An Herbalist’s Guide to 7 Common Perimenopausal Symptoms & Treatment

Natural Remedies for Perimenopause
Written By Tara J. Gregorio

Perimenopause is a season of change that can last 8–10 years before your final menstrual cycle.

For some, it’s smooth sailing. For others, symptoms like heavy bleeding, hot flashes, insomnia, and heart palpitations can be overwhelming.

Functional medicine teaches us to view these symptoms as signals, not random annoyances. By supporting the body with herbs, diet, lifestyle shifts, and hormone balance, you can make this transition more graceful.

As herbalist Susun Weed says:

“Menopause is not a disease. It’s a natural process of life. The joy of menopause is the world’s best-kept secret.” (Weed, 2002)

Below, I’m sharing seven common perimenopausal symptoms with natural treatment strategies from both traditional herbalism and functional medicine.

Perimenopause Natural Remedies

1. Perimenopause Bleeding

The first thing many women notice is a heavier cycle, sometimes with extreme blood clots. These clots can drop iron levels dramatically, leading to fatigue, dizziness, and more.

If you’re also living in a mold-contaminated home, the puzzle deepens. Mold exposure can raise estrogen levels and worsen clotting, especially for women with the MTHFR gene variant.

My story: I discovered hidden mold under my washing machine after experiencing persistent blood clots even post-fibroid surgery. My daughter had similar symptoms when she began menstruating.

What to do:

  • Inspect for mold and remediate thoroughly. Read this post to learn more.

  • Run a DUTCH hormone test to assess estrogen/progesterone balance.

  • Consider bioidentical progesterone during cycle Days 14–28. In my experience, this, combined with mold removal, reduced the clots so I can learn how to manage my body.

2. Blood Clots: How to Treat?

If you have large or frequent clots:

  • Check for environmental toxins like mold.

  • Support iron levels through diet (grass-fed beef, liver, leafy greens) and supplementation if needed.

  • Balance hormones with practitioner guidance. Progesterone often plays a key role in clot resolution.

3. Perimenopause Heart Palpitations

Palpitations can stem from low estrogen, high histamine, or even magnesium deficiency.
Herbs to support heart rhythm and calm the nervous system:

  • Motherwort – 10–30 drops tincture up to 3x/day.

  • Hawthorn – strengthens heart muscle and vessels.

  • Lemon Balm – mild calming effect, especially for anxiety-linked palpitations.

  • Black Cohosh – especially if palpitations coincide with hot flashes.

4. Natural Remedies for Perimenopause Hot Flashes

Hot flashes affect up to 75% of women during perimenopause. They often correlate with liver health and cortisol spikes.

Lifestyle steps:

Herbal allies:

  • Motherwort

  • Sage

  • Black Cohosh

  • Red Clover (phytoestrogen source)

5. Perimenopause Rage & Emotional Swings

Emotional surges, especially anger-triggered hot flashes, point toward liver support needs in both Traditional Chinese Medicine and functional medicine.

Helpful herbs:

  • Milk Thistle (liver detox support)

  • Schisandra Berry (adaptogen + liver tonic)

  • Lemon Balm (calming and digestive aid)

6. Natural Remedies for Perimenopause Insomnia

Sleep struggles can be hormonal, stress-related, or both.
First, look at your daytime habits: caffeine intake, screen exposure, and evening stress.

If progesterone is low (confirmed by DUTCH test), bioidentical supplementation on Days 14–28 can be life-changing.

Herbal sleep aids:

  • Skullcap

  • Motherwort

  • Lavender

  • California Poppy

  • Kava Kava

  • Valerian Root

7. Perimenopause UTI Treatment

Painful urinary symptoms aren’t always an infection; they can be low estrogen or a microbial imbalance.

Testing tips:

  • Start with a standard UTI test. If negative, request a UroKey test (MicrogenDX) to detect hidden pathogens.

  • Consider DUTCH testing to check estrogen status.

If estrogen is low:

  • Vaginal suppositories with estriol (2x/week).

  • Topical bioidentical estrogen as needed, balanced with progesterone to prevent excess estrogen effects like clots or breast tenderness.

Closing Thoughts

Perimenopause can feel like uncharted territory, but with the right tools, it’s navigable. Herbs, lifestyle shifts, environmental awareness, and hormone support create a powerful toolkit.

This season is also an opportunity to reclaim time for yourself to lift heavy weights, rest deeply, and listen to your body’s messages.

Ready to learn more?

Book a private health consultation for natural support from a certified herbalist. Book it here.

xo

Tara

More Reading

Tara J. Gregorio

I’m an expert on postpartum recovery and herbs for women’s health - I love teaching others how to use herbal and homeopathic remedies, so they feel confident they will work fast enough.

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