4 Steps to Navigating Perimenopause
Navigating perimenopause can feel just as overwhelming as perimenopause itself.
It's hard to know where to start.
For years, I felt like I was knocking on all the wrong doors, getting turned around in circles. It was disorienting - and defeating. But I'm so glad I stuck with it.
Once I got the help I needed, I became committed to helping others get oriented. This has developed into a four-step approach to navigating perimenopause. It came about naturally from my own experience, and since then, I've gotten validation from lots of reading and hearing back from experts.
Whether you’re at the beginning of your journey or playing whack-a-mole with your symptoms, below are my 4-Steps for Navigating Perimenopause:
STEP ONE: FIND THE RIGHT DOCTOR
You have the right to proper healthcare.
You have the right to a doctor who is educated about menopause and HRT.
You have the right to be taken seriously.
If you found a doctor like that - YAY! So so happy for you.
But if you're like most of us, your doctor has gaslit you, failed to discuss HRT, or lacks basic education about menopause. All too often, it's all three.
The good news is, there are educated and helpful doctors out there - you just have to find them.
Where do you start?
Start by recording your symptoms. Write down all the things that feel... off.
No one knows your body like you do. Trust yourself.
Wondering about symptoms? Here is a helpful list of symptoms and a tracker in one.
Fill it out and share it with your doctor.
How is Peri diagnosed?
Peri is primarily diagnosed via symptoms, not blood work! There is no specific test for Peri.
Blood work can be helpful, but mostly to rule out other health issues.
Think of it like a check-up - good data to have on hand. Especially as you age.
What should you expect:
Once you bring your symptoms and concerns to your doctor, you should expect a plan.
Such plans could be more tests (to rule other health issues out), referral to a specialist (such as someone specifically educated in menopause health), or starting Hormone Replacement Therapy (HRT).
Three Notes on HRT:
Everyone has the right to HRT.
If your doctor is not up to date on HRT, I highly recommend sharing the Menopause Society's 2022 Position Statement on HRT or reading The New Menopause, by Dr. Mary Claire Haver, which covers HRT in depth.
There is no "right age" to start HRT, but modern guidelines suggest the sooner the better.
HRT isn't for everyone. There are many reasons - both medical and personal - why someone may not be a candidate for HRT. Thankfully, there is so much you can do with diet and exercise to help manage your symptoms.
WHAT IF YOUR EXISTING DOCTOR CAN'T OR WON'T HELP YOU?
Don't worry! YOU have options:
Search for a Menopause Certified Doctor via the Menopause Society.
Google “Menopause clinics near me”.
Call your insurance and ask if they have a Menopause specialist in their system.
Even though it may not seem like it at times, you are in control of our body. You need to be your own best advocate and prioritize your health. Don't take no for an answer.
STEP TWO: CONSIDER CHINESE OR FUNCTIONAL MEDICINE
Hormones and health are personal. Yet most medicine is looked at through the data of a 175lb male. (Because that's where they've done the most research).
You are a unique individual. And getting personalized care can be a game-changer.
Functional and Chinese medicine are similar because they look at each patient individually but through a holistic lens.
Functional medicine blends conventional and holistic treatments.
Many practitioners are MDs capable of writing prescription medications, but they also look at your entire lifestyle, including nutritional health.
They can dig into your personal needs and help you navigate supplements to help improve your overall health and ease your symptoms.
(Note: Supplements could be their own step and I will be adding a section dedicated to just that. If you want to know when that's available, sign-up here.)
You can learn more from the Institute of Functional Medicine here.
Chinese medicine uses acupuncture, herbs, and other treatments to balance the body’s energy and address symptoms.
Chinese herbs have been used for centuries to treat health, and there are some wonderfully powerful ones to support perimenopause.
Unlike nutritional supplements, Chinese herbs really must be tailored to the individual. Make sure you only take them under the guidance of an accredited practitioner.
In certain states, like California, an acupuncturist may have additional training - similar to that of a functional medicine doctor.
In these cases, they may be able to order bloodwork and specialized tests.
TIP: Look for a Chinese medicine practitioner who specializes in fertility. This is more widely advertised, but a fertility specialist typically supports the entire reproductive cycle.
For those in select locations, this site has a short list.
STEP TWO: PROTEIN, PROTEIN, PROTEIN.
In perimenopause, your body becomes less efficient in processing certain types of foods. One of those foods is protein.
Protein supports muscle mass, bone density, tissue health, hormones, immunity, energy, and metabolism. And each one of these functions starts to decline in peri for various reasons.
The bottom line is your body needs more protein just to maintain the same level of function it did before. Adding more lean protein to your diet is one of the most important things you can do for your health in perimenopause.
How much? 30 grams 3x a day.
Worried about perimenopause weight gain? Become familiar with protein cravings. Yes! Protein Cravings. In perimenopause, you might feel new hunger cravings, but are not connecting them to your body's need for protein. As I result you may feed those cravings with the wrong nutrition - fueling up on extra calories when what your body really needs is protein.
Of course, there is a lot more you can do with your diet. Switching to whole foods, and cutting back on processed ones, is the best thing you can do for your overall health.
A whole-food diet can help reduce perimenopause symptoms like inflammation, high blood pressure, and bad cholesterol.
So do try to eat healthier. And make sure you're getting enough vitamins and minerals.
But don't slack on the protein.
STEP FOUR: WEIGHT LIFTING
Exercise is good for the mind, body, and soul. It releases endorphins, reduces stress, and improves mood - not to mention all the physical benefits ;)
If you haven't already - find something that gets your heart rate up and that you enjoy.
Do it 3- 4x a week. Fast walks, hikes, bikes, yoga, dancing, boxing, twerking, prancercise (yes that's a real thing) - whatever! Just do it!
But once you enter your peri years... there is something we all have to do:
Add weights. (Can you hear me groaning?)
Weightlifting is a non-negotiable for the rest of our lives. It protects our muscles and bones, particularly against osteoporosis.
The good news? You can start where you are. A push-up, a 2 lb weight, a single squat.
You don't have to rush off to CrossFit.
Here is a helpful article on how to get started weightlifting.
Over time you'll be amazed at what your body can do when you add weights - including staying strong and mobile well into your old age.
P.S. True confession - this is the hardest step for me
There you go! Four Steps to Navigating Perimenopause.
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