Perimenopause Care That Actually Works
Functional Medicine for Perimenopause: Beyond Hot Flashes and Hormone Pills
Perimenopause can start in the mid-to-late 30s and last a decade. Estrogen and progesterone fluctuate unpredictably, disrupting sleep, metabolism, mood, and energy. Functional medicine identifies the exact hormonal pattern driving your symptoms and builds a protocol around your genetics, not a population average. In-person in Marquette, MI and virtual in Michigan.
Trusted & loved by our patients.
Years of clinical experience
Why Standard Treatment Falls Short
Perimenopause Is Not One Problem. It's a Pattern of Interconnected Shifts.
Two women with the same FSH level can have completely different perimenopause experiences based on how they metabolize estrogen. Functional medicine for perimenopause maps the full hormonal pattern through advanced labs and genetic testing, then builds a protocol specific to your case. In-person in Marquette, Michigan and virtually in Michigan. Related: estrogen dominance, low progesterone.
- Comprehensive perimenopause panel: FSH, LH, estradiol, progesterone, testosterone, and SHBG
- Genetic testing to identify estrogen metabolism variants and methylation pathway function
- Thyroid and adrenal assessment to rule out co-occurring hormone disruptions
- Personalized supplement protocol targeting your specific perimenopause hormone pattern
Is This Right for You
Functional Medicine for Perimenopause Works Best for Women Whose Symptoms Don't Fit a Single Explanation
Waking at 3am Unable to Get Back to Sleep
Progesterone has a direct sedative effect and begins declining years before periods stop. This is one of the most common and treatable causes of perimenopausal sleep disruption.
Abdominal Weight Gain That Will Not Shift
Estrogen fluctuations affect insulin sensitivity and cortisol. The result is abdominal fat accumulation that does not respond to calorie restriction the way it used to.
Mood Swings or Anxiety That Arrived in Your Late 30s or 40s
Fluctuating estrogen directly affects serotonin and dopamine. Women who had stable moods in their 20s and 30s can develop significant anxiety or mood instability during perimenopause.
Hot Flashes or Night Sweats
Vasomotor symptoms are triggered by estrogen instability affecting the hypothalamic thermostat. Functional medicine addresses the hormonal root cause rather than managing the symptom alone.
Irregular Cycles Getting Harder to Predict
Cycle irregularity is often the first concrete sign of perimenopause. Combined hormone testing and genetic evaluation reveal what is changing and what can be done about it.
You Want a Clinician, Not Just a Wellness Program
Julie McDonald is a PA-C with 22 years of clinical experience. Monarch FM is a medical practice, not a wellness subscription. Virtual care is available in Michigan.
Over 22 years of medical experience ★★★★★
The Monarch FM Process
How We Approach Functional Medicine for Perimenopause
Perimenopause is a transition that unfolds over years. Our goal is not to mask the transition but to make it physiologically manageable by identifying exactly where your hormone system is under strain and correcting it with precision. The 12-Week Reset (The 12 Week Reset is our foundational program, and where every patient begins. Comprehensive bloodwork (including hormones) and genetic testing give us a clear picture of what’s driving how you feel — so we can build your specific plan across Nutrition, Sleep, Stress, Supplements, and Mindfulness, the foundation functional medicine builds on), is structured to address hormonal instability in phases, with measurable outcomes at every stage.
- 22 Years of Clinical Experience
- MMS | PA-C | FMACP Certified Provider
- In-Person in Marquette, MI | Virtual in Michigan
Perimenopause-Specific Lab Evaluation
We run a targeted perimenopause panel including estradiol, progesterone, testosterone, DHEA-S, cortisol, fasting insulin, thyroid function, and genetic markers affecting estrogen metabolism. This gives us a precise picture of where your hormonal transition currently stands.
Identifying Your Specific Pattern
Perimenopausal hormone patterns vary significantly from woman to woman. Some experience estrogen dominance early in the transition. Others move into estrogen deficiency quickly. Julie reviews your results to identify your specific pattern and connects it to your reported symptoms before designing any protocol.
Personalized Protocol for Hormonal Stabilization
Your protocol is built around your lab results and genetic profile. It includes a targeted supplement plan, nutritional guidance focused on perimenopause-specific metabolic shifts, and adjustments for sleep, stress, and body composition. No protocol is templated or generic.
Progress Tracking and Adjustment
We track results through repeat hormone panels and, for in-person patients, InBody 570 body composition analysis. Virtual patients receive the same clinical follow-up and protocol adjustments throughout the program. Perimenopause is a moving target, and your protocol evolves as your hormone levels do.
A Different Kind of Care
Perimenopause Symptoms Are Not Inevitable. They Are Treatable with the Right Information.
Functional medicine for perimenopause is not about prescribing estrogen and hoping for the best. It is about understanding which hormonal shifts are creating which symptoms in your specific body and building a targeted response. Related: estrogen dominance, low progesterone, hormonal mood swings, menopause. In-person in Marquette, MI and virtually in Michigan.
Questions & Answers
Frequently Asked Questions
What is perimenopause and how do I know if I am in it?
Perimenopause is the hormonal transition preceding menopause, typically beginning in the late 30s to early 40s. It is characterized by fluctuating estrogen and declining progesterone, which can cause irregular periods, hot flashes, night sweats, sleep disruption, mood changes, and weight shifts. You do not need to have stopped your period to be in perimenopause. Many women experience the most disruptive symptoms while cycles are still occurring. A formal evaluation requires lab testing drawn at the right point in your cycle, along with a clinical evaluation of your symptom history. At Monarch FM, we combine this with genetic testing to understand how your body is handling the transition metabolically. Virtual care is available if you are not in Marquette, Michigan.
