Our lives are full of BIG transitions and one that is least celebrated is perimenopause. The body that you have come to understand and appreciate over the years begins to change in mysterious and frustrating ways. How women experience this transition depends on several different factors, inflammation being key. Supporting optimal well-being in each of our systems and our overall health plays a major role in how well and easily we age. 

Another key factor in supporting your well-being during this transition? Ensuring that you have a trusted, skilled, and compassionate doctor on your side to hear you out, make recommendations based on your lifestyle and needs, and be a cornerstone of your support system!

Starkel Nutrition’s resident naturopath and women’s health expert, Dr. Lea McKinstry, has six years of experience treating symptoms of perimenopause. For this week’s blog, we asked Dr. McKinstry to pick one particular case study that would represent a standard treatment plan for a patient exhibiting menopausal symptoms. Here is what she laid out for us:

“In this case, I met with a 45-year-old woman presenting with fatigue, low libido, trouble sleeping at night, has a bowel movement every 3 days, periods are heavier with noticeable clots, and premenstrual mood swings that feel out of control. Scary, but normal symptoms!  

Here is what I prescribed to my patient: 


  • Movement – to prevent bone loss, protect heart and brain, improve sleep, and reduce stress
  • Adrenal support – we spend much of the first half of our life building, and the second half should be enjoying what we’ve built but it took a lot of overwhelm and overdrive to get here, so it’s important to nourish your adrenals. 
  • Keep alcohol minimal – alcohol may help in the moment but will take its toll on sleep and mood. Enjoy minimally. 


  • Increase soluble fiber, for a daily bowel elimination, feeding microbiome, and optimize hormones. 
  • Maintain healthy blood sugar balance – to support balanced mood and hormone support
  • Fermented foods – support a healthy microbiome
  • Fruits and veggies – reduce inflammation and oxidative stress
  • Omega-3 – preferably fish meal, at least twice a week

Supplements and/or Medications

  • Nutrient and Herbs – there are several nutrients and herbs to support hormone balance, reduce hot flashes, improve libido, support adrenals, and promote sleep
  • Menopause hormone therapy – using bioidentical estrogen and progesterone, which are identical to the body’s own hormones and so they are safer and have fewer side effects than contraceptive drugs or older types of hormone therapy. This form of therapy can relieve menopausal symptoms such as hot flashes, mood issues, and sleep disturbances. 
  • Deciding to use herbs or hormone therapy will depend on many factors.” 

If any detail in this case study rings true to you, Dr. McKinstry is accepting new clients and is here to help you! She is available for telehealth appointments on Mondays and Thursday mornings, as well as in-person or telehealth appointments on Wednesdays. Please give our administrative team a call at 206-853-0534 or schedule yourself online here.

It’s not you, it’s your hormones. And Starkel Nutrition is here to help!

Interested in learning more? Schedule an appointment with Dr. McKinstry to get support on your journey to holistic and kind health.

Written by Starkel Nutrition provider, Dr. Lea McKinstry, ND

Edited by Starkel Nutrition Marketing Assistant, Mairin McCurdy