Perimenopause is the natural transition leading up to menopause, during which a woman’s hormone levels—especially estrogen and progesterone—begin to fluctuate and decline. It typically affects women between the ages of 35 and 50, though the onset and severity of symptoms vary from woman to woman. For many in Del Mar, these changes may first appear as subtle signs: disrupted sleep, mood shifts, irregular periods, or unexplained fatigue.
While perimenopause is a normal phase of life, untreated symptoms can significantly impact daily well-being, relationships, work performance, and emotional health. Recognizing the early signs is key to getting the right care—care that supports your body naturally, restores hormonal balance, and promotes long-term wellness.
At the Stengler Center for Integrative Medicine, located just a short drive from Del Mar in Encinitas, Dr. Mark Stengler offers a trusted, evidence-based approach to perimenopause relief. As a board-certified Naturopathic Medical Doctor and a leader in natural hormone therapy, Dr. Stengler blends the best of modern diagnostics with faith-informed care that respects the whole woman—body, mind, and spirit.
Whether you’re just beginning to notice changes or you’re already feeling overwhelmed by symptoms, you don’t have to walk through this alone. Our personalized, integrative care programs are designed to help women like you reclaim energy, clarity, and peace—naturally and safely.
Perimenopause is the transitional phase before menopause when a woman’s reproductive hormones begin to shift. It’s a natural stage of life, but one that can bring a variety of physical, emotional, and cognitive changes due to fluctuating hormone levels.
Most women begin perimenopause in their late 30s to mid-40s, although it can start earlier in some cases, especially due to genetics, chronic stress, or underlying health conditions. This phase may last several years and varies in intensity from woman to woman.
The key shifts during perimenopause include:
Because these hormone levels rise and fall unpredictably during perimenopause, symptoms can be confusing and easily mistaken for other issues such as thyroid dysfunction, depression, or simply aging.
Understanding the distinction between these two phases is crucial:
Many of the most disruptive symptoms occur during perimenopause, making early intervention especially important.
As progesterone levels decline and ovulation becomes irregular, menstrual cycles can shift dramatically. Periods may become:
Sudden episodes of heat, flushing, and sweating—especially at night—are caused by fluctuations in estrogen. These symptoms can disrupt sleep, increase stress, and contribute to daytime fatigue.
Hormonal changes directly impact neurotransmitters in the brain, influencing emotional stability. Many women experience:
Perimenopausal women frequently report difficulty with focus, word recall, and short-term memory. This “brain fog” can be disorienting and frustrating, particularly for women balancing family and professional responsibilities.
Falling and staying asleep becomes more difficult during perimenopause, often due to hormonal imbalances, night sweats, or heightened cortisol. This lack of quality rest contributes to daytime fatigue, poor focus, and weakened immune function.
Declining estrogen can cause thinning of vaginal tissue, resulting in dryness, discomfort during intimacy, and reduced sexual desire. These issues can affect emotional well-being and intimate relationships, yet they’re highly treatable with the right care.
Hormonal fluctuations can slow metabolism and promote fat storage, especially around the abdomen. Women may also experience bloating, puffiness, and water retention, even with no change in diet or activity level.
For many women in Del Mar, perimenopause can disrupt nearly every aspect of life—from energy and sleep to mood and metabolism. One of the most effective and natural tools we offer at the Stengler Center for Integrative Medicine is Bioidentical Hormone Replacement Therapy (BHRT)—a safe, customized solution to restore hormonal balance and improve quality of life.
BHRT uses hormones that are chemically identical to those your body naturally produces, such as estrogen, progesterone, and testosterone. These plant-based hormones are tailored to your unique needs and delivered through creams, capsules, or pellets, based on your preferences and lab results.
Once administered, BHRT works by:
Unlike traditional hormone replacement therapy (HRT), which uses synthetic or animal-derived hormones, BHRT matches the body’s natural hormone structure exactly. This allows for:
BHRT is also more flexible—it can be compounded specifically for your body’s needs, allowing for adjustments as your hormonal landscape shifts during perimenopause.
When properly prescribed and monitored, BHRT is both clinically safe and highly effective. Research supports its benefits in:
At the Stengler Center, all hormone therapies are guided by comprehensive lab testing, regular follow-up care, and Dr. Stengler’s commitment to evidence-based integrative medicine.
As a board-certified Naturopathic Medical Doctor, Dr. Mark Stengler is a nationally recognized authority in natural hormone balancing. With over two decades of experience and authorship of multiple books on women’s health—including Your Menopause, Your Menotype—Dr. Stengler is known for providing:
What you eat plays a powerful role in hormone production, detoxification, and symptom control. Dr. Stengler works with each patient to design a nutrient-dense, anti-inflammatory eating plan, often including:
He also recommends targeted supplements—such as magnesium, B-complex vitamins, and vitamin D—based on lab testing and symptom profiles.
Many women experience increased stress sensitivity during perimenopause due to adrenal strain. Dr. Stengler uses adaptogenic herbs and botanicals like:
These herbs help normalize cortisol levels, support energy, and improve resilience to daily stress. Spiritual care, prayer, and rest routines are also encouraged as part of our faith-informed healing philosophy.
The liver plays a central role in processing and eliminating excess estrogen. If detox pathways are congested, symptoms like bloating, mood swings, and breast tenderness can worsen.
To support healthy hormone clearance, Dr. Stengler may recommend:
Your gut microbiome affects how estrogen is metabolized and recirculated in the body. An imbalance in gut bacteria (called dysbiosis) can lead to excess estrogen activity, which may worsen symptoms like PMS, weight gain, or mood disturbances.
We address this with:
The thyroid and reproductive hormones are closely linked—yet thyroid function is often overlooked during perimenopause. Even subclinical hypothyroidism can contribute to:
Dr. Stengler includes thyroid screening in his hormone evaluations and provides support through:
If you’re a woman in Del Mar navigating the changes of perimenopause, you don’t have to go through it alone—or settle for temporary fixes. At the Stengler Center for Integrative Medicine, Dr. Mark Stengler offers personalized, faith-informed care to help you understand your symptoms, rebalance your hormones, and feel like yourself again.
Whether you’re experiencing fatigue, brain fog, mood swings, or physical discomfort, there is hope—and natural solutions that work.
📍 Located just minutes from Del Mar in Encinitas, we offer both in-person consultations and virtual visits throughout California for your convenience.
📞 Call us at 760-274-2377 🌐 Or request an appointment online: www.markstengler.com/contact
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