Understanding Perimenopause: Irregular Cycles, Symptoms, and the Importance of Tracking

Dr. Amanda Tracy, a naturopathic doctor specializing in perimenopause and menopause, brings her professional expertise and personal experience to the forefront of women’s health. Through her story, she helps demystify the signs, symptoms, and solutions for women searching for answers about perimenopause.

Early Struggles with Irregular Periods

Dr. Tracy remembers her first challenges with menstruation as a teenager. “My periods never were regular as a teen,” she says. “They would be around for a few months at a time and then they’d disappear for six or 12 months. So I was having times of amenorrhea.”

At the time, Dr. Tracy says she was told that her diet might be the reason for her irregular periods. “I was told that because I was vegetarian, that was probably why. And I probably should just start eating meat and my periods would get better,” she recalls.

But meat never appealed to her. “At that time I was vegetarian mostly because I did not like meat. I didn’t eat a lot of it before being vegetarian, so it wasn’t something I would just try to see if meat helped,” she adds.

Despite ongoing irregularities, she says, “When I had my periods or when I didn’t have my periods, I felt fine. I didn’t have horrible periods or PMS... I just knew something’s not right, but it wasn’t necessarily... making my life miserable.”

Re-examining Diet and Inflammation

As she moved into adulthood, Dr. Tracy gradually shifted her diet from vegetarian to vegan. She found herself removing foods she didn’t enjoy—and noticed an unexpected benefit.“Just coincidentally, after I did that, my periods were regular. So I didn’t necessarily do it for my periods at that time,” she says.

“Dairy causes a lot of inflammation for humans,” she says. “Even if you don’t have lactose intolerance or feel that you have a dairy allergy, it is pro-inflammatory. It does impact estrogen levels.”

Her experience led her to reconsider common assumptions about diet and menstrual health.“Dairy causes a lot of inflammation for humans,” she says. “Even if you don’t have lactose intolerance or feel that you have a dairy allergy, it is pro-inflammatory. It does impact estrogen levels.”

The Overlooked Role of Chronic Stress on Menstrual Cycles

For many women, it’s difficult to separate the effects of hormonal changes from life’s other pressures. Dr. Tracy recalls a turning point in her early 40s when her body sent a clear signal.“

"Eventually, when I entered my 40s, it almost was abruptly on my 40th birthday, I was thinking I really need a sabbatical and take some time off. My body was giving me some signs that I needed some time off. And then it kind of just like all hit and I started to get my immune system kind of crashed,” she says.

For Dr. Tracy and many of her patients, chronic stress can mimic perimenopause symptoms.“It really was more of the stress and burnout that was making my cycle look more like perimenopause,” she explains. “That’s something I saw for many years in my practice... we find that it’s more chronic stress that’s depleting their hormones and their ovaries are doing really well.”

Recognizing chronic stress, she adds, isn’t always straightforward. “Some of the signs... can be hitting an energy slump like in the afternoon... craving things at that time, like caffeine or sugar or carbs... or being more easily triggered emotionally.”

Practical Steps for Recovery

Rather than waiting for things to worsen, Dr. Tracy learned the value of rest and daily habits. She credits a simple, consistent practice with helping her restore balance.“Having that one week per month for a year, it took dedication for me to stick to that... each month that I had that week, got better and better,” she says. Even short walks and journaling made a difference: “Those little pieces of white space help to prevent the stress from building up.”

Tracking Symptoms to Spot Perimenopause

As she stabilized her stress, Dr. Tracy noticed classic signs of perimenopause—changes she encourages others to track.“I started to notice that my cycles were a little bit closer together... And I started to notice some PMS symptoms, like some breast tenderness or some bloating,” she says.

“Really paying attention and tracking... gives you the information to know when things are changing.”

“Just noticing those symptoms was a sign and then I started tracking my cycles more and started to notice more distinct symptoms.” She emphasizes, “Really paying attention and tracking... gives you the information to know when things are changing.”

What to Expect in Perimenopause

Dr. Tracy defines perimenopause as the years leading up to menopause—often five to ten years of shifting hormones and symptoms.“That’s when your hormones are starting to change where your ovaries aren’t necessarily ovulating as well as they were in your 20s or early 30s,” she says.

“Estrogen can go up and down more dramatically... but as we’re having that, usually progesterone is on a slow decline through our 40s. That’s where most of the perimenopause symptoms come from.”

Common symptoms include irregular periods, heavier or lighter bleeding, increased PMS, and changes in sleep or energy. She also highlights less familiar symptoms, such as heart palpitations and joint pain, which can be linked to fluctuating estrogen.

A Holistic Approach

Dr. Tracy’s naturopathic and integrative method differs from conventional medicine, which often relies on birth control, IUDs, or antidepressants to manage symptoms.“We do lab tests... and then we’re using things that help to improve progesterone and supplements that might help with ovulation,” she says.

She also evaluates for low iron and thyroid changes, noting, “Low iron and low ferritin... can be a reason for the periods to be lighter or for them to be further apart. But also a lot of women in perimenopause start to have heavier periods... if they have too much estrogen. And that can lead to low iron over time.”

Advocate and Track Your Health

Dr. Tracy encourages women not to settle for incomplete answers. “Looking at someone who’s going to do more testing is the first way to go,” she says. She recommends finding clinicians through professional organizations and tracking your own symptoms to get the most from your healthcare visits.

“The best way to start is tracking your own symptoms,” she advises. “If you have a record of changes happening, [your doctor is] more likely to receive that information and go further.”

She concludes, “I really want women to be aware that these things that they’re noticing happening could be related to chronic stress and/or perimenopause together. And the best way to start is tracking your own symptoms.”