Perimenopause

What is Perimenopause?

Perimenopause is the transitional stage leading up to menopause, when hormone levels — especially estrogen and progesterone — begin to shift and fluctuate. This phase can begin as early as your late 30s or early 40s and may last several years. During this time, your cycle may still continue, but it becomes less predictable, and symptoms may come and go in waves.

 

Perimenopause is not a disease — it is a natural hormonal transition. However, the symptoms can be confusing, disruptive, or overwhelming. Many women describe this phase as feeling like their body and mind are changing faster than they can adjust.

 

At First Call DPC, we recognize that perimenopause is not “just hormones” and you are not “being dramatic.” You are experiencing real physiological change — and the right support can make this transition steadier, healthier, and more empowering.

What Causes Perimenopause?

Perimenopause is caused by shifts in the ovaries’ production of estrogen, progesterone, and testosterone. Unlike menopause, where hormone levels stabilize at a lower state, perimenopause is characterized by fluctuations — hormones go up and down, sometimes dramatically.

These fluctuations can affect:

Brain neurotransmitters (mood & emotional regulation)

Sleep cycles

Libido and sexual comfort

Stress tolerance and nervous system resilience

Metabolism and body composition

Menstrual cycle length and intensity

Other factors that often interact with perimenopause include:

Increased life responsibilities during midlife

Chronic stress or emotional load

Nutrient absorption shifts

Changes in thyroid function

Slower metabolic rate

Sleep disruption

This is why perimenopause can feel physically, mentally, and emotionally complex — because it is.

What Symptoms Will I Experience With Perimenopause?

Symptoms can vary widely from one person to another, and they often evolve over time. Common signs include:

Cycle Changes

Longer or shorter menstrual cycles

Heavier or lighter periods

Mid-cycle spotting

Physical Symptoms

Night sweats or hot flashes

Weight gain, especially around the abdomen

Breast tenderness

Joint stiffness or muscle aches

Headaches or migraines

Emotional & Cognitive Symptoms

Mood swings or emotional sensitivity

Anxiety or increased stress reactivity

Irritability

Brain fog or difficulty concentrating

Feeling overwhelmed by things that used to feel manageable

Sleep Changes

Trouble staying asleep

Difficulty falling asleep

Waking up unrefreshed

Sexual Health Changes

Reduced libido

Vaginal dryness or discomfort during intimacy

Slower arousal response

Many women say:

  • “I feel like my body has changed overnight.”
  • “My emotions feel unpredictable and hard to control.”
  • “I don’t feel like myself — and I don’t know how to explain it.”

Your experience is real — and it is meaningful.

What Should I Try at Home Before Seeing a Provider for Perimenopause?

Some supportive practices can help stabilize hormonal rhythms:

Prioritize High-Quality Sleep

Aim for a regular sleep schedule. Evening screens and caffeine can intensify symptoms.

Include Protein in Every Meal

Helps stabilize blood sugar, reduce cravings, and support metabolism.

Strength Train 2–3 Times Per Week

This protects muscle, bone density, and long-term metabolic health.

Reduce Alcohol, Especially at Night

Alcohol can worsen hot flashes, sleep disruption, anxiety, and mood swings.

Practice Nervous System Regulation

Gentle breathwork, stretching, or quiet walking helps regulate cortisol and emotional balance.

If symptoms interfere with daily life, energy, mood, or relationships — you deserve clinical support. Perimenopause is not something you need to “just endure.”

Best Treatment Options for Perimenopause

The right treatment depends on the stage of the disease, symptom severity, and your unique physiology. At First Call DPC, we take a root-cause, whole-body approach that may include:

Depending on your needs, treatment may include:

Bioidentical Hormone Support

Low-dose estrogen and/or progesterone therapy can stabilize mood, sleep, cycles, and hot flashes.

Testosterone Optimization (When Appropriate)

Helps restore energy, libido, motivation, strength, and mental clarity.

Adrenal and Stress Resilience Support

Because cortisol and estrogen are deeply interconnected.

Peptide Therapy

Can support sleep quality, cognitive clarity, emotional stability, and tissue recovery.

Nutritional & Metabolic Guidance

We help stabilize blood sugar, gut function, and inflammation — major drivers of symptom severity.

Targeted Supplements

Such as magnesium, omega-3s, adaptogenic herbs, and B vitamins to support hormone pathways and mood regulation.

This is not “one-size-fits-all” menopause care.
This is precision-guided hormone and metabolic support designed specifically for you.

Our Process for Treating Perimenopause

In-Depth Consultation

We take the time to understand your symptoms, stress load, lifestyle, emotional experience, and goals.

Comprehensive Lab Testing

We evaluate hormones, thyroid function, metabolic health, inflammation, nutrient levels, and adrenal stress patterns.

Clear Explanation & Collaborative Planning

We review what’s happening in your system — in clear language — so you can understand your body with confidence.

Personalized Treatment Plan

You receive a tailored strategy to stabilize hormones, improve sleep, restore clarity, support metabolism, and help you feel like yourself again.

Direct Access & Ongoing Support

You stay connected to your provider — because perimenopause is a journey, not a single appointment.

At First Call DPC, you are supported — not rushed, minimized, or dismissed. Perimenopause can be a time of renewal, strength, and self-understanding — when you have the right care. When you’re ready to feel balanced, grounded, clear, and in control again — we’re your first call.