I agree with the natural progesterone cream. I had a hysterectomy last year and use it and also remifemin (which helps estrogen levels). I have no ovaries though. The progestrone will probably be enough to help with perimenopause. I use a different brand though. I use Emerita Pro-gest. Whichever one you use make sure the package says "USP" progestrone (at least 400mg). You might want to try a few before you find one you like. I like the emerita because it comes in single doses and it smells good. If you use a pump, it is hard to tell when you are going to run out. You can get natural progestrone at Harry's (whole foods) or any health food store. If you use it at night before bed, it really helps you sleep too! Also, if you are having trouble sleeping, try taking a calcium magnesium vitamin before bed.