Could You Be in Perimenopause?

April 26, 2011
Ann Louise Gittleman, PhD, CNS

Ann Louise Gittleman, PhD, CNS

Award-winning nutritionist and New York Times bestselling author.

100722087What you need to know about the change before the change.

What on Earth was happening to my body? Exhausted after several nights of not being able to sleep properly, here I was again, awake at 4 A.M., feeling palpitations in my heart. Until this began, I would have slept through a hurricane. Was this the start of a heart condition or a nervous breakdown?

After a productive but extremely stressful year of travel, radio shows, lectures, and book promotions, I had relocated my office and was in the midst of remodeling my home. While the pressure of all these activities had propelled me to a new level of stress and tension, I kept reminding myself that in the past I had thrived under pressure. Anyway, no matter how much stress I had been under—from manuscript deadlines to speeches in front of thousands of people—once my head hit that pillow, I was out and always slept through the night.

Something was definitely changing in my body. I began to imagine the possibility of never getting a good night’s sleep again, and that made me feel even more anxious and depressed. It wasn’t until I took an entire battery of blood tests (including an FSH hormone indicator) that it dawned on me what was really happening. At age forty-plus, I was in perimenopause.

So, what is perimenopause?
It’s the approximately 10 years during a woman’s life when two hormones in her body—estrogen and progesterone—are beginning to fluctuate.

I would bet there are 50 million women in American who may not realize they are in the throes of the change before the change. Although we often think of perimenopause as starting when women are in their forties, I have found in my own practice that the condition can even start to occur among women who are around age twenty-eight. Perimenopause is not always like traditional menopause with hot flashes or night sweats. Rather, very often the first signals of fluctuating hormones that women have include insomnia, irritability, lack of focus or attention span, weight gain, and anxiety.

One of the most important aspects is that these are tricky symptoms and often misdiagnosed because they are seemingly unconnected. That is why this whole period of life needs to be taken a lot more seriously by women and physicians alike. To me this is very important. A lot of women are being misdiagnosed, and they cannot get better without a correct diagnosis of the underlying condition.

Are you in perimenopause?
Take this quiz and find out. Score according to the intensity and frequency—1 if the symptom is mild or occasional, 2 if it’s moderate or frequent, and 3 if it’s severe. Answer all ten questions and add up your final score.

(1) Do you feel depressed or have “the blues” for no apparent reason?
(2) Do you experience restlessness, irritability, and anxiety?
(3) Have your sleep patterns changed, with frequent awakenings or insomnia?
(4) Does your heart sometimes pound while you are resting or sitting?
(5) Do you have food cravings?
(6) Do you have bloating to fluid retention?
(7) Do you need to urinate more frequently?
(8) Has your sex drive diminished?
(9) Do you often have headaches or migraines?
(10) Are you starting to put on weight around the middle?

If you scored between 10 and 18: Don’t worry, you’re not going crazy. You are probably just beginning the perimenopause transition. A hormone-regulating diet and supplements, regular moderate exercise, and better management of stress may be all you need to alleviate your symptoms.

If you scored between 18 and 28: Diet, exercise, and stress management may or may not be enough to alleviate your symptoms. Additional nutrients and natural progesterone cream should make all the difference.

If you scored above 28: You are fully in perimenopause. The remedies above may be sufficient. If they are not, consider taking natural hormones, but first have a Salivary Hormone Test for hormone levels.

Peri Zappers
There are no rookies on this all-star team. All of these zappers are combat-hardened veterans from the symptom wars.

(1) Flaxseed Oil – It contais both omega-3 and -6 fatty acids, helps to balance estrogen, and is the chemical precursor of the fatty acid EPA and of hormone-like prostaglandins.

(2) Black Currant Seed Oil – It’s a potent source of the fatty acid gamma linolenic acid (GLA), which converts hormone-like prostaglandins.

(3) Multivitamins and Magnesium – A combo of certain vitamins and magnesium may be necessary to get your hormonal system back in balance. The formulation in UNI KEY’s Female Multiple provides the optimum 2:1 ratio of magnesium to calcium, in favor of magnesium.

