Perimenopause can be a confusing and stressful time for many women because it can feel like mood changes, sleep problems, hot flashes and irritability, and memory issues or brain fog are dismissed by doctors. It can feel like there are few solutions. Thankfully, now more than ever, you can do many things to ease symptoms and make this transition more comfortable and even positive for many women.

What is Perimenopause?

Perimenopause is the time frame between the usual reproductive years with regular monthly periods and ovulation and menopause. Menopause is reached after you have had no period for 12 months, and estrogen decreases, and you can no longer become pregnant. The average age for this is around 51 years old, but perimenopause usually starts in the mid-40s. Many women feel like something or someone has taken over their personality because the symptoms can be profound and dramatically impact their quality of life.


Signs & Symptoms of Perimenopause

Symptoms can affect how you feel during the day as well as how you sleep. It can also affect how sensitive you are to stress, physical stress, and emotional and mental stressors. Many women also find it can affect cognition or thinking.

Here’s what you might notice or feel as you enter perimenopause:

  • Mood changes (depression, anxiety, irritability)
  • Low libido
  • Irregular menstrual cycles (shorter periods, longer cycles, etc.)
  • Hot flashes
  • Insomnia
  • Fatigue
  • Weight gain (often around the abdomen)
  • Hair loss
  • irregular periods that can become heavier or lighter depending on the person


The Resilience Medicine Philosophy in Perimenopause

Although the menopause transition is a normal and natural phase of life, it doesn’t mean that it is always easy or symptom-free. Many, if not most, women find they need at least some extra support to feel their best selves during this time. Often, what you need will change from early perimenopause till late as you approach menopause since hormones will change over time. For example, at the start, some symptoms may be from lower progesterone levels, and then as time progresses, estrogen levels fluctuate quite wildly at times before they settle at the lower post-menopausal baseline. Each of these phases can be treated slightly differently for the most benefit and relief from symptoms. Apart from body-identical HRT, which can play a role for many women, other things include:

  • a hormone balancing low GI diet personalized to your needs, cannabinoid therapy
  • using other herbal and natural supplements to ease symptoms and help with sleep
  • following a simple mind-body practice for a few minutes each day to help balance stress.

Many women may benefit significantly from HRT after discussing the benefit vs potential risks with their doctor. In general, body-identical hormones are now preferred if this option is chosen as part of your plan as they have fewer side effects and generally give better symptom control.