Many women fear perimenopause, that time in life when a woman’s reproductive hormones start to downshift.
Indeed, perimenopause has gotten a bad reputation because it can be accompanied by a raft of unpleasant symptoms, including weight gain, mood swings, severe period problems (like heavy or irregular, bloating, and PMS), feeling tired all the time, lackluster skin and hair, thyroid issues, non-existent libido, and infertility.
But here’s what most women don’t know: these symptoms aren’t inevitable. Yes, the hormonal shifts during perimenopause are real, but the symptoms are optional. When you adopt a phase-based self-care routine, you can sidestep the unpleasant symptoms of perimenopause.
And don’t stop reading if you’re in your 20s and perimenopause is the last thing on your mind! If you’re experiencing any type of period problem or hormonal imbalance right now, your symptoms are a harbinger of things to come… and not in a good way. If you feel crummy now and you don’t take steps to balance your hormones, you stand to feel even worse during perimenopause.
What is Perimenopause?
Perimenopause means “around menopause” and it starts for most women around age 35 and lasts until menopause (your very last bleed). Symptoms can crop up during perimenopause because of the inevitable hormonal shifts that happen as the body starts to move out of its childbearing orientation.
More specifically, perimenopause is characterized by uneven swings in estrogen, progesterone and androgens. These hormones follow a more or less even pattern during your 20s and early 30s, but they start to behave more erratically as you enter your late 30s and 40s and, as you get closer to menopause, they start to trend downward.
Environmental Factors Make Perimenopause Symptoms Worse
Now add in the fact that life in one’s late 30s and early 40s can be full of unique stressors: raising young children and teenagers, working long (often stressful) hours at the peak of one’s career, navigating busy family schedules, and caring for aging parents. This can send the stress hormone cortisol on its own frenzied roller coaster, so now in addition to shifts in reproductive hormones, a woman might be facing the symptoms of high cortisol, like feeling tired-but-wired all the time, never sleeping, intense sugar cravings, and imbalanced blood sugar.
Your level of exposure to endocrine disrupting toxins also makes a difference in how well you’ll navigate perimenopause. Today there are more endocrine disruptors in the environment than ever before, and these chemicals can overwhelm the body’s detox system (which is in charge of getting rid of used-up hormones as well as toxins) and wreak a special kind of havoc on the thyroid, which is very sensitive to chemical exposure.
The Two Phases of Perimenopause
Perimenopause happens in two phases: Phase 1 and Phase 2. Today I’m going to focus on how you can ease symptoms and engage in cyclical self-care during Phase 1, but it’s important to understand both phases.
Phase 1 (35 to 45 years old)
This phase is when reproductive hormone production starts to shift and become less consistent. That said, if you’re in good hormonal health and you’re engaging in cyclical self-care (see my advice below) you shouldn’t feel symptoms during this phase. 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 signs that your hormones need some TLC…ASAP!
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’ve taken care of your hormonal health during Phase 1. However, many women let the symptoms they experience in Phase 1 go unaddressed and that compounds their symptoms in Phase 2.
But as I said earlier, extreme symptoms aren’t inevitable during perimenopuase. You can use targeted strategies in each phase to ease symptoms and feel your best.
Phase 1 Perimenopause: Symptoms & Solutions
I recommend that all women follow the same core food, supplement, and cyclical self-care strategies in Phase 1 to minimize perimenopause symptoms.
Then, if you still don’t feel your best, you can customize the protocol by taking specific steps to address your unique symptoms.
Here are my three core strategies for every woman in perimenopause, followed by steps you can take to address specific, lingering symptoms.
The 3 Core Strategies for a Symptom-Free Perimenopause
Strategy #1: Practice Phase-based eating. The first essential strategy for having a symptom-free perimenopause is to eat specific foods each week of your cycle, changing what you eat in each phase to support optimal hormone balance and metabolism.
This phase-based approach to eating provides the most variety of micronutrients to support overall hormonal balance. It also ensures that you’re getting key foods at critical times to break down the excess levels of estrogen that can cause breakouts and PMS. Not to mention that this approach will improve the quality of your bleed, support fertility, and boost sex drive, energy, and mood.
You’ll enjoy a wide variety of cuisines when you start eating cyclically – macrobiotic, raw, ketogenic, Mediterranean, some intermittent fasting and not ever get stuck doing one day in and day out. Phase-based eating is the true differentiator for the FLO protocol. Everything about your diet and lifestyle should be relevant to your female biochemistry, and the FLO protocol ensures that.
