Perimenopause is the transition phase from regular menstrual cycles to menopause. A natural biological phase in women's lives, it typically begins in their 40s but can start as early as the mid-30s.

Perimenopause is characterized by hormonal changes as the body prepares for menopause, resulting in decreased fertility. Symptoms vary widely from person to person but may include irregular periods, increased menstrual bleeding with clots, hot flashes, sleep disturbances, and mood changes. Despite these potential challenges, perimenopause is a normal part of aging, and with proper support and information, women can confidently navigate this stage of life.

Menopause is the natural biological stage that follows perimenopause, marking the end of a woman's reproductive years. It occurs when the ovaries cease most of their production of the hormones estrogen and progesterone and no longer release eggs for fertilization. A woman is considered menopausal when she has not had a menstrual period for one full year.

While it is often associated with symptoms such as hot flashes, night sweats, mood changes, vaginal dryness, and changes to skin, hair, and nails, every woman's experience with menopause is unique. Understanding what to expect can empower women to take proactive measures to manage potential symptoms, ensuring a smoother transition into this new chapter of life.


To understand the role hormones play, you may find it helpful to think of hormones as chemical messengers. As various tissues and glands generate hormones, they initiate and regulate many physiological functions throughout your body. That is why your ability to produce hormones in sufficient quantities and at the proper times is important. It is also why the hormonal changes that occur as you age can have an impact on your health.

Your hormone levels constantly fluctuate as they circulate through the body. We tend not to notice hormonal fluctuations unless they change rapidly and cause symptoms.

In your everyday life, hormones naturally fluctuate in response to things that occur around you, from your last meal to the stress of driving in bad traffic, a conversation you had with a co-worker, and even lunar cycles. In other words, like the tide, the ebb and flow of hormones is constant. For this reason, recognizing symptoms of hormonal imbalances can be tricky.

However, the most obvious indications of hormonal activity in women are the physical and emotional changes that often accompany the menstrual, perimenopausal, and menopausal phases of life. As women move through perimenopause and menopause, hormone levels, particularly estrogen, fluctuate and eventually decline. Most women are likely to notice mood, sleep, weight, and energy changes that correlate to these hormonal changes. In addition, increasing dryness throughout the body — of skin, lips, hair, nails, vaginal area, joints, eyes, etc — is a hallmark symptom of menopause and of aging for a woman, more broadly.


When hormone levels change during perimenopause and menopause, sodium levels in the body's cells and the amount of essential fluids in the body both tend to drop. This can cause dehydration throughout the body, which is why you may begin to experience physical signs of systemic dryness during perimenopause.

With the onset of menopause, an accelerated decrease in estrogen levels occurs, leading to even more significant symptoms of dryness, such as dry skin, brittle nails, lifeless hair, and vaginal dryness, due to a decrease in essential fluids. In addition, estrogen plays a vital role in maintaining skin moisture by promoting the body's production of certain substances like hyaluronic acid and oils, and when these levels are insufficient, women may experience more rapid aging and drier skin.

Hormone replacement therapy (HRT) and bioidentical hormones are the conventional medical treatment used to supplement estrogen levels. However, this approach is not without its pitfalls, and it pathologizes what is really a natural phase of life. For this reason, women should carefully consider the potential side effects and risk factors associated with HRT and bioidentical hormones if they are contemplating treatment. Fortunately, there are natural alternatives available for relieving symptoms of dryness.


Topical moisturizers that contain ingredients known to enhance hydration, such as hyaluronic acid and ceramides, may be helpful when applied to dry skin, lips, and hair. Because your skin is your body's largest organ, any ingredients that are absorbed into the skin may also be absorbed into your bloodstream. Thus, it is desirable to choose organic products free of dyes, synthetic fragrances, parabens, sulfates, and formaldehyde releasers.

Oil-based topical moisturizers can also be beneficial, but they do not provide lasting hydration and are typically only barrier products that are not absorbed into the skin.

Lubricants and personal moisturizers are effective remedies that can offer immediate relief for women who experience vaginal dryness that causes discomfort or pain during sex. These personal moisturizers may also be used daily to provide more regular relief. For advice on selecting these products, see our list in Best Organic Lubes and Personal Moisturizers 2023.

For more lasting, natural relief from dryness, consider Tributary Renew Hydration, a science-based organic herbal dietary supplement. It relieves systemic dryness where it begins, within. Tributary’s proprietary blend of herbs works from the inside out to restore your skin, lips, nails, hair, and vaginal moisture.

Please see Benefits of Botanicals and How to Relieve Dryness for additional information on natural remedies for dryness caused by menopause and perimenopause.


Another natural way to help balance hormone levels is to make lifestyle changes, like adding foods rich in Omega-3 fatty acids and phytoestrogens to your diet. Phytoestrogens are plant-derived compounds found in many of the foods you already enjoy. Try to include as many of them in your daily diet as possible. Here are a few of the top foods that contain phytoestrogens.

Ground flaxseeds added to smoothies; sulfur-rich vegetables like garlic, cabbage, broccoli, Brussels sprouts, and cauliflower; and Allium family members such as onions, garlic, and leeks are all good sources. Legumes are a fantastic way to add phytoestrogens to your diet and provide a generous serving of protein, especially chickpeas, lentils, and fresh soybeans (edamame).

And don't forget to include seasonal fruits (plums, peaches, pears, apples, grapes, and dark-colored berries), dried fruits (dates, prunes, and apricots), and whole grains (especially rye and wheat bran). Adding these types of foods can help improve hormonal regulation.

Do your best to avoid or limit sugar and highly processed or deep-fried foods. For more information about how easy changes to your diet can help balance hormones and renew hydration, read How to Relieve Dryness.

In addition to dietary changes, drinking plenty of water (some with electrolytes), getting enough sleep, maintaining a healthy weight, moderate- or even light-intensity resistance training (weight training), and cardiovascular exercise have all been found to have beneficial effects on hormone levels.

Other helpful information may be found in What Causes Dryness and Tributary Botanicals.