Perimenopause is one of the most misunderstood and overlooked phases of a woman’s life. It is a hormonal transition that can last anywhere from four to twelve years, beginning long before many women ever expect it. During this time, hormones fluctuate dramatically, cycles shift unpredictably, and symptoms emerge that often feel confusing, overwhelming, and disruptive to everyday life. Many women describe perimenopause as “losing themselves,” without realizing that their hormones—not their personality—are changing.

At Glow Health & Wellness, we specialize in helping women understand, navigate, and thrive through perimenopause using personalized, root-cause care. Led by Casey Posey, MSN, APRN-BC, our approach blends comprehensive hormone testing, bioidentical hormone therapy (when appropriate), lifestyle guidance, thyroid and adrenal support, and emotional validation to help women feel seen, heard, and deeply supported. Whether you visit our Destin clinic or connect via Telehealth throughout Florida and Alabama, you don’t have to go through this transition alone.

Perimenopause is not a disease. It is a normal hormonal shift. But that doesn’t make the symptoms easy. With proper care, education, and support, this chapter of your life can become the beginning of a stronger, clearer, more grounded version of yourself.

What Is Perimenopause?

Perimenopause is the transitional stage leading up to menopause, defined as the point when a woman has gone 12 full months without a menstrual cycle. While menopause itself is one moment in time, perimenopause is the long hormonal transition that happens before it—often starting in a woman’s mid-to-late 30s or early 40s, though it can begin earlier.

During perimenopause, hormone levels fluctuate unpredictably. Progesterone typically drops first, then estrogen begins shifting up and down in sharp, erratic waves. Testosterone may decline gradually. These hormonal changes affect the brain, metabolism, mood, sleep, digestion, weight, skin, and emotional regulation.

Many women are unprepared for the length and intensity of symptoms because traditional medical training often minimizes or overlooks this phase. Casey takes the opposite approach—she acknowledges perimenopause as a real, significant, and transformative stage that deserves thorough evaluation and compassionate support.

Common Symptoms of Perimenopause

Symptoms may begin subtly, then intensify over time. Some women experience only a few symptoms; others experience many. None of them mean “you’re crazy,” “you’re overreacting,” or “it’s just stress.” These are hormonal changes—real, measurable, and treatable.

Common symptoms include:

• Anxiety, irritability, or mood swings
• Rage or emotional sensitivity
• Sleep struggles and early waking
• Hot flashes or night sweats
• Irregular or heavy cycles
• Brain fog or difficulty concentrating
• Fatigue that doesn’t improve with rest
• Weight gain, especially around the midsection
• Decreased stress tolerance
• Low libido
• Vaginal dryness
• Breast tenderness
• Headaches or migraines
• Hair thinning or loss
• Skin changes, dryness, or acne
• Bloating or digestive shifts
• Feeling overwhelmed or “not like yourself”

A hallmark symptom of perimenopause is sudden emotional intensity, often driven by declining progesterone, which plays a major role in calmness, sleep, and mood regulation. Women often say this is one of the most difficult changes—and also the most misunderstood by providers, partners, and even themselves.

Casey helps women make sense of these changes with clarity, reassurance, and a plan.

Why Many Women Feel Unheard

Too many women seek help for perimenopause symptoms only to be dismissed with phrases like:

• “Your labs are normal.”
• “It’s just stress.”
• “This is part of aging.”
• “You’re too young for menopause.”
• “There’s nothing to do but wait it out.”

This is not acceptable care—and it’s not accurate.
Casey believes women deserve to be heard, believed, and supported.

Perimenopause symptoms often appear years before conventional lab ranges show clear abnormalities, which is why functional, optimal-range evaluation is critical. Casey looks not only at labs but at patterns, symptoms, timelines, and your lived experience.

Your symptoms are real. They are treatable. And they matter.

How Casey Evaluates Perimenopause

Casey takes a comprehensive, functional approach that goes far deeper than a standard hormone panel. She evaluates:

• Progesterone patterns (often the earliest indicator)
• Estrogen fluctuations
• Testosterone levels
• Thyroid health
• Cortisol and stress response
• Sleep quality
• Insulin sensitivity
• Inflammation
• Cycle history
• Metabolism and weight changes
• Mood and cognitive patterns

She explains how your symptoms connect to your hormones, helping you finally understand what is happening in your body.

Bioidentical Hormone Therapy

For many women, bioidentical hormone therapy (BHRT) is transformative during perimenopause. Because this phase involves fluctuations—not total depletion—BHRT is customized carefully to smooth out hormonal instability.

Treatment may include:

• Bioidentical progesterone
• Bioidentical estrogen (in some cases)
• Testosterone support
• Thyroid optimization if needed
• Sleep and stress-supportive therapies

Progesterone alone can dramatically improve:

• Sleep
• Anxiety
• Emotional stability
• Hot flashes
• Heavy cycles
• Breast tenderness

Bioidentical estrogen may be added when symptoms indicate significant estrogen fluctuation or decline.

Casey adjusts therapy based on your symptoms, cycle stage, labs, and how your body responds. The goal is not to “medicate menopause”—but to support women through a phase of life that affects nearly every system in the body.

Functional Support for Perimenopause

In addition to BHRT, Casey often incorporates:

• Supplements that support mood, sleep, and hormone metabolism
• Lifestyle strategies for stress reduction
• Strategies for weight stability and metabolic health
• Peptide therapy for sleep, resilience, and energy
• Gut health support to reduce inflammation
• Adrenal and cortisol-balancing approaches

Perimenopause is not just about hormones—it is a whole-body transition. Casey treats it as such.

Perimenopause & Weight Gain

Weight changes in perimenopause are extremely common. Hormonal fluctuations can disrupt:

• Insulin sensitivity
• Cravings
• Sleep
• Metabolism
• Fat storage
• Cortisol regulation

This is not “lack of discipline”—it is physiology. Casey designs weight-loss or metabolic plans that support your shifting hormones, making weight loss possible again.

Perimenopause & Mental Health

Many women experience emotional symptoms that are frightening or unfamiliar, including:

• Anxiety
• Irritability
• Low motivation
• Emotional vulnerability
• Crying spells
• Racing thoughts
• Mood swings
• Feeling disconnected from oneself

These symptoms are not personal flaws. They are driven by hormonal neurochemistry. Casey helps women understand the brain-hormone connection and provides treatment that brings emotional balance back into reach.

Telehealth Care for Women in Florida & Alabama

Women across Florida and Alabama can access full perimenopause care through Telehealth, including:

• Consultations
• Lab review
• Bioidentical hormone therapy
• Medication management
• Peptide support
• Follow-up and ongoing guidance

Medications can be shipped to your home, making care convenient and accessible.

In-Clinic Care in Destin

For women who prefer in-person support, our Destin clinic offers a warm, comfortable space where you can receive comprehensive evaluations, in-depth consultations, and additional supportive therapies such as IV drips or weight-loss guidance.

You Are Not Imagining This. And You Are Not Alone.

Perimenopause is one of the most life-altering transitions a woman can experience—yet it is rarely talked about and often misunderstood. At Glow Health & Wellness, we believe women deserve better. You deserve answers. You deserve a provider who listens. You deserve relief.

With Casey Posey, MSN, APRN-BC, you will never be dismissed. You will be supported, educated, and guided with compassion and expertise.

Perimenopause is a chapter—not the whole story.
With the right care, this can become a time of renewal, strength, and profound personal clarity.

Glow is here to walk that journey with you.