Strategy #2: Engage in phase-based exercise. The cyclical nature of your 28-day menstrual cycle provides the perfect architecture for planning how to work out and when to work out.
During each phase of your menstrual cycle your body is primed for different kinds of exercise. At certain times—during the luteal phase and during menstruation, for example—the nutrients and hormones in your body are directed toward building up the lining up of your uterus, so you won’t have all the internal resources you need to work out at full capacity.
During the other phases, however, your body can channel all its resources into a really strong workout.
By engaging in phase-based exercise, you will save yourself from exhaustion, burn-out, and unpleasant perimenopause symptoms. Get my recommendations for what type of movement to engage in and when right here.
Strategy #3: Maximize Your Micronutrients With Perimenopause Supplements. If you’re eating a whole-food, phase-based diet and you’re exercising in sync with your cycle, do you need to take supplements to have a symptom-free perimenopause?
Yes!
Supplements are non-negotiable for keeping hormones balanced and stable as you enter Phase 1 perimenopause.
Food should always be your first strategy. To heal your hormones, you have to feed your body a micronutrient-rich diet of hormonally-supportive foods in a cycle-syncing pattern. There’s no single supplement that can make up for bad or inconsistent food choices. But supplementing with specific micronutrients gives the body the extra support it needs during times of hormonal transition.
This is why we created the EASE supplement kit—to help you prolong youth with healthier hormones. Here are the micronutrients you’ll find in EASE, and how they will support your perimenopause journey:
- Melatonin: Supports slow hormonal aging by increasing egg quality and chances of conception and promoting deeper sleep and rest. Also helps support a healthy sex drive and may support healthier bones.
- B vitamins, Saffron, and Scelectium: This combination supports healthier, more regular ovulation, boosts energy and clears stress, increases mental focus, reduces hot flashes and stress, and supports moods.
In addition to EASE, you may want to consider a probiotic. A healthy microbiome is essential for managing hormonal conditions—and this is especially true as you enter perimenopause. Women aged 35 to 45 need optimal gut health in order to absorb the key micronutrients they get in their food and supplement. Good gut health also means a healthy estrobolome, or the community of bugs in the gut that help metabolize excess estrogen.
Specific Strategies for Lingering Perimenopause Symptoms
Once you’ve put my 3 core strategies in place, you will start to feel better. But you may still need additional support in certain areas. That’s normal. Here are some of the common symptoms unique to perimenopause and additional steps you can take to help ease them:
Irregular, heavy, or painful periods. Try taking Vitex, also called chasteberry. It has been shown to support regular ovulation and healthy progesterone levels. But proceed with caution if you have PCOS. In some women with PCOS, certain reproductive hormones are already high and Vitex may raise those hormones even further, which you don’t want.
PMS/PMDD. Studies also suggest that Vitex, also called Chasteberry, may help improve symptoms of PMS and PMDD. One study even found that Vitex outperformed fluoxetine (generic name for Prozac) for easing symptoms of PMDD (premenstrual dysphoric disorder).
Fertility struggles. By supporting regular ovulation and healthy hormone levels, Vitex can be a great choice for fertility support during perimenopause. Research that looked at a proprietary blend of herbs that included Vitex found that the supplement supported fertility without negative side effects. (Don’t combine Vitex with fertility drugs, however, because that can lead to over stimulation of the ovaries) CoQ10 has also been shown to help improve egg quality.
Depression and irritability. Try taking maca powder, which studies suggest may help improve symptoms of depression. Some animal research also suggests that maca may help with cognitive function and concentration.
Weight gain. Try alpha lipoic acid, which helps support healthy blood sugar and insulin balance and, in turn, healthy weight loss and healthy weight maintenance. The compound may also guard against bone loss. ALA also helps support and nourish the liver and optimal liver function is essential for getting rid of excess estrogen and keeping reproductive hormones balanced. Alpha lipoic acid is one the key ingredients in the my Balance Detox supplement.
Dull skin and hair. A high-quality omega-3 supplement will help nourish dry skin and hair. Also, an obvious tip, but one that often gets overlooked and under-appreciated: stay hydrated! This works wonders for skin and hair.
