Manage perimenopause, weight issues and PCOS when 35 and older

Mid-thirties? Troubled with PCOS? Want to lose weight? This one’s for you.

Many women don’t like perimenopause; that time in life when a woman’s reproductive hormones start to decline.

Dr Disha Sridhar

I am a Gynaecologist Obstetrician ( MD, DNB OBGYN )with an emphasis on INTEGRATIVE MEDICINE.

What is Perimenopause, exactly?

Simply put, it means “around menopause”. The time that the body is naturally transitioning into menopause, thereby marking the end of the reproductive years. 

Why is Perimenopause dreaded?

Indeed, perimenopause has gotten a bad reputation because it can be accompanied by an array of unpleasant symptoms; including weight issues, mood changes, period problems (like heavy or irregular, bloating, and PMS), tiredness, fatigue, sleep issues, lacklustre skin and hair, thyroid issues, non-existent libido, and infertility. If you already have PCOS or any other hormone imbalances, to begin with. However, it can also get worse, owing to pre-existing and growing hormonal fluctuations.

PCOS and Perimenopause: How are they related?

To understand the relationship between PCOS and perimenopause, we first need a modern, holistic view of PCOS. 

Although high levels of testosterone are key to the diagnostic symptoms, they are NOT the root cause of PCOS, themselves. The female body produces testosterone as a precursor to the dominant estrogen, called estradiol. Women with PCOS have low, improperly cycling levels of estradiol, and their bodies produce high levels of testosterone to increase levels of estradiol. The true root cause of PCOS is low estradiol caused by a defect in “aromatase” (the enzyme that converts testosterone to estradiol in the female ovaries). Estradiol is the master hormone in the ladies body and plays a key role in the health of every major organ system. There are receptors for estradiol in the brain, throughout the digestive tract, the cardiovascular system, skin, muscles, bones, and in the immune system. Due to chronic low estradiol coupled with receptor issues, women with PCOS tend to have higher rates of obesity, cardiovascular diseases, diabetes, autoimmune disease and mood disorders such as depression and anxiety. 

Categorizing PCOS as only reproductive (period and fertility) disorder is a gross simplification that deeply harms the health of women. PCOS is a road which leads to bigger diseases in life including cancers.

Are these symptoms inevitable? NO! Read further and find out more.

Yes, the hormonal shifts during perimenopause are real, but the symptoms are optional. When you adopt a Truhealing lifestyle and cyclic self-care routine, you can sidestep the unpleasant symptoms of perimenopause. 

And don’t stop reading if you are in your 20s, these tips are good for you too. If you are younger but are having period problems, PCOS, fertility issues and/ore thyroid weakness, these tips will help you too.

Understanding perimenopause better 

15 years before a woman hits her menopause – is the time referred to as perimenopause. Essentially, when the hormones start declining.

During perimenopause – which can last anywhere from five to 15 years – before menopause, you may feel like your body isn’t your own anymore, as though something is seriously wrong. More specifically, perimenopause is characterized by uneven swings in estrogen, progesterone and androgens. These hormones follow a more or less even pattern during your 20s and early 30s, but they start to behave more erratically as you enter your late 30s and 40s; as you get closer to menopause, they start to trend downward.

Your reproductive hormones are beginning their descent. The first to retreat is progesterone, followed by estrogen and others. When these hormones decline during perimenopause, cortisol and insulin go up. All of this leads to very annoying, sometimes scary symptoms, for women over 40 years old.

The light at the end of the tunnel 

Good news is that there is a way in which you can efficiently restore normal hormonal balance and balance your weight.

Here is a closer look at how the Truhealing way can get your hormones back in sync during perimenopause.

The good news is that once you start understanding and honouring your cyclic nature, you’ll be able to enjoy a wide variety of cuisines when you start eating cyclically – macrobiotic, raw, ketogenic, Mediterranean, some intermittent fasting techniques; but never stuck with only ONE method day in and day out. Honouring your feminine rhythm with nature’s rhythm is the true differentiator of the Truhealing protocol. Everything about your diet and lifestyle should be relevant to your female biochemistry, and this protocol ensures just that. 

Making the perimenopause journey SMOOTH:

With that cheery prognosis, what should PCOS women, perimenopausal women, and especially PCOS perimenopausal-menopausal women do? 

