What Is Perimenopause? Signs, Symptoms, and How Hormone replacement therapy Can Help
- tealfoster9
- Jun 19
- 4 min read
Understanding Perimenopause and Hormonal Imbalance
Perimenopause is the transitional phase that begins several years before menopause, typically in your late 30s or 40s, when hormone levels begin to fluctuate. Learn about Perimenopause and how Hormone Replacement Therapy can help.
What Causes Perimenopause?
Perimenopause is caused by the gradual decline of ovarian function, leading to unpredictable shifts in estrogen, progesterone, and testosterone. These hormonal changes affect everything from your menstrual cycles to your mood, metabolism, energy, and sleep. You're not imagining things — your symptoms are real and rooted in biology.
Common Symptoms of Perimenopause
Perimenopause is often described as a hormonal rollercoaster, with a variety of symptoms.
Symptoms of Perimenopause:
Irregular or heavier menstrual cycles
Hot flashes and night sweats
Mood swings, anxiety, or irritability
Fatigue and brain fog
Low libido or vaginal dryness
Sleep disturbances
Forgetfulness
Joint pain
In our clinic, we often see women who were told they are “normal,” that nothing is wrong, or are repeatedly told they’re just depressed and offered antidepressants. They come in stating they feel "crazy," unsure of why they feel so off — and unaware that these changes are often the result of shifting hormones in perimenopause. Once we identify the true cause, there’s often a sense of relief that they’re not alone, and that there’s a clear, evidence-based path forward.
Why Perimenopause Matters for Long-Term Health
This is a key window of time where intervention can prevent or reduce the long-term impacts of perimenopause and hormone decline.
Long-Term Impacts of Hormone Decline Include:
Bone loss and osteoporosis
Cardiovascular risk
Genitourinary symptoms
Emotional and cognitive decline
Treating perimenopause early allows for a proactive rather than reactive approach to hormone health.
How Hormone Replacement Therapy (HRT) Supports Women
Bioidentical Hormones and Their Benefits
Hormone replacement therapy offers a personalized approach to restoring hormone balance using molecularly identical hormones that your body recognizes. Unlike one-size-fits-all therapies, hormone replacement therapy allows you to start low and slow and fine-tune over time based on how you feel.
Hormones Commonly Used in Hormone Replacement Therapy:
Progesterone
Helps stabilize mood, reduce anxiety, and regulate menstrual changes
Estrogen
Improves hot flashes, sleep, vaginal dryness, brain fog, and bone density
Testosterone (in small, controlled doses)
Supports libido, energy, muscle tone, and mental clarity
These hormones are typically prescribed through creams, patches, capsules, or injections, and are carefully monitored through follow-up and symptom tracking.
What to Expect from Your Hormone Replacement Therapy Plan
Personalized Evaluation and Testing
We assess your symptoms, labs, lifestyle, and goals
Thoughtful Dosing
You’ll begin with carefully titrated hormone therapy to avoid overcorrection or side effects
Symptom Monitoring & Support
Ongoing care ensures your plan evolves with your needs
Whole-Body Wellness
Nutrition, sleep, stress, and lifestyle all play a role in hormone success
This isn’t about masking symptoms — it’s about helping you feel strong, steady, and in control again.
Lifestyle Factors That Enhance Hormone Balance
Hormones are foundational, but whole-person care makes the biggest difference.
Treatment may also include lifestyle factors to enhance the results of Hormone Replacement Therapy, such as:
Nutritional guidance
Sleep optimization
Mind-body support
Weight and metabolic coaching
Together, these strategies help women move through perimenopause with resilience and confidence — not frustration and confusion.
Moving Through Perimenopause with Confidence
Perimenopause isn’t the end of feeling good in your body — it’s the beginning of your next empowered phase. With the right support, you can move through this transition with clarity, strength, and full access to who you are.
We don’t just refine wellness — we define it.
Frequently Asked Questions About Perimenopause and Hormone Replacement Therapy
What are the first signs of perimenopause?
Early signs of perimenopause include irregular periods, mood swings, sleep disturbances, hot flashes, and decreased libido — all caused by fluctuating hormone levels.
Can Hormone Replacement Therapy help with perimenopause symptoms?
Yes. Hormone replacement therapy (HRT) helps balance estrogen, progesterone, and testosterone, reducing symptoms like brain fog, fatigue, and night sweats.
Learn More About Hormone Therapy >
Is Hormone Replacement Therapy safe for treating perimenopause?
Bioidentical hormone therapy uses plant-based hormones identical to those in your body. When prescribed and monitored correctly, it's considered a safe and effective treatment for hormone imbalance.
When should I start Hormone Replacement Therapy for perimenopause?
You can begin hormone therapy during early perimenopause. Starting sooner can prevent long-term effects like bone loss, mood decline, and cardiovascular risks.
How long does it take for Hormone Replacement Therapy to work for perimenopause?
Most women notice symptom improvement from hormone therapy within a few weeks, with full results in 2–3 months. Personalized dosing and follow-up are key to optimal outcomes.
What are the risks of not treating perimenopause symptoms?
Untreated hormone imbalance during perimenopause can lead to increased risk of osteoporosis, cognitive decline, heart disease, and worsened quality of life.
ABOUT TEAL FOSTER, DNP, FNP-C
Founder of Refine Wellness Clinic, Stillwater MN
With over 15 years of diverse clinical experience, Dr. Teal Foster is a board-certified Family Nurse Practitioner and founder of Refine Wellness Clinic in Stillwater, MN. Her background spans emergency medicine, women’s health, concierge care, and aesthetics, uniquely positioning her to deliver results-driven, personalized treatments. Teal combines her medical expertise with a passion for wellness and beauty, helping patients look and feel their best at every stage of life. At Refine, her approach is collaborative, compassionate, and rooted in evidence-based care—focused on empowering each patient through customized hormone therapy, advanced skin rejuvenation, and holistic health solutions.
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