Low sex drive. Studies suggest that maca may help boost sex drive in menopausal women, and other research found that maca may act as a “toner of hormonal processes” in early post-menopausal women. Additional research has shown that maca may help with low libido as a side effect of taking SSRI antidepressant medications in menopausal women. The adaptogenic herb ashwagandha may also help support sexual function in women.
Stress and anxiety. Taming stress requires a multipronged approach, one that includes lifestyle modifications, exercise, and more. But adaptogenic herbs can be a powerful part of your stress-reduction arsenal. I recommend ashwagandha, which research suggests is a safe and effective way to build up resistance to stress and improve self-reported quality of life. Holy Basil is another great choice for stress and anxiety support, according to research.
Coming Off Birth Control to Conceive. If you’re coming off birth control after many years on the pill, I recommend several important steps for hormone healing and fertility support. But one of the best things you can do is prioritize eating leafy greens and cruciferous vegetables like broccoli, cauliflower, cabbage, and Brussels sprouts. These foods help support estrogen metabolism in the liver and bring your hormones back into balance after years of hormonal birth control.
Thyroid issues. With thyroid concerns, your first best bet is always to consult a trusted healthcare practitioner. You’ll want to run thyroid lab tests and discuss next steps with a licensed professional. But you’ll also want to make it a top priority to avoid endocrine-disrupting chemicals as much as possible. The thyroid is uniquely sensitive to endocrine disruptors. I recommend ALL women take steps to protect themselves from these environmental chemicals, but it is especially critical if your are working to heal your thyroid.
Always remember, that once you have the right information about how your body really works, you can start making health choices that finally start to work for you! You can do this – the science of your body is on your side!
Support Your Hormonal Health and Perimenopause Journey With BALANCE + EASE
Because you’ve asked for hormone-friendly supplement recommendations, I created a solution that I am so thrilled to be able to offer to you on your hormonal balancing journey:
Balance by FLO Living Supplements is a complete package that works together to keep your hormone levels healthy. Balance includes a 2-month (2 cycle) supply so you’re never caught short in any phase of your cycle.
When you take these 5 supplements daily, you’ll be giving your body excellent micronutrients to support healthier hormone levels. Which means that you’ll start to see your worst period symptoms get better… and even disappear after a while.
Learn more about the BALANCE Bio-Hacking Supplement Kit
To best support your perimenopause journey, I recommend BALANCE in conjunction with EASE. The extremely slow hormonal changes that take place during the first phase of menopause are normal — and they also need support. When your cycle remains regular for as long as possible, you will have better brain, heart, muscle, and bone health after menopause.
I would add Vitamin C to that list. It’s really good both for stress and for boosting progesterone production. In clinical studies women taking 750 mg. of Vitamin C per day increased their progesterone levels significantly (and it was like 87% of the women on the Vitamin C so it was a REALLY relevant study). And you know they probably gave them the cheap synthetic Vitamin C so a whole foods based supplement in a divided dose (because you can only absorb so much at once) can be really beneficial.
Any suggestions for vaginal dryness?
Support your body’s natural estrogen cycles with the right kinds of phytoestrogenic foods.
Alisa
I am 53 years old and in what you would term Phase 2 of perimenopause. I tried the pill once, hated it, and haven’t used hormones since, and have had regular periods up until about a year ago. At that point, they became regularly “irregular” (every-other-month 26/32 day cycle), and I just experienced my first 6-month stint without a period. All of this to say that I am really intrigued by your program and absolutely feel the women’s week by week cycle is a real thing — only I don’t see a protocol for phase II women? I would like to look at diet and exercise in a similar way but I am no longer having a cycle to align with and I don’t see a section on your website addressing the dropping off of menses. Would love to know if I am missing it and if there is more information I might read about the floliving approach to phase 2. Thanks!
Hi Victoria,
Thank you for reaching out! At the moment I do not have a phase II or menopause program… YET! Stay tuned!
Alisa
I’m with you on this. 51 and the last year’s cycles have been wacky- I’ve been doing my best to go by the timing of my last period and/or the phases of the moon. Looking forward to more guidance from Alisa on this!
Hi ladies, When you are in perimenopause, cycle syncing may not make a lot of sense since cycles may not longer be regular. We recommend focusing on the blood sugar balancing and liver supporting aspects of the protocol – you can find more info in WomanCode book or the Monthly Flo protocol online.