How does functional medicine treat perimenopause differently from conventional medicine?
Conventional medicine typically approaches perimenopause with birth control pills or hormone replacement therapy. Both can be appropriate in some cases, but neither investigates why your hormonal transition is producing your specific symptoms. Functional medicine for perimenopause starts with a comprehensive evaluation of how your hormones are interacting with each other, your genetics, thyroid, adrenal function, and metabolic health. This allows a protocol that addresses the actual physiological drivers of your symptoms. For more on how hormones connect, see our hormone treatment overview page.
Can functional medicine help with perimenopause weight gain?
Yes. Perimenopause weight gain is driven by a combination of declining estrogen, rising cortisol, and changes in muscle metabolism. Standard calorie restriction rarely resolves it because the root cause is hormonal and metabolic. At Monarch FM, we use InBody 570 body composition analysis to measure fat, muscle, and visceral fat specifically, and we design protocols that address the hormonal drivers of perimenopausal weight changes. This is available both in-person and through our 12-Week Reset program (The 12 Week Reset is our foundational program, and where every patient begins. Comprehensive bloodwork (including hormones) and genetic testing give us a clear picture of what’s driving how you feel — so we can build your specific plan across Nutrition, Sleep, Stress, Supplements, and Mindfulness, the foundation functional medicine builds on) virtually.
What tests does Monarch FM run for perimenopause?
Our perimenopause evaluation includes FSH, LH, estradiol drawn on day 3 and day 21 of your cycle, progesterone, testosterone, DHEA-S, and SHBG. We also evaluate thyroid function with a full panel including T3, T4, reverse T3, and TPO antibodies, along with fasting insulin, cortisol, and inflammatory markers. We add genetic testing to assess COMT, MTHFR, and CYP enzyme variants affecting how your body metabolizes and clears hormones. This is significantly more comprehensive than what most conventional providers order for perimenopause.
Is perimenopause care available virtually?
Yes, completely. Monarch Functional Medicine offers full virtual perimenopause care for patients anywhere in Michigan. We coordinate lab work through a draw site near you, and all consultations and follow-up appointments are conducted via telehealth. The clinical program, including the 12-Week Hormone and Metabolism Reset (The 12 Week Reset is our foundational program, and where every patient begins. Comprehensive bloodwork (including hormones) and genetic testing give us a clear picture of what’s driving how you feel — so we can build your specific plan across Nutrition, Sleep, Stress, Supplements, and Mindfulness, the foundation functional medicine builds on), is fully deliverable virtually. In-person visits are only needed for our physical equipment (InBody 570, infrared sauna, vibration plate).
What is the difference between perimenopause and menopause?
Menopause is defined as 12 consecutive months without a menstrual period. Perimenopause is the transition that leads to menopause, often lasting 4 to 10 years before that 12-month mark is reached. During perimenopause, hormones fluctuate unpredictably. During menopause and post-menopause, estrogen and progesterone decline to consistently low levels. The symptoms of perimenopause are often more volatile than those of menopause itself because of these fluctuations. Monarch FM treats both transitions. See our page on functional medicine for menopause if your periods have been absent for 12 months or more.
Can perimenopause cause anxiety and mood changes?
Yes, and this is one of the most clinically significant but least discussed aspects of perimenopause. Estrogen modulates serotonin, dopamine, and GABA activity in the brain. As estrogen fluctuates during perimenopause, these neurotransmitter systems become less stable, which directly affects mood, anxiety, and stress resilience. Women who had no history of anxiety can develop significant symptoms during perimenopause for the first time. This is physiological, not psychological. At Monarch FM, we treat hormonal mood instability as a hormone problem first. See our page on hormonal mood swings.
How do I get started with perimenopause treatment at Monarch FM?
Book a free 15-minute strategy call. This call is designed to help you understand whether our approach is right for your situation before any financial commitment. You can also review the 12-Week Energy, Hormone and Metabolism Reset (The 12 Week Reset is our foundational program, and where every patient begins. Comprehensive bloodwork (including hormones) and genetic testing give us a clear picture of what’s driving how you feel — so we can build your specific plan across Nutrition, Sleep, Stress, Supplements, and Mindfulness, the foundation functional medicine builds on), page directly. The program is available in-person in Marquette, Michigan and virtually for patients anywhere in Michigan. No referral required.
Patient Results
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Your Biology. Your Protocol.
No Two Perimenopause Patterns Are the Same. Your Treatment Should Not Be Either.
At Monarch FM, every perimenopause protocol begins with comprehensive lab testing and genetic analysis, not a standard dose based on your age. Julie McDonald reviews every result individually to identify the exact hormonal pattern driving your symptoms. In-person in Marquette, MI and virtually in Michigan.
Ready to Start
Perimenopause Should Not Define the Next Decade of Your Life.
The symptoms are real. The hormonal drivers are identifiable. The protocol to address them exists. Monarch Functional Medicine treats perimenopause with clinical precision, whether you are in Marquette, Michigan or working with us virtually from anywhere in Michigan.
Join hundreds of patients who have reclaimed their energy, hormones, and health.
