Navigating Perimenopause: How to Proactively Support Your Body Through Change
This if the first installment of my Spring Hormone Series - where I will be focusing on navigating the menopause transition with vitality and resilience
If you’re in your late 30s or 40s and starting to notice changes in your mood, energy, cycles, or sleep—you’re not imagining things. You may be entering perimenopause, the often-overlooked first chapter in the menopause transition.
What is Perimenopause?
Perimenopause is the transition phase leading up to menopause when a woman’s hormone levels, especially estrogen and progesterone, begin to fluctuate and decline. This phase can last anywhere from 4 to 10 years and usually starts in the late 30s to early 40s (although symptoms can appear earlier).
During perimenopause, women may experience a number of symptoms due to fluctuating hormones.
Progesterone levels typically begin to decline before estrogen levels. In early perimenopause patients frequently experience symptoms related to lower progesterone - including:
Irregular periods
Sleep disturbances
Increased anxiety
Later in perimenopause, when estrogen levels begin to decline, patients may experience more symptoms related to low estrogen, such as:
Hot flashes and night sweats
Mood swings
Brain fog and memory lapses
Navigating Perimenopause
This phase is not just about periods becoming irregular—it's a complex shift that affects metabolism, bone health, and emotional well-being. The good news? You don’t have to just “deal with it.” There are real, effective ways to support your body and mind through this season of change.
Start with the Foundations: Lifestyle Support for Hormonal Balance
Before any discussion of hormone therapy in perimenopause, I begin with lifestyle foundations—the critical pieces that can dramatically reduce symptoms and support long-term health. Nutrition, movement, sleep, and stress management may sound like simple wellness advice, but during perimenopause, they become essential tools for resilience.
🥗 Nutrition fuels your body and supports detoxification, blood sugar stability, and hormone synthesis. An emphasis on quality protein and increased fiber are especially important.
🏃🏻♀️ Exercise helps regulate mood, protect bone density, and improve insulin sensitivity. In addition to cardiovascular exercise, establishing a strength training routine in perimenopause will help to offset menopausal muscle and bone loss and make it easier to maintain a healthy weight.
🛌 Sleep is the time your body repairs and rebalances—but it’s also often disrupted during perimenopause, making it even more crucial to prioritize. I work with my clients on a sleep “toolbox” that often involves magnesium and relaxing herbs and amino acids.
😣 Stress management is key to supporting adrenal health and reducing cortisol, which can worsen hormonal fluctuations, promote weight gain, and contribute to poor mood. Counseling, meditation, and various herbal formulas can be a game-changer.
By starting here with a proactive perimenopause, we help you build a strong foundation—often reducing the intensity of symptoms and giving your body the best chance to recalibrate naturally.
When Lifestyle Isn’t Enough: Thoughtful Use of Hormone Therapy in Perimenopause
For some women, symptoms remain disruptive even with these lifestyle shifts—and that’s where targeted hormone therapy can make a meaningful difference. This is never a one-size-fits-all decision. I evaluate each woman’s unique profile and risk factors - together with symptom assessments and targeted hormone testing - to evaluate whether hormone therapy may be helpful.
A few thoughts on hormone therapy in perimenopause:
You do not have to wait a year from your last period to start hormone therapy.
In my experience, hormone therapy in perimenopause often begins with progesterone to improve sleep, ease anxiety, and lessen excessive menstrual bleeding.
Low-dose estrogen can be added to ease hot flashes and night sweats and improve mood.
When prescribed appropriately, hormone therapy in perimenopause can ease the transition and restore quality of life. It’s about feeling like yourself again—energized, clear-headed, and emotionally balanced.
Whether you’re just starting to wonder if what you’re feeling is “normal,” or you’ve been quietly struggling with symptoms for a while, you are not alone—and you don’t have to go through this unprepared. Perimenopause is a powerful transition, but with the right support, you can move through it with strength, clarity, and vitality.
Are you ready to supercharge your health and wellness journey? I can help! As a board-certified Integrative & Functional Medicine physician, I can help you “think outside of the box and dig deeper with a variety of laboratory testing to help uncover the underlying root causes of your symptoms and create a plan personalized for you that goes beyond the prescription pad to incorporate diet/lifestyle change, nutritional supplements, holistic therapies, health coaching and more! Contact us to get started!