Functional Medicine & Wellness

Perimenopause and Hormonal Imbalance

Women’s hormones are different as our taste in music, celebrity crushes or coffee preferences. While there are some consistencies and patterns that more commonly present challenges, EVERY BODY is different. This is one of the main reasons testing is so important. 

After working as a Functional Health doctor for years, I have found that tests serve as our compass. They provide the “why” behind the “what” concerning your health. This is the information we need to determine the right course of action when it comes to addressing and resolving all your health concerns — including those that are hormone-related. 

This brings us to the subject of perimenopause. Without a doubt, it is a major change your body experiences that can significantly impact your overall well being. For those who have not yet gone through it or are in the midst of it, you may find yourself with a lot of unanswered questions. Good news! This blog is here to help clarify at least a few of them.

What are the first signs of perimenopause? 

Perimenopause is when our hormones, namely estrogen(s), progesterone and testosterone) start  to swing. What was predictable in our 20s and 30s begins to go out of whack, which can create irregular patterns in our cycles. Our usual 28 day, on the dot cycle begins to range anywhere between 25 to 34 days. The length and heaviness of our cycle usually changes, typically becoming longer and heavier. Hormonal symptoms become exaggerated taking that PMS, bloating, irritability to a whole new level. All these signs point to the beginning stages of perimenopause. 

What happens to hormones during perimenopause? 

This is the part where scenarios tend to become more personalized, veering off in all different directions depending on the individual. But in the “usual” sense, we initially see decreases in the production of  progesterone, which causes our bodies to become estrogen dominant. This is tricky territory as the delicate ratio of estrogen and progesterone that keeps us balanced and cycling regularly becomes imbalanced. The bottom line is that you don’t want to be in the estrogen dominance zone! This brings us to our next point.

Better ways to balance hormones during perimenopause

There are some valuable tips and tricks that can help you to have a smoother and healthier transition into perimenopause. The most effective ones involve making sustainable lifestyle changes. The areas of focus include:

  • Stress Reduction
  • Sleep Routines
  • Improved Nutrition
  • Exercise Regimens


Each of these categories deserves a little bit more love and attention.

Stress. Cortisol is our main stress hormone. When our stress levels are heightened, we inevitably produce more and more cortisol to the detriment of our sex hormones. So whether it’s a cup of tea, meditation, reading a book or going for a stroll — find a way to get to your happy place. Your hormones will thank you.

Sleep. Getting the right amount of rest is directly correlated to managing your stress levels. If you are overtired, you are much more likely to experience irritability and anxiety. Giving your mind and body the chance to recoup is a must. Make getting at least 8 hours of sleep each night a priority. Bonus points for eliminating screen time, sugars, and alcoholic beverages before bedtime. 

Nutrition. Your eating habits play an important role in your hormonal balance. You want to manage your blood sugar levels, which means avoiding big highs and lows. You’ll want to avoid consuming too many processed carbs and sugars while also ensuring you don’t skip too many meals (no one likes a hangry person). These negative eating habits stress your body out and increase that cortisol production. It’s all about those healthy fats, proteins and veggies in order to get a taste of a more hormonally balanced perimenopause experience. 

Exercise. It is so important to include exercise into your routine. But not just any type of exercise. Perimenopause is a time in your life where the cardio-queen mentality needs to be kicked to the curb. You’ll want to become familiar with strength training since it will ultimately be your new best friend. Don’t be intimidated by visions of dumbbells and bench presses. Yoga, bands and Pilates (my personal favorite!) also fit the bill. 

So many women nearing, or in the midst of, perimenopause do not put enough emphasis on strength-focused workouts and we pay for it in the long run. Females lose muscle mass very quickly in their late 40s and hormones play a large role in this occurrence. That being said, incorporating exercises that improve our strength can help protect our muscles.

Strengthen your knowledge about muscles

The weight gain women see during perimenopause and menopause is mostly hormonal based and a strategy to help prevent this is building muscle! The first reason this statement holds true is that muscle significantly impacts our metabolism, which in turn, affects our ability to shed those pounds. 

The second reason is that strength training helps to protect our testosterone levels, which unbeknownst to many, is a very important hormone for women. 

Testosterone helps our muscles, metabolism, bone health, brain health and so much more. Unfortunately, we come across so many women with undetectable levels of testosterone. This can be the result of many things but the most common ones involve chronic stress, poor sleep habits and – last but not least – too much cardio without strength training. I’m talking to you, my running enthusiasts and avid cyclists.

Side note: While there are lifestyle approaches to offset hormone imbalances during perimenopause, sometimes bio identical hormones are needed. Trust me, I’ve seen them work wonders! During this time, we ‘cycle’ in hormones to keep that healthy balance going. The most common ways to implement this approach involve topical progesterone and/or testosterone.  

Taking control of perimenopause 

Many of our patients come to us looking for guidance on how to navigate this time of their lives emotionally, mentally and physically. I’ve come to realize how important it is to understand these changes do not have to derail us or define the life we are able to live. 

There are so many effective and sustainable strategies to help keep us strong, healthy and vibrant well into our 90s! Hormone balancing and replacement (when needed) is an important part of this — more to come on that subject. You also should not hesitate to reach out to friends to share what you are going through. Perimenopause is a topic that we, as women, don’t talk about enough and yet it is something we ALL experience! 

When it comes to discussing perimenopause, hormones and all things health-related, Omnia Health is here for you. Contact us today to get the conversation started.




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