Perimenopause, a term that was vaguely known in the past, is now showing up everywhere: online, in headlines, and books by celebrities. Here is everything you need to know about the not-so-new hot topic, starting with the basics.
What is Perimenopause?
The word “Peri” comes from the Greek origin meaning “around”, so perimenopause literally means “around menopause”. Thus, it is a very broad term that covers a dynamic shift in changes in menstrual cycles, hormonal status and ovarian follicles that can last as long as 10 years.
Think of perimenopause like puberty in reverse. Imagine puberty as the hormonal “on-ramp” to reproductive life, and perimenopause as the “off-ramp.” Both are transitional hormonal rollercoasters, marked by irregular cycles, mood swings, and shifting body sensations. But while puberty turns the reproductive system on, perimenopause slowly turns it off.
In both stages of life:
- Cycles are irregular: Teenagers and perimenopausal women often have unpredictable periods.
- Hormones fluctuate: Estrogen can rise and fall unpredictably during both transitions. These hormonal shifts often spark intense bursts of rage and emotion, which can occur a bit more frequently.
- Mood and sleep can be affected: This occurs due to the brain’s sensitivity to these hormonal swings. Sleep starts to shift and becomes more of a challenge, even if you’re not staying out late anymore.
- Body changes occur: Teens experience acne and growth of breasts, whereas perimenopausal women may experience hot flashes and weight distribution towards their abdomen. Both are physiologic responses to endocrine upheaval.
One of the main reasons why perimenopause has been trending is because symptoms tend to be all-encompassing. Many women can relate to the symptoms and hormone fluctuations. So the big question is:
How Do I Know I Am in Perimenopause?
One of the biggest challenges women face going through the hormonal transition of perimenopause is the rollercoaster of symptoms that seem to turn on and off periodically. It’s not always as obvious as one might think. Women might have challenges identifying a pattern, and eventually end up chalking up their symptoms to periods of high stress.
3 Steps To Help Identify and Support Your Menopause Transition:
1. Start tracking your menstrual cycle: The mindset of “I think it’s pretty normal” isn’t going to cut it in perimenopause. You need to start tracking your cycle so you can provide data to your healthcare provider (like me!). A change in cycle length, frequency, flow, or PMS symptoms can help identify how your hormones might be shifting.
Here are some of the top period tracking app recommendations:
2. Take inventory of your symptoms: Use the Menopause Foundation of Canada’s symptom tracker. This will help to identify systems that may be impacted by perimenopausal hormone shifts, which can influence what treatments may be offered. Symptoms experienced through the perimenopausal transition are highly variable from person to person. However, susceptibility to certain symptoms can depend on a person’s health history. For example, a woman with a history of anxiety or depression is more likely to experience worsening of these symptoms during the menopause transition.
3. Get some bloodwork done: Getting a routine blood panel can help your healthcare provider rule out other conditions that mimic perimenopause. Many women come to me saying they feel fatigued, anxious, and mentally foggy, and assuming they must be in perimenopause. But when I run bloodwork, I sometimes find a different cause. For example, severe iron deficiency can cause the very same symptoms: fatigue, anxiety, and brain fog.
In addition, the menopause transition itself can bring metabolic changes that may affect cholesterol and blood sugar levels, both of which are important to monitor. Because so many conditions can look like perimenopause, regular blood testing is an essential step in getting an accurate diagnosis and the right treatment.
I Am Definitely in Perimenopause - Where Do I Go For Help?
Perimenopause is everywhere on social media, and women are being overwhelmed with information, along with a flood of products, books, and programs being marketed to them. Now more than ever, it’s essential to seek out trustworthy, evidence-based information. But how do you find a reputable, knowledgeable healthcare provider, especially in Canada where resources and access to care can be limited?
The health care provider you choose to help guide you through your menopause transition can quite literally change the course of your life.
NutriChem has Naturopathic Doctors that are Menopause Society Certified. The Menopause Society has established a set of standards for healthcare providers to ensure quality care for women throughout all the stages of menopause, including perimenopause. Health care providers that have not completed additional continuing education in this area may not be as comfortable in managing perimenopausal symptoms.
What About Hormone Therapy? Is It Too Early To Start If I Am In Perimenopause?
