Perimenopause weight gain is one of the most common concerns women face in their 40s. As hormones begin to shift, many women notice changes in metabolism, body composition, sleep, and energy levels. Even when their diet and lifestyle haven’t changed.
With the growing popularity of GLP-1 medications like Ozempic, Wegovy, and Mounjaro for weight loss, many women are wondering what their options are.
In this article, I’m sharing my personal experience navigating perimenopause, why I’m not currently using GLP-1 medications, and the natural strategies I’m using to support my body during this transition.
Over the past few years, I’ve been navigating something many women experience but often don’t talk about openly: unexpected weight gain.
Despite eating well, staying active, and working in the wellness space for years, my body started to change in ways I hadn’t experienced before. Like many women moving through perimenopause, I’ve gained about 25 pounds.
And if I’m honest, it caught me off guard.
When you’re a nutritionist and herbalist, you sometimes assume that if you follow the “rules”. Eat whole foods, stay active, manage stress. Your body will behave predictably. But perimenopause has a way of reminding us that our bodies are dynamic and constantly evolving.
Recently there has been a lot of conversation around medications that mimic the hormone glucagon-like peptide-1 (GLP-1). These medications, originally developed to support blood sugar regulation in people with diabetes, are now widely used for weight loss.
For many people, these medications can be incredibly helpful tools.
And I want to be very clear about something: the decision to use medications like these is deeply personal. Everyone’s health history, metabolic needs, and life circumstances are different, and those decisions should always be made with a trusted healthcare provider.
For me, though, I’ve chosen not to jump on the GLP-1 bandwagon right now.
Instead, I’ve been using this experience as an opportunity to look more deeply at what my body is asking for during this stage of life.
Perimenopause is a powerful hormonal transition. During this time, the body begins to experience fluctuations in estrogen and a gradual decline in progesterone.
These hormones influence far more than reproductive health. They also affect metabolism, sleep, mood, inflammation, and how the body stores fat.
As estrogen fluctuates, the body often becomes less sensitive to insulin. The hormone responsible for regulating blood sugar.
This shift can make it easier to store fat and harder to lose weight, even when our habits haven’t changed.
Many women also experience disrupted sleep, higher stress levels, and a gradual loss of muscle mass during this phase of life. All of these factors influence metabolism and body composition.
In other words, if your body feels different in your 40s, you’re not imagining it.
While I always prefer to support the body as naturally as possible, I also believe in being honest about when additional support is needed.
As I’ve moved into late-stage perimenopause, the hormonal fluctuations. Particularly the progesterone drops and estrogen spikes. Started to feel like too much for me to comfortably support with herbs and lifestyle alone.
After thoughtful consideration and working with my practitioner, I decided to begin using bioidentical progesterone.
For me, this decision wasn’t about “giving up” on natural approaches. It was about recognizing that sometimes the body needs additional support during major hormonal transitions.
I still rely heavily on nutrition, lifestyle, and herbal medicine as the foundation of my health, but progesterone has become one tool that helps stabilize the hormonal roller coaster that can come with this stage of life.
Rather than looking for a quick fix, I’ve been focusing on supporting the foundations of metabolic and hormonal health.
One of the biggest priorities for me has been maintaining muscle mass. Muscle is metabolically active tissue, meaning it plays a huge role in how efficiently the body burns energy and regulates blood sugar. Strength training has become one of the most important tools in my routine.
I’ve also been paying closer attention to blood sugar balance. Structuring meals around protein, fiber, and healthy fats helps prevent the spikes and crashes that can lead to cravings and energy dips later in the day.
As a herbalist, I regularly use herbs that support hormone metabolism, liver detoxification, and inflammation. All areas that can become more sensitive during perimenopause.
One of my main focuses right now is supporting the liver, which plays a central role in metabolizing hormones like estrogen. I regularly use milk thistle and burdock root, both in capsules and tea form, to support liver function and gentle detoxification.
I also drink a daily herbal tea that includes red clover, burdock root, calendula, dandelion root, and chamomile. This blend supports detoxification pathways, lymphatic movement, digestion, and healthy estrogen metabolism while helping the body process hormonal fluctuations more efficiently.
For inflammation and adrenal support, I’ve also been incorporating herbs like rehmannia and licorice root. These herbs can help support resilience during times of hormonal stress and are particularly helpful when the body feels depleted from the constant hormonal fluctuations that come with perimenopause.
Alongside herbs, there are a few supplements that I consistently rely on. A high-quality B-complex supports energy production and nervous system health, while magnesium plays a crucial role in stress regulation, sleep quality, and blood sugar balance. All areas that can become more sensitive during perimenopause.
And perhaps most importantly, I’ve been focusing on sleep and stress regulation. The stress hormone cortisol plays a significant role in midlife weight gain, particularly when we’re running on poor sleep or chronic stress.
If you’re navigating similar changes, I want you to know that you’re not alone.
Perimenopause isn’t just a hormonal transition. It’s a metabolic one as well. The strategies that worked in our 20s and 30s don’t always work the same way in our 40s.
Medications like GLP-1s may be helpful for some people, and there is absolutely no shame in using tools that support your health.
At the same time, there is tremendous value in understanding what is happening in the body during this phase and learning how to support it through nourishment, movement, herbal medicine, and nervous system care.
For me, this journey has been less about fighting my body and more about learning to listen to it.
And that perspective shift has been one of the most powerful lessons of all.
Many women are searching for natural ways to support perimenopause weight gain without relying solely on medications. While every person’s path is different, understanding how hormones, metabolism, stress, sleep, and inflammation interact during this transition can help guide more sustainable solutions.
This journey is about supporting the body, not fighting it.
If you’re navigating perimenopause and feeling frustrated by weight changes, hormone fluctuations, or new symptoms that don’t seem to make sense, you’re not alone.
Through my practice at Apotheka Herbal, I work with women in their 40s and 50s who want a deeper understanding of what’s happening in their bodies and how to support this transition naturally.
I offer both mini consultations and full consultations, where we can explore herbal medicine, nutrition, lifestyle strategies, and personalized wellness plans designed specifically for this stage of life.
I can also refer out to my wonderful naturopath Dr. Sarah Nyrose who specializes in woman’s health if requested.
Sometimes small, targeted changes can make a meaningful difference in how you feel.
If you’d like support, you can learn more about consultations through Apotheka Herbal.
Written by
Michelle reichert
Nurtionist/Herbalist
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