To most women, perimenopause is a mystery—one of the unexpected symptoms, hormonal fluctuations, and confusion about what’s actually happening in their bodies. Hot flashes, mood swings, disorientation, and insomnia may begin years before menopause officially starts, but most women don’t take action until they’re 56 or older, even though symptoms typically begin in their 40s or even late 30s.

In spite of all this, just 20.7% of women have ever talked about perimenopause with a medical provider. Why? Because mainstream medicine will dismiss symptoms as simply “part of getting older” or use a Band-Aid approach without looking at the underlying imbalances.

Functional medicine goes another way. Rather than covering up perimenopause symptoms, functional medicine addresses underlying hormonal imbalances, nutritional deficiencies, and lifestyle contributors to perimenopause challenges. By considering the larger picture—your diet, stress levels, digestive health, and even exposure to toxins—functional medicine presents a personalized, proactive approach to thriving during this time.

Take a look at what functional medicine can do for you—get you back to you—before waiting years for the answers.

What’s Happening to Your Body? Understanding Perimenopause.

Missing periods is just one aspect of perimenopause; in fact, it’s a major hormonal transition that influences everything from your mood to your metabolism. Though it is a completely natural stage of life, many women feel ill-prepared for the changes it brings.

Menopause is the point at which a woman stops having her period and her reproductive years, and it is preceded by perimenopause, a phase where hormone levels fluctuate, leading to symptoms. Officially, menopause is diagnosed when a woman has gone 12 consecutive months without a period, and the average age in the U.S. is 51. 

This journey has three key stages.

• The transition phase is when estrogen and progesterone start to fluctuate, causing symptoms.
• The official end of the menstrual cycle after a full year without a period is called menopause.
• Menopause marks the end of menstruation and ovarian function. There are two types of menopause: primary and secondary.

The postmenopausal woman faces increased risks of heart disease, diabetes, bone fractures, and even dementia, so it is important to support the body through this transition, not just to endure it.

Common Symptoms: More Than Just Hot Flashes

Symptoms of perimenopause vary from woman to woman, but some of the most common are:

• Your periods may become irregular; you may have lighter or heavier bleeding.
• Sudden heat waves may interfere with sleep and daily activities.
• Emotional ups and downs, increased irritability, feelings of being overwhelmed, mood swings, and anxiety.
• Vaginal dryness, which can be painful or uncomfortable during intimacy.
• Waking up frequently, not being able to fall back asleep, and feeling unrested.
• Many women find it much harder to lose weight and gain belly fat.
• As you age, you may notice that your hair becomes more brittle, your nails are more brittle, and your skin is drier.
• Hormonal changes may also cause loss of breast fullness, and the breasts may shrink in size or change shape.
• It can cause muscle & joint pain, aching joints, stiffness, and even a frozen shoulder.

These symptoms do not follow a set pattern, so many women have a hard time connecting them to perimenopause, and they end up frustrated and confused. The good news? It doesn’t have to be you just “pushing through it.”

The Principles of Functional Medicine

Have you experienced the feeling that conventional medicine views menopausal symptoms in isolation (hot flashes, anyone)? Take this pill. Mood swings? Try another one—you’re not alone. Traditional healthcare deals with symptoms, not the root cause of what’s going on in your body. Functional Medicine is where that fits in.

A Holistic Approach to Menopause Symptoms

The fundamentals of Functional Medicine are that your body works like a unit, not a collection of parts. Instead of just treating the symptoms, such as night sweats or fatigue, with a quick fix, this approach gets to the root of what is out of balance in your body in the first place.

By looking at factors like:

• Hormonal fluctuations – The effect of constantly changing levels of estrogen, progesterone, and cortisol on your symptoms
• Gut health – The role of digestion, inflammation, and microbiome imbalances in menopause symptoms
• Nutrient deficiencies – Fatigue, mood swings, brain fog, and more can all be made worse by nutrient deficiencies.
• Environmental toxins – The exposure to chemical toxins that can disrupt your hormones. 
• Genetics & lifestyle – What your genetics and lifestyle have to do with your menopausal transition. 

Functional Medicine practitioners use advanced lab testing to identify these areas and develop a personalized treatment plan that often includes specific nutrition, lifestyle changes, botanical medicine, or pharmaceuticals, if needed, to restore balance.

How Functional Medicine Differs from Conventional Medicine

The biggest difference? Functional Medicine goes beyond treating symptoms and looks for what’s causing them.

