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Perimenopause and How Acupuncture Can Help

One of the most revered ancient Chinese medical texts, the Yellow Emperor’s Classic of Internal Medicine, poetically refers to menopause as a woman’s Second Spring. This is essentially based on the conservation of blood, regarded as the embodiment of spirit and consciousness. The concept is that as a woman’s physiology moves away from its reproductive role, the vitality that had previously provided nourishment outwardly (to potential offspring via the uterus) is shifted upward instead, to her heart, conferring wisdom and fueling the emergence of a new kind of feminine power. 

While the archetypal imagery is beautiful, not every woman is thrilled about the idea of getting her crone on. And even if she is, the peaceful picture of a wizened senior self is preceded by a years-long transition, often fraught with hormonal fluctuations that impact our moods, bodies and minds. Think of it as a reverse form of puberty at the other end of the reproductive spectrum. Remember what a roller coaster those years were? 

As you probably know, this adult adjustment period is referred to as perimenopause. In contrast to menopause, which is fairly stable, perimenopause is where the majority of the hormonal action is. Both estrogen and progesterone levels typically begin to decline in the mid- to late-thirties, and most women have completed the transition by the age of 52. By this point, estrogen and progesterone levels have dropped as much as 90 percent. Along the way, these two key players typically decline at different rates, with progesterone dropping more quickly and smoothly compared to estrogen, which tends toward a more erratic decline, exhibiting many fits and starts along the way. 

Many women opt to soften the change with the use of hormone replacement therapy (HRT). However, hormone therapy is not a viable option for everyone, and is not without its downsides. Some women simply prefer a more natural process. In either case, acupuncture is a great way to ease the transition and manage symptoms.

Perimenopause symptoms tend to vary among individuals as well as among cultures, and can range from mild to dramatic. For some, signs of perimenopause may be fairly subtle, particularly in the initial years of hormone decline. One of the earliest signs of decreasing hormone levels is changes in the menstrual cycle, with possible shifts in cycle length, regularity, increased blood flow and/or PMS symptoms. Common perimenopausal symptoms for US women include the practically cliché hot flashes or flushes, possibly with simultaneous sweating, insomnia, headaches, moodiness, brain fog, diminished libido, increased urination/urgency and general dryness (including vaginal). Symptoms such as these tend to occur closer to the end of perimenopause, but not necessarily. It’s no wonder this adjustment is not always a welcome one!

The symptoms we experience are not only related to the overall hormonal decline, but also to their levels in relation to one another. For instance, during perimenopause, the fluctuating nature of estrogen can result in periods of relative estrogen dominance, which can manifest as bloating, breast tenderness, mood swings and premenstrual headaches. Likewise toward the end of perimenopause, while the level of estrogen is relatively low, it is again high in comparison to progesterone.

In short, the path through perimenopause is not very predictable. Which is, of course, part of the predicament.  Fortunately for most women, the transition doesn’t happen overnight. This gives us time to adjust to the changes and respond along the way. Whatever your symptoms, Naturna can help smooth the journey. 

One way to support your hormones through this period is to provide the basic resources necessary for optimal health. Get ample rest, movement and beneficial social interaction. Eat a balanced, whole foods diet containing plenty of cruciferous vegetables, high-quality fats and protein. Minimize stimulants such as caffeine, sugar and alcohol. Hydrate yourself adequately with clean water. Consider supportive herbal teas such as red clover and licorice for hot flashes, raspberry leaf for heavy menstrual flow, and valerian root for insomnia.

If you’d like to enhance your efforts, please come to Naturna for a consultation. Clinical trials have shown acupuncture to be an effective way to naturally address perimenopausal symptoms, without unwanted side effects. We would also be happy to provide helpful nutritional, herbal and supplement recommendations to address your personal experience. 


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Avis, N. E., Coeytaux, R. R., Levine, B., Isom, S., & Morgan, T. (2017). Trajectories of response to acupuncture for menopausal vasomotor symptoms: the Acupuncture in Menopause study. Menopause (New York, N.Y.), 24(2), 171–179. doi: 10.1097/GME.0000000000000735

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