If you’re over 40 and haven’t felt quite like yourself recently, you’re not alone. Upwards of 20% of women at the age of 40 are experiencing perimenopause, and that number increases every year after 40 until the average age of menopause at 51. 

Perimenopause can be a confusing time and leaves many women feeling as if their bodies are breaking or failing them. It’s not fair that women work so hard to achieve personal health and achievement in their personal lives and career to only be blindsided by hormone changes, well before they expected them. 

When things inside your body start feeling unwell, it’s natural to want to test something or be assessed by your doctor. The challenge with this phase of life is that hormone levels fluctuate from day to day, which creates a moving target of lab testing and generally unreliable test results. 

If you’ve asked for hormone testing before and have been declined, it’s not likely because your doctor didn’t care how you felt. It’s likely because they didn’t have the time to explain what was happening, and how to assess the hormone changes that happen over 40 without blood work. 


So what can women do over 40 to better understand their hormone health? Here are 3 tips that will help you get started on your own and is excellent information to bring to an appointment with your Naturopathic Doctor that focuses on perimenopause. 

 Track your symptoms. 

As simple as it sounds, tracking your symptoms is what will help you be best supported over the age of 40. Perimenopause is a diagnosis made clinically, meaning that we decide if you are in this phase of life based on what you say, not what your lab work says. Track these simple metrics for the next few months, or until your next appointment

  • Total cycle length. From day 1 of your period to day 1 of the next period. 
  • Signs of ovulation such as cervical mucous change
  • Symptoms such a hot flashes, night sweats, headaches, breast tenderness or moodiness. 

 Remember the past. 

A woman’s past hormonal history such as her puberty experience, fertility and pregnancy experience and cycle leading up to 40 can teach her practitioner a lot about what to expect in her perimenopause phase of life. Women who have had irregular cycles, acne, infertility, gestational diabetes or other pregnancy complications may have a different (or earlier) perimenopause experience than other women. 

Getting connected to your past health history can inform your practitioner about your hormonal health and give context to the symptoms you are experiencing now. 

You might benefit from some key tests. 

Even though perimenopause is diagnosed clinically, we can occasionally see changes in hormone function with key timed blood work. Testing FSH on day 3 of the menstrual cycle, estrogen during your period or progesterone after the time you are supposed to have ovulated can give deeper insight if your clinical picture is hard to understand. 

Testing however should never replace a good history taking or a deep discussion with your practitioner. If you have been offered expensive or additional testing for you hormones, there is likely a more science-backed solution that involves very little laboratory testing. 


Our clinicians love working alongside women in perimenopause to help them feel more like themselves during this decade of life. Women who feel well during perimenopause can continue to do the things they love, without feeling held back by their bodies or their symptoms. If you’re ready to feel more like yourself, reach out to our patient care coordinator team to get connected with one of our perimenopause practitioners.