Hello, my friend! How are you?

Welcome to 2026, and happy January! I hope it's been a great start to the year so far! This month's topic is perimenopause: 3 health priorities you can’t ignore. If you are a female between the ages of 30 and 60, I'm sure you'll learn a lot from this newsletter so be sure to read to the end!

But first: an admin task:

As a reminder, I have changed up how I do newsletters. The purpose of this newsletter is to bring you health tips, information, special offers, and personal stories I don't share anywhere else. This is intended to enhance the experience for patients working with me + provide plenty of value for non-patients too.

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Perimenopause: three health priorities you can't ignore

First: what are perimenopause, menopause, and post-menopause?

If you're wondering what even is perimenopause, it is the transitional, often 2-8-year phase before menopause, during which estrogen and progesterone levels start to fluctuate. This fluctuation can cause irregular periods and symptoms like hot flashes, sleep issues, weight gain, and mood changes (among many more). It commonly begins in a woman's late 30s to early 50s as ovaries gradually slow down. Menopause refers to a single day that marks one year after a woman's last menstrual period. The day after menopause, you are post-menopausal until the end of your life. So if you're still having a period (at least sometimes) and you're between 30-50, you are likely perimenopausal now or soon!

If you’re in perimenopause, chances are you might already be noticing some changes in your mental and physical health as a result. These can be mildly annoying to frustrating or debilitating. Know that there is help available, whether through gentle natural supportive therapies or through hormone therapy. For more information, or to discuss this further, please book an appointment.

But as much as these symptoms can affect your quality of life, there are 3 big other areas of health to pay attention to now––because they have a huge impact on your long-term wellbeing.

1) Your bone health

Bone loss is a real consequence of aging but it doesn’t start at menopause—it actually begins much earlier, often between ages 30–40, and accelerates as estrogen levels decline. Estrogen plays a protective role in bone health, helping maintain bone density and reduce fracture risk. You might not care a lot about this now, but your 80-year-old future you sure does!

As estrogen fluctuates and eventually drops in perimenopause and menopause, bones can become more vulnerable if they’re not adequately supported. What supports bone health in perimenopause?

Optimizing estrogen levels
Weight-bearing and strengthening exercises that challenge your bones
Ensuring adequate calcium intake (about 1200 mg daily from combined sources)
Bone-supportive nutrients like vitamin D, vitamin K2, and magnesium

Focusing on bone health now is an investment in mobility, independence, and fracture prevention later in life.

Unfortunately, standard DEXA (bone scan) screening doesn't become an option until age 65 in BC. By then, a lot of the damage might already be done, and you're left hopelessly trying to undo the damage! If you're in perimenopause, NOW is the time to start to care for your bones.

If you want to understand your bone health between now and age 65, there are private-pay assessments available. Contact me to learn more.

2) Your heart health

This is one of the most overlooked—and most important—topics for women in midlife.

Did you know:

Women are 5 times more likely to die from heart disease than from breast cancer
Heart disease is the leading cause of death in women, responsible for 1 in 3 female deaths
In Canada, a woman dies from heart disease every 22 minutes
Nearly 45% of women over age 20 are living with some form of cardiovascular disease

Estrogen has protective effects on the cardiovascular system, influencing cholesterol balance, blood vessel health, and inflammation. As estrogen levels decrease, women’s cardiovascular risk can rise, often without you ever knowing.

Perimenopause is a critical window to:

Support blood sugar regulation
Optimize cholesterol and blood pressure
Maintain muscle mass and cardiovascular fitness
Address inflammation and stress, both of which strongly impact heart health

To assess your cardiovascular health, some assessments I recommend:

Full cholesterol panel
Regular blood pressure checks
Heart exam
Blood sugar & insulin testing
CRP (inflammation test)

Talk to your doctor about a cardiovascular health assessment, or book in with me for a full assessment. As with everything, if there are any anomalies, you can rest assured that this is the perfect time to be proactive, and that a wide variety of gentle and natural tools exist to help you optimize your cardiovascular health.

3) Your brain health

Many women are surprised by how much perimenopause affects their brain, but often it's the brain-related symptoms like mood changes, brain fog, and sleep problems that show up first! Estrogen, in particular, is so important for the brain! In fact, there is now research showing a benefit of estrogen in prevention of dementia!

Estrogen plays a key role in:

Memory and cognition
Mood regulation
Neuronal repair and protection

As estrogen declines, women may notice:

Brain fog
Word-finding difficulties
Memory lapses and cognitive decline
Mood changes or not feeling like oneself
Increased anxiety or low mood
Sleep problems

This happens because estrogen interacts with key neurotransmitters like serotonin, dopamine, and acetylcholine, and also acts as an anti-inflammatory and antioxidant in the brain. Excitingly, there is some talk in the medical world that estrogen may one day come to be used as a treatment for Alzheimer's disease!

Supporting brain health during perimenopause can help improve brain function now—and reduce long-term neurological risk later. Hormone therapy and even natural treatment options exist to help protect your brain early!

A note on hormone therapy

Hormone therapy can be incredibly supportive, but timing matters.

Research suggests hormone support is generally most beneficial when started in the right window of time, which includes any of these:

When symptoms first become bothersome or disruptive
In late perimenopause or early menopause
Ideally before age 60
Or within 10 years of menopause onset

When appropriately prescribed and monitored, hormone therapy can not only provide symptom relief now but it can also promote bone, heart, and brain health long-term.

Naturopathic doctors in BC (and many other provinces and states) can prescribe hormone therapy. Our emphasis on prevention plus our ability to consider your overall health and well-being makes naturopathic doctors perfect for helping you minimize symptoms through perimenopause and protect your health long-term.

In perimenopause and want to get started with a hormone optimization plan? Please book an appointment––future you will thank you!

That's all for this month!

Comments? Questions? Just reply to this email! I'd love to hear what you think!