The Quiet Shift: Navigating the Realities of Perimenopause
In a powerful and deeply personal moment on her show, Oprah Winfrey opened up about the challenges she faced during menopause—particularly the toll it took on her sleep and overall well-being.
“When I was going through menopause, I didn’t sleep. I didn’t sleep for two years and ended up blowing out my thyroid, and I became nonfunctional. It’s difficult to remain fully present if I’m not getting enough sleep, so I work at getting enough.”
— Oprah Winfrey (A-Z Quotes)
Most general OB-GYNs aren’t deeply trained in hormone balancing, especially for issues like perimenopause, adrenal health, or thyroid interplay—unless they seek additional training in integrative or functional medicine.
That’s why many patients turn to alternative medicine doctors, for deeper help with things like bioidentical hormone therapy, adrenal fatigue, or thyroid/hormone optimization.
For many women, their late 30s bring a new set of physical and emotional shifts that are often misunderstood, misdiagnosed, or quietly endured. These changes don’t happen overnight, but rather arrive subtly — a missed period here, a night of unexplained sweating there. This phase is called perimenopause, and it marks the transition to the end of the reproductive years. But despite affecting millions, perimenopause remains one of the most under-discussed chapters in a woman’s life.
What Is Perimenopause, Really?
Perimenopause — literally meaning “around menopause” — is the transitional time leading up to menopause, when hormone production, particularly estrogen and progesterone, begins to fluctuate. It can last anywhere from a few months to over a decade. Menopause itself is defined as the point when a woman hasn’t had a menstrual period for 12 consecutive months; perimenopause is everything leading up to that moment.
While most women enter perimenopause in their 40s, some may begin to notice changes as early as their mid-30s. Genetics, lifestyle, and overall health all play a role in when — and how — this transition unfolds.
Symptoms That Speak Louder Over Time
The symptoms of perimenopause are wide-ranging and vary from woman to woman. Some experience just a few mild changes; for others, the shift is more dramatic. Common symptoms include:
Irregular or missed periods
Hot flashes and night sweats
Mood swings or increased anxiety
Sleep disturbances
Vaginal dryness or discomfort during sex
Decreased libido
Brain fog or memory lapses
Anxiety and depression
Unexplained weight gain, especially around the midsection
All PMS symptoms
Because these symptoms can mimic other conditions — or simply be written off as stress or aging — many women go years without realizing they’re in perimenopause.
Seeking Answers, Finding Support
There’s no single test to diagnose perimenopause. Healthcare providers often rely on symptom tracking and, when needed, blood tests to check hormone levels. But more importantly, they look at the bigger picture: How is a woman feeling day to day? How are these symptoms affecting her life?
For those struggling with persistent or disruptive symptoms, help is available. Hormone therapy remains one of the most effective treatments for symptoms like hot flashes and vaginal dryness, though it isn’t appropriate for everyone. Non-hormonal medications, lifestyle changes, and complementary therapies can all play a role in managing the transition.
Ancient Tools for Modern Balance
The endocrine system is deeply connected to other body systems like digestion and immunity. Hormones such as cortisol, insulin, and thyroid hormones influence gut health, affecting digestion and nutrient absorption. Imbalances can lead to symptoms like bloating or IBS, while poor gut health can disrupt hormone function. The immune system is also impacted by hormones; for instance, high cortisol can suppress immune function. The liver plays a key role in processing hormones, and if it's overburdened, it can cause hormonal buildup, leading to issues like irregular periods or mood swings. These systems work in harmony, and when one is off-balance, others often follow. A holistic approach is essential to restore balance across the entire body.
Acupuncture, Herbal Medicine, Natural Plant Based Hormones
More women are turning to traditional healing practices like acupuncture and herbal medicine to manage the complex symptoms of perimenopause — and for good reason.
Acupuncture, a practice rooted in Traditional Chinese Medicine (TCM), involves the insertion of very fine needles into specific points on the body to rebalance energy flow, or qi. Studies have shown that acupuncture can help reduce the frequency and intensity of hot flashes, improve sleep quality, ease mood swings, and even alleviate anxiety and depression — all common symptoms during perimenopause.
Herbal Remedies are also widely used in TCM to support hormonal balance and relieve discomfort. Herbs like black cohosh, dong quai, chasteberry (Vitex agnus-castus), and licorice root are commonly prescribed to soothe hot flashes, support mood, and regulate menstrual cycles. These formulas are often customized by licensed herbalists to suit a woman’s individual constitution and symptoms.
While these therapies may not be a replacement for conventional treatment, they can offer valuable support either on their own or alongside other approaches. It's important to work with qualified practitioners and consult your doctor — especially if you’re taking other medications — to ensure safety and synergy between treatments.
Bioidentical Hormones are derived from plant extracts that have been used for thousands of years, such as concentrates of wild yam and soy, which contain plant compounds that can be converted into hormones identical to those produced by the human body.
What We Do
We test baseline hormones.
We educate you about your diet and exercise .
We provide treatment using acupuncture, herbal medicine, nutritional supplements, and natural hormone replacement therapy.
We monitor after two months and relook at your levels to make any final adjustments.