• Conventional medicine usually treats menopausal symptoms with medications such as hormone replacement therapy (HRT), antidepressants, and sleep aids. These can be helpful, but they don’t address why the symptoms are happening.
• Functional Medicine considers how systems interact with each other. A Functional Medicine practitioner might look at whether gut inflammation, adrenal fatigue, or blood sugar imbalances are contributing to your hot flashes instead of simply prescribing a pill.

Take control of your health today! Schedule a Functional Lab Testing consultation with Advanced Integrated Health and start your journey to true healing.

Functional Medicine Treatment for Perimenopause

For many women, perimenopause can feel like an unpredictable rollercoaster—hot flashes, mood swings, brain fog, sleep disturbances, and more. However, these symptoms can be so disruptive that the vast majority of women don’t seek treatment until age 56 or older, even though perimenopause often starts in the early 40s or even the late 30s. Why? They are not well supported by the medical system.

In reality, 80% of OB/GYNs aren’t trained in menopause care, leaving women without the support they need. When something goes wrong in the body, conventional medicine’s first response is usually to start prescribing birth control pills, antidepressants, or hormone replacement therapy (HRT) without really investigating the issue.

Addressing Hormonal Balance in Perimenopause

One of the major reasons for your perimenopausal symptoms is hormonal fluctuations. Women go through a number of physical and emotional changes as their estrogen, progesterone, testosterone, and cortisol levels change. However, these changes don’t occur in a vacuum—hormones influence every system in the body, including digestion, brain function, and sleep cycles.

Instead of prescribing a one-size-fits-all treatment, Functional Medicine utilizes advanced diagnostic testing to measure a woman’s individual hormone levels and determine her specific hormone imbalances. With these imbalances understood, a tailored treatment plan is created, which may include:

• Targeted Nutrition: Flaxseeds (phytoestrogens), cruciferous vegetables (detoxification of excess estrogen), and healthy fats (support hormone synthesis) are some foods that may support hormone production.
• Supplementation: Lab results will dictate which supplements are needed, such as magnesium (for sleep and stress), vitamin D (for bone and mood), and adaptogenic herbs (like ashwagandha or maca) to help level out hormonal swings.
• Lifestyle Adjustments: When it comes to stress, it is a major disruptor of hormonal balance, so mindfulness practices, better sleep hygiene, and exercise (tailored exercise like yoga, strength training, walking, etc.) are often part of the treatment plan.

The Role of Gut Health in Perimenopause

Many women are surprised to learn that gut health plays a key role in hormone regulation, but the connection is undeniable. Having a healthy gut is important for estrogen metabolism, nutrient absorption, and inflammation control, all of which can affect perimenopause symptoms.

Symptoms of estrogen metabolism dysregulation (when gut health is compromised) include:

• Vaginal dryness – Poor gut health can lead to poor ability of the body to process and eliminate excess estrogen, which can lead to dryness and discomfort.
• Mood swings and anxiety – The gut is referred to as ‘the second brain’ as it produces neurotransmitters such as serotonin that affect mood and emotional state. Having an imbalanced gut can increase anxiety, depression, and irritability.
• Sluggish digestion, bloating, constipation – Perimenopausal women often suffer from these digestive issues, which can make other symptoms worse.

How Functional Medicine Supports Gut Health in Perimenopause

As part of a comprehensive perimenopause treatment plan, Functional Medicine practitioners work on optimizing gut health. They may recommend:

• Probiotics & prebiotics are beneficial bacteria that keep the gut microbiome in check, and that’s important for hormone metabolism.
• An anti-inflammatory diet lowers processed foods, sugar, and inflammatory oils that support gut health and help to ease perimenopausal symptoms.
• Digestive enzymes, zinc, and omega-3 fatty acids are among the supplements that can facilitate the digestion and absorption of nutrients to ensure the body is in optimal condition.

Lifestyle Changes for Perimenopause Relief

Perimenopause and menopause usher in a flood of changes—some predictable, some entirely unexpected. From mood swings and hot flashes to sleep disturbances and weight gain, this process can be overwhelming.

While hormone therapy is an option for some women, many are turning to nature for guidance on how to tame their symptoms and enhance their overall health. That’s where lifestyle changes come into play.

Functional Medicine addresses perimenopause relief using a whole-body approach, emphasizing diet, exercise, and stress management strategies to aid in hormone balance, bone health, and mental well-being. This is how adopting the proper lifestyle modifications can make your transition easier and more energized.

1. Diet and Nutrition

Eating appropriate foods becomes crucial throughout perimenopause. Your body loses its weight and energy control abilities, and mood regulation capabilities when hormone levels fluctuate. A balanced diet containing essential nutrients and protein together with fiber helps decrease hot flashes and night sweats, and mood swings and simultaneously strengthens bones and maintains metabolism.

