Perimenopause: A Time of Personal Empowerment

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“It can’t be menopause, can it?” was the protesting question posed by a 47-year-old patient with perfectly regular periods. Her recent hot flashes and ‘more than usual’ overnight sweating had prompted her concern. Debra, whom I had treated for skin problems years prior, was back in my office with a brand new symptom – “I’m not myself anymore!”

Many women are caught off guard by the changes happening within their bodies and don’t expect symptoms until menopause, or complete cessation of the menstrual cycle. Yet a woman’s last period is usually preceded by a long period of transition, beginning anywhere from her late-30’s to late-40’s, lasting from two to 10 years or longer. This illusive and often misunderstood transition phase is called perimenopause.

“But my mother didn’t go through menopause until she was 52!” Debra continued to protest. Further investigation revealed other subtle changes in recent years, which Debra did not attribute to her changing hormones. She had accumulated seven stubborn pounds around her waistline in two years, and felt more irritable with her husband and children. But most of all Debra was questioning her relationships. Suddenly, and without any provocation on their part, Debra’s friends, co-workers, family members, and husband were all put under a microscope.

Throughout the menstrual cycle, the Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) stimulate ovulation, and the hormones estrogen and progesterone counterbalance each other, with estrogen rising and progesterone falling during the first half of the cycle, and vice versa during the second half.

The physical changes at perimenopause begin with a gradual decline in progesterone, while estrogen levels remain the same or even increase. This results in the estrogen levels remaining unopposed, without the usual counterbalance, creating estrogen dominance. Symptoms of estrogen dominance include bloating (water retention), irregular periods (too heavy, too light, too frequent or infrequent), decreased sex drive, mood swings, weight gain around the middle, and even premenstrual head- aches.

These discomforts are the body’s attempt to adjust to the relative estrogen excess. And it’s not uncommon for women experiencing symptoms of estrogen excess to be given a prescription for more estrogen, making their mild symptoms worse as a result.

With the progression of perimenopause, progesterone levels continue to decline, while estrogen levels may begin to fluctuate. This occurs because the ovaries start to allow multiple eggs to mature during successive menstrual cycles, instead of one at a time. The progesterone levels decline because fewer and fewer maturing eggs complete the entire ovulation process.

“I’m angry all the time,” Debra continued. She had become especially irritable with her children. Questions such as “where is my pink sweater,” which in the past would have caused her to attentively help find the sweater, suddenly triggered a hostile response of, “It’s where you left it!”

Debra felt resentful for having to work-full time, prepare all the meals, and do the household chores, all without her husband’s help. Even though she had been doing it all for years, the responsibility had become unbearable in the last little while, and the resentment had escalated into frequent shouting matches between them.

Debra no longer trusted her mate and felt suspicious of his motives. She would listen in on his conversations, anticipating slanderous remarks about her. Debra even accused one of her friends of organizing social gatherings and excluding her on purpose. And Debra’s sister was overly critical of how Debra conducted her life. Although Debra was fully aware that it was her perception that had changed and the people in her life were no different, she was unable to stop the persistent unwanted thoughts and feelings.

The emotional turmoil was causing her hot flashes and sweats during the night, and occasional difficulty falling asleep.


Being familiar with Debra’s medical history made it easier for me to prescribe the next homeopathic remedy. Her new information and symptoms, combined with her old, pointed to a homeopathic closely related to the original remedy responsible for clearing up her eczema. I prescribed the remedy Graphites.

The onset of perimenopause triggers the process of reclaiming personal power. “Any uncomfortable symptoms that reveal themselves during times of hormonal shifts will be magnified and prolonged if a woman is carrying a heavy load of emotional baggage,” explains Christiane Northrup, M.D., in her book The Wisdom of Menopause. She goes on to explain that while our culture leads us to believe that our mood swings are a result of raging hormones, the opposite is actually true. Evidence shows that repeated episodes of stress due to relationships, children, job situation, or any life issue you feel powerless over, are behind many of the hormonal changes in the brain and body. In other words, all unresolved issues, stemming from childhood and perpetuating in every subsequent relationship, are contributing to and exacerbating the perimenopausal hormonal imbalance.

Six weeks after the homeopathic prescription, Debra came in for her follow-up appointment. Her hot flashes and sweats had completely disappeared and she was sleeping through the night again. She was still irritated by people in her life, but to a lesser degree. Debra had become aware of certain unresolved emotional issues that needed attention. More than ever before, she was aware of her feelings of “not being good enough,” which manifested in all her relationships. She had started seeing a psychologist to further explore those feelings. I prescribed the same homeopathic remedy – this time in a higher dose.


One must read Northrup’s book to fully understand and appreciate what happens to our hormones and brain chemistry during perimenopause. In fact, it should be required reading for all women turning 40. The book explains how the body sends us continuous signals to look within. The changes in brain chemistry issue a “wake-up call” to heal body, mind, and emotions. The first of the series of wake-up calls happens during PMS, as the monthly reminder of the growing backlog of unresolved issues accumulating within. Since women’s brains are hormonally programmed to nurture others at the expense of the self, their grievances often get swept under the carpet during the childbearing years.

Another big wake-up call, according to Northrup, is postpartum depression. If the issues remain unresolved still, the perimenopausal period serves as the ‘mother’ of all wake-up calls, screaming to unravel a mountain of past wounds.

On her third visit, Debra told me she felt happier and more confident than ever before. For the first time in her life, she felt compelled to be in charge of her own life and follow her inner voice. She felt more harmony in her relationships and didn’t have the need to quarrel with her husband or children. She was planning to start a catering business – a life-long dream since her teens.

The hormones FSH and LH, which were present for short periods during the menstrual cycle, giving us insights in small doses, become constantly and abundantly available during perimenopause and beyond. The ‘hormonal veil’ (which compels us to nurture others before ourselves during childbearing years) lifts, and a woman can see clearly what happened to her life.

As a result, women start making positive changes in their lives, often leaving dead-end relationships and jobs, engaging in creative pursuits and starting new businesses. Ignoring the wake-up calls and denying their spirit’s longing is often the reason women get serious illnesses shortly after menopause, including breast and ovarian cancers.


How do you avoid the surprises perimenopause brings? Be true to yourself. Listen to your intuition, it speaks the truth. “Defy social and cultural dictates throughout your childbearing years, so that by the time you reach perimenopause you will have put into effect many of the changes that cry out to be made at midlife,” advises Northrup. Perimenopause teaches us to be authentic and joyful – if we’re listening. If you need help tuning in, homeopathic medicine can help.

Homeopathy is a powerful yet gentle system of holistic medicine that stimulates the organism to heal itself. It works on the physical, mental and emotional planes simultaneously, resolving physical discomforts and releasing emotional traumas. Perhaps the most important feature of homeopathy is that each person who seeks help is given a remedy based on individual needs.

While Debra was given the remedy Graphites to help with her emotions and balance her hormones, each woman is likely to receive a different homeopathic remedy, one that corresponds to her unique symptoms, circumstances, and emotions.

Homeopathic treatment can both prevent and eliminate hormonal imbalances at any stage in a woman’s life, setting her free to fulfill her creative potential.


1. Northrup, Christiane, M.D., The Wisdom of Menopause, Bantam Publishing, 2001
2. Ikenze, Ifeoma, M.D., Menopause and Homeopathy, North Atlantic Books, 1998

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