Perimenopause & Menopause: Understanding Your Hormones and Supporting Your Health
Perimenopause and menopause are natural stages of a woman’s life, but that doesn’t mean you have to struggle through them.
For some women, the transition is relatively uneventful. For others, changing hormones can bring a wide range of symptoms that affect sleep, energy, mood, cognition, menstrual cycles, weight, pain and overall quality of life.
As a naturopath, I look beyond the symptoms themselves to understand the factors that may be influencing how you are experiencing this transition and develop an individualised approach to support your health through perimenopause and beyond.
What is perimenopause?
Perimenopause is the transitional stage leading up to menopause. It can begin several years before your final menstrual period, with some women noticing changes as early as their late 30s.
During this time, reproductive hormones become increasingly variable. Progesterone tends to decline, whilst oestrogen can fluctuate significantly before eventually declining as menopause approaches.
This hormonal variability is one reason why symptoms can feel so unpredictable. You may feel completely different from one month to the next, and symptoms can change throughout the transition.
Menopause itself is defined as 12 months after your final menstrual period. In Australia, the average age of menopause is around 51, although it commonly occurs between the ages of 45 and 55.
What are the symptoms of perimenopause and menopause?
Symptoms vary considerably between women. Some experience very few changes, while others find that symptoms significantly affect their physical and emotional wellbeing.
Common symptoms include:
- Hot flushes and night sweats
- Changes in body composition and weight gain
- Body aches and joint pain
- Vaginal dryness
- Lowered libido
- Reduced muscle strength
- Increased sensitivity to alcohol
- Skin changes, including hives or rashes
- Dizziness or vertigo
Each woman will not necessarily experience all of these symptoms, and symptoms can change considerably throughout the transition.
Hormonal & menstrual
- Irregular periods
- Heavier / lighter bleeding
- More painful periods
Nervous system & mood
- Brain fog and difficulty concentrating
- Anxiety and irritability
- Low mood or depression
- Difficulty sleeping
- Dizziness or vertigo
Physical
- Weight gain
- Fatigue and low energy
- Headaches and migraines
- Hot flushes
- Night sweats
- Body aches
- Joint pain & stiffness
- Vaginal dryness
- Changes in libido
- Hives and rashes
- Alcohol sensitivity
What’s actually happening to your hormones?
One of the defining features of perimenopause is hormonal fluctuation. Progesterone gradually declines, whilst oestrogen tends to fluctuate wildly. This can contribute to changes in your menstrual cycle, sleep, mood, headaches and migraines, anxiety and bleeding patterns.
As you move closer to menopause, oestrogen eventually settles at a much lower level. This change can bring symptoms such as hot flushes, night sweats, vaginal dryness, brain fog and changes in body composition.
Testosterone also declines with age and may contribute to changes in libido, energy, muscle strength and muscle mass.
Understanding these hormonal changes can help explain why you may suddenly feel “not yourself” and cannot predict how you will feel. But…. hormones are only part of the picture.
Why do some women struggle more than others?
There is no single explanation for why one woman may experience significant symptoms while another barely notices the transition. Your experience can be influenced by a combination of factors, including:
Stress and nervous system health
High levels of ongoing stress can influence sleep, mood and the severity of menopausal symptoms. Chronic stress can also make it harder for the body to adapt to hormonal changes.
Metabolic health
Changes in insulin sensitivity and blood sugar regulation influence weight, energy and long-term metabolic health. Supporting metabolic health becomes increasingly important during midlife to reduce the likelihood of insulin resistance and type 2 diabetes developing.
Thyroid function
Thyroid dysfunction can cause symptoms that overlap with perimenopause, including fatigue, changes in mood, struggles with weight and menstrual irregularities. Thyroid health is therefore worth considering when symptoms are complex or unexpected.
Nutritional status
Nutrient insufficiencies can contribute to symptoms such as fatigue, poor energy, mood changes and reduced resilience. Heavy menstrual bleeding can also increase the risk of iron deficiency during perimenopause.
Gut health and digestion
Digestive health and the gut microbiome can influence nutrient absorption, inflammation and hormone metabolism, making gut health another important part of the bigger picture.
Hormonal health history
A history of conditions such as PMS, PCOS, endometriosis or other hormonal concerns may influence your experience of the menopausal transition.
Genetics and lifestyle
Genetics can influence your susceptibility to certain symptoms, but lifestyle and environmental factors also play an important role.
Perimenopause, weight gain and metabolic health
Changes in body composition are a common concern during perimenopause.
Declining oestrogen can lead to changes in insulin sensitivity and changes in muscle mass, sleep disruption, stress resilience and this can all influence how your body stores and uses energy.
This is why I don’t believe that weight changes during midlife should simply be approached by eating less or exercising more. I look at overall diet quality, blood sugar regulation, thyroid function, sleep support, stress management, exercise levels and overall nutritional status as part of a broader approach to metabolic health.
