Perimenopause


Perimenopause is the transitional phase leading up to menopause, typically beginning in a woman’s late 30s to mid-40s and lasting anywhere from 2 to 10 years.

During this time, the ovaries gradually begin to produce less estrogen and progesterone, leading to hormonal fluctuations that can significantly impact physical, emotional, and mental health.


What’s Happening in the Body During Perimenopause?

  • Estrogen and progesterone levels become erratic, causing imbalances
  • Ovulation becomes irregular, impacting menstrual cycles and fertility
  • FSH (follicle-stimulating hormone) levels rise as the ovaries become less responsive
  • Testosterone levels may decline, contributing to fatigue, low libido, and muscle loss


Common Symptoms of Perimenopause

Emotional & Cognitive Symptoms, Irregular or heavy periods, Mood swings, anxiety, depression

Hot flashes, night sweats, Brain fog, poor concentration, memory lapses, Sleep disturbances, insomnia, Irritability or emotional sensitivity, Breast tenderness, Low libido or sexual discomfort

Vaginal dryness, Decreased motivation or self-esteem, Weight gain (especially belly fat)

Increased fatigue or burnout, Hair thinning or dry skin, Loss of confidence or emotional detachment


  How Perimenopause Affects Daily Life

  • Sleep disruption leads to fatigue, brain fog, and poor productivity
  • Mood swings or anxiety can strain relationships and mental health
  • Irregular cycles may cause embarrassment or social limitations
  • Weight gain and low libido can impact self-image and intimacy
  • Decreased resilience may reduce confidence and decision-making

  Treatment Options for Perimenopause

     Bioidentical Hormone Therapy (HRT)

  • Progesterone: Improves sleep, reduces anxiety, supports cycle regulation
  • Estrogen: Reduces hot flashes, vaginal dryness, and mood symptoms
  • Testosterone: May support libido, mood, and energy

Formulations may include creams, capsules, patches, or pellets.

    Non-Hormonal Medications

  • SSRIs or SNRIs for mood or hot flashes (if hormones are contraindicated)
  • Gabapentin or clonidine for hot flashes/night sweats
  • Sleep aids (temporary use)


  Natural Supplements for Perimenopause

SupplementBenefitVitex (Chasteberry)Supports progesterone and cycle balance

Maca RootImproves energy, mood, and libido

AshwagandhaReduces stress and balances cortisol

Black Cohosh eases hot flashes and night sweats

Evening Primrose Oil Hormonal skin and breast tenderness support5-HTP or L-theanine

Supports mood, sleep, and anxiety



Vitamins & Minerals to Optimize During Perimenopause

Vitamin D3 for Bone health, immune support, hormone balance

Magnesium glycinate for Sleep, mood, muscle relaxation

Vitamin B6 + B12 for Energy, neurotransmitter support, reduces fatigue

Omega-3 fatty acids (DHA/EPA) Anti-inflammatory, mood and skin support

Zinc + SeleniumThyroid support, immunity, and hormone balance

Iron or Ferritin support Important if heavy bleeding is present


Perimenopause is a natural but often misunderstood stage of life. The hormonal shifts can be overwhelming, but personalized care, including lifestyle support, lab-guided supplementation, and hormone therapy when appropriate, can help women thrive—not just survive—during this transition.

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