Perimenopause is a stage of life that most do not anticipate with a lot of enthusiasm. For most, it marks a significant shift of seasons, not only in how we relate to our bodies, minds, spirits, but also marks a change in how we are in the world and in relationship with others. Perimenopause is the year or more long journey to the close of the reproductive season of life, and for some this time is a graceful and mild change, as if shifting weight from one foot to another. For me, this change has been abrupt, uncomfortable, and inconvenient–to say the least. I entered into this phase while in medical school, battling hot flashes, insomnia, night-sweats, and mood swings while balancing my responsibilities as a student and clinician. I’d like to say I did so with grace, and outwardly I have colleagues and friends who will swear up and down that they didn’t know it was so troublesome for me–but the internal struggle that I had, and continue to have, as I transition–at a pace simultaneously abrupt and gradual–into my new identity as a woman on the other side of menopause. When I sit across from my patients to discuss this phase of life and all that accompanies it, I hear more than their symptoms–I feel their silent struggles: what they love and hate about this time, what they want to release and what they want to keep forever, and what they wish they could celebrate and grieve out loud. When I sit across from my patients to discuss life during perimenopause and after menopause, I provide the medical, physical, emotional, social, and spiritual support that they need and deserve as they embrace their new self: a phoenix rising up from the ashes, more brilliant, wise, and powerful than ever before. Here’s to the seasons changing!

Hot Flashes


Low libido/vaginal dryness


Joint/Leg Pain

Weight gain

Hormone Therapy


Women often feel that hormone therapy is the only option for their menopausal symptoms and sometimes, it is necessary, however, seeing a Naturopathic doctor can help you find ways to help lesson your symptoms. It usually involves an extensive initial intake of 60-90 minutes that may include physical, mental, emotional concerns including past history as well as possibly running labs looking from all angles. Your treatment is then targeted for your specific needs and tweaked as necessary to include herbal tincture, tea, capsules as well as other nutrients that may be indicated.

Lifestyle Practices for Menopause


Women who exercise regularly and eat well prior to perimenopause often are more likely to a more positive menopausal experience.

Alcohol at greater than 4 servings per week can increase estrogen levels. So, why is this a problem? It depends on the person. Estrogen levels can be high or low during this phase in life. A really good reason to test estrogen levels and work on the core issues.

There are many ways that estrogen levels become elevated even in menopause. Plastics, phthalates, and parabens which are all chemicals in the environment that act like estrogen. Estrogen is also stored in fat, so being overweight can cause excess estrogen. If your gut health is not optimal, you are likely to recycle estrogen and reabsorb it back into the intestines.

Further, estrogen is often not the real problem or cause of menopausal symptoms, it is decreased progesterone levels which balances estrogen so with a decrease in progesterone and possible increase in estrogen, you can end up with a significant imbalance between the two.

There are foods that have a large impact on estrogen such as processed foods and sugars so limiting these is important. Also, looking at food intolerances such as gluten, dairy, eggs. Foods that might be helpful are flax seeds and soy which help the body process hormones better. Be sure to use organic soy products.