Thriving Through Perimenopause: Personalized Care for a Healthier Future
Navigating Perimenopause
All of us move through milestone stages in life, but for women, one of the most transformative is perimenopause—the transition leading up to menopause. Often beginning in the 40s (though it can start earlier), this stage is marked by fluctuating hormones, irregular cycles, and a host of physical and emotional changes. For some, the experience feels subtle and gradual; for others, it can be disruptive and even overwhelming.
At Sunrise Functional Medicine, Dr. Tracy Tranchitella, ND, works with women to navigate this transition with more ease, using personalized strategies that address not just symptoms, but the bigger picture of health. Functional medicine looks at perimenopause as an opportunity to understand the whole person, identify root causes of imbalance, and support lasting wellness.
What Happens During Perimenopause?
Perimenopause, sometimes called the menopausal transition, is the body’s shift from reproductive years into menopause. Hormones such as estrogen and progesterone begin to decline, but not in a straight line—their levels can fluctuate dramatically from day to day. This unpredictability is what often drives symptoms like:
- Hot flashes and night sweats
- Irregular or heavy periods
- Mood changes, anxiety, or depression
- Sleep disturbances
- Musculoskeletal aches and pains
Beyond symptoms, research shows that women in perimenopause may also face shifts in cardiometabolic health, body composition, and even cognition. Lower estrogen levels can affect fat distribution, raise cholesterol, and increase systemic inflammation—all factors linked to long-term disease risk.
Lifestyle as Medicine
The encouraging news is that lifestyle plays a central role in how women experience perimenopause. Studies continue to show that nutrition, movement, and stress transformation practices can improve symptoms and reduce risks. Functional medicine takes these findings a step further, tailoring them to each woman’s history, needs, and goals.
Cardiometabolic Health and Body Composition
Weight changes and metabolic shifts are common concerns during perimenopause. A 2020 U.S.-based study highlighted how visceral fat—especially the kind that gathers around the abdomen—can increase significantly during this stage, particularly among white women. This change was linked with rising cholesterol and LDL-c levels, which are markers for cardiovascular risk.
Encouragingly, observational studies have found that women who reduce sedentary time, eat more fruits and vegetables, and build strength and cardiovascular fitness are better able to maintain healthier body composition and protect heart health. A small 2021 trial put these insights into practice: women who followed a three-month personalized nutrition plan (modeled on the DASH diet) or a combined nutrition-and-exercise program saw significant improvements in cardiometabolic markers. These results reinforce that small, consistent lifestyle changes really do move the needle.
Sleep, Mood, and Mental Health
Sleep disturbances are another hallmark of perimenopause, often tied to fluctuating estrogen and progesterone. Research has shown that yoga can make a meaningful difference. In one trial, perimenopausal women who practiced yoga three times a week for 20 weeks reported improvements not only in overall symptoms but also in sleep quality.
Mood changes and depression are also more likely during perimenopause, especially in women with a history of depression. A 2020 meta-analysis found that exercise and mind-body therapies such as walking, dance, relaxation practices, and massage—when practiced consistently over 12 weeks or more—were linked to significant improvements in mood. This means that building a personalized plan around both body and mind isn’t just supportive, it’s essential.
Perimenopause Through a Functional Medicine Lens
Where conventional approaches often focus narrowly on symptoms, functional medicine seeks to understand the whole picture. During perimenopause, hormone patterns can vary widely: some women may show signs of estrogen dominance, others low hormone metabolism, and others a broader insufficiency. Dr. Tranchitella often begins with a detailed health history, looking at how factors like stress, sleep, gut health, toxic exposures, and blood sugar regulation play into hormone balance. These root causes frequently shape the severity and type of symptoms a woman experiences.
The Institute for Functional Medicine (IFM) uses the “PTSD” framework—production, transport, sensitivity, and detoxification—to guide the evaluation of hormonal imbalances. By identifying where disruptions occur, a personalized plan can be built using nutrition, botanicals, lifestyle therapies, or, when appropriate, hormone support.
Practical Strategies for Supporting Wellness
What does this look like in real life? For one woman, it might mean adopting a resistance training program twice a week to support muscle strength and protect against fat gain. For another, it might mean daily walking and targeted nutrition strategies to balance blood sugar. For women experiencing mood changes, stress-reduction practices like yoga, meditation, or even structured relaxation techniques can be transformative. Perimenopause is not just about “getting through” but about setting a foundation for long-term health. Addressing cardiometabolic risk, protecting bone density, supporting brain health, and stabilizing mood now helps ensure a healthier postmenopausal future.
Looking Ahead with Confidence
While perimenopause is a universal life stage, every woman’s journey is unique. By embracing a functional medicine approach, it becomes less about symptom management and more about whole-person wellness. The tools—nutrition, movement, stress management, and, when needed, targeted therapies—are practical, effective, and adaptable.
Dr. Tranchitella helps women to navigate perimenopause in a way that feels empowering and supportive. Whether you’re struggling with hot flashes and poor sleep or simply want to take a proactive stance on your health, a personalized plan can help you move through this transition with more ease and energy. Perimenopause doesn’t have to be a time of struggle. With the right support, it can be an opportunity—a stage to reset habits, deepen self-care, and build resilience for the decades ahead. Learn more and request a consultation today >>