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Why All Women Over 40 Need To See A Functional Medicine Doctor

As you embark on your journey beyond the milestone of turning 40, it's important to acknowledge the changes that come with this stage of life. Physiological shifts, both physical and mental, can become more pronounced, bringing with them new challenges and experiences.

It's not uncommon to face weight gain, sleep disturbances, and symptoms related to mental health as you age. However, aging gracefully is within reach, and the key lies in working closely with a physician who uses a functional and holistic approach.

In this blog, we delve into the hormonal fluctuations that arise after 40, illuminating the related symptoms and why it's crucial to consult a functional health doctor. By taking a proactive approach, you can ensure that you age with vitality and well-being.

Hormonal changes in your 40s:

As we know, menopause doesn’t typically occur until a woman is in her 50s. But did you know that your hormones will start dramatically changing as early as your late 30s? This means that your 40s is a time of adjustment and further hormonal change, also known as perimenopause- the first step in transitioning into menopause. Perimenopause is an extended transitional state, meaning it can last for months or years. The average duration of perimenopause is 4 years, but for some women, perimenopause can last for upwards of 10 years.

The main hormonal change that women experience during perimenopause is variations in the level of estrogen in circulation. Estrogen is a hormone produced by the ovaries and serves many roles throughout the body, including protection against heart disease, promotion of healthy bone development, growth and development of the reproductive anatomy, and significant effects on brain structure and communication.

During peak reproductive years, the amount of circulating estrogen rises and falls predictably throughout the menstrual cycle. However, when a woman enters perimenopause, ovarian production of estrogen varies dramatically until finally slowing substantially. And while your body adjusts to these new changes, you’ll be in estrogen withdrawal, hence the symptoms.

Perimenopause is a time of intense hormone fluctuations, which will inevitably have a significant impact on a woman’s entire body. Some of the many symptoms of perimenopause include:

  • Hot flashes

  • Night sweats

  • Mood swings

  • Vaginal dryness

  • Irregular periods

  • Difficulty losing weight

  • Memory loss

  • Painful intercourse

  • Skin and hair changes

As said above, these are just some of the symptoms associated with perimenopause and the hormonal changes that occur when a woman enters her 40s. In the next sections, we’ll discuss some of the key symptoms- including mental health changes, weight loss and gain, and fatigue and sleep.

Mental health in your 40s:

The drastic hormonal changes that typically occur when a woman is in her 40s are also often accompanied by intense changes in mood In fact, 10-20% of perimenopausal women experience mood symptoms. One of such mood change can be the onset of depression during perimenopause. Multiple studies have linked perimenopause to depression, as well as the worsening of existing depressive symptoms. A study published in the Archives of General Psychiatry found that perimenopausal women are twice as likely to be diagnosed with major depressive disorder as those who had yet to enter this hormonal transition. The study also found that perimenopausal women were four times as likely to develop depressive symptoms. Women at particular risk of developing depressive symptoms during perimenopause were those who hadn’t given birth, have taken antidepressant medications in the past, and had frequent hot flashes.

While research has more clearly linked depression and perimenopause, it’s less clear when it comes to anxiety. However, it is a symptom of perimenopause that many women report experiencing. Anxiety can occur during perimenopause for several reasons- changes in estrogen levels have been closely linked to feelings of anxiety, a lack of sleep and hot flashes have been known to trigger anxiety, and a fear of aging and midlife stressors can also lead to anxiety. Moreover, the pain and uncomfortableness caused by perimenopause seem to be a trigger for intense feelings of anxiety. Women who experience high stress in everyday life, have more severe hot flashes and sleep disturbances, and have poor health are at a higher risk of developing anxiety during perimenopause.

Sleep and fatigue in your 40s:

As you very likely already know, women are at a greater risk than men of developing chronic insomnia during their lifetimes. In fact, 63% of women aged 18 or older report suffering from insomnia. And, as you age and get closer to menopause, your likelihood of developing symptoms of insomnia increases. Nearly 60% of women with perimenopause report experiencing insomnia symptoms at least several nights a week. The symptoms of insomnia include:

  • Daytime tiredness or sleepiness

  • Irritability, depression, or anxiety

  • Not feeling well-rested after a night of sleep

  • Difficulty falling asleep

  • Waking up during the night

  • Waking up too early

  • Ongoing worries about sleep

Any of these sound familiar?

