Many women are told that perimenopause is just something they have to “push through.” Hot flashes, night sweats, heavy periods, brain fog—these are written off as normal, unavoidable signs of aging. But as a doctor who specializes in this transition, I can tell you: these symptoms are not random, and they are not inevitable.
The truth is, perimenopausal symptoms have root causes. When you identify them and apply the right strategies, symptoms can improve quickly—sometimes within days. Here are three surprising reasons I see in my patients all the time, and what can be done to resolve them.
1. Blood Sugar Instability
Blood sugar imbalances are one of the most overlooked drivers of perimenopausal symptoms. Even if you don’t have diabetes, swings in blood sugar can cause cortisol spikes that intensify hot flashes, night sweats, and irritability.
Once blood sugar is stabilized with the right balance of protein, fiber, and healthy fats, women are often shocked at how quickly symptoms calm. I’ve had patients see hot flashes disappear in just a few days once their meals were dialed in correctly.
2. Stress Hormones Hijacking the System
During perimenopause, the ovaries naturally produce less estrogen and progesterone. If stress is high, the body diverts resources to cortisol production instead. This stress response can hijack hormone balance and leave you with disrupted sleep, low energy, and unpredictable cycles.
This is why stress management isn’t optional—it’s medicine. Targeted practices like breathwork, restorative exercise, and in some cases carefully chosen supplements can re-train the nervous system. Once cortisol is under control, the body can begin to regulate hormones properly again.
3. Gut Health and Hidden Infections
The gut does far more than digest food—it helps process and eliminate hormones. When the gut is sluggish or the microbiome is out of balance, estrogen can recirculate and drive “estrogen dominance.” That’s when symptoms like bloating, breast tenderness, and heavy cycles show up.
But here’s something most doctors miss: low-lying, undiagnosed infections in the gut. Parasites, yeast overgrowth, and pathogenic bacteria often linger beneath the surface, quietly disrupting hormone clearance and fueling inflammation. Left unchecked, they can worsen almost every perimenopausal symptom.
When these infections are identified and treated properly, women not only feel lighter and clearer, but their hormone symptoms stabilize dramatically. This is one of the most important root causes I look for in my patients—and one of the reasons standard care often falls short.
A Smarter Path Through Perimenopause
Conventional medicine often reduces perimenopause to either prescriptions or patience—“wait it out.” My approach is different. I connect the dots: blood sugar, stress response, gut function, and hidden infections. When these pieces are orchestrated together, the body finds balance again.
Perimenopause doesn’t have to mean struggle. With the right strategy, symptoms resolve, energy returns, and women step into this new phase feeling strong, clear, and in control.
Here are some videos that talk about dealing with Perimenopausal symptoms
Here is a link to my previous blog in case you missed it.