How my own perimenopause journey changed the way I help women
After years of helping women improve their relationship with food, I started to notice a pattern: More and more clients were not just looking to make peace with eating. Rather, they were dealing with multiple things at once: trying to heal from decades of yo-yo dieting, while being blindsided by a body that suddenly felt like someone else’s.
They were waking up at night in a panic, drenched with sweat. Forgetting words in the middle of sentences – even at work! Their pants suddenly didn’t fit. Annual blood tests revealed rising cholesterol and blood glucose levels. And, on top of it all, they were sandwiched between the needs of their aging parents and their kids’, all while trying to hold together their own personal and professional lives.
Distressed by their ever-increasing pants size, they were told by their doctors to eat less and exercise more. They’d wait months for an appointment to discuss how they were struggling, only to be handed a prescription for an antidepressant, even though anxiety was never a part of their story. They were confused, angry, and overwhelmed.
And who could blame them?
A recent study published in The Lancet Diabetes and Endocrinology revealed that only 40% of women with moderate to severe hot flashes were receiving treatment. (1)
Forty percent.
Let’s let that sink in.
On the surface, hot flashes might just seem like a nuisance, but there are ripple effects that spill into every facet of a woman’s life: disrupting sleep, messing up hunger and appetite cues, tanking mood, and having you reach for caffeine and food just to get through the day.
That 40% statistic isn’t just a gap in our healthcare system – it’s a quality-of-life crisis that most providers are missing.
Here’s what perimenopause actually involves.
And Then Crippling Perimenopause Symptoms Came for Me
And here’s where I get personal:
As a dietitian, when my hot flashes got persistent, I doubled down. I know I wouldn’t advise my clients to do this, but it was during the pandemic, and I was exhausted and vulnerable, and I hoped it would help.
First, I cut out alcohol entirely. Even a glass or two of wine affected my sleep, so it seemed a logical place to start. Then I focused more on blood sugar, making sure I paired everything I ate with some protein and/or fiber. Maybe it helped a little? But I couldn’t sleep through the night for months, and I carried a cooling towel with me everywhere I went.
At one point, I was having more than 40 hot flashes every day.
The final straw: I met my friend for our regular walk in January of 2021. Here in Virginia, it was 40 degrees outside. I didn’t wear a coat, because I didn’t need one.
I’m a rule follower – most dietitians are!
So when I pored through the menopause research, I followed the guidelines: menopause hormone therapy (MHT) – what used to be called HRT – should only be started after the last menstrual period. So I carried on. Until I couldn’t.
I finally had a good conversation with my primary care provider. Together, we decided that the potential benefits (for me) outweighed the reasons to wait. Coupling hormone therapy with nutrition and lifestyle changes changed everything for me. (As a dietitian, I am not a prescriber. I am only sharing my personal story, not advocating for the use of prescription medication. That is a decision that needs to be made with your medical provider.)
The History of Research on Menopause Hormone Therapy
That research rabbit hole led me back to an experience I’d nearly forgotten. Early in my career, before my Master’s program, I spent a year volunteering at the Women’s Health Initiative site at George Washington University, reviewing dietary records for one of the largest women’s health studies ever conducted.
The WHI was ultimately halted early when it showed an increase in breast cancer in the women taking hormone therapy. The fallout was swift and monumental. Many doctors stopped prescribing hormone therapy, and a large percentage of an entire generation of women were denied treatment.
What many people still don’t know is that the hormone formulations used in that study are rarely prescribed today, and the study participants were started on hormone therapy years after menopause. Modern hormone therapy, most of it bioidentical and FDA-approved, looks very different. But the fallout was lasting. The research gap it created is still being filled. To this day, we know far less about perimenopause than we should, and too many health recommendations for women are still just extrapolated from studies done on men.
How Two Health Crises Helped Form One Philosophy
I wanted to help my clients, who were struggling. So I went deep.
I immersed myself in menopause research, focusing on nutrition and lifestyle, as well as on helping my clients navigate their medical care and advocate for themselves with their providers. After completing the rigorous MSCP exam, I became a Menopause Society Certified Practitioner. Earning that credential required the evidence-based study that this population needs and deserves.
Menopause is a hot topic now. There are lots of opportunists entering the space to capitalize on the much-needed awareness. I want to protect my fellow women from predatory programs and protocols that empty your wallet but don’t materially improve your life.
Perimenopause wasn’t my only personal health struggle, though.
I also was a patient in the functional medicine space during my own gut health journey. Long story short: I had a parasite infection that had wrecked my digestive system. Relief after my doctor prescribed medication didn’t last, and I had a medicine cabinet full of expensive supplements and an ever-dwindling list of “accepted foods.” Again, I engaged in more study and found a way to heal my gut AND eat the foods I loved. That experience is part of why I feel so strongly that gut healing doesn’t have to mean living on five foods and a pile of supplements.
Both experiences shaped how I think about the functional medicine space.
I had also been studying functional nutrition for a decade. And while I believe the core of functional medicine is brilliant – look for root causes rather than just managing symptoms – I kept seeing the same issues in my practice.
Clients would arrive depleted, eating a shrinking list of foods, spending hundreds of dollars on supplements, and following rigid protocols that left them unable to eat a normal meal with their families. They didn’t know who to trust. I once spoke with a potential client whose labs were so severely elevated that she ended up in the hospital — a side effect of a supplement she’d been taking for months. No one had caught it.
My approach is different. I believe in finding root causes, but I also believe healing doesn’t have to be expensive or depleting. Some of the most meaningful changes cost nothing at all.
My philosophy is simple: food first, targeted supplementation when genuinely indicated, and always working to expand your life — not shrink it.
What This Means if You’re Looking for Support in Perimenopause
Going through perimenopause myself didn’t just change what I knew. It fundamentally changed how I practice.
I know what it’s like to “do everything right” and still struggle. To lie awake at 3 am, staring at the ceiling and wondering how you’re possibly going to function at work that day. And I also know the relief that washes over you when you find something that finally helps.
My personal and professional story is in the room with me every time I sit down with a client.
If you’re wondering what working together actually looks like — what we’d focus on, how I approach the complexity of midlife health, and what makes this approach different from the tons of advice you’ve already tried — I wrote a follow-up piece just for that. You can read it here:
What Can a Menopause Nutritionist Do For Me? →
Ready for advice on your unique situation? Book a free midlife nutrition conversation to see what your next chapter could look like once you have the support of an experienced nutrition professional on your team.
Not quite ready? Grab my free perimenopause guide — what’s happening to your body, and how to support it without working harder against it
References:
Islam R, Bond M, Ghalebeigi A et al.
Prevalence and severity of symptoms across the menopause transition: cross-sectional findings from the Australian Women’s Midlife Years (AMY) Study
The Lancet Diabetes & Endocrinology, 2025; 13, 765-776
Writing Group for the Women’s Health Initiative Investigators. Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women’s Health Initiative Randomized Controlled Trial. JAMA. 2002;288(3):321–333. doi:10.1001/jama.288.3.321
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