Perimenopause is the natural transitional phase leading up to menopause, typically occurring between the ages of 35 and 50. During this time, many women experience significant hormonal fluctuations—especially in estrogen, progesterone, and testosterone—that can lead to a wide range of physical, emotional, and cognitive symptoms.
From irregular periods and night sweats to anxiety, fatigue, and brain fog, perimenopause can impact every area of a woman’s life. These symptoms are often misunderstood or overlooked—but with early recognition and a targeted, holistic care plan, they can be successfully managed or even reversed.
At the Stengler Center for Integrative Medicine, nationally recognized integrative physician Dr. Mark Stengler helps women in Orange County navigate perimenopause with clarity, confidence, and natural solutions. A board-certified Naturopathic Medical Doctor, author, and hormone health expert, Dr. Stengler combines advanced diagnostic tools, bioidentical hormone therapy (BHRT), and faith-informed care to support total wellness during this life transition.
Perimenopause is the stage that marks the beginning of the body’s natural transition toward menopause. It can begin as early as the mid-30s, but most women notice changes in their early to mid-40s. This phase can last several years, with symptoms intensifying as hormone levels continue to fluctuate.
During perimenopause, your ovaries begin to slow down the production of key reproductive hormones:
These shifts can lead to a cascade of symptoms that affect everything from your metabolism to your mood.
It’s important to understand that perimenopause is not menopause. Menopause is officially diagnosed after 12 consecutive months without a menstrual period. Perimenopause, on the other hand, is the transitional period leading up to that point, when hormone levels are in constant flux.
Unlike menopause, where hormone levels are more stable (though lower), perimenopause is marked by irregular hormone patterns, which can cause symptoms to come and go unpredictably.
Fluctuating estrogen and progesterone levels can lead to:
These changes are often among the first signs of perimenopause.
Sudden waves of heat, facial flushing, and sweating—especially at night—are caused by hormone-triggered changes in temperature regulation.
Hormonal imbalance impacts neurotransmitters like serotonin and GABA, resulting in:
Estrogen plays a role in brain function. When levels drop, many women report:
Waking up feeling exhausted, even after a full night’s sleep, is common during perimenopause. This can be due to:
As estrogen declines, it can lead to:
These symptoms often go unspoken—but they are both common and treatable.
Hormone changes affect how your body stores fat and uses energy. Many women notice:
For many women in Orange County, the symptoms of perimenopause become life-altering. That’s where Bioidentical Hormone Replacement Therapy (BHRT) can make a profound difference. At the Stengler Center for Integrative Medicine, BHRT is customized to safely and naturally restore your body’s hormonal balance—helping you feel like yourself again.
BHRT uses plant-derived hormones that are molecularly identical to those your body naturally produces—such as estrogen, progesterone, and testosterone. Unlike synthetic hormone therapy, which often comes with harsh side effects and health concerns, bioidentical hormones are:
BHRT can be delivered through creams, capsules, or troches—and doses are precisely tailored to your unique needs.
Modern clinical research supports BHRT’s safety and effectiveness when administered under medical supervision. Documented benefits include:
At the Stengler Center, your treatment is based on scientific evidence and decades of real-world success.
Dr. Stengler begins every BHRT plan with comprehensive hormone testing, evaluating:
From there, he creates a personalized treatment plan that addresses not only hormonal balance but also your nutritional status, adrenal function, and long-term health goals.
What you eat directly affects your hormone function. Dr. Stengler provides personalized nutrition guidance that includes:
These nutritional strategies help regulate hormones, reduce symptoms, and restore metabolic efficiency.
Your adrenal glands help produce hormones—especially as ovarian hormone production declines. Chronic stress can wear down this system and worsen perimenopausal symptoms.
Dr. Stengler recommends adaptogens like:
These natural herbs help rebalance the body’s stress response and improve hormone resilience.
Your liver is responsible for breaking down and clearing excess estrogen. If liver function is sluggish, it can lead to estrogen dominance, triggering heavy periods, mood swings, and weight gain.
Dr. Stengler may recommend:
A healthy liver = cleaner hormone balance.
The estrobolome is a network of gut bacteria involved in estrogen processing. Poor gut health can cause estrogen to recirculate rather than being safely eliminated.
To optimize gut function, Dr. Stengler may include:
A healthy gut improves hormone clearance and supports better mood, energy, and immune health.
Thyroid imbalances are common during perimenopause—and often missed. Symptoms like fatigue, weight gain, depression, and cold sensitivity may point to subclinical hypothyroidism.
Dr. Stengler uses comprehensive thyroid panels (not just TSH), and treatment may include:
Addressing the thyroid can significantly improve perimenopausal outcomes.
If you're a woman in Orange County struggling with the symptoms of perimenopause—whether it’s fatigue, anxiety, sleep disruption, or weight gain—know that you don’t have to go through it alone. There is a proven, natural way forward.
At the Stengler Center for Integrative Medicine, Dr. Mark Stengler offers compassionate, personalized care to help restore balance and vitality at every stage of life.
📞 Call 760-274-2377 🌐 Or request your appointment online
Whether you're looking for in-person support at our Encinitas clinic—just a short drive from Orange County—or prefer the convenience of virtual care, we make it easy to get the help you need.
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