You may have come to believe that hot flashes, weight gain, and a nonexistent libido are inevitable parts of getting older. Same with with regular ovulation, easy periods, and balanced hormones. But these extreme symptoms are not the norm—and they are NOT what you should expect at this age.
Forget what you’ve seen, heard, and believed up until this point about entering your mid-30s and beyond. Your body does not have a set-in-stone expiration date for producing sex hormones, in fact recent New York Times reported research shows we can delay menopause with food!
You don’t need to fear perimenopause. But you do need to understand what your body is biologically programmed to do during perimenopause and how you can take care of yourself NOW to make this hormonal transition as seamless as possible. (You’ll also want to pay attention to the hormonal transitions happening during this phase if you want to get pregnant in your mid or late 30s or beyond.)
How to Have Easy Perimenopause
The first thing to know? Perimenopause begins much earlier than many women realize: around age 35 and lasts for the next decade or more. And how you experience perimenopause—whether it’s easy for you or riddled with devastating symptoms—is largely determined by the hormonal health you’re in when you hit your mid-30s.
That is, if you’re experiencing period problems now—symptoms like severe PMS, painful periods, irregular periods, bloating, acne, fibroids, and heavy bleeding—your hormonal health is compromised and it doesn’t bode well for your next 10 or 15 years. I don’t mean to scare you, but you might be facing some of the horror stories you’ve heard about perimenopause.
On the other hand, if you’re taking care of your hormonal health right now—if you’re engaging cyclical self-care and the key biohacks for balancing and healing your unique female physiology —your transition into perimenopause can be smooth sailing.
So what can you do right now to reclaim your hormonal health and transform perimenopause from a transition to be feared to a milestone that should be celebrated—and barely noticed, at least symptom-wise?
Let’s start by taking a close look at what happens during perimenopause.
Let’s clearly define “perimenopause.” It’s a term that refers to the time between your reproductive years and your very last period. It takes a long time, and even though it sets off old-age alarms for many women—when, as I mentioned above, this phase starts much earlier than most women think it does AND there is nothing shocking, abnormal, or bad about going through this hormonal transition (or about aging in general, but that is for another blog post a different day).
What’s more, so many women are getting pregnant naturally and having children in their late 30s and early 40s. The word “perimenopause” conjures up images of old maids, when in fact many women are waiting until perimenopause to start a family.
Natural hormonal changes DO happen during this time, so it’s important to know what’s going on.
In a nutshell, perimenopause is when a woman’s ovaries begin to move from ovulating like clockwork to not ovulating anymore. This is accomplished by the slow and steady rise of follicle stimulating hormone (FSH) and fluctuating estrogen levels. Over time, these fluctuating hormone levels become waning hormone levels and they stop signaling the process of ovulation all together (menopause). Think of this as a kind of reverse-puberty.
This era of shifting hormone signaling in the body is why good hormonal health is so important when you’re about to enter this phase of life. If your hormones are out of balance and causing difficult symptoms before you’re in perimenopause (when they should be be having), the addition of the natural hormone fluctuations that occur during perimenopause will not make symptoms any better. Far from it. Your symptoms are likely to get way worse.
Perimenopause can be divided into two phases:
Phase 1 (35 to 45 years old)
This phase is when reproductive hormone production starts to shift and become less consistent. That said, you shouldn’t feel symptoms during this phase if you’re in good hormonal health. You should be ovulating and menstruating regularly and have good muscle tone, skin quality, energy, and sex drive. In other words, you should still be making enough hormones to feel vital and youthful. If you are experiencing symptoms like difficulty with fertility, vaginal dryness, accelerated skin aging, or dry hair (or all of the above), these are huge messages that your hormones need some TLC. To add insult to injury, these are symptoms that women don’t expect to experience until much later. Dealing with them as young as your mid-30s can put a major dent in your quality of life and indicates you are aging biologically faster than your chronological years.
Phase Two (45 to 55 years old)
During this phase, FSH levels rise to the point where you no longer ovulate. And while that sounds dramatic, this phase will be relatively smooth sailing if you’re taking care of your hormonal health. However, many women let the symptoms they experience in Phase 1 go unaddressed and that compounds their symptoms in Phase 2.
You can use targeted strategies in each phase—before perimenopause, during perimenopause Phase 1, and during perimenopause Phase 2—to heal your hormones and erase pesky perimenopausal symptoms.
If you’re NOT in perimenopause yet… Begin cyclical self-care, stat! The first step is to track your period.
The next step is to eat, exercise, and make lifestyle choices in line with your cycle. This is especially important if you’re experiencing any period problems like severe PMS, irregular periods, heavy periods, bloating, acne, fibroids or hormonal migraines. You’ll also want to make sure your liver and detoxification system are in tip-top shape. One of the best ways you can support detox everyday is by eating cruciferous vegetables like broccoli, kale, and Brussel sprouts. If you’re on hormonal birth control, you may want to consider other options. A history of being on the Pill can make perimenopause worse.
If you’re in Perimenopause Phase 1… You’ll want to stick to your cyclical self-care routine, and liver health becomes even more important during this phase. Continue to emphasize phytonutrient-rich vegetables and drink warm water with a squeeze of fresh lemon juice in the mornings. Tending your adrenal health is critical in this stage of life, so you will want to prioritize rest and relaxing activities, but you might also consider taking adaptogens, including:
Maca powder. I recommend maca powder as part of a wider hormonally-supportive diet when you’re age 35 or over and experiencing symptoms of perimenopause. Maca can help with:
- Low energy levels
- Low sex drive
- Brain fog and poor focus or concentration
- Mood swings and depression
- PMS symptoms
Ashwagandha. This well-researched herb has been shown to reduce oxidative stress (the internal process that contributes to cell damage and accelerated aging) and support a healthy stress response. In a double-blind, placebo-controlled study, ashwagandha was shown to improve stress resistance and participants’ self-assessed quality of life. When it comes to hormones, ashwagandha has been shown to safely improve sexual function and low libido for some women (perhaps because it supports healthy testosterone production). I recommend ashwagandha if you struggle with anxiety and/or if you’re wrestling with low libido.
