Is It Perimenopause? Why Symptoms Might Start Earlier Than You Think—and What to Do About It

Perimenopause—the hormonal transition leading up to menopause—is often associated with women in their 40s. But the truth is, symptoms can begin as early as age 29. If you’ve noticed changes in your mood, cycle, energy, or mental clarity, your hormones could be talking to you.

At Integrative Health & Wellness, we specialize in identifying and treating early hormone imbalances using a functional medicine approach—one that addresses root causes and empowers you with a personalized plan.

Common Perimenopausal Symptoms

These symptoms are often brushed off or misdiagnosed—but they are your body’s signals that hormone levels are shifting:

• Irregular or missed periods

• Fatigue or persistent low energy

• Hot flashes and night sweats

• Low libido or vaginal dryness

• Mood swings, anxiety, or depression

• Brain fog or trouble concentrating

• Difficulty sleeping

• Weight gain (especially abdominal)

• Hair thinning or dry skin

If these sound familiar, you’re not alone—and you’re not imagining things.

Functional Testing: What We Look For and Why

A traditional approach may rely on a single hormone test, but functional medicine goes deeper. We evaluate hormone health alongside metabolic, adrenal, and nutritional markers to understand your full hormonal picture.

Hormone Testing

• Estrogen (Estradiol, E1, E3): Low levels are linked to mood swings, hot flashes, and vaginal dryness.

• Progesterone: Low levels can cause anxiety, sleep issues, and irregular periods.

• Testosterone (Free & Total): Needed for libido, motivation, and muscle strength.

• DHEA-S: A key adrenal hormone; low levels may signal burnout or chronic stress.

• FSH and LH: Help determine where you are in your hormone transition.

Metabolic and Nutritional Markers

• Vitamin D (25-hydroxyvitamin D): Deficiency can cause fatigue, depression, frequent infections, and joint pain.

• Insulin & Fasting Glucose: Help assess for blood sugar imbalances that can worsen hormonal symptoms.

• Hemoglobin A1c: Reveals average blood sugar over 2-3 months; a clue to insulin resistance.

• Thyroid Panel (TSH, Free T3/T4, Reverse T3, Antibodies): Thyroid dysfunction often mimics or compounds hormone imbalance.

Why Sublingual Vitamin D is Better

Most commercial vitamin D capsules contain binders and fillers that your body has to break down—some of which never fully absorb. Sublingual vitamin D drops skip digestion and absorb directly under the tongue, increasing bioavailability and reducing nutrient loss in the gut.

For women with hormone symptoms, optimizing vitamin D is critical—it supports immune function, mood, bone health, and even estrogen metabolism.

When Do We Recommend Bioidentical Hormones?

When testing reveals a significant drop in estrogen or progesterone—and symptoms are interfering with daily life—we may recommend Bioidentical Hormone Replacement Therapy (BHRT). These are plant-derived, molecularly identical to your body’s natural hormones, and can be compounded as:

• Progesterone sublingual drops or creams (for sleep, anxiety, and cycle regulation)

• Estrogen sublingual drops (for mood, cognition, vaginal health, and energy)

• DHEA or testosterone supplementation (based on adrenal health and libido needs)

Our protocols are carefully titrated based on symptoms, labs, and how you feel.

How Hormone Balancing Can Change Your Life

When hormone levels are optimized and supported with lifestyle, nutrition, and targeted therapies, women report:

• Better energy and stamina

• Improved mood and mental clarity

• Restored libido

• Deeper, uninterrupted sleep

• Fewer hot flashes and night sweats

• Weight balance and improved metabolism

• The feeling of being yourself again

Ready to Reclaim Your Balance?

If you’ve been told “your labs are normal” but you still feel off, it’s time to dig deeper. Our integrative approach helps uncover what’s really going on—so you can feel better, think clearer, and thrive.

Book a virtual or in-person consult today and take the first step toward restoring your hormonal harmony.

[Call Us at 717-803-0876]

[Book Online: www.integrativewellpath.com]

Bonus: Free Download – The Perimenopause Symptom Tracker

Track your symptoms and cycle patterns before your visit. Bring this with you to your appointment for more personalized care.

email clinicalstaff@integrativewellpath.com for the tracker