All women experience hormonal rhythms and wisdom, determined to a large degree by their time of life. The initiation of regular menses (monthly period bleeding) at the time of puberty rarely commences smoothly. The journey through puberty into a time of regular ovulation usually takes 2 to 6 years. Maturity leads to regular ovulation (release of a fertile egg from the ovary) every month for the next 30 to 40 years. One month is very much like the month before it, and the month after it. It is this process of ovulation that maintains regular monthly hormonal change, and cyclic times of fertility. Menopause is the cessation (stopping) of ovulation, resulting in low hormones and defined as having no periods for one year. This is being over and through “the change”. The average age of menopause is 51 years old (give or take 5 years).

Perimenopause refers to the years leading up to menopause (going through ‘the change of life’). This is the time when there are changes in the timing of the menstrual cycle The menstrual flow is often different and PMS symptoms are more severe. It occurs because ovulation becomes irregular in timing, and intensity, leading to irregular periods, and wildly fluctuating hormone levels. Hormones levels can be high or low, and vary chaotically from month to month. Symptoms can start in the 4-8 years before menopause, and vary greatly from month to month, and from woman to woman. Due to this “chaotic journey”, hormonal testing (blood or saliva) needs to be done and evaluated extremely carefully. These tests often provide useful information; they rarely provide final answers.

A holistic medical approach creates an individualized support program. This is based on a women’s story. Her story includes her lineage (genetics), her past and present medical history, objective laboratory information; as well as her unique insight, desires, needs and resources. Holistic support seeks to expand options. In perimenopause that involves a drug free support program, with or without bioidentical hormone replacement therapy. Advice must be practical so it can be followed consistently. Healing partnerships are relationships with practitioners that nurture yourself empowerment to successfully maintain positive lifestyle changes. As always, good communication promotes realistic expectations about progress. Progress should be frankly evaluated over time. Consistently applying practical positive changes helps bring balance to complicated issues. Nurturing support, from yourself and others, makes the journey easier.