I am just wondering on what basis the doctor is diagnosing perimenoapuse.
The could be other reasons for hormonal changes in the mother. I think this
situation would first warrant getting some hormone levels measured. Ideally
a saliva test is best, but may be difficult to have covered by insurance or
ordered by a traditional medicine MD. Blood and urine tests are available
for this as well, but are not as accurate. Here is a description from
Diagnos-Techs, Inc.
6620 South 192nd Place, Building J
Kent, Washington 98032
Toll Free (800) 878-3787 Fax: (425) 251-0637 
E-mail: [log in to unmask] 
I have no financial interest in this company. See their website for the
complete article on what this test measures and it's clinical applications.

"Cycling - Pre & Peri Menopausal Panel Description Doctor Page" 
This Female Hormone Panel (FHP) is a dynamic mapping of the bioactive (Free)
Fractions of 17 Beta-Estradiol and Progesterone as they vary in
concentration through a complete menstrual cycle.The panel also includes a
Free Testosterone level reflecting the Average of the Follicular, Ovulatory,
and Luteal phases of the cycle, and a DHEA and IgM titer: The extended panel
also includes 3¬4 LH & FSH measurements. The panel uses 11 saliva samples
collected during specified time slots* through the menstrual cycle. *A time
slot is a window of 2-3 days.Both patient and doctor can actually view the
profile of ovarian hormones during the female cycle (Figure 1: FHP
curve).Guess work is minimized and hormonal balance evaluation becomes an
objective reality. The applications of the FHP are broad and allow the
detection of several abnormalities that include the following: A. Luteal
Phase Defects (LPD) Luteal phase defects are common and may affect 8% (4) to
about 35% (5) depending on the sub-population of women included in the
study. Luteal phase defects shoe abnormalities in Progesterone output and
can be classified into 3 subclasses: LPD-I, LPD-II, LPD-III. The FHP report
will make the distinction and explain the differences. Urine and serum
hormone concentration in mid-luteal phase are practically useless in LPD
detection. The inadequacy has been worded as follows: "We reject the notion
that a single mid-luteal phase progesterone assay is sufficient to make the
diagnosis of luteal phase defect" (4). The mid-luteal phase Progesterone
assay "is of little or no assistance in establishing a diagnosis" of luteal
phase deficit. Wentz, A.C. Clinical Obstet. Gynecol. 22:169 (1979) Briefly
summarized, mid-luteal testing is a technique shown to have poor or minimal
correlation with luteal insufficiency on a patient-to-patient basis (6,7,8).

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