Holy Basil. This herb supports a healthy adrenal response as well as helping stabilize blood sugar, which is essential for healthy hormone balance. Research also suggests that holy basil can help protect the liver and support liver function. I recommend holy basil if stress and anxiety are an issue and/or if you wrestle with imbalanced blood sugar. If you have a history of taking over-the-counter or prescription medications, you may consider taking holy basil for liver and detox support.
Reishi mushroom. Reishi is a powerful adaptogen that is also full of antioxidants. The antioxidant benefits of reishi are well-studied, and when it comes to hormones studies show that reishi (and other cordyceps mushrooms) may help ease hormone-related symptoms by exerting an anti-androgenic effect in the body.
If you’re in Perimenopause Phase 2…
Phase 2 is when FSH levels rise to the point where you no longer ovulate. Because many women experience accelerated hormone aging in Phase 1, they have a rough time in Phase 2. But when hormones are balanced entering this phase, your body should adapt relatively seamlessly by manufacturing slightly less, but a balanced amount, of estrogen and progesterone and testosterone. If you’re having hot flashes, night sweats, no libido, etc., then you likely have unbalanced levels of these hormones.
Take D3 and Evening Primrose Oil. These two supplements are especially helpful in the second phase of perimenopause. Evening primrose oil is a source of gamma-linolenic acid (GLA), an essential fatty acid that influences prostaglandin synthesis and calms perimenopausal symptoms. Vitamin D is foundational for hormone balance and overall health at every stage of life. You can read more about D3 here.
Increase your Zinc intake. Zinc is critical for the production of testosterone production. Having enough testosterone eases the perimenopausal transition. Zinc is bountiful in beans and seeds. You can also supplement with 50mg a day.
Eat enough healthy fat. Cholesterol (yes, the very substance that has been demonized for many years) is what our body uses to make our hormones. You need enough healthy fat in your diet to have enough cholesterol to support adequate hormone production. Your body is slowing down hormone production at this stage, so it’s critical to make sure you have enough of this key building block.
Getting Pregnant in Perimenopause
If you’re planning to get pregnant after age 35, you have nothing to fear. Even though you’ve entered this new hormonal phase, with the right hormone support can increase your chances of getting pregnant easily and naturally. For my definitive guide on getting pregnant after 35, click here. And if you are in your mid-30s and thinking of starting a family or already trying, consider adding the following supplements:
Vitex. This herb, also called Chasteberry, supports regular ovulation, healthy progesterone levels and robust levels of FSH.
CoQ10. This has been shown to improve egg quality.
Your Happiness Is In Your Hormones
Are your mood swings, anxiety, and blues really just a hormonal imbalance? Let me show you the natural mood shifts you have over the 4 phases of your cycle and how to balance your moods naturally. In this masterclass, you’ll discover:
- How to balance serotonin and dopamine naturally
- How adrenal fatigue affects your moods and what to do about it
- And get my natural food and supplement prescription for mood enhancement
Carla B says
Hi can you do more of an in depth talk on this topic ?
Thank you for this!!
I’m in my early 30’s and experiencing a lot of acne to the point that my skin is getting scarred,and am experiencing some slight weight gain and lower energy levels. I also experience really painful cramping for the first 2 days of my period, sharp clawing-type pains.
I know you have mentioned avoiding wheat and dairy to help with hormone balance, but these are big staples of my diet! I try to eat sprouted and organic wheat in breads, and I rely on dairy as my source of protein in the form of Greek yogurt and cheese. We eat minimal amounts of meat so I really rely on things like whey-protein pancakes. How important is it to completely ditch dairy and wheat? What advice can you share for those of us who need these staples in our diet, either because everyone else in the family needs to eat them, or they provide the calcium and protein that are hard to get from other foods, especially if we are avoiding soy or can’t do a lot of meat.
If you are struggling with hormonal issues, then these foods are important ones to question. There are many options in the grain world that don’t have gluten, so this should be ok for you to experiment with. Once you have removed these foods for several weeks you should see improvements in your health – this will let you know that your body is doing better without them.
Regarding dairy, please note that the calcium in dairy is not well utilized by the body. If you are looking for calcium there are many better foods to focus on like seaweeds, dark leafy greens, almonds, etc. Dairy naturally contains hormones like estrogen as it usually comes from a pregnant or recently pregnant cow. There are other issues with it as well. In any case, their are protein powders like hemp, pea and rice that can replace the whey protein and other sources of protein like eggs, legumes and occasional meat/fish (it sounds like you do intake these).
Another question–what do you recommend for extreme breast sensitivity? Mine are tender before, during, AND after menstruation. Its frustrating! (Early 30’s, no drinking or smoking, and I eat a variety of fruits and veggies.)
Outside of making the necessary diet and lifestyle changes, you can try evening primrose for these symptoms.
Hi Alisa I must say I wish I knew this information in my 20 s my journey after 35 has been difficult somewhat especially as it relates to irregular and heavy bleeding and headaches. Is there a herb to stop persistent bleeding. I also notice I sometimes bleed heavier after eating
Do you recommend starting all four adaptogens (maca, ashwagandha, holy basil, reishi) simultaneously? Or would it be better to start using one and after a period of time, layer in a second adaptogen after a period of time, , layer in the third until all are being used?