Menopause is often viewed as a single life event, but it’s actually the culmination of a gradual process that begins with perimenopause. Technically, menopause itself is defined as having gone 12 consecutive months without a menstrual period, marking the end of the reproductive years. Yet, instead of focusing solely on this endpoint, or worrying specifically about perimenopause or menopause, I would love for us all to be more in tune with our cycle and how best to support our health and body at every stage of life.
A lot of our health issues arise because we have been taught to accept certain symptoms as normal rather than seeing them as signs from the body that something is wrong. By learning to support our unique circumstances, symptoms and how best to support them, we can help to make huge improvements to our health.
That being said, it’s particularly important to zone in on any symptoms during the perimenopause, so let's talk about it.
In this article, I’ll outline what to expect during perimenopause, how to recognise the symptoms, and ways to support your body as you navigate this life phase.
When to Start Thinking About Perimenopause
Perimenopause may begin as early as our mid to late 30s. While every woman’s journey is unique, women who have experienced hormone-related symptoms in their teens or twenties - such as irregular cycles, severe PMS, or mood swings - may find that these symptoms intensify if they haven’t been addressed previously. And by addressing them, I mean looking into the root cause and restoring the body systems from a holistic perspective as well as treating symptoms with pharmaceuticals, like painkillers or birth control. If we’ve been doing solely the latter, it might be unreasonable to expect that we are going to sail through perimenopause and menopause with zero problems. So if any of the above symptoms resonate with you, it’s worthwhile working with a health practitioner to try and manage them, rather than simply masking them.
Understanding The Stages of Perimenopause
Perimenopause simply means the time ‘around’ menopause. It is when hormones start to change in anticipation of menopause. The average duration of perimenopause is four years, however it can last for as long as ten years.
There are several stages of perimenopause where the hormones fluctuate - this is why the blanket HRT approach that we are familiar with, is not always the answer in the early stages:
Early Perimenopause: In this stage, oestrogen levels begin to fluctuate and we tend to have more cycles where we don’t ovulate and progesterone levels drop, leading to symptoms like shorter menstrual cycles and signs of oestrogen dominance, such as bloating or breast tenderness. This period can also bring on mood shifts or fatigue.
Late Perimenopause: As perimenopause progresses, periods become less frequent, and oestrogen levels start to drop. You may notice skipped cycles or longer gaps between periods.
Menopause: Menopause is defined as twelve consecutive months without a menstrual period. This is the official marker of the transition, but the symptoms and hormonal shifts can continue for years after this point.
As we enter perimenopause, and our bodies experience shifts in hormone production, we often associate only oestrogen and progesterone with this phase. However, our adrenal glands also play an important role in maintaining hormonal balance, particularly by producing testosterone, which the body can convert into oestrogen. These glands are primarily responsible for managing our response to stress, so if we are constantly stressed, the adrenal glands may become overworked, leading to burnout symptoms that can overlap with perimenopausal symptoms. This is why managing stress is crucial during the perimenopause years, so here are a few ways we can manage it.
The Importance of Food and Lifestyle Choices
Now that we understand what’s happening during perimenopause, let’s talk about proactive steps we can take to support our health.
Balanced Nutrition and Blood Sugar Management: With dropping oestrogen levels, our bodies may become more insulin resistant, making it harder to stabilise blood sugar. To manage this, it is key to keep our protein intake up, whilst avoiding simple carbohydrates and including lots of great sources of fat to balance blood glucose after meals. Incorporate complex carbohydrates and focus on whole grains and fibre-rich foods to avoid blood sugar spikes
Essential Nutrients for Thyroid Health: Many women experience thyroid issues in their 40s, as hormone levels change. Nutrients like iodine, iron, zinc, and selenium are essential for thyroid function. A balanced diet that includes seafood, leafy greens, nuts, and seeds can help to provide these nutrients.
Stress Management and Self-Care: Setting boundaries and prioritising yourself can be one of the most empowering - and challenging - exercises during this stage. Ask yourself where you want to spend your energy. Activities that bring you joy, whether it’s a daily walk, quiet moments in nature, or creative pursuits, can help lower stress levels and support adrenal health. It’s so important to find something that helps you clear your mind. Meditation and mindfulness practices may not resonate with everyone, but finding a way to clear your mind - even if that means simply observing your surroundings while walking- can make a difference.
3 Surprising Symptoms of Hormonal Change
Hormonal shifts can create some unexpected changes in your body. There are over 100 symptoms associated with perimenopause. Here are a few common, yet surprising, symptoms linked to perimenopause and menopause:
Frequent UTIs: Lower oestrogen levels can affect the urinary tract, leading to an increased risk of infections.
Itchy Skin: As oestrogen declines, skin may become drier and more prone to irritation or itchiness.
Reduced Libido: Hormonal fluctuations can impact your libido, a symptom that may come as a surprise if it wasn’t an issue before.
Embrace Your Body’s Signals
Rather than seeing perimenopause as something to dread, it can be a chance to really understand your body and listen to its needs. By learning how to support your health through food, lifestyle, and mindful practices, perimenopause most definitely can be navigated with a sense of clarity.
Remember, this journey is about honouring your body’s signals and giving yourself the care and attention you deserve. If you’re feeling stuck, reach out for guidance - it’s never too early (or too late) to begin supporting your health in meaningful ways.