Understanding Perimenopause and Menopause

By Dr. Mary Knudsen ND

Understanding Perimenopause and Menopause

Perimenopause and menopause are natural phases in a woman’s life — but that doesn’t mean they always feel natural! With hormones shifting and symptoms popping up in unexpected ways, this transition can leave you feeling overwhelmed. But knowledge is power — and with the right strategies, you can thrive through it.

Perimenopause: The Transitional Phase Before Menopause

Perimenopause is like a hormonal rollercoaster, and your body is the passenger. It can last up to 10 years, typically beginning in your 40s — though sometimes earlier.

 What’s Happening?
Your estrogen and progesterone levels are fluctuating unpredictably, which can leave you feeling a little out of sync.  One month, your period may be heavy; the next, barely there. Sound familiar?

Common Signs of Perimenopause:

• Hot flashes and night sweats that seem to come out of nowhere
• Mood swings or feelings of anxiety
• Struggling to get a good night’s sleep
• Brain fog that makes you forget why you walked into the room
• Vaginal dryness or discomfort
• A sudden dip in libido
• Persistent fatigue, even after plenty of rest

Menopause: The New Normal

Menopause is officially here when you haven’t had a period for 12 consecutive months. Most women reach this milestone around age 51.  This means post-menopause is 1/3 of a woman’s life!

What’s Happening?
Your ovaries have stopped releasing eggs, and your estrogen and progesterone levels are now much lower.

Common Signs of Menopause:

• Hot flashes and night sweats may continue
• Vaginal dryness and discomfort during intimacy
• Changes in skin elasticity and hair thinning
• Mood shifts and anxiety
• Brain fog and forgetfulness

Post Menopause

Long-term health risks:

• Bone loss (osteoporosis): Lower estrogen can weaken bones
• Heart health concerns: Estrogen helps protect your heart, so your risk may increase
• Genitourinary Syndrome of Menopause (GSM): Dryness, irritation, and urinary discomfort are common

How to Manage Perimenopause and Menopause

The good news? There’s plenty you can do to feel your best through these changes.

Lifestyle Tips:

• Move your body: Regular exercise supports mood, sleep, and heart health.
• Nourish with intention: Load up on calcium, vitamin D, and hormone-supportive foods like flaxseeds and leafy greens.
• Manage stress: Meditation, breathwork, or even a nature walk can help calm your nervous system.

Hormone Support:

• Hormone Replacement Therapy (HRT): This can be a game-changer for moderate to severe symptoms — talk to your healthcare provider about whether it's right for you.
• Vaginal Estrogen Therapy: This is a targeted treatment to ease dryness and discomfort.

The Bottom Line

Every woman’s experience is unique. Whether you’re navigating perimenopause’s unpredictability or settling into postmenopause, your journey deserves compassion and care. Small, consistent lifestyle changes and the right support can make this transition smoother and more empowering.

Feeling overwhelmed? You're not alone — reach out to your naturopathic doctor for guidance tailored just for you!