Women are more likely to experience symptoms of insomnia during the years leading up to menopause for several reasons. It’s largely due to the natural hormonal progression that occurs during perimenopause. Estrogen plays a large role in the metabolism of serotonin and other neurotransmitters that affect our sleep-wake cycles. Estrogen also helps to keep your body temperature low at night, helping you sleep better. With less estrogen, women may find it harder to fall asleep, lower quality sleep, poorer mood, and higher body temperatures.

Weight in your 40s:

Throughout a woman’s life, fat deposition will change as hormone levels fluctuate. Specifically, the sex hormone estrogen plays a large role in how fat is distributed throughout the body. Throughout puberty, as estrogen levels rise in girls, fat is distributed throughout the buttocks, breasts, and thighs. Then, during the reproductive years, fat in a woman’s body is deposited in the thighs, buttocks, breasts, and pelvis to provide an additional energy source for eventual lactation and pregnancy.

However, when women begin to transition into menopause, estrogen levels drop and weight distribution changes. As estrogen levels decrease, there is a decrease in lean body mass and fat begins to allocate around the belly. This midsection fat is also known as visceral fat. One study found that visceral fat depots may increase to 20% of total body fat during menopause, compared to only 5-8% in the premenopausal state. This increase in midsection fat tends to lead to a more apple-shaped body.

The hormone fluctuations, inadequate sleep, and changes in mood can make it very difficult to lose the weight put on during perimenopause. To lose weight, you will need a dietary plan and exercise regime tailored specifically to you and your unique situation.

But wait! It’s not all bad!

Despite writing paragraphs about all the difficult changes associated with turning 40, we’re not done yet. Turning 40 can also be an amazing time of growth and self-empowerment. Women in their 40s often have a greater sense of confidence and self-assurance, and they may feel more comfortable in their own skin. With life experience and a newfound sense of stability, women in their 40s may feel more equipped to tackle new challenges and pursue their dreams.

Overall, turning 40 is a unique and personal experience for each woman. While there may be physical and emotional changes, it can also be a time of self-discovery and growth. Embracing this new chapter in life can bring a sense of renewal and a newfound sense of purpose.

But, if perimenopausal symptoms are left unchecked, they can mar this sense of purpose. Finding a doctor who can not only treat the surface symptoms, but can also identify and address the underlying cause is key to rocking perimenopause. And, that’s where functional medical doctors come in.

Why all women over 40 need a functional medicine doctor:

As you just read, a lot is happening when a woman turns 40- hormones are fluctuating, weight is changing, sleeping is difficult, and mental health can be worsening. Therefore, you need a doctor who will take a holistic approach to treatment.

One of the key ways that functional medicine doctors can help women during peri-menopause is by evaluating hormone levels and imbalances. This may involve testing for levels of estrogen, progesterone, and testosterone, as well as thyroid and adrenal function. By identifying any hormonal imbalances, a functional medicine doctor can then work with the patient to address these issues through lifestyle changes, dietary adjustments, and natural hormone replacement therapy.

Another important aspect of functional medicine treatment is addressing underlying gut health issues. As the gut and brain are closely connected, poor gut health can contribute to common symptoms such as anxiety, depression, and sleep disturbances that many women experience in their 40s. A functional medicine doctor may recommend dietary changes, probiotics, and other supplements to improve gut health.

Functional medicine doctors can also help women during peri-menopause by addressing underlying nutrient deficiencies. This may involve testing for deficiencies in vitamins, minerals, and other essential nutrients and recommending supplements to address these deficiencies.

Finally, functional medicine doctors may also work with patients to reduce stress through lifestyle changes, counseling, and stress management techniques. By addressing these key areas, functional medicine doctors can help women struggling with perimenopause symptoms improve their overall health and well-being.

At The Johnson Center, we treat aging not by simply treating the symptoms, but by treating the cause of your symptoms. Working with patients this way can slow down the process of aging and chronic diseases, increase energy, decrease weight, improve sleep, low sex drive, and overall feel better.

To learn more about the Johnson's Center's approach to aging, click here to contact us! If you have any more questions about your path to optimal health, email our office at or call 276-235-3205.

The Johnson Center for Health services patients in-person in our Blacksburg and Virginia Beach / Norfolk locations. We also offer telemedicine for residents of Virginia and North Carolina!