I have all the menstrual pain I used to have, plus my nipples are burning, though I don't get a period. What's causing this?

What you describe is actually pretty common in my experience.  The PMS-like symptoms of bloating, breast pain, irritability and cramping are all due to progesterone.  Clearly, you are still making enough progesterone to get those symptoms.  When we go through perimenopause, the ovarian hormones estrogen and progesterone are both declining, but that decline is not smooth or necessarily even. It occurs in "fits and spurts.”  Chances are you are not currently making enough estrogen to signal ovulation or to thicken the lining of the uterus to where you generate a perceivable period.  So you get the symptoms that a period is coming, but don't really get one.

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