Navigating Perimenopause: A Naturopathic Guide to a Graceful Transition
by Dr. Faryal Luhar, ND
Embracing a natural transition
Perimenopause marks a woman’s journey into a new phase—where hormonal shifts ripple through physical, emotional, and mental landscapes. While this transition is inevitable, suffering debilitating symptoms is optional. Perimenopause is not a cliff one falls off; it’s more like a winding scenic road with a few unexpected potholes and surprise detours. With the right map and some self-care pit stops, it is possible to cruise into this next chapter with confidence, vitality, and maybe even a little sass!
The naturopathic perspective on this journey incorporates various natural and whole-body strategies to address the root causes of unpleasant symptoms. Preventive measures are also utilized to optimize health as the body ages. Naturopathic support shifts women from feeling helpless and overwhelmed onto a path of empowerment, balance and vitality.
Understanding Perimenopause: What It Is and When It Begins
Perimenopause is the body’s natural lead-up to menopause, signalling the gradual decline of female hormones and typically occurs around age 40-51. During this phase, the ovaries begin to produce less estrogen and progesterone triggering a cascade of changes – including fluctuations in menstrual cycles and irregular periods. The timeline for this phase can vary significantly ranging from 2-10 years with some women complaining of symptoms as early as age 35.
When the ovaries take their final bow on the reproductive stage of life, and the menstrual period ceases for 12 months consecutively, this is known as menopause. At this point the primary reproductive hormones – estrogen and progesterone, are at their lowest. Testosterone levels which play an important role in women’s health also begin to decline. For many women, the experience of menopause is more stable and settled compared to perimenopause, when hormone levels fluctuate erratically while declining. As such the symptoms can be varied, unpredictable and often go unrecognized as the body shifts into this phase.
Signs & Symptoms: What to Watch For
An array of symptoms spanning physical, mental, and emotional domains occurs. Let’s not forget that hormone receptors are present all over the body including the brain, bones, skin, heart, digestive system and more and as hormones decline, symptoms related to these organ systems will appear.
Typically, the first hormone to decline is progesterone and women can continue to have healthy 28-day menstrual cycles without realizing that they are not producing sufficient progesterone. Progesterone changes affect women profoundly and its benefits go far beyond preparing and supporting the body during pregnancy. Progesterone calms the brain and nervous system and allows women to have more psychosocial resilience. This is largely due to its interaction with GABA (gamma-aminobutyric acid); the body’s main calming neurotransmitter which produces anti-depressant, stress-reducing, and slightly sedative effects. As such initial symptoms include:
· Anxiety and mood changes: unease, sadness or irritability
· Sleep disturbances: difficulty falling or staying asleep which can be related to night sweats or anxiety
· Decreased resilience to stress
· Cognitive issues: forgetfulness or “brain fog”
· Fatigue: often linked to poor sleep or increased stress
· Joint Pain/Muscle aches: a secondary effect of weight distribution and disrupted sleep
· Menstrual changes: short luteal phase, spotting, heavier periods, prolonged periods, worsening PMS
· Migraines: these may worsen
Estrogen influences breast development and sexual maturation, feminine curves, pregnancy and lactation, vaginal lubrication, and the health of the heart, bones, skin and immune system. Declining levels manifest in various symptoms such as:
· Hot flashes and night sweats: sudden waves of heat accompanied by sweating and flushing, particularly at night
· Vaginal dryness: thinning and drying of vaginal tissues, leading to discomfort, itching, or pain during intercourse, frequent urinary tract infections
· Brain fog: difficulty concentrating, forgetfulness, or feeling mentally sluggish
· Weight gain: especially around the mid-section
· Decreased libido: disinterest in sexual activity or difficulty with arousal
· Accelerated skin ageing/Thinning hair
· Loss of bone density
Estrogen plays a protective role in women’s health. In perimenopause and menopause, as estrogen levels steadily decline, the risk for chronic diseases such as heart disease, osteoporosis, and dementia increases.
There are lesser known or unusual symptoms that can be experienced by many women, which are often dismissed. Some of these are related to changes in histamine tolerance which can cause allergies or the sensation of itchy skin. Tinnitus, metallic or burning taste in the mouth, gum sensitivities or even digestive disturbances are other perimenopausal symptoms.
A common frustration women encounter upon seeking conventional medical assistance for symptoms is that they are commonly met with a doctor who may prescribe a different medication for each symptom. Examples include antidepressants for mood swings, sleeping pills for insomnia, or hormonal birth control to ‘’regulate cycles’’. Women are often told ‘’it’s just stress’’ or that they are ‘’too young for menopause’’ or ‘’ your blood work looks normal and you still have a period’’. This symptom-by-symptom approach fragments care, often leaving women feeling unheard and unsupported. The naturopathic perspective shifts the focus back to the whole person, recognizing that all these issues may stem from the same hormonal transition.