Perimenopause and nutrition
Your nutritional needs don’t stop changing simply because your reproductive years are coming to an end. In fact, nutrition becomes particularly important during this stage of life.
A balanced diet that provides adequate protein, fibre, healthy fats, vitamins and minerals can support energy, muscle mass, metabolic health and overall wellbeing.
For many women, this is also a time to reconsider restrictive dieting. Eating enough of the right foods can be far more beneficial than continually trying to reduce calories.
Useful Testing in Perimenopause
Because so many symptoms can overlap with other health conditions, I take a comprehensive approach when assessing women during perimenopause and menopause. Depending on your symptoms and health history, I may recommend testing important health markers such as:
- Full thyroid panel
- Iron studies
- Vitamin D
- Vitamin B12 and folate
- Homocysteine
- Fasting blood glucose and insulin
- Lipid & cholesterol panel
These can often be tested via your GP. Other functional markers I may refer my patients to have tested include: gut microbiome stool analysis, organic acids, hair tissue mineral analysis – just as some examples.
Hormonal testing may sometimes provide additional information, although hormone levels fluctuate significantly throughout perimenopause and testing is not always necessary or useful.
I choose testing based on your individual symptoms, health history and treatment goals rather than using the same testing protocol for every woman.
My naturopathic approach to perimenopause & menopause
My approach is not about trying to halt or reverse menopause. Instead, it is about supporting your health through this natural transition and addressing the factors that may be making your symptoms more difficult to manage.
Depending on your individual needs, support may include:
- Dietary guidance to support metabolic health
- Support for hormonal and menstrual symptoms
- Nutritional supplementation to address deficiencies
- Gut and digestive support
- Stress and nervous system support
- Sleep strategies
- Lifestyle and exercise recommendations
Herbal medicine and vitamin & mineral supplements may be used to provide the above support. Functional testing may be recommended.
Naturopathic care can also be used alongside conventional treatments such as Menopausal Hormone Therapy (MHT). It is important to inform me of any medications you are taking so I can prescribe safely.
Menopause is a new chapter
It is important to recognise menopause as a natural transition rather than something that needs to be “fixed”.
For many women, this stage of life can be empowering and transformative. At the same time, experiencing significant symptoms shouldn’t simply be dismissed as something you have to put up with.
You deserve to understand what is happening in your body and have access to appropriate support to help you feel well throughout the transition.
Frequently Asked Questions
What is the difference between perimenopause and menopause?
Perimenopause is the transitional period leading up to menopause, during which reproductive hormones fluctuate and menstrual cycles begin to change. Menopause is reached when you have gone 12 consecutive months without a menstrual period.
When does perimenopause start?
Perimenopause commonly begins during the 40s decade, although some women notice changes in their late 30s. The timing and duration vary considerably between women.
How long does perimenopause last?
There is no set duration. The menopausal transition can last several years, with symptoms varying significantly between women. For some , it can be a fairly swift transition.
Can perimenopause cause anxiety?
Yes. Hormonal fluctuations during perimenopause can be associated with changes in mood and anxiety. Sleep disruption, stress and other factors can also contribute.
Can perimenopause cause migraines?
Yes – Some women notice new or worsening headaches or migraines during perimenopause. Fluctuating oestrogen can be an important factor, although individual triggers vary.
Why am I gaining weight during perimenopause?
Changes in oestrogen, muscle mass, sleep, stress and metabolic health can all contribute to changes in body composition during midlife. Looking at nutrition, protein intake, movement, muscle mass, blood sugar regulation, thyroid hormones and sleep can be more helpful than simply restricting calories.
Do I need hormone testing to know if I’m in perimenopause?
Not necessarily. During perimenopause, hormone levels can fluctuate considerably, so a single hormone test may not provide a clear picture. Your age, menstrual pattern and symptoms are often indicative. Testing may be appropriate in some circumstances to investigate other potential causes of symptoms.
Can naturopathy help with menopause symptoms?
Naturopathic care can provide individualised support for symptoms such as hot flushes, sleep difficulties, fatigue, mood changes, headaches, digestive symptoms and changes in body composition. Treatment may include nutrition, herbal medicine, nutritional supplements and lifestyle strategies.
Can I see a naturopath if I’m taking MHT?
Yes. Naturopathic support can be used alongside conventional menopause care including MHT (menopausal hormone therapy). It is important to discuss any medications, supplements or herbal medicines you are taking with your healthcare practitioners, particularly if you are using prescription medication.
Personalised Perimenopause & Menopause Support
You don’t have to navigate the hormonal transition to menopause alone.
A naturopathic consultation provides an opportunity to look at your symptoms within the context of your hormonal, nutritional, metabolic, digestive and overall health, and develop a personalised plan to support you through perimenopause and beyond.
Appointments are available online across Australia, as well as in person in Lennox Head, NSW.
This article is for educational purposes only and is not intended to replace professional medical advice. Always consult with your healthcare provider before making changes to your treatment plan.
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