In today’s episode, Dr. Lisa and Dr. Toni discuss all things perimenopause…what it is, what’s happening and how to test for it. Not sure if you’re in perimenopause or what is happening with your hormones? Experiencing hot flashes, irregular periods, mood swings and insomnia? Listen in!

What is the difference between menopause and perimenopause?

Menopause is when you have not had a menstrual period for 12 months.

Perimenopause is the transition period before you reach menopause and can last for 4 years, 8 years or longer. 

What is happening with your hormones in perimenopause?

Perimenopausal symptoms, as well as your hormones, can be unpredictable and might fluctuate throughout perimenopause:

  • You may get PMS symptoms some months, not others
  • You may get other menopausal symptoms some months and not others
  • Changes that can happen around perimenopause and menopause includes bone loss and osteoporosis, shifts in weight and metabolism, brain and mood changes
  • The most common symptoms you may experience include:
    • Insomnia
      • 30-60% of women experience in perimenopause
      • Research show correlations between plastic exposure and body care products and self-report insomnia (testing urinary phthalate levels – Hatcher 2020)
    • Fatigue
      • See more info about fatigue:
    • Depression and Anxiety
      • Up to 40% of women face depression or mood changes in perimenopause
    • Hot flashes
      • You can experience one of four patterns of hot flashes
        • Early onset, late onset, high frequency, low frequency
      • See more info about hot flashes: Episode 32
    • Irregular menstrual cycles and heavy bleeding

Your body’s normally predictable hormone cycle that happens over the month changes during perimenopause:

  • You might not ovulate every month or you might ovulate early
  • You have changes in your menstrual cycle length of 7 days or more (shorter or longer cycles) then have longer cycles and more skipped periods until you reach menopause 
  • Your estrogen levels can go up and down more than usual
  • Your progesterone levels tend to decrease overall
  • Your FSH level may elevate or fluctuate
  • Your stress hormone cortisol and thyroid hormones can be impacted 

Does every woman experience the transition from perimenopause to menopause the same way?


You can have one of 4 different patterns of estrogen and 3 different patterns FSH levels, as well as different combinations of other symptoms at different stages of perimenopause. 

How can you tell if you are ovulating?

  • Monitor your basal body temperature (BBT)
  • Check your cervical fluid and cervical position

Perimenopausal Journal to track your symptoms and your menstrual cycle.

Today’s Mama Must Have:

Dr. Lisa is a big fan of this paleo crepe recipe that Stuart also loves:

Dr. Toni loves seeing Frankie play with simple wooden blocks and hand-me-down Lego blocks

Thank you for joining us today!

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Please tell your perimenopausal mama friends about us, too!

You can also support us by visiting our Patreon page where you can find out how you can join us for our monthly patron webinar where we do a deeper dive discussion about all things perimenopause,

Stay safe and healthy everyone!

Disclaimer: The information provided in this presentation is not meant to replace treatment with a licensed health care practitioner. It is for informational purposes only. Consult with a Naturopathic Doctor or other licensed health care professional to determine which treatments are safe for you.