Guest Feature: Thriving During Hormonal Shifts by Ashley Koch

I’m Ashley Koch, aMYLK super fan and a licensed clinical nutritionist with a specialty in functional medicine. On Saturdays, you can find me at the PSU farmers market picking up my favorite vanilla hazelnut aMYLK and pumpkin spice aMYLK when it’s in season.


In my professional life, I partner with women to improve their health, balance hormones, and address digestive concerns through one-on-one and group support. I work with women virtually and in person, utilizing nutrition and lifestyle medicine to increase their energy, joy, and overall vitality. From an early age, I was fascinated by the dynamic nature of female hormones and how our daily choices shape our health outcomes. Entering perimenopause renewed my passion for providing evidence-based lifestyle tools, nutrition and education to help women navigate various hormonal transitions.


Perimenopause can start as early as your 30s or as late as your 50s, and nearly 75% of women experience symptoms that disrupt daily life. The average onset age is 47, and this phase is marked by a drop in estrogen, unpredictable hormone fluctuations, and a decline in progesterone. These hormonal shifts bring uncomfortable symptoms and increase the risk of obesity, metabolic syndrome, cardiovascular disease, osteoporosis, and Alzheimer’s. Common symptoms include fatigue, brain fog, sleep disturbances, memory challenges, anxiety, joint pain, difficulty focusing, hot flashes, and low libido. Many women experience these symptoms without realizing what stage of their hormonal journey they are in.


One of the most notable changes during perimenopause is the decline of estrogen, a powerful hormone I often describe to women as their “superpower.” Estrogen is what makes us creative, wise, brilliant, and dynamic. Unfortunately, as we age, estrogen levels begin to drop, bringing along various symptoms and long-term health risks. To truly understand these effects, it's important to explore the essential roles estrogen plays in our bodies.

Estrogen’s role in the female body beyond reproduction:

• Increases insulin sensitivity and improves our glucose metabolism.

• Powers our brain

• Provides anti-inflammatory effects to our blood vessels and positive impacts our cholesterol levels, promoting heart health

• Regulated the distribution of fat

• Protects our bones

• Maintains our hearing structures

• Supports skin hydration and elasticity

• Improves and maintains the health of our hair

• Reduces inflammation

• Sustains muscle 

 

Navigating the natural aging process and the effects of declining estrogen can feel challenging, but there are many ways to reduce our risks and support overall health. These are called modifiable risk factors—everyday choices we can make to improve our outcomes as estrogen levels decrease. Factors within our control include nutrition, regular exercise and movement, quality sleep, effective stress management, minimizing exposure to environmental toxins, and regular visits with a primary care physician to monitor and manage additional metabolic risks. Bio-identical hormone therapy may also be an option for women.

A healthy transition from reproductive years into perimenopause, menopause, and post-menopause is built on a foundation of these interconnected factors. Each piece supports the others, helping to create a balanced approach to navigating this life stage. At the core of this foundation, our relationship with food and movement can set us up for a successful, positive transition through these major shifts.

 

Image: Modifiable factors for Women’s Health 

 

In my work as a Licensed Clinical Nutritionist with a specialty in Functional Medicine, I partner with women to restore balance and support creating a solid foundation for well-being in this transformational time in women’s lives. In our work together, we explore nutrition, metabolic heath, gut health/digestion, hydration, sleep, stress management, toxin exposures, detoxification, movement, and many other factors that could be impacting symptoms. The work I have the opportunity to do with clients gives me a chance to dive deep into their symptoms and health history and creating a roadmap to improving outcomes and reversing symptoms.

Do you often feel tired? This is a common experience for many women, especially during perimenopause and menopause. Beyond the hormonal shifts taking place, there are multiple sources of fatigue that can make it challenging to sustain energy. During this phase, without the natural protection that hormones provide, we need to actively support our bodies in building quality energy.

When clients come to me with fatigue, we often uncover several underlying patterns. For some, chronic inflammation is a key contributor. Chronic inflammation can feel like trying to climb a mountain with a heavy load on your back; the body is working hard to address this inflammation, leaving little energy for daily activities. Nutrient deficiencies are another common factor. The transition into menopause is a metabolically demanding time that requires an abundance of essential nutrients to fuel our cells. Without these vital resources, we simply run out of steam. Finally, glucose dysregulation often plays a role in low energy levels. As we age, our bodies can lose efficiency in managing blood sugar swings, making it essential to balance carbohydrate intake with adequate protein, healthy fats, and fiber. This balance helps stabilize energy levels throughout the day, supporting activities without exhausting our reserves.

Understanding and addressing these patterns and more can make a significant difference in regaining energy and vitality during this transition.

Are you experiencing digestive symptoms? Digestion plays a crucial role in breaking down and transporting food to deliver nutrients to our cells, where they’re used for energy production and repair. It’s not just about what we eat but also about how well we absorb those nutrients—and hydration is equally essential. As estrogen levels decline, women often experience slower movement of food through the digestive tract and reduced diversity in the gut microbiome.

The gut microbiome is a vast ecosystem of trillions of microorganisms in the digestive tract, including bacteria, fungi, and viruses. These organisms are crucial for immune function, weight regulation, hormone production, and the creation of metabolites that support numerous bodily processes. They protect the colon, produce essential nutrients, and communicate with our immune system to help maintain overall health. Additionally, a healthy digestive barrier is critical to preventing food sensitivities, autoimmune responses, and inflammatory conditions.

Protecting your digestive health starts with recognizing and addressing abnormal symptoms rather than accepting them as “normal.” Here is a list of common but abnormal symptoms:

In this transformative phase of life, understanding and supporting the body’s needs can make a profound difference in well-being. Perimenopause, menopause and post-menopause may bring new challenges, but with the right foundation—built on balanced nutrition, regular movement, restorative sleep, effective stress management, and conscious care of digestive health—women can navigate these years with resilience and vitality. Embracing modifiable factors and creating a personalized approach to well-being empowers women to protect their health and energy for the long term. By addressing the root causes of symptoms and supporting the body holistically, this journey can be one of strength, balance, and newfound self-care. 

If you are looking for one-on-one support, I have a few openings for new clients in November, visit this link to schedule a free complimentary discovery call and learn more about how I can support you in your health journey. I would love to be your collaborative health care partner, helping you identify missing pieces and create the health you want.  If you schedule an appointment before December 6th, receive 15% off your first session with discount code: aMYLKfamily

If you are looking for group support, join my January Better Blood Sugar + Better Metabolism Group program, where will learn how to stop your cravings, increase your energy and gain more confidence in your food choices with the support of a community. Receive 15% off with discount code: aMYLKcommunity

-  Ashley Koch, MS, CNS, Licensed Clinical Nutritionist and Functional Medicine Specialist at Ashley Koch Functional Nutrition + Wellness.