By Dr. David L. Pollack

Many women understandably feel concerned about perimenopause. What should be a natural and relatively smooth transition is often anything but. The widespread belief that menopause is destined to be a difficult experience is simply not accurate. In fact, many patients who begin care and support before menopause are pleasantly surprised to find that their perimenopausal journey is far more manageable—and even symptom-free.

With the right guidance, women can often move through this phase with minimal to no hot flashes, night sweats, mood swings or weight gain. The fear of inevitable bodily or emotional upheaval doesn’t have to be the reality. The key lies in understanding what’s happening in the body and taking proactive steps early on.

What is Menopause?

Menopause marks the natural end of the reproductive years, characterized by a shift in hormone balance—primarily a decrease in estrogen and progesterone. These changes are triggered by rising levels of pituitary hormones like LH (luteinizing hormone) and FSH (follicle-stimulating hormone). But to truly grasp the impact of this transition, we must look at the broader hormonal system—especially the role of the adrenal glands.

While the ovaries produce about 75 to 85 percent of a woman’s estrogen, the adrenal glands are responsible for the remaining 15 to 25 percent. The adrenals also create all the precursors for estrogen and progesterone. This makes adrenal health essential to hormonal harmony—especially as the ovaries slow down their hormone production during perimenopause.

One of the most important hormones produced by the adrenal glands is cortisol. Commonly associated with stress and weight gain, cortisol’s primary role is to manage inflammation. But it’s important to understand that the body views stress much more broadly than just emotional strain. From the adrenal system’s perspective, stress is any stimulus that requires a response. This includes emotional triggers, physical stressors like posture, injury or exercise, and chemical stress from poor nutrition, toxins, hormone imbalances and even chronic internal inflammation.

When stress or inflammation becomes chronic, the adrenal glands prioritize cortisol production over other hormones. This means estrogen and progesterone take a back seat. If this pattern continues for years, it can create a hormonal landscape that makes perimenopause symptoms far more intense or difficult to manage.

The good news? Our adrenal system is not a fixed machine—it’s adaptable and responsive to care. With high-quality nutrition, proper supplementation, acupuncture, moxibustion and supportive lifestyle choices, we can repair and nourish the adrenal glands. Doing this before and during perimenopause makes a world of difference.

I’ve seen countless women move through this stage with renewed clarity and comfort. With the right support, what once seemed like an overwhelming transition becomes an empowering, even celebratory, chapter of life.

Pollack Wellness is located at 66 Commack Rd., #204, in Commack, NY. For more information, call 631-861-HEAL (4325) or visit PollackWellness.com.