By: Dr. Carolina Leon, ND, Naturopathic Pratitioner

Irregular cycles, frequent PMS symptoms, heavy periods, cramps – these are a common experience for many forty-somethings. Perimenopause usually hits in a woman’s 40s, but can also start much earlier, or much later. The hormonal changes you experience during this four- to six-year time period leading up to menopause can bring with it a range of unpleasant symptoms.

But there are a number of tested and true ways to nurture your body and restore a natural state of balance during this important transition.

For one of my 51-year-old patients, along with irregular periods and cramping, she suffered from ongoing digestive/gastric issues and ‘brain fog.’ However, with the addition of some dietary changes, supplementation, and herbal medicine, we were able to eliminate her symptoms within a few short weeks.

The first sign of perimenopause is usually when cycles start to become irregular and shorter. Here’s a common pattern: in the first six months as perimenopause kicks in, your cycles often become shorter, then after six months, they get longer and longer until your period stops.

Every woman’s body is different and while symptoms vary, they often include:

  • Hot flashes
  • Reduced libido
  • Bloating
  • Mental fog
  • Frequent UTIs
  • Vaginal dryness
  • Fatigue 
  • Irritability
  • Depression

But what’s really going on during perimenopause and why does it cause women so much discomfort? 

As women age, their ovaries begin to shut down and stop producing the hormones estrogen and progesterone. So when menopause occurs, the body has to instead rely on the adrenal glands and adipose tissue. While many women report that they don’t ‘feel stressed’ during this period, their years of accumulated stress had affected their adrenals, thus compromising their ability to take over the production of the sexual hormones (estrogen and progesterone) that used to be made by the ovaries. Leading to the symptoms commonly found during perimenopause that include fatigue, insomnia, and food cravings.

So a big part of caring for your body during perimenopause involves healing and supporting the adrenal glands, along with addressing many of the gut health issues women also encounter during this time. Ninety percent of the neurotransmitters: serotonin, is actually produced in the gut. This molecule is crucial for mood balance, which tends to fluctuate during the transitioning period of perimenopause. To alleviate symptoms, both, the adrenal glands, as well as the digestive system, need to be addressed and supported.

As a naturopathic doctor, I typically recommend using a number of natural and evidence-based modalities to address the main drivers behind perimenopause symptoms:

1) Diet –  increase your intake of omega-3 fatty acids through foods like ground flax seeds. Flax seeds contain alpha-linolenic acid (ALA for short), which converts into the omega 3s DHA and EPA in the body. These are anti-inflammatory and important in the balancing of hormones.

2) HerbsRhodiola is a well-known adaptogen that helps support the adrenal glands that can be depleted when a person undergoes or has undergone stress chronically. This added support to your adrenal system helps you manage and adapt to the symptoms resulting from perimenopause as the adrenals take over the work of the ovaries.

Chaste tree contains iridoids, flavonoids, progestins, and essential oils, which help regulate the hormones estrogen and progesterone, which fluctuate during perimenopause. In addition to helping with abdominal cramping during your period, research suggests that this herb can help with PMS.

3) Probiotic supplements – taking a good quality, daily probiotics can help reset gut health and help with much of the digestive problems that come along with perimenopause.


All bodies are unique, and the types of supplements, herbs, and diets, as well as dosages and timing all, vary from person to person. Reach out to Dr. Leon to find out what protocol is best for your body.