In her conversation with Paula Zelaya, Colombian physician Dr. Alexandra Jauregui, an expert in functional medicine, shared her extensive knowledge on perimenopause, hormonal changes, and strategies women can adopt to navigate this phase of life with health, vitality, and balance.
What is Perimenopause and When Does It Begin?
Dr. Jauregui explains that many women mistakenly believe menopause starts at 50, but the body’s reproductive and hormonal changes begin much earlier, often in the mid-to-late 30s:
- Women are born with a limited number of eggs, and by age 35, ovarian reserve starts to decline, affecting both the quantity and quality of eggs.
- This decline triggers hormonal fluctuations, leading to symptoms such as fatigue, mood swings, and changes in metabolism.
- Perimenopause refers to this transitional phase before menopause. Unlike menopause, it is more unpredictable because hormone levels fluctuate irregularly, causing symptoms that are often misattributed to stress, lifestyle, or aging.
Perimenopause is a stage where you don’t fit anywhere. Women often think their symptoms are due to stress, but it’s their body changing.
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Common Symptoms of Perimenopause
According to Dr. Jauregui, women may experience:
- Sleep disturbances due to progesterone decline
- Mood swings, irritability, and anxiety
- Low energy and chronic fatigue
- Changes in libido
- Weight gain, particularly in the lower abdomen
- Hair thinning, skin changes, and digestive issues
She emphasizes that progesterone, the calming hormone, is usually the first to decline, leading to sleep and emotional imbalances.
Why Weight Gain Occurs During Perimenopause
Hormonal shifts directly impact metabolism and body composition:
- Estrogen and progesterone imbalance changes fat distribution.
- Cortisol and insulin fluctuations promote fat accumulation, especially in the abdomen.
- Muscle loss reduces metabolism, alters hormone balance, and increases the risk of conditions like osteoporosis and cognitive decline.
Muscle is our diamond during perimenopause. It protects bones, brain function, and metabolism. Strength training is essential.
Functional Medicine Approach by Alexandra Jauregui
Dr. Jauregui differentiates functional medicine from conventional medicine:
- Conventional medicine often treats symptoms individually (e.g., prescribing medication for anxiety).
- Functional medicine investigates root causes, including hormonal imbalances, gut health, sleep, stress, and metabolism.
- Personalized care focuses on addressing underlying issues, not just temporarily masking symptoms.
She shares examples where anxiety or weight gain may be linked to gut dysbiosis, sleep deficits, or chronic cortisol elevation, rather than solely psychological or lifestyle factors.
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Nutrition and Lifestyle Recommendations
Dr. Jauregui emphasizes practical steps for maintaining health during perimenopause:
- Prioritize protein intake to preserve muscle mass and regulate hormones.
- Strength/resistance training for at least 30 minutes a day to maintain muscle and metabolic health.
- Reduce gluten and processed sugars to minimize inflammation, stabilize insulin, and improve digestive health.
- Balanced meal structure: Starting meals with vegetables or salads can reduce insulin spikes and control appetite.
- Avoid restrictive diets: Focus on nourishment over caloric restriction, particularly in perimenopause.
If women adjust their lifestyle and nutrition, they regain energy, improve body composition, and feel vibrant again. It’s not about dieting; it’s about living well.
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Early Signs of Perimenopause
Dr. Jauregui notes that women may experience subtle changes before menopause:
- Decreased sexual desire
- Fatigue and difficulty exercising effectively
- Sleep disturbances
- Weight gain resistant to diet and exercise
- Mood changes or irritability
You may feel like something is off but still hear that your hormones are normal. That’s when perimenopause is beginning.
The Role of Muscle in Hormonal Health
One of Dr. Jauregui’s central points is that muscle is critical during perimenopause:
- Muscle preserves metabolic rate, supports hormone balance, and protects against osteoporosis and cognitive decline.
- Losing muscle can worsen insulin response, decrease testosterone, and affect brain function.
- Strength training combined with proper protein intake is the key to maintaining vitality.
Muscle is our diamond. Maintaining it is essential for longevity, hormone balance, and overall wellbeing.
Personal Experience and Lifestyle Insights
Dr. Jauregui also shares her own journey:
- She eliminated gluten from her diet after consulting a functional medicine specialist, noticing dramatic improvements in energy, skin, and digestive health.
- She emphasizes that functional medicine is not about extreme restrictions but strategically adjusting diet, supplements, and lifestyle to support health.
- She encourages women to educate themselves, track their symptoms, and seek knowledgeable professionals.
Do not normalize fatigue, sleep problems, or digestive issues. Your body is signaling that something needs attention.
Key Takeaways from Dr. Alexandra Jauregui
- Perimenopause begins earlier than commonly thought, often in the late 30s.
- Hormonal fluctuations affect mood, sleep, metabolism, and body composition.
- Muscle preservation is critical—strength training and protein intake are non-negotiable.
- Functional medicine seeks root causes, not just symptom management.
- Lifestyle and nutrition adjustments profoundly impact how women experience perimenopause.
- Be proactive: track symptoms, educate yourself, and work with trained professionals.
The Bottom Line
Dr. Alexandra Jauregui’s discussion highlights that perimenopause is not a period to fear, but a stage to understand and embrace.
By recognizing the early signs, addressing hormonal fluctuations, prioritizing muscle health, and adopting functional medicine principles, women can navigate this transition with vitality, balance, and confidence.
Nutrition, strength training, and mindful lifestyle choices are key tools, empowering women to transform perimenopause into a phase of renewed energy, mental clarity, and overall wellbeing.
As Dr. Jauregui emphasizes, the more proactive and informed women are, the better prepared they will be to enjoy the next chapter of life fully and healthily.