How to Treat Perimenopause Symptoms Naturally and Effectively
Perimenopause is the hormonal transition leading up to menopause—and for many women, it can feel like a total upheaval of body, mind, and mood. From brain fog and night sweats to anxiety and irregular periods, the symptoms can be frustrating and confusing.
The good news?
You can treat perimenopause symptoms naturally, effectively, and without being told “you’re just getting older.”
Let’s talk about what’s really going on and how to start feeling like yourself again.
1. Test—Don’t Guess
Start with comprehensive lab testing that includes:
Sex hormones (estrogen, progesterone, testosterone)
Cortisol (stress hormone) patterns
Thyroid function
Blood sugar and insulin markers
I use comprehensive blood testing including full thyroid panels to get a complete picture of what’s driving your symptoms.
2. Balance Blood Sugar
Unstable blood sugar can worsen weight gain, irritability, and fatigue.
Focus on:
High-protein meals (aim for 30+g per meal)
Healthy fats (like avocado, olive oil, coconut)
Fiber-rich veggies
Avoiding refined carbs and sugar crashes
This is one of the most powerful (and underrated!) ways to support hormone balance.
3. Support Your Adrenals
Your adrenal glands help manage stress and produce backup hormones as your ovaries slow down. Chronic stress can lead to burnout, sleep issues, and hormone chaos.
Try:
Gentle movement (like walking, pilates, or yoga)
Prioritizing sleep (no scrolling at midnight!)
Adaptogenic herbs (like ashwagandha or rhodiola—check with your provider first)
Daily rituals to reduce overwhelm (like journaling or breathwork)
4. Consider Bioidentical Hormone Therapy (BHRT)
For many women, symptoms become more manageable with bioidentical hormones tailored to their needs. BHRT can help restore balance, support the menstrual cycle, improve sleep, ease mood swings, and reduce hot flashes. It is important to find a provider who has had extensive specialized training in hormone optimization based on medical literature to ensure safety and efficacy.
It’s not about “replacing youth”—it’s about restoring function, vitality, and quality of life.
5. Nourish Your Gut
Your gut plays a big role in detoxing excess hormones and producing neurotransmitters like serotonin. If you’re dealing with bloating, constipation, or food sensitivities, gut support may be a key piece of your hormone puzzle.
Start with:
Probiotic-rich foods (like sauerkraut or kefir)
A daily fiber goal (at least 25g)
Reducing inflammatory foods (like gluten, processed sugar, and seed oils)
Hi, I’m Emily Koska, your women’s hormone expert based in Fargo, ND.
I’m passionate about helping women feel like themselves again.
As a nurse practitioner, mom, and fellow woman in the thick of midlife, I know what it feels like to be dismissed or told 'everything looks normal' when nothing feels normal. That’s why I created The Hormone Hangout Blog —to help women advocate for the care, answers, and support they deserve.
With love,
Emily
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