Silver Linings?

I write this at 5am, in our temporarily quiet home while everyone is asleep. I used to get frustrated when I woke up early like this. Now, I relish in the peace and quiet. Before I had kids, I remember talking with a mom-friend who said she recently started getting up at 5am to write. It was the only time she had to herself. A long time lover of sleep, I was disgusted at the thought. I totally get it now…

This isn’t specific to perimenopause, but in my practice I do counsel women on seeing the bright sides of certain negative situations (like when your body wakes up earlier than your soul wants to). In this example, waking early offers an important opportunity for ME-time, something we all have less of as we age and have more and more responsibilities (whether or not that involves kids).

Another example is PMS. Long ago, I read Christiane Northrup’s book, Women’s Bodies, Women’s Wisdom. It inspired me to look differently at the phases of our cycles. She talks about PMS being a time when our bodies are more sensitive to the world around us. This is an obvious statement, I know! I don’t mean sensitive as in emotionally reactive, but sensitive as in more perceptive and more receptive. It’s like the blinders are taken off for a few days. This is uncomfortable.

But Dr. Northrup writes about it being an opportunity for us to receive information, process that information and make decisions. It’s a unique time and an opportunity to be introspective, realize what is and is not working for you and come up with an action plan.

Perimenopause, for many women, feels like PMS on steroids. For many of the women I meet in my practice, I probably wouldn’t recommend taking action based on their PMS experiences (most would end up in jail, I think). I do like Dr. Northrup’s idea, though, that during those days that we are more sensitive, we can’t ignore the daily annoyances of life. Some of these irritations are silly, some are really big and yet we go about our day-to-day lives and try our hardest to push through and not see them. I talk to women who are in unhappy relationships or jobs that are not fulfilling. PMS can be a time to reflect on these areas of our lives and at least set an intention for change.

I would recommend not acting on that plan until the PMS is over, however…And talk to your girlfriends and mentors and therapist to make sure you don’t sound like a crazy person.

Could this be the “P” word?

I have a medical clinic in Seattle where I practice naturopathic medicine ( I am a primary care physician focusing on women’s health issues for women mostly in the 25-50 year old range. This is a little story about one of those women, who is so like many of the 35-45 year old women I talk to every day.

I met Elaine about one year ago in my practice  (her name has been changed to keep her confidentiality). She was a 46 year old woman struggling with her weight, which continued to go up despite increasing exercise and diet changes. She also talked about PMS symptoms that seemed to be getting worse over the year and had noticed her periods were starting to change. We discussed the possibility and likelihood of Perimenopause given her age and symptoms. I’ll never forget the look of shock on her face when I said the P word. She burst in to tears at the thought. She was truly taken aback.

After meeting with her and talking about the lack of information “out there” about what happens to women’s bodies as we approach menopause, I decided to take action and get the word out. Hence, this blog. Since meeting Elaine, I’ve met many women in similar situations, myself included. No one is quite as shocked as she was, but almost daily I hear, “No one talks about this. I wish I would have known what to expect.”

Here are the top 10 symptoms of Perimenopause**:

  1. Your periods will change
  2. Your sex drive will change
  3. Your body will change and start to look different
  4. Your hair may start to thin
  5. Your skin will change (remember the acne you had as a teen? Yeah…)
  6. You will hate your husband/partner
  7. You will yell at your kids/pets
  8. Your sleep quality will change
  9. You will start to forget things (“wait, why did I come in to this room??”)
  10. You will feel like you have PMS all month long

**PLEASE NOTE: you may breeze through perimenopause and menopause without the slightest hint of any of these symptoms! A lot of women do. Many women struggle for years with one or more of these symptoms, however, so know that, and be gentle and kind with your lady friends.

In future posts, we’ll break each of these down and talk about natural and conventional medical treatment options (with a focus on natural ones, of course!). Stay tuned…


My mission in creating this site is to share information about the changes in women’s bodies as they go through perimenopause, the 10-year time period before menopause.


I’ve worked with many women going through this transition, confused about the changes their bodies are going through and desperate to understand and feel better. I’d like to share my own experience and offer tips and suggestions on how to make this transition a smooth one. Come along for the ride!