Why "Normal" Labs Don't Mean You're Fine in Perimenopause
You leave your doctor's office more confused than when you arrived. Your labs came back "normal," but you're dealing with insomnia, weight gain, brain fog, and mood swings.
If this sounds familiar, you're not imagining it. There's a real reason why conventional lab work isn't capturing what's happening during perimenopause.
The Perimenopause Testing Problem
Perimenopause hormones are inherently difficult to test. Unlike menopause (when hormone levels are consistently low), perimenopause is characterized by wild fluctuations.
Your estrogen might surge dramatically one day and drop the next. Progesterone levels shift as ovulation becomes irregular. What your hormones look like on Tuesday could be completely different from the previous Tuesday.
When your doctor runs hormone labs on a random day and says "everything looks fine," that snapshot is essentially meaningless. It doesn't capture the roller coaster happening in your body.
This is why women in their late 30s and 40s are experiencing real symptoms—insomnia, depression, weight changes, brain fog—and being told there's nothing wrong.
Your Symptoms Are More Reliable Than Numbers
After treating hundreds of women navigating perimenopause, I've learned that symptoms are more reliable than lab numbers for understanding where you are in this transition.
Your body is communicating through:
Sleep quality and patterns
Mood changes throughout your cycle
Energy levels and brain fog
Cycle changes (shorter, longer, heavier, irregular)
Stress tolerance
Body composition shifts
These symptoms, in context with your health history, tell me far more than a single hormone panel.
Not Treating the Cause
Conventional medicine typically offers one main perimenopause treatment: birth control pills.
Birth control can help with heavy bleeding or worsening fibroids (or for birth control!). But it works by suppressing hormones so dramatically that you stop cycling altogether. It's really a band-aid, not a root cause solution.
Many women don't feel well on birth control or aren’t interested in suppressive medications. And birth control doesn't address what's happening systemically in your body.
A Whole-Body Approach
Comprehensive perimenopause care uses your symptoms as clues to understand what's happening, even when lab work doesn't show conclusive results.
Everything in your body affects everything else. Chronic stress impacts progesterone production. Poor sleep disrupts hormone balance. Blood sugar instability worsens symptoms.
This is why I use a holistic approach that includes:
Symptom pattern analysis
Nervous system and stress support
Herbal medicine
Nutritional and metabolic optimization
Individualized timing and dosing for hormone replacement therapy (even in perimenopause!)
What You Can Do Now
Perimenopause symptoms often start in your late 30s or early 40s—sometimes earlier. Most women have no idea what to expect because nobody talks about it.
When you understand what's actually happening, you can advocate for yourself, make informed decisions, and create a plan that works for your body.
Ready to understand where you are in the perimenopause transition? Download my free Perimenopause Playbook. You'll learn the phases of perimenopause, how to track symptoms, what labs to ask for, and how to advocate when you're dismissed.
Meet Your Doctor
Hi, I’m Dr. Caitlin Fanning, ND (Naturopathic Doctor),
I help women who are struggling with hormone changes, fatigue, and infertility optimize their hormones and get their life back so they can feel like their best self.
If you're ready to take charge of your health and make real, lasting changes to your energy, your hormones, or your overall well-being, I would love to talk more!