By Dr. Emily Wiggins

Perimenopause is a powerful and sometimes challenging transition that can begin several years before menopause. During this time, hormone levels, especially estrogen and progesterone, fluctuate, creating changes in mood, energy, sleep, and cycles. While these shifts are natural, they can also bring symptoms like irregular periods, hot flashes, night sweats, anxiety, weight gain, and changes in libido.

The good news is that there are many ways to support your body through this transition using natural therapies, nourishment, and intentional lifestyle choices.

Nourishing the Body Through Food

What you eat during perimenopause can make a profound difference in how you feel. Focus on foods that help stabilize blood sugar, support the liver, and balance hormones.

Prioritize protein at each meal to maintain muscle mass and stabilize mood and energy.
Eat plenty of fiber from vegetables, fruits, seeds, and legumes to promote healthy estrogen metabolism.
Include healthy fats such as avocado, olive oil, nuts, and seeds to support hormone production.
Support your liver with cruciferous vegetables like broccoli, kale, and cabbage to aid in detoxifying excess hormones.
Reduce alcohol and sugar, which can worsen hot flashes, night sweats, and sleep issues.

Some women also find benefit from phytoestrogen-rich foods such as flaxseeds, fermented soy (tempeh, miso), and lentils, which can gently support estrogen balance.

Herbal and Nutrient Support for Perimenopause

Herbal medicine offers a wide range of options to ease perimenopausal symptoms and support hormonal harmony.

Each person’s needs are unique, but some commonly used herbs include:

Vitex (Chaste Tree Berry) to support progesterone and balance irregular cycles.
Black Cohosh to help reduce hot flashes and night sweats.
Maca Root to support energy, libido, and mood.
Ashwagandha to calm the nervous system and improve sleep.
Dong Quai for menstrual regulation and uterine support.

Nutrient support may also include magnesium, B vitamins, and omega-3 fatty acids to regulate mood, support adrenal function, and ease inflammation.

Lifestyle Practices That Make a Difference in Perimenopause

Perimenopause is as much an emotional and spiritual transition as it is physical. Slowing down and tending to your nervous system is key.

Prioritize rest and regular sleep. Aim for a consistent bedtime and create an evening routine that helps your body unwind.
Move regularly. Incorporate strength training, gentle cardio, and stretching to maintain muscle tone, bone health, and circulation.
Practice stress reduction. Prayer, meditation, yoga, breathwork, and time in nature all help regulate cortisol and reduce symptom intensity.
Cultivate connection. Sharing your experience with other women or working with a trusted practitioner can offer deep emotional support and perspective.

From our perspective, perimenopause is not a problem to fix but a process to honor. Your body is recalibrating, asking for deeper nourishment and alignment. When we support the body’s innate wisdom rather than override it, we create the foundation for a smoother transition into menopause and beyond.

When to Seek Guidance

If symptoms are disrupting your quality of life, it can be valuable to work with a naturopathic doctor who understands hormonal transitions. Through individualized care, including lab testing, herbal support, and nutritional therapy, we can identify what your body truly needs and create a plan to restore balance.

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