NATUROPATHIC DOCTOR IN ONTARIO
Understanding the Perimenopausal Transition
A Guide for Women in Their 30s and 40s
Perimenopause
Perimenopause isn’t a stage that gets enough attention—and yet, for many women, it can feel like everything is changing without explanation. From heavy periods and brain fog to mood shifts and disrupted sleep, the perimenopausal transition can be confusing and, at times, distressing. But it doesn’t have to be.
At Sequence Wellness, we help women navigate this transition with clarity, support, and evidence-based care. Let’s dive into what perimenopause really is, what you can expect, and how to know when your symptoms might be more than just “getting older.”
What Is Perimenopause?
Perimenopause, or the menopausal transition, is the natural stage of life that occurs before menopause. It can begin as early as your mid-30s (though more commonly in your 40s) and last anywhere from 2 to 8 years. This phase is marked by fluctuating hormones—primarily estrogen and progesterone—which leads to a wide range of symptoms that can feel both physical and emotional.
It’s important to know that menopause isn’t diagnosed until you’ve gone 12 consecutive months without a menstrual period, which most commonly occurs at 51 years of age. Until then, you’re in perimenopause—even if you’ve already started noticing significant changes.
What Causes These Changes?
During perimenopause, your ovaries begin to slow down. They release fewer eggs and become less responsive to hormonal signals from your brain. This impacts the entire hypothalamic-pituitary-ovarian (HPO) axis, which is responsible for regulating your reproductive hormones.
Here’s what’s happening under the surface:
- Progesterone levels begin to drop first—this hormone is produced only after ovulation, which becomes less regular with age.
- Estrogen becomes erratic, sometimes rising higher than normal before eventually declining. This can lead to what’s known as estrogen dominance, where estrogen is high relative to low progesterone.
The result? A cascade of symptoms that can change monthly, weekly, or even daily.
Common Symptoms Of Perimenopause
Because perimenopause affects the whole body, the symptoms can be incredibly varied. You may experience:
- Irregular or heavy periods
- Breast tenderness
- Bloating
- Mood swings or anxiety
- Brain fog and memory lapses
- Hot flashes and night sweats
- Vaginal dryness or discomfort
- Joint or muscle pain
- Sleep disturbances or insomnia
Not every woman experiences every symptom—but even a few can have a noticeable impact on daily life.
Why Does This Phase Matter?
Perimenopause isn’t just a waiting period before menopause. It’s a significant hormonal transition that can affect long-term health. Shifts in estrogen and progesterone can influence your:
- Bone density
- Cardiovascular health
- Blood sugar and insulin sensitivity
- Cholesterol levels
- Cognitive function
- Emotional resilience
That’s why recognizing and addressing these changes early can make a big difference—not only in how you feel now but in how you age later.
Is It Normal to Feel “Off”?
Yes—but that doesn’t mean you have to suffer through it.
Many women are told their symptoms are just a normal part of aging. While perimenopause is natural, struggling through it isn’t your only option. Understanding the root of your symptoms allows for targeted, effective care—whether through lifestyle support, supplementation, or hormone therapy (when appropriate).
At Sequence Wellness, we take a personalized approach to care. We recognize that no two women experience this transition the same way, and your treatment shouldn’t be one-size-fits-all.
What About Lab Testing?
Testing for perimenopause can be tricky. Hormone levels fluctuate so much during this time that a single lab result often doesn’t tell the whole story. That said, hormone testing—when interpreted within the context of your symptoms—can still offer valuable insights.
Tests we may consider include:
- Estradiol (E2) and progesterone levels
- FSH (follicle-stimulating hormone)
- Antral follicle count (to assess ovarian reserve)
- DUTCH hormone panels or cycle mapping for more detailed insights
- Mira at-home serial hormone testing to get a really detailed picture of your hormonal fluctuations.
Sometimes, the best clue is simply listening to your body and tracking symptoms over time.
How We Help at Sequence Wellness
Our perimenopause care is grounded in education, empowerment, and personalized treatment. Whether you’re dealing with heavy cycles, trouble sleeping, mood swings, or all of the above, we support you with:
- In-depth consultations and symptom analysis
- Functional hormone testing when appropriate
- Nutrition and supplement guidance
- Lifestyle coaching for stress, sleep, and movement
- Hormone therapy evaluation and monitoring, when needed
We believe that every woman deserves to feel at home in her body—at every stage of life.
Takeaway: You’re Not Alone, and There Are Answers
Perimenopause may be common, but it’s not always simple. If you’re feeling confused or frustrated by changes in your body, it might be time to take a closer look.
At Sequence Wellness, we specialize in helping women navigate the hormonal transition of perimenopause with clarity and compassion. You deserve a care plan that works with your body—not against it.
Want to find out if you’re in perimenopause or learn how to feel better during this stage?
📞 Book a consultation with us today. We’re here to help you feel like yourself again.
Your Doctor: Meet Dr. Sarah
Dr. Sarah Goulding is a licensed naturopathic doctor in Ottawa Ontario and has a BSc in neuroscience and biology from Dalhousie University (2004), and did her 4-year naturopathic training at the Canadian College of Naturopathic Medicine (2010). She’s since accumulated over a decade of clinical experience, and refined her practice to focus on women’s health and digestion. She is licensed and registered as a Naturopathic Doctor in Ontario by The College of Naturopaths of Ontario (CONO) and is a member of the Canadian Association of Naturopathic Doctors (CAND) and the Ontario Association of Naturopathic Doctors (OAND).
Dr. Sarah Goulding blends science and compassion, and acts as a personal health researcher to help you navigate your health. Tools that she uses include nutrition, supplements and botanicals, bioidentical hormones, and lifestyle modifications. The closer you get to the root cause, the gentler the therapies needed to resolve the issue.
