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Many women believe that the time to start taking hormones is when they finally stop menstruating. However, women can experience symptoms long before their last period. In fact, symptoms can start as early as 8-10 years before they stop bleeding.

These symptoms include but are not limited to sleepless nights, low libido (sex drive), exhaustion, weight gain, headaches, night sweats, vaginal dryness, intense mood changes and irregular periods. These symptoms can easily disrupt our day to day lives leading to a lack of joy, frustration, and low mood. Perimenopause means “around menopause,” the time leading up to menopause and the menopausal transition.

Many women ignore the symptoms of perimenopause and/or start to live with them as if they were part of the normal process of aging as a female. These are not symptoms that women should have to live with or accept as normal. However, by the time that most patients get to my initial assessment, they share stories of seeing their primary care provider (doctor) many times without any help.  Patient’s often recall being told “this is part of aging,” “there is nothing wrong with your hormones,” and “your hormones are fine.” But when we do a thorough hormone panel on those women, we find the reasons for the symptoms and treat them effectively. I thought I would include two testimonials from patients who I have treated through this important transition.

“My menstrual cycle is regular and lighter, and I sleep 8 hours a night regularly.  To put it lightly, I feel fantastic in comparison to how I felt prior to starting HRT.  I’m so thankful I did!”


“I have been working with Tammy for about 5 years and she has changed my life and my hormone health. The symptoms that I had have been lessened immensely, she is always available to answer questions and help me.”


Symptoms during this transition time, as we move toward menopause wax and wane. Some months women feel fine, other months, there period are heavy and more frequent and spotting can occur in between period more regularly. This intense and increase bleeding leads to lower iron levels which is a very important contributor to symptoms, including hair loss, fatigue and brittle nails. I will talk about iron levels in a future column. Women often feel their best during the time in their menstrual cycle when their progesterone and estrogen are high and balanced when their estrogen starts to increase, shortly after bleeding starts, Day 1 of your cycle, into Day 14 of your cycle. Women are happier, energetic and feel more like themselves during this time. The goal of hormone therapy during perimenopause is to replicate this time period for the entire the month. Women also experience worsening PMS (premenstrual syndrome) symptoms during this phase of their life.

As previously stated in other columns, some women breeze through this time in their life with few to no symptoms, however, others are very symptomatic and need added support to feel themselves again. Polycystic ovarian syndrome, often under diagnosed and undertreated can lead to severe symptoms in perimenopause. Other factors include being overweight, smoking, and alcohol consumption. In fact, many women quite or limit alcohol consumption during perimenopause because it makes them feel worse. Women often give up their favourite white or red wine during this phase, without really knowing why they must. Other triggers that increase symptoms during this transition include caffeine and stress.

Perimenopausal symptoms were the reason I sought out BHRT almost 7 years ago. Here is my testimonial from 2016:

I started feeling the effects of perimenopause:

·        lack of energy (like zero)

·        sex drive (gone)

·        anger (lots of it)

·        crying (lots of that too).


My physician’s only answer was to put me on antidepressants and a sleep medication. But I knew there had to be another option. Then, I found Bioidentical Hormone Replacement Therapy (BHRT). Wow, after few months I was feeling so much better. So, I decided to dive in, and it has been 7 years now.

I have never looked back!


Now I am here to help you!


Looking forward to our website launch later this month, keep reading!

Tammy O’Rourke is a Nurse Practitioner with a Ph.D. in Nursing. She spent the first 20 years of her career in primary care. About seven years ago she started having symptoms of several hormonal imbalances, for which her doctor prescribed medications to address anxiety, depression, and sleep issues. These medications left her feeling numb, more tired, and angry at a system that wasn’t addressing the root cause. Tammy was in perimenopause, that 8–10-year period before menopause that leaves women feeling tired, out of control, moody, lacking in self-confidence, and unwell.

She made the move to invest in her health and discovered bio-identical hormone replacement therapy, which helped significantly with her symptoms. So much so that she decided to learn more about hormones. She became certified in the United States through World Link Medical and she has been helping men and women with their hormone problems for more than four years. Tammy is passionate about her hormone practice and continues to help women and men across the country.

She recently relocated to Cape Breton Island with her husband, who grew up in The Pier.


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