Perimenopause is the transitional phase before menopause, typically beginning between the ages of 35 and 50. During this time, the body experiences fluctuating levels of estrogen, progesterone, and other hormones, which can lead to a wide range of symptoms—from mood swings and fatigue to irregular periods and sleep disturbances.
While perimenopause is a natural part of life, that doesn’t mean women have to suffer through it. Early recognition of symptoms and proper, personalized care can make all the difference in maintaining energy, emotional balance, and overall wellness.
That’s where Dr. Mark Stengler comes in.
As a board-certified Naturopathic Medical Doctor, Dr. Stengler has helped countless women navigate perimenopause using a compassionate, evidence-based, and faith-centered approach. At the Stengler Center for Integrative Medicine, located just north of La Jolla in Encinitas, he combines the best of natural and conventional medicine to address the root causes of hormonal imbalance—not just the symptoms.
His care is rooted in:
Perimenopause is the natural transition period leading up to menopause, when a woman’s reproductive hormones begin to shift. It marks the beginning of the end of the fertile years, but it can also bring unexpected and sometimes confusing symptoms as hormone levels fluctuate.
The most notable hormonal shifts during perimenopause include a gradual decline in estrogen and progesterone—two key hormones responsible for regulating the menstrual cycle, mood, sleep, metabolism, and more. These fluctuations are not always steady. Instead, hormone levels can rise and fall unpredictably, which is why symptoms often vary from month to month.
For most women, perimenopause begins in the late 30s to early 40s. It can last anywhere from four to ten years, depending on genetic, lifestyle, and environmental factors. The average age of menopause—the point when a woman has gone 12 months without a menstrual cycle—is around 51, so perimenopause may span much of a woman’s 40s.
It’s important to distinguish between these two stages:
Understanding where you are in this transition is essential to choosing the right care and support. At the Stengler Center, we use advanced hormone testing and in-depth symptom assessments to determine your phase and provide personalized care plans.
Hormonal fluctuations during perimenopause often lead to:
Sudden waves of heat, flushing, and sweating—especially during the night—are hallmarks of perimenopause. These symptoms can disturb sleep and contribute to fatigue and irritability during the day.
As estrogen and progesterone impact neurotransmitters like serotonin and GABA, many women experience:
Forgetfulness, trouble concentrating, and difficulty with mental clarity are often reported. These symptoms are typically linked to low estrogen or cortisol imbalances and are especially frustrating for busy professionals and caregivers.
Whether due to night sweats, hormonal insomnia, or cortisol dysregulation, poor sleep is a frequent concern. The result is chronic fatigue, lower stress tolerance, and difficulty maintaining focus.
Declining estrogen levels lead to changes in vaginal tissue and moisture, which can affect intimacy, confidence, and comfort. Libido often decreases as well—though many women regain it with appropriate hormone and lifestyle support.
Shifts in hormone levels—especially estrogen, cortisol, and insulin—can slow metabolism and promote fat storage, particularly around the midsection. Bloating and water retention are also common and may signal liver or gut imbalances.
For many women in La Jolla, Bioidentical Hormone Replacement Therapy (BHRT) offers a safe, natural, and effective way to restore hormonal balance during perimenopause. When carefully prescribed and closely monitored, BHRT can dramatically reduce symptoms like hot flashes, fatigue, brain fog, and mood swings—without the risks associated with synthetic hormone treatments.
BHRT involves the use of hormones that are biologically identical in structure to the ones naturally produced by a woman’s body—primarily estrogen, progesterone, and sometimes testosterone. These hormones are typically derived from plant sources and customized to meet your body’s exact needs, based on lab testing and symptom analysis.
The benefits of BHRT during perimenopause include:
Conventional hormone replacement therapy (HRT) uses synthetic or animal-derived hormones, which can carry greater side effects and safety concerns—especially when not carefully matched to a woman’s biochemistry.
In contrast, bioidentical hormones:
When used under the guidance of an experienced integrative physician like Dr. Mark Stengler, BHRT is considered clinically safe and effective for many women. Peer-reviewed research supports its benefits in managing perimenopausal symptoms while reducing the long-term risks associated with untreated hormone imbalance—such as osteoporosis and cardiovascular issues.
Routine follow-up testing and careful dose adjustments are key to ensuring safety and optimal results.
Dr. Mark Stengler is nationally recognized for his expertise in natural hormone therapies and has over 20 years of experience helping women restore balance through customized BHRT protocols. At the Stengler Center for Integrative Medicine, each BHRT plan is:
Food is medicine—especially when it comes to hormone health. Dr. Stengler provides personalized nutrition guidance to help women:
Key supplements often include:
Perimenopause often overlaps with chronic stress, leading to adrenal fatigue and cortisol imbalances. Dr. Stengler incorporates adaptogenic herbs such as:
These herbs help normalize the body’s stress response, reduce anxiety, and support steady energy and mood. When guided properly, they are a safe and effective complement to BHRT or standalone therapies.
The liver plays a central role in breaking down and clearing excess hormones—especially estrogen. A sluggish or overburdened liver can contribute to estrogen dominance, which worsens symptoms like bloating, breast tenderness, and mood swings.
To enhance liver function, Dr. Stengler may recommend:
The gut microbiome includes a collection of bacteria known as the estrobolome, which helps regulate how estrogen is metabolized and recycled in the body.
Dysbiosis (gut imbalance) can lead to improper estrogen clearance, increasing symptoms of hormonal imbalance. Solutions include:
Even mild or subclinical thyroid imbalances can mimic or worsen perimenopausal symptoms like:
Dr. Stengler performs comprehensive thyroid testing (beyond standard TSH) and treats with a combination of nutrients, natural thyroid support formulas, and—if needed—thyroid hormone therapy as part of an integrative plan.
If you're a woman in La Jolla navigating the challenges of perimenopause, know that you don’t have to face it alone. Whether you're dealing with mood swings, fatigue, brain fog, or other disruptive symptoms, there are safe, natural solutions available to help you regain balance and vitality.
At the Stengler Center for Integrative Medicine, Dr. Mark Stengler offers personalized, compassionate care rooted in science and faith. His approach combines advanced diagnostics, bioidentical hormone therapy, nutritional guidance, and natural therapies—tailored to your unique needs.
📞 Call us today at 760-274-2377 🌐 Or schedule your consultation online
We proudly offer:
Follow us for daily wellness inspiration, natural health tips, and encouragement:
📘 Facebook
📸 Instagram
