5 Ways To Optimize Perimenopause

Are you in your 40s and still having periods? If so, this post is for you. You are in a unique stage of life called perimenopause, a natural period when sex hormones and cycles are slowly changing.

Please don’t fret about being in your 40s! Fortunately, nature gives you this decade as a nice long transition from your reproductive years into menopause. You have lots of time to tend to your mind-body health and get things in order to rock the third trimester of your life, the menopause years. When I work with women in perimenopause, we have conversations about what to expect and do in order to sail through this transition without fuss or drama. Here I discuss five things to pay attention to during perimenopause.

1. Harness your mindset

Use perimenopause as a decade of preparation. Think about how you want to live and feel when you enter your 50s, and don’t let your mother’s experience dictate yours. Do you want to feel strong, confident, fit, healthy, flexible, creative, beautiful, or sexy? You get to be all of these things in your 50s, and more! NOW is the time to shape how you feel and live as you get older. Your lifestyle shapes how you age far more than your genetics do, and YOU choose your lifestyle, which leads to….

2. Put yourself first

Self-care is giving the world the best of you instead of what’s left of you

Put yourself at the top of your to-do list, before everyone else – if you have trouble doing this, you need to check out my friend Victoria Albina’s Feminist Wellness podcast. Make nourishing food, 8 hours of restorative sleep, and daily exercise non-negotiable. If you don’t yet have these three basics down, now is the time to learn them.

Next, decide which mental health practices are essential for your well-being, and book them so they are also non-negotiable. You know yourself best… what do you need on a regular basis to reduce stress and maintain your mental-emotional-spiritual wellness? Massage or acupuncture, social dates, alone time, meditation, yoga, therapy, vacations, creative hobbies – you GET to fit in the core things that relax and rejuvenate you.

3. Know your hormones and your options

Expect progesterone to drop first, and it’s usually a very slow change over your 40s. One of the signs is shorter cycles (under 28 days) that start with spotting. You get to decide if you want to supplement bio-identical progesterone during this time – talk to your practitioner about the pros and cons. You can also use herbs and supplements to even out your cycles and reduce any perimenopause symptoms like hot flashes, mood swings, or insomnia.

Then estrogen drops more quickly between ages 46-56 (the average is 51), and that’s when periods start to get wonky. You may feel like you’re in puberty again, with irregular or heavy periods and crazy mood swings. Again herbs and supplements can help ease any uncomfortable symptoms if you have them – not all women do!

Around age 51 (plus or minus up to 5 years), your period stops. At this time you get to consider the use of bio-identical estrogen, as well as testosterone and DHEA if desired. FYI always use progesterone with estrogen. If your doctor gives you estrogen without progesterone, run to another doctor, as this means your doctor is not practicing safe and optimal hormone replacement. See a doctor who specializes in bio-identical hormone replacement (BHRT), and go in person to get physical exams. Discuss the potential benefits of estrogen (for vaginal tissue, skin, heart, bones, and brain) plus any personal risk factors. If you do choose HRT, read 5 Steps To Take Before Using Bioidentical Hormone Replacement.

You can also choose not to use HRT, and instead use lifestyle and herbs/supplements to stay healthy and vibrant as you go through this transition. Or, you can use over-the-counter low levels of bio-identical progesterone, DHEA, and estriol (a weak and safer estrogen good for vaginal lubrication). Choose the health practitioners you want on your perimenopause team – and be picky.

4. Nurture your adrenals

Adrenal health and resilience will get you through perimenopause smoothly. This is because:

  1. As your ovaries stop producing hormones, you rely more on adrenal production and orchestration of sex hormones. So you want good adrenal function!
  2. If your adrenals are over-producing adrenalin and cortisol, then you are more susceptible to vasomotor symptoms like night wakings, hot flashes, and sweats.

Test your adrenals and address any dysregulation. This takes lifestyle changes that improve your stress levels, sleep quality, light and dark exposure, movement types and timing, and nutrition. Herbs and supplements can also help, but not without lifestyle changes. Learn exactly how to do this in our Fix Your Adrenals course.

5. Check your insulin and blood sugar

Women in their 40s often experience abdominal weight gain even without changes in eating or exercise. Then they wonder if it’s their hormones – and they are right. However, the hormonal culprit is usually high levels of insulin.

High insulin is common for women over 40 and signifies insulin resistance, which develops slowly over a life of refined carbohydrate and sugar intake. Often this first shows up in your 40s – as stubborn abdominal weight.

You can check insulin with a fasting blood test that includes insulin and glucose, hemoglobin A1C, lipids, and C-peptide. If you show up on the insulin-resistant spectrum (an apple-shaped body with waist measurement equal to or larger than hip circumference is a clue), then it’s simple – you learn how to eat and move to reverse insulin resistance. An efficient metabolism with stable blood sugar also reduces perimenopause symptoms, a win-win.


There’s more to pay attention to, however, these five aspects are critical! Want some help with a personalized perimenopause program? We are here for you!

aptos, santa cruz, monterey, acupuncture, functional medicine, herbal medicine,paris healing arts, doctor laura paris, dr. laura paris, dr laura paris

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