literally if you look at it if you've ever tracked a perimenopausal woman the estrogen one month I'll check her and she's like 278 and I'm like oh your estrogen dominant then the next month I check her and her estrogens like 2 then the next month I check her and she's back up to 150 the estrogen levels are all over the place in perimenopause and then once you get to late phase perimenopause basically estrogen and progesterone both basically go to sea and what happens in women when this happens as we see this increase in visceral fat deposition there's a clear connection between falling estradiol levels and insulin sensitivity