Understanding Perimenopause – A Functional & Integrative Approach

Before we dive into today’s topic, let me share a little about why this is so important to me. I work with a lot of women in their 40s and 50s, and not a week goes by without a conversation about the challenges of perimenopause and menopause. Many of you know me as a personal trainer, but what you might not know is that I’m also a Functional Diagnostic Practitioner. Before moving to New Zealand, I spent years studying functional medicine, specialising in the endocrine system and gut health—because when these two systems are balanced, everything else just works better.

These days, I split my time, with about 80% focused on training and 20% on functional medicine. People often ask why I didn’t go all-in on functional medicine, and honestly, I thought about it a lot. But most people saw me as a PT, so that’s where I focused my energy. I figured if I could sprinkle in some nuggets of wisdom on gut health and hormones during training sessions, I could still make a meaningful impact.

So, with that in mind, let’s talk about perimenopause—because let’s be real, it can feel like a rollercoaster. This phase, which can last anywhere from a few months to over a decade, is when our hormones start fluctuating before menopause officially kicks in. Think irregular periods, hot flashes, mood swings, and sleep issues. Sounds fun, right? The good news is that with the right approach, we can make this transition a whole lot smoother.

Instead of just throwing solutions at symptoms, functional medicine looks at what’s actually going on inside our bodies. That’s where specialty testing comes in handy. Three tests that can be game-changers for understanding perimenopause are:

DUTCH Test – This advanced hormone test gives a full picture of how your body is metabolising estrogen, progesterone, and cortisol. It doesn’t just measure hormone levels—it also looks at how well your body is detoxifying and clearing them. This is crucial because even if estrogen levels appear “normal,” poor metabolism can lead to estrogen dominance, which can trigger symptoms like weight gain, headaches, and heavy periods. The DUTCH test also evaluates adrenal function by assessing cortisol patterns throughout the day, helping to identify stress-related hormonal imbalances that could be contributing to fatigue, anxiety, or poor sleep. Honestly I think everyone should do a Dutch Test just even if it’s just once in their life. From a hormonal perspective it’s the test that by far gives you the biggest bang for your buck.

GI Mapping – Gut health and hormones are deeply connected. The gut microbiome, the beneficial bacteria living in our intestines, plays a crucial role in estrogen metabolism and nutrient absorption. If digestion issues, bloating, or food sensitivities are part of your perimenopause experience, a Comprehensive Stool Analysis can provide valuable insights into the health of your microbiome and how well your body is absorbing essential nutrients. Since gut imbalances can contribute to hormonal fluctuations, addressing these issues can help bring things back into balance.

Thyroid Testing – Many perimenopausal symptoms overlap with thyroid dysfunction. A full thyroid panel (not just TSH!) can reveal if your metabolism, energy levels, and mood are being affected by thyroid imbalances.

What we eat makes a huge difference in how we feel during perimenopause. A diet rich in whole foods, healthy fats, and phytoestrogens (hello flaxseeds, pumpkin, sesame and sunflower!) can help support both estrogen and progesterone levels. Cutting back on processed sugar and inflammatory foods? Also a big win for reducing mood swings and fatigue.

And let’s not forget about supplements. Some of my go-to recommendations include:

• Magnesium – Amazing for relaxation, sleep, and keeping stress in check.​
• B Vitamins – Help with energy and nervous system support.​
• Adaptogens (e.g., Ashwagandha, Rhodiola) – Keep stress hormones balanced.​
• Omega-3 Fatty Acids – Reduce inflammation and support heart and brain health.​

Additionally, several herbal remedies and supplements have shown promise in alleviating perimenopausal symptoms:​

• Black Cohosh – Helps reduce hot flashes and night sweats.
• Panax Ginseng – Improves mood and enhances overall well-being during menopause. ​
• Chasteberry (Vitex Agnus Castus) – Traditionally used to alleviate hormonal imbalances; many studies suggest it can help with mood swings and hot flashes.
• Aguaje (Mauritia flexuosa) – A South American fruit rich in phytoestrogens. Supports hormonal balance.

