Skip to main content

Natural Awakenings South Central Pennsylvania

Perimenopause SOS

Apr 30, 2024 09:31AM ● By Ashlyn Zikmund

photo credit: pexels-rdne-6539885    

Perimenopause can be characterized by many changes in the eight to 10 years preceding actual menopause, where hormone levels fluctuate, leading to many possible symptoms. During perimenopause, there is a slow decline of estrogen and progesterone levels. Typically, progesterone levels decrease more drastically due to irregular ovulatory cycles. This can present as changes in bleeding, more frequent periods, heavier periods or spotting before the menstrual period. There are several options to support women if they are having irregular bleeding—not only to provide a better quality of life, but also to make sure they do not become iron-deficient.


Perimenopause symptoms that impact women most routinely are mood changes, weight changes, hot flashes and irregular bleeding. Women in perimenopause are much more likely to experience a worsening of existing pre-menstrual syndrome (PMS) mood symptoms or experience new onset anxiety or depression due to the hormone fluctuations. However, there are many options, both natural and pharmaceutical, to support women during this period of life.


Women also tend to experience weight gain during the menopause transition. On average, women gain one pound per year, but this can vary widely. The variety of other symptoms occurring are typically an obstacle to making lifestyle changes, and the motivation to exercise may decrease due to low energy and sleep disturbances. A decrease in estrogen alone also has impacts on resting energy expenditure, which is a large contributor to metabolism. This can be corrected in part by appropriate hormone therapy if indicated.


Another large part of weight management in perimenopause is leveraging protein intake. At age 40, dietary protein intake should increase to about 20 percent of total calories, or about 0.54 grams per pound, of body weight. Total calories may also be reduced by about 10 percent, depending on activity level and weight-loss goals. Other research even suggests that 0.68 to 0.77 grams per pound is needed to prevent age related muscle mass.


Dr. Ashlyn Zikmund

Dr. Ashlyn Zikmund is a naturopathic doctor at Natural Paths to Wellness, located at 1524 Cedar Cliff Dr., in Camp Hill. For more information, call 717-494-4500 or visit