Is This Perimenopause and Can HRT Help?

 In Perimenopause

Short answer:

Yes and YES. AbsoTOOTly. This intentional typo will make sense in a minute.*

There is more to these questions so let’s get into it.

What is Perimenopause?

Perimenopause is the time around when your period starts to CHANGE and up until a year after your last period.  This transition period can last 5-10 years (give or take). Once you have been a year without your period you have reached post-menopausal status. 

Sounds fun right? Like you finally made it and now you go in peace to live your life without bleeding every month? Maybe some do, but the majority do not.

Turns out hormones are pretty important. Without our lovely estrogen, progesterone and testosterone circulating, life can be pretty dull and intolerable at times.

Luckily, it doesn’t have to be and before we get into solutions, let’s cover some important ground like what to look for!

Perimenopause symptoms:

Fun fact! The symptoms in perimenopause can be the same as in menopause and they can also change over time. 

 They include:

  • Hot flashes and night sweats (I do not think this one is a secret; if so, it is poorly kept!) Did you know that 20% of women never experience them while others can experience hot flashes every day for 30 years? Oh, mother nature you so funny.
  • Joint and muscle pains
  • Low mood or mood swings
  • Bloating, digestive problems* (The toot joke was funnier in my head)
  • Anxiety, depression
  • Headache or worsening migraines
  • Worsening PMS, irregular periods
  • Nerve issues like ringing in the ears and pins and needles 
  • Brain fog, memory problems, lack of focus
  • Vaginal dryness, itching, increased need to pee
  • Loss of libido, painful sex
  • Sleep problems
  • Skin and hair changes
  • Bladder issues and incontinence

You can track and monitor symptoms with the balance app while also receiving easy-to-consume information. We use this app to generate health reports to individualize care for our clients.

Even if you’re okay living with some of the symptoms above (no judgment, but why be okay with living less than your best life?!) you should have an individual assessment to review your options.

Things we DO NOT want to happen:

  • Bone loss
  • Osteoporosis
  • Type 2 diabetes
  • Cognitive change and early dementia
  • Obesity 
  • Depression (2-3x increased risk)
  • Heart disease (5x more likely after menopause) 
  • Bowel cancer

Although there aren’t currently recommendations for women outside of premature ovarian failure (POI) that hormone therapy should be used to prevent the above conditions, perimenopause is a time to be proactive about your health!

Why starting HRT EARLIER is BETTER:

If you came across our last blog post (Not Your Mother’s Menopause) you are aware that the menopause conversation needs to be restarted to educate women that there are options. Hormone replacement therapy (HRT) is one of those options that has unfairly received a bad rap in the past. We want to educate our clients so they can make the best health decision for themselves.

We would like to have our hormones until at least 51 years old (the average age of menopause). The longer the better! Many women start to experience perimenopausal symptoms earlier. This can lead to higher risks for the conditions listed above.  (Premature ovarian insufficiency (POI) is a topic we will cover in more depth another day. It is when women experience menopause before age 40 and affects 1 in 100 women).

Early diagnosis + Early treatment= Preventative care 

If you start taking HRT within 10 years of your menopause you will reap the maximum benefits and reduce risks related to treatment. This is usually under 60 years old. Most women notice the biggest impact within the first year HRT is started. If you missed this window it does not mean you can’t start.  It simply means you need to talk to a menopause-focused practitioner to discuss your health status and risks. Luckily you came to the right place!

Another aspect that can’t be ignored is the lifestyle piece.

Lifestyle factors:

 Some changes that would not only improve the transition through perimenopause but also make you healthier in general are:

  • Diet changes
  • Incorporating appropriate exercise
  • Quit smoking
  • Reducing alcohol
  • Stress management
  • Cognitive behavioral therapy

We have worked with a varied group of health and wellness professionals that we could connect you with on a case per case basis if you feel you need any extra support with the lifestyle part.


Perimenopause and menopause are unavoidable but suffering in silence is. HRT may or may not be right for you (it’s just one tool in our toolbox), however, if you’re looking for more information or are ready to receive your individualized assessment visit us here.  We are on a mission to support and educate women so they can continue to prosper in every aspect of their lives.



  1. Anagnostis, P. Lambrinoudaki, A. Stevenson, J. C., & Goulis, D. G. (2022). Menopause-associated risk of cardiovascular disease. Endocrine Connections. 11(4).
  2. Canadian Menopause Society. Pocket guide Menopause Management: A practical tool for healthcare professionals.
  4. Newson, L. (2022). Balance App.
  5. POI Guideline Development Group. (2015). Guideline of the European Society of Human Reproduction and Embryology. P 76-69, 76-78, 85, 91, 99.
  6. The NAMS 2017 Hormone Therapy Position Statement Advisory Panel. (2017). The 2017 hormone therapy position statement of The North American Menopause Society. Menopause. 2017 Jul;24(7):728-753.doi: 10.1097/GME.0000000000000921.
  7. “The 2022 Hormone Therapy Position Statement of The North American Menopause Society” Advisory Panel. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7):767-794. doi:10.1097/GME.0000000000002028
  8. Featured Image by tawatchai07 on Freepik
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