Not long ago, women were told that they had to wait 1 year since their final menstrual period for them to start hormone therapy treatment. We now know this is not true, nor is it an evidence-based approach.
During the perimenopausal transition, women are often most susceptible to severe symptoms such as:
- Anxiety
- Depression
- Weight gain
- Brain fog
- Hot flashes
- Sleep disturbances
- Joint pain, and much more.
There is no need for a woman to suffer for a year before being offered treatment to manage her symptoms.
In addition to this, initiating hormone therapy earlier results in a greater benefit vs risk ratio in regards to bone health, cardiovascular health and mental health. If a woman is a good candidate for hormone therapy, she can actually initiate hormone therapy in perimenopause prior to losing her menstrual cycle
Once again, this is typically best managed by a healthcare provider with additional experience and expertise in this area. Many women will be offered birth control to manage perimenopausal menstrual irregularities, but they may not get symptom relief from the various other perimenopausal symptoms
Supportive Nutrients For Perimenopausal Symptoms
For Sleep Disturbances, Increased Anxiety, and Brain Fog
A highly bioavailable magnesium glycinate formula that supports neuromuscular relaxation and nervous system balance. Clinical studies have shown that magnesium supplementation may help perimenopausal women:
- Improve sleep quality
- Reduce anxiety symptoms
- Support cognitive clarity
The glycinate form is well tolerated and less likely to cause digestive upset than other magnesium forms.
Combines phosphatidylserine, GABA (gamma-aminobutyric acid), and L-theanine, nutrients that support the stress response and promote calm focus. Phosphatidylserine is a phospholipid known to reduce cortisol levels and support memory under stress. GABA and L-theanine have demonstrated anxiolytic and sleep-promoting effects in clinical trials, especially when taken in combination. This formula is particularly helpful for perimenopausal women experiencing:
- Emotional reactivity
- Cognitive fog
- Sleep disruptions
For Muscle Aches, Joint Pain & Inflammation
A high-potency, molecularly distilled omega-3 supplement rich in EPA and DHA. Omega-3 fatty acids have well-established anti-inflammatory effects, and when taken during the menopausal transition, can help:
- Improve joint pain
- Reduce muscle soreness
- Support cardiovascular health
- Improve mood and cognitive resilience
Curcumin is a potent anti-inflammatory and antioxidant compound that has demonstrated benefit in numerous trials for reducing:
- Joint stiffness
- Muscle aches
- Systemic inflammation
BCM-95 has superior absorption compared to standard curcumin and is ideal for daily use in inflammatory conditions exacerbated by hormonal decline.
For Metabolic Changes & Prevention of Muscle Loss
1. Logical Choice Whey Protein
This grass-fed, undenatured whey protein provides a complete amino acid profile to support:
- Lean muscle maintenance
- Metabolic function
- Satiety
Protein needs increase during perimenopause to help counter sarcopenia (age-related muscle loss) and insulin resistance. Whey protein, in particular, is rich in leucine, a key trigger for muscle protein synthesis. Daily supplementation can support body composition goals and reduce midlife weight gain.
A clinically formulated blend of prebiotic fibres designed to:
- Reduce gut inflammation
- Support the microbiome
- Improve digestion
Given the bidirectional relationship between gut health, hormone metabolism (including estrogen recycling), and immune regulation, addressing gastrointestinal imbalances can have downstream effects on mood, inflammation, metabolism, and cognitive clarity. This formula is particularly suited for women with digestive symptoms alongside hormonal changes.
The Bottom Line
Perimenopause can feel like a whirlwind, but you don’t have to navigate it alone. By tracking your symptoms, getting the right lab work, and working with a menopause-trained healthcare provider, you can feel more balanced, energized, and in control, starting today. At NutriChem, our naturopathic doctors are passionate about helping women thrive through this transition.
Book your appointment today and take the first step toward feeling like yourself again.
Key Resources
References
The 2022 Hormone Therapy Position Statement of The North American Menopause Society. (2022). Menopause, 29(7), 767–794. https://doi.org/10.1097/GME.0000000000002028
Lega, I. C., Fine, A., Lam Antoniades, M., & Jacobson, M. (2023). A pragmatic approach to the management of menopause. Canadian Medical Association Journal (CMAJ), 195(19), E677–E682. https://doi.org/10.1503/cmaj.221438
