As a functional medicine pharmacist I commonly get asked questions about hormone replacement therapy and this question comes up all the time. What is perimenopause, what are the symptoms, and how can I start feeling like myself again? So in this post we will look at each one of these questions in more detail.

What is Perimenopause?

Perimenopause can begin about 8 to 10 years before menopause, when a women’s ovaries gradually produce less and less estrogen. This typically stars in a women’s 40s, but it is not uncommon for it to start in a women’s 30s as well. Once peri-menopause starts it last up until menopause, at the point when the ovaries stop releasing eggs.

In the last 1-2 years of perimenopause, a women begins to drop in estrogen faster and faster. This is when some of the menopausal symptoms begin, even though menstrual cycles are still regular.

What are the symptoms of Perimenopause?

Common symptom of perimenopause include

  • Hot flashes
  • Breast tenderness
  • Lower Sex Drive
  • Sleep Problems
  • Moodiness
  • Fatigue

During peri-menopause women experience symptoms of estrogen dominance which means there is to much estrogen in relation to progesterone. Symptoms of estrogen dominance include:

  • Bloating
  • Headaches
  • Decreased Sex drives
  • Increased symptoms of PMS
  • Weight gain, hair loss, cold feet/hands


The British Medical Journal explains it like this “The paradox of peri-menopause is that estrogen is that estrogen levels soar and become erratic before they eventually settle into the low, stable levels of menopause. That’s why the onset of peri-menopause is really based on characteristics changes (symptoms) that likely result from these hormonal changes in women with regular flow.”

6 Tips for Reducing Perimenopausal Symptoms

  • Reduce Stress- While this is much easier said then done, it is really important. Stress directly increases cortisol production which has an enormous impact on your hormone balance.  When you feel stressed your body naturally drops its progesterone levels, because it feel like it is being chased by a tiger, even if it is just your mind trying to take on to much in a day.
  • Get More Sleep- insufficient sleep can lead to insulin resistance, which causes weight gain, and can also lead to higher testosterone levels. More info
  • Weight Management- Fat tissues produce estrogens  which releases estrogens into the blood. This over production of estrogens leads to an unhealthy balance of estrogens to progesterones and causes the symptoms of estrogen dominance. So finding time to exercise can help reduce stress, help bone strength, and help with estrogen dominance symptoms.
  • Nutrition- Nutrition is different from weight loss in that if you are able to add the right foods to your diet like xenoestrogens you can start balancing hormones with your meals.
  • Gut Health–  Avoiding inflammatory foods, adding daily probiotics, prebiotics and lots of phytonutrients like cucumin (found in tumeric) and resveratrol(found in grapes) can really improve your gut -based inflammation, that can help maintain healthy estrogen levels and may even help prevent cancers.
  • Supplements that help- I believe that if you had supplements containing Nrf2 , Omega 3 fatty acids, DIM, and I3c, and calcium-d-glucarate you can really enhance your bodies ability to eliminate estrogens thus reducing your peri-menopausal symptoms.

In Closing

While it is not fun to start perimenopause it can be managed with or without medications. Just try one of these 6 tips to reduce your perimenopausal symptoms.  t doesn’t have to be stressful and can be quite manageable with a good action plan and action. The easiest way to get started with your symptoms is to turn it into a game so it doesn’t feel stressful. The goal of this game isn’t to win, but to continually making changes within your life so you can reduce stress, get more sleep, and live better.  So pick one of the 5 tips that you would think would be a good start and just go for it.

Don’t plan, don’t think about it , just try something, and if you aren’t getting the results you want schedule a chat with one of our staff.  We are just a click away. If you would like to learn more about this topic contact us and we are always wondering what we should talk about in a future blog post.

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