Perimenopausal hormonal swings can feel like a wild rollercoaster, almost like puberty in reverse. In addition, women also face health concerns related to heart health, weight loss resistance or metabolic sluggishness, and muscle and bone loss. Estrogen and progesterone fluctuations are central to symptoms and managing their balance is foundational.
The Naturopathic Approach
Using a framework that is holistic and comprehensive, naturopathic medicine emphasizes the importance of identifying and addressing root causes while supporting the body’s natural healing capabilities. Insightful testing paves the way for custom-made interventions through the use of functional laboratory tests to assess sex hormones, blood sugar regulation, thyroid profile, cortisol, lipids and heart health and even body composition. Treatments are then personalized to each woman’s unique symptoms and long-term health goals.
Naturopathic strategies include:
· Targeted nutrition for healthy hormone production and detoxification focused on whole-foods and phytoestrogens such as flaxseeds and organic soy to ease night sweats and hot flashes. Anti-inflammatory foods such as fatty fish and olive oil support heart health and improve mood and cognitive function.
· Optimizing gut health is crucial to enhance absorption of nutrients. Regular bowel movements support clearance of hormones. A healthy gut microbiome specifically related to estrogen known as the estrobolome is vital and can be supported with fibre-rich plants and fermented foods such as sauerkraut and kimchi.
· Botanical medicines such as Vitex, Black Cohosh or Maca are incorporated according to individual needs to support hormone pathways. Supplements such as vitamin D and calcium for bone health are considered as the risk of osteoporosis increases during this stage. Magnesium is another important mineral and plays a crucial role in muscle relaxation, sleep quality, and mood stabilization, all of which can be disrupted during perimenopause.
· Stress management which emphasizes self-care practices become essential to improve resilience and keep cortisol levels balanced which otherwise negatively impact estrogen and progesterone. Meditation and other creative outlets are ways of learning to ‘’let go’’ and prioritize wellness. Adaptogenic herbs such as Ashwagandha or Rhodiola can also be used to maintain healthy adrenal output.
· Movement is essential for optimizing body composition and minimizing abdominal weight gain. Strength training to maintain muscle mass and bone density along with cardiovascular exercises are encouraged. Movement also releases endorphins enhancing mood and mental resilience.
· Prioritizing sleep is challenging but necessary during this transition as it affects metabolic health such as insulin resistance, as well as energy, moods, immunity and weight. Morning exposure to sunlight impacts healthy melatonin output at nighttime. Thyroid imbalances can affect sleep quality so evaluating hormones to determine unique patterns can point to helpful sleep support supplements such as GABA, l-theanine, or passionflower as needed.
· Consider BHRT which is the use of prescribed plant-based hormones and is a safe and effective tool during this transformative process. Seeking out a qualified health professional to explore this option is important.
Perimenopause need not be a mystery or a misery. It may feel daunting, but with a naturopathic compass, women can navigate with strength, grace, and autonomy. This life stage is complex, but the right support eases this transition into a phase of empowerment rather than surrender and allows for renewal, balance and a deeper connection to one’s own health.
Meet the Amrita Voice
Dr. Faryal Luhar,
Naturopathic Doctor
Dr. Faryal Luhar, ND is an internationally recognized Naturopathic Doctor with 20 years of clinical experience spanning Canada, South Africa, Saudi Arabia, and Dubai. Known for blending science, tradition, and innovation, she specializes in uncovering the root causes of illness and designing personalized, results-driven treatment plans that harness the body’s innate ability to heal.
Her integrative approach combines functional medicine with clinical nutrition, botanical medicine, Chinese medicine and acupuncture, combination homeopathy, and genetic-based healthcare. This diverse toolkit allows her to treat a broad range of conditions—from complex women’s health concerns to chronic diseases like diabetes, and pain syndromes such as migraines—while also focusing on prevention, healthy aging, and optimal vitality.
Dr. Luhar is passionate about translating advanced laboratory insights, including gene-based assessments, into practical, empowering strategies that help patients become the authors of their own health stories. She sees every patient as a partner and teacher, believing that education and empowerment are the most powerful prescriptions.
Beyond her clinical work, she has authored numerous articles in leading wellness magazines and is a sought-after voice in the media, with multiple appearances on television and radio. Her global practice gives her a unique lens on health that bridges cultures, traditions, and cutting-edge science.
At the heart of her work is a mission: to inspire people to live balanced, vibrant lives filled with clarity, resilience, and possibility, no matter where in the world they call home.
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