Natural Health and Wellness for the Whole Family

Is it Perimenopause? Hormones during your 40’s and late 30’s

By Joanne Aponte, ND March 15, 2021

If you are a woman in your late 30’s and 40’s, there can be a lot of disruption in your hormonal cycling that can lead to significant symptoms that decrease the quality of your life:

  • Very heavy periods
  • Shorter menstrual cycles (periods come closer together)
  • Irregular periods (long cycles or missing a period)
  • Sore and tender breasts
  • More frequent migraines (especially ones that come before, during or after your period)
  • Night sweats (typically right before, during or after your period)
  • Trouble with your mood– mood swings, low stress threshold, anxiety, depression, irritability and sometimes even rage
  • Heart palpitations
  • Trouble sleeping

If you are experiencing some of these symptoms, you could be in the phase of life called Perimenopause. Perimenopause is the process of hormonal and brain changes leading up to menopause when your periods will finally stop and your fertility ends. The process typically starts at some point in your 40’s and for some women as early as their late 30’s.  

Perimenopause can last up to 10 years before you finally have your last period (Menopause). While it’s a completely normal transition, it can be tumultuous time for many women. It can be like puberty all over again and what woman wants that?!

Perimenopause involves a sequence of events.  First there is a decline in progesterone levels and high and fluctuating estrogen levels. It’s as if your estrogen is on a roller coaster.  As you progress through the process, eventually estrogen levels will drop and remain consistently low. Towards the end of this process, there are changes in insulin metabolism – this partly explains why it’s so much harder to lose weight in your 40’s!

Most of the symptoms of perimenopause are due to the declining levels of progesterone, combined with the elevating levels of estrogen. Estrogen can spike up to 3 times higher than when you were younger. This big gap between high levels of estrogen and low progesterone is what causes problems.

So, what can you do to stay feeling healthy and happy during this process?

  1. Manage your stress and aim to keep your body in parasympathetic mode (aka “relaxed mode”).  
    1. Regular exercise
    1. Spend time outdoors everyday
    1. Have meaningful relationships and good social connections.
    1. Breathing techniques, yoga and acupuncture are great too!
    1. Adaptogenic herbs such as Ashwaganda and Rhodiola can be very beneficial.
  2. Get adequate sleep and maintain a consistent sleep schedule. If you are unable to sleep on your own, magnesium, adrenal support and progesterone could help. Decrease caffeine to a maximum of 1 cup per day. Try green tea or Matcha instead as these are also great for hormone balance.
  3. Keep alcohol consumption low – drinking alcohol interferes with your body’s ability to metabolize and clear estrogens. Not what we want to have happen when estrogen levels are already too high! Unfortunately, alcohol never helps our hormones.
  4. Eat a healthy whole foods diet that is low in sugar, low in white refined and packaged foods and low in dairy. Think of dairy like a condiment. Eat 2-3 cups of cruciferous vegetables each day (cauliflower, kale, broccoli, cabbage, collard greens and Brussel sprouts).
  5. Ensure good blood sugar balance and address pre-diabetes or insulin resistance – high levels of blood glucose and insulin are very inflammatory and can lead to more hormonal imbalance and fluctuation.
  6. Try Magnesium – this mineral helps with sleep, reduces migraine frequency and is great for irritability and anxiousness. It is also involved in metabolism of estrogen and can help maintain better estrogen balance.
  7. If you are having very heavy periods – you may need progesterone or nutrients to help lower estrogen. Iron deficiency can make heavy periods worse, so it’s a good idea to have your iron levels checked.
  8. If your mood is really struggling, you might need to improve production of neurotransmitters in the brain.  Magnesium, B complex and the amino acid 5HTP are helpful for this.
  9. Support better estrogen and progesterone balance. A phytonutrient from broccoli called DIM (Diindolylmethane) can help balance the estrogens when they are high. To boost low progesterone, the herb Chaste tree berry helps your brain increase your natural progesterone production. For some women, using a progesterone cream or prescription pill might be needed. Progesterone is particularly helpful when there are heavy periods, sleep problems and high feelings of stress and anxiety.

Editor’s Note: The information in this article is intended for your educational use only. Always seek the advice of your physician or other qualified health practitioners with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.


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