For relief from specific symptoms:​

• Hot Flashes:
  • Ground Flaxseed – Rich in lignans, reduces the frequency of hot flashes. ​
  • Black Cohosh – As mentioned, can help alleviate hot flashes.​
  • Vitamin E – Some studies suggest it can help reduce the severity of hot flashes.​
  • Magnesium – Supports overall relaxation and can help with temperature regulation.​
  • Pomegranate Seed Oil – Contains phytoestrogens;  studies have explored its potential benefits for menopausal symptoms.​
  • Acupuncture – May help reduce the frequency and severity of hot flashes.​

Peppermint Spray – Provides a cooling sensation that can offer temporary relief during hot flashes.​

If I had to pick one thing to help manage perimenopause symptoms, strength training would be at the top of my list. As estrogen levels shift, we naturally start losing muscle, which can slow down metabolism and increase the risk of osteoporosis. Lifting weights—or even just using resistance bands or bodyweight exercises—helps maintain muscle, keeps bones strong, and boosts energy levels. Plus, it’s hands down one of the best ways to manage stress, balance hormones, and feel more confident in your body. Even just a couple of strength sessions a week can make a huge difference in how you feel.

Better Sleep = Better Hormones

Struggling with sleep? You’re not alone—perimenopause can seriously mess with your rest. Between fluctuating progesterone and unpredictable cortisol levels, it’s no wonder so many women experience restless nights. But good sleep is non-negotiable if you want to balance hormones, keep your mood steady, and feel your best. A few simple habits can make a big difference: sticking to a consistent bedtime, cutting down on screens before bed, and having a solid wind-down routine (think warm baths, meditation, or deep breathing). Supplements like magnesium and adaptogens can also help, but creating a sleep-friendly environment is key.

What’s the Difference Between Synthetic and Bioidentical Hormones?

There is a lot of discussion around bioidentical versus synthetic hormones. The key difference often cited is that bioidentical hormones have the same molecular structure as those naturally produced by the body, while synthetic hormones may have slight structural variations. In theory, this means bioidentical hormones could be better recognised and utilised by the body. However, from a research perspective, the overall effectiveness and safety profiles of both types appear similar.

What really matters is how hormones are metabolised in your body and whether they are prescribed and monitored correctly. Regardless of whether they are bioidentical or synthetic, the right balance is crucial for symptom relief and overall well-being. If you’re considering hormone therapy, working with a knowledgeable practitioner who understands hormone metabolism and functional testing can make all the difference.

Wrapping Up: Don’t Guess, Test

Navigating perimenopause can be tricky, but with the right tools and knowledge, you can feel empowered and in control. Remember, it’s not about guessing or relying on one-size-fits-all advice—it’s about understanding what’s going on inside YOUR body and taking a personalised approach. That’s where functional medicine and specialty testing come in.

Testing like the DUTCH test, GI mapping, and thyroid panels can provide valuable insights into your hormone balance, gut health, and overall well-being. By getting to the root of what’s happening, you’ll be equipped to make informed decisions that support a smoother transition through perimenopause.

So, if you’re ready to take that next step toward feeling your best, don’t hesitate to reach out. A DUTCH test is a fantastic place to start—trust me, it’s worth it! Let’s figure out what’s really going on and make sure you’re giving your body the best chance to thrive.

If you’re interested in getting a DUTCH test or any of the other tests mentioned, just drop us an email at Results Personal Training with the subject line “Don’t Guess, Test! “. We’d love to help guide you through this process and ensure you get the best possible support during this phase of life. Don’t forget we have a library of practitioner strength supplements that are potent, proven and professional. If you would like any mentioned in this post then just give us an email. 

Take care of yourself, and remember: you’ve got this!