Perimenopause Support

Root-Cause Naturopathic Care for Hormonal Transitions in Toronto & Across Ontario

If your cycles are changing, your mood feels unfamiliar, your sleep is disrupted, or your body no longer responds the way it used to — you may be in perimenopause, even if you’re still getting a period.

Perimenopause is a natural life stage, but debilitating symptoms are not something you have to “just live with.” As a Toronto-based naturopathic doctor, I help women understand what’s happening hormonally and support their bodies through this transition using root-cause, evidence-informed care.

Common Symptoms of Perimenopause

Perimenopause is the transitional phase leading up to menopause, often beginning in a woman’s late 30s or 40s. During this time, estrogen and progesterone levels fluctuate — sometimes dramatically — leading to a wide range of physical, emotional, and metabolic symptoms.

Importantly, perimenopause can last several years, and many women are told they’re “too young” for symptoms to be hormone-related.

Perimenopause looks different for every woman. Symptoms may include:

Changes in menstrual cycle length or flow
PMS that feels worse or different than before
Anxiety, irritability, or low mood
Sleep disturbances or nighttime waking
Weight gain or changes in body composition
Fatigue or burnout
Brain fog or difficulty concentrating
Hot flashes or night sweats
Decreased stress tolerance
Changes in libido

These symptoms often fluctuate — another key sign of perimenopause.

Why Perimenopause Symptoms Occur

Symptoms aren’t caused by low hormones alone, but by hormonal unpredictability combined with other stressors on the body. They are also often amplified by a number of factors.

Common contributors include:

Progesterone Decline

Progesterone often drops earlier and faster than estrogen, contributing to anxiety, poor sleep, heavier periods, and worsened PMS.

Estrogen Flucutations

Estrogen may spike and crash unpredictably, influencing mood, weight, migraines, and temperature regulation.

Chronic Stress & Cortisol

Chronic stress amplifies perimenopausal symptoms by further suppressing progesterone and disrupting blood sugar and sleep, leading to broken sleep and weight gain

Blood Sugar Instability

Fluctuating hormones affect insulin sensitivity, increasing cravings, fatigue, and weight changes.

Thyroid & Metabolic Shifts

Thyroid function and metabolic rate may change during perimenopause, compounding symptoms.

perimenopause naturopathic doctor toronto

How Perimenopause Is Assessed in Naturopathic Medicine

Perimenopause Testing

Perimenopause is primarily a clinical diagnosis, meaning symptoms and patterns matter as much, if not more than, lab results.

A comprehensive assessment may include:

Detailed Symptom & Cycle History
Cycle-Timed Hormone Testing When Relevant
Salivary or Urinary Hormone Testing
Thyroid Function Assessment Beyond TSH
Blood Sugar & Insulin Markers
Nutrient Status Evaluation
Inflammatory & Gut Health Markers

The goal is to understand how your body is adapting — and where it needs support.

Learn more about hormone testing to see if you're in perimenopause >

Naturopathic Support for Perimenopause

Naturopathic care during perimenopause focuses on stabilizing hormonal fluctuations and supporting the nervous system, metabolism, and detoxification pathways.

Care may include:

Nutrition strategies to support blood sugar and estrogen metabolism
Lifestyle support for stress resilience and sleep quality
Targeted supplementation to address deficiencies
Botanical medicine when appropriate
Gut and liver support
Individualized care based on symptom patterns and life stage

Treatment is always personalized — there is no one-size-fits-all approach to perimenopause.

Many women reach perimenopause feeling unprepared, unheard, or dismissed. My approach prioritizes education, investigation, and proactive support — so this transition feels manageable, not overwhelming.

I support women experiencing:

Early perimenopause
Worsening PMS in their late 30s and 40s (I call this the 'pre-perimenopause phase')
Perimenopausal weight gain
Sleep and mood changes
Hormone-related fatigue

Care is available for women across Toronto and Ontario.

FAQ

the 10 most common questions I get asked as a Naturopathic Doctor regarding perimenopause

1 / What age does perimenopause usually start?

Perimenopause *can* begin in a woman as early as their late 30s or 40s, though symptoms can start earlier, especially with high stress or underlying hormone imbalances. However, not all changes in hormones should be labeled perimenopause.

2 / I'm in my early 40s - should I assume I'm perimenopausal?

Absolutely not! As we move out of peak reproductive years, shifts can happen, but it does not automatically mean perimenopause is on the horizon. Working with someone to assess the symptoms and getting some blood work is the most important first step.

3 / Can you still have regular periods in perimenopause?

Yes. Many women in perimenopause still have regular periods, especially early on. Symptoms often appear before cycles become irregular. In fact, irregular cycles is often the last symptom to present.

4 / Why does perimenopause cause anxiety and sleep problems?

Declining progesterone and fluctuating estrogen affect the nervous system, making women more sensitive to stress, anxiety, nighttime waking, and poor sleep quality.

5 / Is weight gain during perimenopause hormonal?

Often, yes. Hormonal fluctuations, insulin resistance, stress hormones, and metabolic changes can all contribute to weight gain during perimenopause.

6 / Can perimenopause symptoms come and go?

Yes. Symptoms often fluctuate month to month due to unpredictable hormone patterns, which is a hallmark of perimenopause.

7 / How is perimenopause diagnosed?

Perimenopause is primarily diagnosed based on symptoms and cycle changes. Hormone testing can provide helpful insight but is interpreted alongside clinical history.

8 / Can blood work be 'normal' in perimenopause?

Yes. Many women have “normal” labs despite significant symptoms. Hormone patterns and fluctuations matter more than single lab values.

9 / How does a naturopathic doctor support perimenopause?

A naturopathic doctor addresses root causes using comprehensive assessment, nutrition, lifestyle support, targeted supplementation, and botanical medicine. When appropriate, Dr. Holmberg is also licensed to prescribe Bioidentical Hormone Replacement Therapy >

10 / When should I seek help for perimenopause symptoms?

If symptoms are affecting sleep, mood, weight, or quality of life — don't struggle! It’s worth seeking personalized support at all phases of hormone transitions!