The relief of perimenopause symptoms requires these dietary elements:

• During perimenopause, brain function and mental health benefit from omega-3 fatty acids, which exist naturally in salmon, walnuts, and flaxseeds.
• The combination of Vitamin D with Calcium serves as a vital duo that protects your bones, thus preventing osteoporosis and fractures. A combination of dairy products, leafy greens, and fortified foods, along with sun exposure, helps preserve optimal vitamin D and calcium levels.
• Berries, together with nuts and colorful vegetables, contain antioxidants that protect the body from stress, which leads to aging and hormone imbalance.
• Functional Medicine practitioners suggest detox-friendly diets because these foods help liver function and reduce hot flashes and night sweats intensity. Broccoli, along with cabbage and Brussels sprouts, act as cruciferous vegetables to aid the body in breaking down estrogen effectively.

2. Exercise and Physical Activity

Physical activity is not just about fitness—it may be the most effective tool on hand for managing perimenopause and menopause symptoms. Ongoing exercise keeps the heart strong, bones dense, muscles toned, and the mind sharp. It also reverses weight gain, a source of frustration for many in this phase of life.

The best exercises for perimenopause are: 

• Cardio – Jogging, cycling, brisk walking, and swimming strengthen heart and lung function and stimulate metabolism. Studies show 0/7–32 minutes of moderate-intensity exercise per day can reduce hormone levels and reduce hot flash intensity.
• Strength Training – Resistance exercises or weight lifting preserve bone and muscle mass, reducing osteoporosis and fracture risk.
• Yoga & Flexibility Exercises – Yoga, Pilates, and stretching improve flexibility, posture, and stress resistance, in addition to mental health and stress management.
• Outdoor Activities – Nature walks, hiking, or even just a short park walk decreases levels of cortisol (stress hormone), allowing for easier relief from anxiety and mood swings.

3. Stress Management and Relaxation Techniques 

Stress plays an important part in how women experience perimenopause and menopause. High levels of cortisol have been shown to worsen symptoms like hot flashes, insomnia, and weight gain. Effective stress management can enhance mood, sleep, and hormonal balance.

Key stress management techniques include:

• Meditation & Mindfulness – Even 5–10 minutes of meditation or guided breathing daily can lower stress hormones and build emotional resilience.
• Tai Chi & Yoga – Gentle movement exercises such as Tai Chi and Yoga can decrease anxiety, balance hormones, and enhance flexibility.
• Journaling & Gratitude Practice – Writing out thoughts, emotions, or even a gratitude journal daily can shift focus away from stress and promote positivity.
• Self-Care Rituals – It could be a warm bath, aromatherapy, or simply turning off screens – allowing oneself time to unwind can really help alleviate symptoms.

Embracing a New Approach to Perimenopause & Menopause

Too often, women going through perimenopause and menopause have been presented with Band-Aid remedies—a quick 8-minute doctor visit, a sparse laboratory work-up, and a prescription that may or may not alleviate the source of their symptoms. It’s reactive symptom management that is more interested in disease treatment than in achieving real health.

But perimenopause is not just about symptoms—it’s about your overall well-being, energy, and long-term health. Instead of masking issues with a “pill for every ill,” functional medicine offers something different: a tailored, proactive approach that treats YOU as a unique individual. By considering genetics, environment, and lifestyle, Functional medicine allows you to take charge of your body and feel your best—naturally.

Here at Advanced Integrated Health, we’re committed to real health care, not just sick care. With the aid of advanced testing and customized treatment programs, we create individualized solutions that are specifically suited to your body’s unique chemistry. If you’re ready to shatter the cookie-cutter mindset and feel like yourself again, we’re here to help.

References

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2. Bland J. Defining Function in the Functional Medicine Model. Integr Med (Encinitas). 2017 Feb;16(1):22-25. PMID: 28223904; PMCID: PMC5312741. Avaialble at: https://pmc.ncbi.nlm.nih.gov/articles/PMC5312741/.
3. Cunningham, A.C. et al. (2025) ‘Perimenopause symptoms, severity, and healthcare seeking in women in the US’, npj Women’s Health, 3(1), pp. 1–8. Available at: https://doi.org/10.1038/s44294-025-00061-3.
4. Hopkinsmedicine.org (2024) Perimenopause, Hopkinsmedicine.org. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/perimenopause.
5. Wolff, J. (2018) Doctors don’t know how to treat menopause symptoms, AARP. Available at: https://www.aarp.org/health/conditions-treatments/menopause-symptoms-doctors-relief-treatment/ .