Total Therapy Blog

World Menopause Day

Navigating the Changes: Signs and Symptoms of Perimenopause and Menopause

As a Naturopathic Physician specializing in menopause and bioidentical hormone replacement therapy, it’s crucial to understand the signs and symptoms that women may experience during perimenopause and menopause. These life stages mark significant hormonal shifts in a woman’s body, and understanding these changes can encourage the right support and solutions for well-being.

Perimenopause: The Prelude to Change

Perimenopause, often beginning in the late 40s or early 50s (or even earlier for some), is a transitional phase that generally lasts for 8-10 years. This transitional phase  is characterized by various physical and emotional changes, including:

  • Irregular Menstrual Cycles: One of the earliest signs is irregular periods, which can be shorter, longer, heavier, or lighter than usual.
  • Hot Flashes and Night Sweats: These sudden waves of heat and sweating can be uncomfortable and disruptive, often leading to sleep disturbances. Initially they are often felt in the week before and the week of the menstrual bleed.
  • Mood Swings: Hormonal fluctuations can affect mood, causing irritability, anxiety, or even depression.
  • Vaginal Changes: Dryness and discomfort may occur due to declining estrogen levels, making sexual intercourse less comfortable.
  • Changes in Libido: Some women experience a decrease in desire during perimenopause. 
  • Fatigue: Hormonal imbalances can lead to fatigue and low energy levels.
  • Changes in Hair and Skin: Thinning hair and changes in skin texture are not uncommon.

Menopause: Embracing a New Chapter

Menopause marks the official end of a woman’s reproductive years, occurring when there is no menstrual period for 12 consecutive months. While many of the symptoms from perimenopause may persist, some new ones can emerge:

  • Persistent Hot Flashes and Night Sweats: These symptoms may continue but often become less intense over time.
  • Mood and Cognitive Changes: Memory problems and mood swings can persist, affecting daily life.
  • Changes in Body Composition: Many women notice changes in body fat distribution, often leading to increased abdominal fat. One in two women are insulin resistant in menopause, making abdominal weight gain a common occurrence.
  • Bone Health: Decreased estrogen levels can affect bone density, making postmenopausal women more susceptible to osteoporosis.
  • Cardiovascular Health: Postmenopausal women are at a higher risk of heart disease, making heart health care more critical than ever. Genitourinary Symptoms: Vaginal dryness, urinary symptoms, and increased frequency of urinary tract infections may continue or worsen.
  • Joint Pain and Frozen Shoulder: Estrogen is anti-inflammatory, and as estrogen levels decline, many menopausal women get more joint pain and generalized inflammation. Often after auto-immune and rheumatological disorders are ruled out, women continue to suffer from this joint pain which limits their mobility and increases the risk of changes to the body and cardiovascular disease.

Seeking Solutions and Support

As a Naturopathic Physician, I understand that each experience with perimenopause and menopause is unique. It’s essential to explore individualized approaches to managing symptoms and maintaining overall health, such as:

  • Bioidentical Hormone Replacement Therapy (BHRT): BHRT can help replace hormones naturally, reducing symptoms like hot flashes, night sweats and mood swings, joint pain, and poor sleep.
  • Lifestyle Modifications: Embracing a healthy diet, regular exercise, stress management, and adequate sleep can make the world of a difference.
  • Supplements: Some find relief through  natural supplements like black cohosh, flaxseed, or soy. Working on gut health and gut microbiome composition – through diet and supplements –  often minimizes symptoms of fatigue, brain fog, and physical changes. 
  • Mind-Body Practices: Techniques such as  yoga, meditation, and Acupuncture can help manage stress and improve well-being.
  • Regular Check-Ups: It’s crucial for women to have regular check-ups and discuss their menopausal symptoms with healthcare professionals.

If you find yourself nodding along or experiencing any of the mentioned changes, or if you’d like to get ahead of the game – which I highly recommend – click here to book an appointment. I would love to connect and guide you through this important life stage.

Perimenopause and menopause are natural phases in women’s lives , but they don’t have to be challenging! By recognizing the signs and symptoms and seeking appropriate support and treatment options, you can embrace these transitions with confidence. For those considering Bio-Identical Hormone Replacement, keep in mind that an early conversation is important, as there is a 5-10 year therapeutic window!


– Dr. Maria Fabbro, ND.


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