Understanding perimenopause.
The years before menopause are often underestimated and misunderstood. I help you navigate this transition with medical precision.
" Perimenopause is not a simple “deficiency state” - it is a biological transition that often needs internal medicine–level assessment. "
Perimenopause is the transition toward menopause. It often begins in the 40s (sometimes late 30s) and can last years. Estrogen and progesterone fluctuate widely, which can produce many physical and mental symptoms.
Important: perimenopause is not “just hormone deficiency” in a simplistic sense - it is a phase of hormonal instability. That instability affects almost every organ system - from brain to heart to metabolism.
Why is it missed so often?
The label is often: stress.
Symptoms like palpitations or insomnia are attributed to stress, while the hormonal context is missed in routine care.
“Too early” is a common belief.
While cycles are still regular, many assume menopause cannot be near - but perimenopause begins long before periods stop.
What can you do?
The first step is sound diagnostics. I help you separate what fits perimenopause from what needs a different internal medicine workup.
Targeted labs - not a generic “check everything” panel.
From lifestyle steps to an informed discussion of HRT when appropriate.
Protecting heart, bone, and metabolism long term.
Sound familiar?
You do not have to wait until symptoms take over daily life. The Perimenopause Clarification bundles two video visits, diagnostics, and a plan - package €490 (labs billed separately).