(4) Zinc – This mineral is a must if you are a vegetarian.

(5) Natural Progesterone Cream – In perimenopause, your symptoms are frequently due to a low progesterone level. Taking an artificial progesterone (progestin) can intensify your symptoms and also make your body feel that something is not quite right. Natural progesterone is the same molecule as that in our bodies. Taken as a non-proscription cream, it rebuilds your body’s progesterone level, restores hormonal balance, and helps relieve a wide array of symptoms including decreased sex drive, depression, abnormal blood sugar levels, fatigue, fuzzy thinking, irritability, thyroid dysfunction, water retention, bone loss, fat gain, and low adrenal function.

(6) Exercise – Be vigorously active for a half hour, five days a week. Do different things each day—make it fun!

(7) Destressing Stress – Take a good look and see if you can interrupt the cycles of your stress.

(8) Adrenal Refresher – When you are under a lot of stress, replacing lost minerals and vitamins can help your adrenal glands secrete stress hormones.

(9) Hesperidin – It helps to reduce hot flashes by improving venous tone, restoring normal capillary permeability, and improving lymphatic drainage. There are 500 mg of hesperidin complex per serving packed into UNI KEY’s Female Multiple.

(10) Natural Hormone Therapy – Use the natural hormone estriol (the safest estrogen), specially prepared for your needs as indicated by saliva tests of your hormone levels.

Related Articles and Podcasts

Ann Louise Gittleman, PhD, CNS, is an award-winning New York Times bestselling author of more than thirty books including The Fat Flush Plan series and her latest book, Radical Metabolism. She’s been rewriting the rules of nutrition for more than 40 years and is internationally recognized as a pioneer in the field of diet, detox and women’s health issues. 

For a FREE daily dose of tips and strategies for maintaining healthy weight, conquering insomnia, and much more…check out my Radical Health Tips.

I’d like to meet and greet you on my Facebook groups, so won’t you check us out at the Radical Metabolism RevolutionFat Flush Nation, or my Inner Circle!


  1. Susan

    Dr. Ann-
    I have been under the care of Dr. Lam and his nutritionist for almost 2 years because I have stage 3 adrenal fatigue. I was immediately taken off anything that might be too energizing and therefore cause my adrenals to work even harder. Although I am much better now, I’m still not my old self. I believe, in retrospect, that my adrenals have been weak my entire life.

    I can no longer be Dr. Lam’s patient due to costs, and am now fending for myself. I keep reading about Unikey’s adrenal product and am wondering if it would help me. I just don’t want to end up in bed again with a complete crash because it might be too energizing for my tired adrenals.

    Is that product for people who are in the beginning stages of adrenal exhaustion or can it be used for people whose adrenals are near collapse?

    Thank you!

  2. Sierra

    Susan, the UNI KEY Adrenal Formula is great nutritional support for all kinds of adrenal ailments. It provides raw bovine glandulars from certified disease free herds of New Zealand, as well as supportive vitamins and minerals that your adrenals need to function properly. I’ve used the Adrenal formula for almost a year now, with great success. I’ve also spoken to many others who use it for a wide variety of adrenal concerns, and they all swear by it!

  3. Sierra

    Susan, you may also want to look into the Earthing products that Dr. Ann Louise has mentioned in previous blogs. Earthing does an amazing job of soothing and restoring tired adrenals and helping to normalize Cortisol rhythms. Hope this helps you!

  4. Susan

    Thank you! 🙂

  5. Lorraine McDonald

    Of all the symptoms of the Perimenopause, I find the lack of interest in sex the hardest to bear. What suppliments would help?

  6. Administrator

    Testosterone is the hormone of desire. Zinc can help as it is a precursor of testosterone as is progesterone.

  7. Sierra

    Lorraine, I would consider the Hot Times Testosterone Cream for Women, available through Uni Key Health Systems. There is also a male version so the men in our lives don’t feel left out 🙂


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