First of all, don’t panic or despair. BOTH PCOS AND PERIMENOPAUSAL CAN BE TREATED. AND, with treatment, the prognosis improves dramatically! It is possible to have PCOS and be healthy. It is possible to go through perimenopause and stay healthy. The secret is to live the healthiest life you can. I know that this may seem like a piece of very boring advice. 

But the truth is that PCOS doesn’t have to be a disease. 

It has been around for tens of thousands of years and it became a disease state in modern society due to modern unhealthy behaviours. The best way to reverse PCOS is through a holistic approach. How? First, let us get the basics right.

1. Eat a mostly plant-based diet high in beans, fruits, and veggies with just a little animal protein in moderation to support muscle health

2. Get enough sleep – 7-8 hours EVERY night

3.Practice some intermittent fasting 

4.Exercise DAILY

5. Get some sunshine every morning and afternoon

6. Manage and lower your stress

7. Avoid harmful chemicals in your food and environment

The science behind how Truhealing lifestyle can help you in perimenopause:


1. Balance insulin resistance: This refers to a condition in which insulin goes unrecognized by cells. They don’t allow insulin to usher glucose into cells for energy. Insulin resistance is generally caused by eating too many carbohydrates and refined sugars. It is the leading cause of hot flashes and night sweats. Truhealing diet cuts carbohydrates and adds healthy fats. With fewer carbs, there is less insulin circulating in the body, and this works to reverse insulin resistance and the symptoms that go along with it.

2. Promotes intermittent fasting: With this strategy, you go up to 12 to 14 to 16 hours without eating, mostly overnight. Intermittent fasting prevents insulin resistance and clears unhealthy estrogens from the body. We’re exposed to these estrogens from the environment, including birth control pills, plastics, pesticides and non-organically raised meats. All of these cause estrogen imbalance. Intermittent fasting is thus an excellent way to turn up hormone-balancing a few more notches higher!

More about the Truhealing diet

Truhealing diet is packed with detoxifying vegetables. Most of the vegetables are highly alkaline, especially green leafy veggies, cruciferous vegetables like broccoli, cauliflower, cabbage, and greens and onions, garlic etc. These alkaline vegetables help the liver detoxify more efficiently and reduce the production of excess estrogen.

Truhealing diet emphasizes on hormonal-balancing fats. Insulin is managed well by monounsaturated fats, namely those in avocados, my favourite fat. Highly alkaline, avocados support weight control, as several clinical studies suggest. Monounsaturated fats, in general, also provide the building blocks the body needs to make and rebuild both estrogen and progesterone.

Truhealing diet also has the scope to include some animal proteins for hormone-building vitamin B12. Animal proteins such as grass-fed beef, wild-caught fish, and organically raised poultry are high in vitamin B12. A deficiency in this vitamin can lead to decreased estrogen and progesterone, along with increased cortisol levels. Vegans and vegetarians are often low in this nutrient because they avoid animal products. Please understand that vitamin B12 is the single most important nutrient affected by ageing and starts its downhill descent by midlife — which is why supplementation is essential, especially if you don’t eat animal products.

Truhealing lifestyle also covers the most important aspect – reduces excess cortisol. Apart from cyclic dietary strategy, we also focus on stress management tools and self-care. Introducing healthy carbs when required can lower cortisol at night so that you sleep better. Poor sleep has a solid link with hormonal imbalances, cravings, insulin resistance, and weight gain.

We at Truhealing also recommended herbal supplements. We love to tap into the power of mother nature to align with our hormones. Three of my favourite supplements for perimenopause are ASHWAGANDHA,nHOLY BASIL and VALERIAN ROOT. They all help with cortisol balance and sleep.

So start working on the above tips!

When all your hormones are in balance, you minimize the uncomfortable, often scary symptoms of perimenopause and get on with living a happy, energized, and content life.

As a practising medical doctor, I have helped hundreds of women successfully navigate across PCOS and perimenopause. By choosing the best lifestyle approaches and appropriately using medicines whenever required, women with Hormone problem s and PCOS can transition through the menopausal journey and come out strong, vital, and glowing! Not only do I see it with my patients, but as a perimenopausal PCOS woman myself, (I am a 40-something-mom of two) I have walked this path, and I stand proudly as a living testament that the PCOS perimenopausal years can be some of the most fulfilling, vibrant, and creative years of your life.


Originally published Octomber 9, 2020 by Dr Disha Sridhar