Perimenopause 101: What Every Woman Should Know

September is Perimenopause Awareness Month—a time to bring clarity and care to a transition many women face silently. Perimenopause can start in your 30s, last for years, and affect everything from mood and sleep to metabolism and memory.

This guide breaks down:

• What’s really happening with your hormones

• Common myths and misunderstood symptoms

• What actually helps—from nutrition to stress support

• When to check in with your doctor

Every journey is different. With the right tools and support, you don’t have to navigate it alone. Let’s talk about it.

✨ Perimenopause isn’t a decline—it’s a transformation.
This powerful biological shift invites women into a new chapter of strength, clarity, and elevated self-care. When we stop pathologizing the process and start supporting it—through hormone stabilization, foundational health, and personalized strategies—energy returns, mood steadies, and confidence rises.

From sleep changes to mood swings, these aren’t signs of falling apart—they’re signals to tune in, gather tools, and lead your own rite of passage. With education and empowerment, perimenopause becomes a journey of renewal, not survival.

As women enter perimenopause, hormonal shifts can make them more vulnerable to insulin resistance—even if they maintain a healthy lifestyle. This silent condition not only increases the risk for metabolic syndrome, diabetes, and heart disease, but can also worsen common perimenopausal symptoms like weight gain, brain fog, and fatigue. Early screening and targeted interventions can protect long-term health and improve quality of life during this transition.

Hormone replacement therapy (HRT) is vital for long-term health outcomes for women entering menopause, but optimizing overall health is critical to its success. Emerging research highlights a strong connection between a woman’s metabolic, psychological, sexual, and urogenital health and the severity of menopause symptoms, as well as how well HRT works. Functional medicine emphasizes preparing all body systems before starting HRT to ensure safe, effective, and lasting results.

Why Optimize All Systems First?

• Amplification of dysfunction: If systems like digestion, detoxification, or immunity are compromised, HRT can worsen inflammation or metabolic stress, leading to unpredictable symptoms.

• Hormone metabolism relies on system health: Poor gut function, for example, can disrupt estrogen metabolism, while inflammation or toxin overload reduces hormone receptor sensitivity, limiting HRT benefits.

• Reduced side effects: Unchecked imbalances in insulin, adrenal, or thyroid function, or nutrient deficiencies, increase the risk of adverse reactions or poor outcomes.

Key Systems to Prioritize

• Digestion and Microbiome: A healthy gut supports hormone metabolism and nutrient absorption. Dysbiosis (leaky gut) can disrupt estrogen recycling.

• Liver Detoxification: The liver clears hormones; impaired detox can lead to hormone buildup.

• Inflammation Control: Chronic inflammation or infections can alter hormone signaling, increasing HRT side effects.

• Metabolic Balance: Robust mitochondrial function and balanced insulin, cortisol, and thyroid levels enhance HRT’s effectiveness. Addressing insulin resistance and optimizing diet and movement are essential.

By creating a healthy foundation across these systems, HRT becomes safer and more transformative, improving quality of life, longevity, and resilience.

One of the simplest yet most effective ways to jumpstart your metabolism? Eliminate snacking between meals.