XO, Christina – FLO Coach
Needing more support? Please reach out to schedule a session
Dear Christina,
I’d love to talk to you. I’m 52 and getting my first set of irregular periods. I’ve been dealing with fibroids since having my son at 41. Alisa’s description of the phases didn’t really speak to me since I had a baby at 41 and was in the fertility phase during those years. I use the Flo app. But I want to hear more about how to support perimenopause now. Thanks so much, Brooke
Hi Brooke,
I would love to connect with you and talk about how to support yourself during perimenopause. There are definitely different tools needed for different women at this sage. Here is the link to schedule a session:
30 Minutes session click HERE
60 Minute session click HERE
Just enter my name, Christina, in the coupon section when checking out.
XO, Christina – FLO Coach
Do these now ship internationally? I live in the uk.
You can order them via shopandship.com!
Hello! I’m wondering of your phase 2 program will be coming out any time soon :-)?
Thanks,
Kim
Add me to the list of Phase 2, please!
I’m also interested in Phase 2 info and help! Anxiously awaiting…!
Thank you!
Hi, what about not being able to sleep? I have no problem falling asleep but then I wake up after 4hrs and feel as if had light sleep. I guess is the cortisol hormone waking me up I am 37y and had been doing Intermittent fasting16:8 for 6 years, but about two month ps ago my sleep has been terrible, I just found out about your work by accident in YouTube and stopped IF, and eating all nutritious food as you recommend but I still can get my sleep back, I occasionally take melatonin and then I sleep like a baby but, I wish I didn’t have to. Is there a natural way to care for my sleep?
Thank you so much for you work.
I wish I had known you earlier.
Hi Ana,
Try having 4oz cold tart cherry juice about 45 minutes before bed. Do this consistently. The cherry juice has been shown to naturally raise melatonin levels in the body in a non-habit forming way. Hang in there! Healing sleep is frustrating.
Alisa
I would also love to be part of the phase 2 program. Perimenopause and Hashimoto’s has been a challenging combo. At least once a month I consider taking medical leave. I am working with a Naturopath and OBGYN. I would love information like the CycleSync program to understand the changes my body is experiencing and better support her. It is hard to find good information.
Are there any authors that you would recommend on peri menopause? I seem to remember someone referenced in one of Alyssa Vitti’s audio books, but I didn’t write it down.
I don’t know if I am in Phase 1 or Phase 2. I am 51 years old and had uterine ablation 20 years ago due to problems with heavy periods and symptoms. As a result I haven’t had menses for 19+ years.
I am intrigued by your program and believe in the changes in weekly cycle is a real thing. I would like to follow the diet and exercise protocol similar but I have no way to know my cycles to align with.
Can your Flo Living supplements be taken during perimenopause and into menopause?
Hi Amanda, the FLO supplements are designed to support women in their reproductive years. You can check out Dr. Anna Cabeca for support during menopause!
XO, Christina – FLO Coach
Interested in phase 2!
I recently had a blood draw and found out that I am pre menopausal at the age of 43, which explains the night sweats, and lack of period for almost 3 months. I have a history of infertility, most likely linked to endometriosis, with low levels of progesterone. I also have the MTHFR mutation. How do you know where to even start when you don’t know where you are in your cycle, since I haven’t had one in so long?
For the lingering perimenopause symptoms, should I take those supplements only during certain phases or for my whole cycle? I’m asking particularly about Maca and Vitex, as I took them in my Luteal phase, and they helped, but now I’m not sure if I should continue them in my Menstrual phase. Thanks very much.
I am 42 and for the first time ever am over a week late with my period. I have cycle synced using the Flo method for years, and have almost always had 28 day cycles without variation.
My question is, how do I cycle sync when my period is late like this? Do I act as if it is the luteal phase until it comes, or do eventually I move to acting as if I am in the follicular phase?
Thank you sincerely in advance for any assistance and support!
Hi Leah, You want to keep moving with your cycle syncing regardless, and then you can reset your diet to your period once it comes. At your age is when shifts to your cycle can start – you can consider adding in EASE, which is really helpful for making that perimenopause transition easier.
XO, Christina – FLO Coach
I was wondering have you come out with your Phase 2 program at this time?
Hello Alisa,
Thanks for the great advise and tips.
I was wondering have you come out with your Phase 2 program at this time?
Dr Anna Cabeca was mentioned above- I have just bought her book Menupause, which is great for phase 2.