What is Perimenopause?

You might be surprised to hear that perimenopausal hormone changes begin at age 40 to 44 and for some women start in their mid-30’s.  Perimenopausal symptoms typically show up as changes to the length of a woman’s menstrual cycle, or changes to the duration and flow of the bleed.  Estrogen levels can rise and fall unevenly during perimenopause and woman often anovulatory cycles where the ovary does not release an egg.  Hormonal fluxuations typically occur for 3 to 4 years but can go on for as long as a decade.

Symptoms of Perimenopause

The classic symptoms include:

  • Changes in menstrual cycle pattern
  • Hot flashes and night sweats
  • Sleep disturbances and insomnia
  • Urination problems

Other symptoms include: 

  • Fatigue
  • Skin changes, hair changes, dental changes, vision changes
  • Decreased libido
  • Depression, anxiety and mood changes
  • Heart palpitations
  • Hair loss
  • Headaches
  • Leg cramps
  • Nose bleeds, varicose veins
  • Blood sugar imbalances
  • Decreased memory
  • Abdominal weight gain

Hormone Testing

For most women we recommend annual basic blood work to help identify any health issues and prevent future disease.  Basic blood work includes a complete blood count, comprehensive metabolic panel, lipid panel, vitamin D, thyroid testing, ferritin, and hormone levels.  These biomarkers can help assess any issues with anemia, blood sugar dysregulation, thyroid disorders, cholesterol issues, hormone levels and nutrient deficiencies.

Advanced Hormone Testing

We may also recommend advanced hormone testing using a lab called the Dutch Complete Hormone Test.  This hormone test helps evaluate sex hormones and their metabolites including estrogen, progesterone, DHEA-S, testosterone, overall diurnal pattern of cortisol, melatonin levels, and other markers that look at oxidative stress and nutritional status.

Natural Solutions To Support Hormones

For the majority of women, perimenopausal symptoms can be effectively managed with naturopathic medicine.  We help women build a strong foundation of health including eating a healthy diet, exercising regularly, making time for self-care and stress reduction activities.  Natural medicine also offers a variety of vitamin and nutritional supplements, botanical medicine, and homeopathy, which can support and balance a woman’s hormone levels naturally.  If these treatments are not adequate then bio-identical hormone replacement (bHRT) options can be considered.  We do not prescribe bHRT at our office but we can provide referrals for bHRT prescribing physicians.