A few weeks ago, a client shared something that broke my heart—an experience that, unfortunately, is common among many women. She said, “When I tried to bring up concerns about my hormones being out of balance with the practitioners I worked with, they just brushed it aside and never really addressed it.” This left her feeling confused and concerned, unsure of how to interpret the changes in her body.
For some reason, the transition into menopause remains a mystery, though it shouldn’t be. It is just as natural and expected as puberty and the onset of menstruation. In fact, some refer to it as “the second puberty.”

When this client first came to me, it was clear she was perimenopausal. She was on the younger side of the average age range, but well within normal limits. However, it was her age that made her question what was happening. She simply needed the facts.

Understanding the Transition

Menopause is not a sudden event but a multi-year transition. It is not a switch that flips overnight, halting menstrual cycles instantly. The reduction in progesterone typically begins five to ten years before menopause. During this time, ovulation may become incomplete or absent, even as menstruation continues.

Menopause is officially reached when a woman has gone 12 consecutive months without a menstrual cycle. If bleeding occurs before that 12-month mark, even at month 11, the clock resets, signaling that the transition is still in progress.

Most women—about 95%—experience menopause between the ages of 44 and 55, with the average age in the U.S. being 50 to 51. Since the transition begins years earlier, women may start experiencing perimenopausal changes as early as their mid-30s.

The Four Phases of Perimenopause

Dr. Lara Briden, ND, outlines the four phases of perimenopause in her book Hormone Repair Manual: Every Woman’s Guide to Healthy Hormones After 40: 1) Very Early Perimenopause – Cycles remain regular, but early signs of change may appear. This phase typically lasts two to five years. 2) Early Menopause Transition – Cycle lengths start to vary by seven or more days. 3) Late Menopause Transition – Periods become irregular, with longer cycles and skipped periods. Together, phases two and three last about three years. 4) Late Perimenopause – The final 12 months without a cycle before menopause is officially reached.

The Role of Hormones

Perimenopause begins with a decline in progesterone, a hormone necessary for ovulation. This natural progression leads to an imbalance between estrogen and progesterone, often resulting in a condition known as estrogen dominance. This does not necessarily mean estrogen levels are high, but rather that they are elevated in relation to progesterone. Achieving hormonal balance can help ease uncomfortable symptoms.

Symptoms of estrogen dominance may include heavy or skipped menstrual cycles, PMS, anxiety, brain fog, breast tenderness, migraines, and depression. While hot flashes are commonly thought to be caused by excess estrogen, they are actually triggered by adrenaline surges due to erratic drops in estrogen levels.

Here’s something you can try today if you’re experiencing estrogen-related symptoms: drink maca lattes or maca tea. Maca is a powerful antioxidant that promotes estrogen detoxification. However, if your doctor has told you that your estrogen levels are low or you are experiencing hot flashes, maca is not recommended.

Midlife Maca Latte Recipe
1 tbsp coconut oil
½ tsp (or to taste) organic maca powder (Navitas is a recommended brand)
1 tsp glycine powder (Source Naturals is a good option)
1 tsp inositol powder
12 oz boiling water
Vanilla and/or cinnamon to taste
Blend until frothy and enjoy!

Dawn is an Applied Functional Medicine Practitioner and applies the principles of Functional Medicine to find the root cause of a disease dynamic. She helps clients make the lifestyle changes necessary for addressing issues such as autoimmune disease, insulin resistance, hormone imbalance, gut health, and infertility. Dawn provides one-on-one coaching, coaching groups and classes. Email [email protected].

Dawn Mills

Dawn is an AFMC (Applied Functional Medicine Certified) Practitioner (https://afmccertification.com/)

She resides in Virginia and enjoys spending time with her 4 grown children and 13 grandchildren. Personal health challenges started her on a journey that led her to this field of study and ultimately coaching other people in addressing their own health challenges.  She applies the principles of Functional Medicine, finding the root cause of a disease dynamic, to her coaching, educating her clients and helping them make the lifestyle changes necessary for  addressing issues such as autoimmune disease, insulin resistance, hormone imbalance, gut health, and infertility. 

Dawn provides one-on-one coaching, coaching groups and classes.

Feel free to reach out with questions –  [email protected]