The literal definition of perimenopause means “around menopause.” It is also referred to as the menopausal transition where hormone fluctuations begin to cause irregular menstrual cycles. The start of perimenopause varies for each woman, ranging from the early 30s to late 40s. This transition can last close to 10 years with the definition of menopause being 12 consecutive months without a menstrual period. Once this mark has been met, a woman is considered post-menopausal.  

 During perimenopause, some women may experience shorter or longer cycles than they are accustomed to. This is due to shifts in sex hormones, including estrogen and progesterone. Estrogen released from the ovaries starts to decline during perimenopause which can then impact the cyclical role of progesterone as well. A decline in estrogen is associated with disrupted body temperature controls that are directed by the hypothalamus in the brain – cue the unpleasant hot flashes and night sweats. The transient nature of these symptoms can be very confusing and unsettling for some women as one month to the next may be completely different with changes to their sleep patterns, mood, worsening anxiety and depression, headaches, and weight changes. The cluster and timing of symptoms is unique for each woman, making it a nebulas and isolating experience for some. If you feel confused and disorientated by a not so organized array of symptoms, you are not alone! 

 There are dietary and lifestyle practices that can help you manage symptoms and even regain some consistency in your cycle. Creating a nutritional foundation built upon quality sources of protein and a variety of colorful plants at consistent mealtimes will help to regulate your blood sugar and provide the substrates needed for your body to adapt and maintain balance. This article delves into strategies for stress management, supplements, and environmental exposures to support for hormonal communication on the journey ahead. Rather than thinking of this time as a dreaded, slow, and dramatic closing of reproductive years, think of it as a transition, and all transitions bring opportunities for change (yes, positive change). Here are my top 4 tips for navigating menopause: 

• Practice mindful moments & boundary setting 

 If there is one thing to prioritize, it’s stress management. If you feel the impulse to sigh or roll your eyes, I understand you. Building a stress management practice can ironically create more stress for some people. Time is valuable and limited, thus a stress management practice does not need to be an hour-long silent meditation. A 10-minute walk, a 2-minute breath break from work, a couple of standing stretches, a note of gratitude, pruning your vegetable garden, and connecting with a loved one all count. Mindfulness is created in the moments you take to live, breathe, and be in the present.  

 Journaling is a great tool to reflect on what helps you feel grounded, safe, and relaxed. For many women, learning to say NO and setting boundaries is crucial. “People pleasing” and carrying the burdens or workloads of a large family/group may have helped you in your twenties and early thirties, but this time provides a chance to set new personal principles and boundaries. Like all practices, this “muscle” takes time to build. Start by practicing what it feels like to pause, take time to think about your commitments and what you want to create time for.  

• Take a tea & towel break

 Herbal teas are one of nature’s medicines. To help with hot flashes, look for teas that contain red clover. Red clover is a wild, meadow dwelling plant that contains minerals, vitamin C, and isoflavones (phytochemicals that resemble estrogen). One of my favorite perimenopausal tea blends is by Agni which is an Ayurvedic-inspired food company directed towards supporting women at every phase of life. This blend also contains peppermint which can have a cooling effect. Consider using peppermint oils topically to help cool down your body temperature. Make your own “spa” towels by filling a bowl with cold water, adding 2-3 drops of peppermint oil, submerge a washcloth, then place in a bag in the fridge or freezer until ready to use. 

• Maca & melatonin – supplemental support

 Maca root is a plant native to Peru traditionally used to help warriors build energy before battle. Maca is a member of the revered cruciferous family that includes ancestors like kale, cauliflower, cabbage, and radishes that support liver detoxification. There are many different varieties of maca root and the preparation does impact the therapeutic qualities. MacaLife® is the active ingredient used in Femmenessence MacaLife formulated for perimenopause. I like MacaLife® because it is a specific phenotype of maca standardized and studied in women experiencing symptoms of perimenopause and menopause. Maca is known for its adaptogenic qualities and ability to balance hormones, potentially through supporting the hypothalamic-pituitary-thyroid- adrenal-ovarian (HPTAO) axis which is a fancy way of describing the brain’s communication to your stress and sex hormone producing structures. Although the mechanisms of action are not exactly understood, this HPTAO axis plays a role in regulating body temperature and nervous system activity which could explain the reduction in hot flashes, nervousness, depression and more in women taking standardized maca preparations in clinical trials. 

 Melatonin is a hormone produced by the pineal gland in response to darkness, helping regulate our sleep and wake cycles. Supplementing has risen in popularity as a sleep aid and sleep disruptions are common for women in the perimenopausal phase. Sleep hygiene is the most important thing to support your sleep wake cycle, but temporary or intermittent melatonin supplementation may help get your sleep on-track. Typical doses you’ll find on the shelf range from 0.3 – 20 mg. In adults, the body naturally produces about 0.3 mg of melatonin per day which declines with age. However, larger doses do not always provide greater benefit and can lead to vivid dreams, waking after several hours, or grogginess the next morning. Using a dose closer to our natural production has been found to increase blood levels of melatonin and restore sleep.  

 The form of melatonin may also be important. I like to use a product called Herbatonin because it shares an identical chemical structure to melatonin but is derived from plants. It contains other beneficial plant compounds that may act as antioxidants, protecting the brain and cellular mitochondria. Herbatonin is available in a 0.3 mg dose as well as a 3 mg dose. The higher 3 mg dose is meant for temporary use (3-5 days) for jet lag and support with getting back to your circadian rhythm after a phase of restless nights. There is some speculative concern that supplemental melatonin can decrease your own (endogenous) production, however, this has not been found in the scientific literature to date. Foundational sleep hygiene is necessary to improve and foster good sleep. Supplements can be appropriate in some cases but will not replace the behavioral and lifestyle practices that you implement for your own well-being. And keep in mind that each woman is unique, so it’s important to first discuss your supplement plan with a functionally trained provider.  

• Defend against EDCs (Endocrine Disrupting Chemicals)

 Unfortunately, we live in an environment filled with industrial and consumer chemicals that mimic and disrupt human hormones. These are referred to as Endocrine Disrupting Chemicals or EDCs which bind to our hormone receptors causing a cascade of “false” messages. This can potentially worsen perimenopause symptoms. We also need to consider the overall toxic burden on our livers. The liver is essential to the metabolism and regulation of sex hormones including estrogen. Xenoestrogens, or “foreign” estrogens from chemical products, have estrogen-like qualities that can block estrogen receptors and lead to an overabundance of circulating estrogens associated with fibroids, mood swings, headaches, and sleep disruptions. 

 To help protect yourself against EDCs, eat a balanced diet that promotes blood sugar balance with adequate protein, healthy fat, and fiber-rich carbohydrates. Minerals, B vitamins, and sulfur compounds from the cruciferous family will help support your innate detoxification systems. Limiting your exposure to EDCs is also essential, but finding safe cleaning, cooking, and body care products can feel overwhelming at first. I suggest you start with skin care, makeup, and hair products that you use every day. Your skin is absorbent and quite literally drinks up what you apply onto it. Use the EWG’s Skin Deep database to look up products that you currently use and safer alternatives. For an online retail haven of clean and organic options, check out Credo Beauty. Plastics are also a concern with BPA (bis-phenol A) being a well-known xenoestrogen that has brought more attention to EDCs in consumer goods. Check canned foods for “BPA-free” lining, ensure that plastic food containers and water bottles are BPA-free, and avoid heating food in any type of plastic. A transition to cleaner and non-toxic household and body care products can take time and a financial investment. One strategy is to start with body and face lotion that covers a large surface area and move onward from there.