Perimenopause is the transitional phase leading up to menopause and can begin years before periods stop, often in the lat 30s or 40s.

Common signs include:

• Changes in cycle length or flow

• New or worsening PMS

• Sleep disturbance

• Mood changes or irritability

• Brain fog

• Hot flashes or night sweats

• Worsening migraines or anxiety

Hormone levels can fluctuate significantly during perimenopause, which means blood tests may appear “normal” despite real symptoms. Diagnosis is therefore based primarily on symptoms, cycle patterns, age, and overall health, not a single lab value.

A comprehensive assessment looks at the full clinical picture rather than one hormone result.

Menopause is defined as 12 consecutive months without a menstrual period, assuming no other medical cause.

Some people assume menopause begins when symptoms start, but symptoms often begin years earlier during perimenopause. Others may still be cycling while already experiencing effects of low estrogen or progesterone.

Bloodwork (such as FSH and estradiol) may support the diagnosis in certain situations, but timing, symptoms, and history remain essential for accurate interpretation.

Understanding whether someone is in perimenopause or menopause matters because management strategies can differ, especially around hormone therapy and cycle-related concerns.

Mood changes are a common and often under-recognized symptom of hormonal transition, particularly in perimenopause.

Fluctuating estrogen and progesterone can affect:

• Neurotransmitters such as serotonin and GABA

• Stress tolerance

• Sleep quality

• Emotional regulation

For many people this shows up as:

• Increased irritability

• Anger or rage that feels out of character

• Lower resilience to stress

• Feeling “overwhelmed” more easily

These changes are biological, not a personal failure, and they often coexist with life stress, caregiving demands, or burnout. A thoughtful approach considers hormones, sleep, stress, physiology, thyroid function, iron status, and overall health rather than assuming the cause is purely psychological.

Yes.

Today’s best evidence supports the use of Health Canada-approved bioidentical hormones, which are molecularly identical to those your body naturally produces.  When prescribed thoughtfully and monitored with care, these formulations have a strong safety profile.

Most of the fear around hormone therapy comes from the 2002 Women’s Health Initiative (WHI) study.  This trial included more than 16 000 postmenopausal women, averaging 63 years of age. Many already had risk factors for disease. They were given synthetic hormones — conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA) — formulations that are never used at Harmony Health & Hormones.

The study caused widespread fear when headlines suggested hormone therapy was unsafe. What those headlines missed is that these results reflected older women using outdated synthetic hormones, not the bioidentical formulations prescribed today.

Hormone therapy can help improve your symptoms, enhance your mood and well-being, protect your heart, bones, brain, overall well-being, and even decrease your risk of certain types of cancer.

WOMEN - hormones can improve:

• Heavy and painful periods

• Mood

• Sleep

• Vaginal dryness

• Libido

MEN - hormones can improve:

• Strength

• Libido

• Mood

• Sleep

• Body composition

Hormone therapy may be continued for as long as the potential benefits outweigh the risks and it remains aligned with your goals.

No. Symptoms do not need to be extreme or disruptive to daily life to be worth addressing.

Many people experience subtle but meaningful changes—such as reduced sleep quality, lower resilience to stress, mood changes, or declining energy—that gradually affect quality of life over time. Hormonal transitions are often progressive, and waiting until symptoms are severe is not required.

Assessment focuses on:

• Symptom patterns and duration

• Cycle history and life stage

• Overall health and risk factors

• Patient goals and preferences

Treatment decision are individualized and may include education, monitoring, lifestyle strategies, or medical therapy depending on the clinical picture.

No. Some extended health insurance plans may reimburse services provided by Nurse Practitioners, and many patients can claim fees under a Health Spending Account (HSA). Check with your plan provider for details on your specific coverage.

Yes.

All clients begin with baseline bloodwork so we can understand your current hormone levels and rule out other causes of symptoms. Follow-up testing is performed as needed to ensure safe, effective treatment.

This depends on your symptoms. Most people notice improvement within 4-8 weeks, with full benefits typically reached by 3-6 months. Your treatment is gradually and safely adjusted over time based on symptoms, goals, and labs.

Yes.

I provide hormone optimization for both men an women, including perimenopause, menopause, and andropause.

Yes — when properly dosed, testosterone is beneficial for mood, libido, strength, and metabolic health.

Yes.

Women without a uterus may still benefit from hormones such as progesterone for bone, brain, sleep, and metabolic health. Treatment is individualized based on your age, symptoms, and health history.

Once you start therapy, follow-ups occur every 3 months for the first year. After that, most clients transition to every 6 months, depending on your stability, goals, and how you're feeling.

If you ever need more support, we can create a personalized plan that meets your needs.

Certain formulations require a specialized compounding pharmacy to ensure consistency, accuracy, and quality. If you prefer to use your own pharmacy for standard prescriptions, we can discuss what is possible.