Perimenopause, the transitional phase before menopause, can begin anywhere from a woman's late thirties to mid-forties, often a decade or more before periods stop. Yet it is one of the most under-recognised and under-supported phases in women's health.
During perimenopause, oestrogen and progesterone levels fluctuate unpredictably before declining. This affects not just the reproductive system but the brain, bones, cardiovascular system, gut, skin and metabolism. The symptoms women experience encompass cognitive changes, mood shifts, sleep disruption, joint pain, weight redistribution and profound fatigue.
Nutritional therapy during perimenopause works to support the body through this transition, reducing symptom severity, protecting long-term health and ensuring the hormonal decline happens as smoothly as possible.
Irregular periods: cycles becoming shorter, longer or unpredictable
Hot flushes and night sweats
Sleep disruption: difficulty falling asleep or waking in the night
Brain fog, memory lapses or difficulty concentrating
Mood changes: anxiety, low mood or increased irritability
Joint aches and muscle stiffness
Weight gain around the abdomen
Heart palpitations
Reduced stamina or exercise tolerance
My approach to perimenopause focuses on four interconnected areas: blood sugar stability, adrenal support, gut health and liver detoxification. These systems become increasingly important as ovarian hormone production declines.
Phytoestrogen-rich foods, specific nutrients that support oestrogen metabolism, targeted anti-inflammatory strategies and blood sugar management form the nutritional foundation. Lifestyle factors (sleep, stress, exercise type) matter enormously in perimenopause and are addressed as part of any plan.
Where appropriate, the DUTCH Complete provides a detailed picture of how oestrogen is being metabolised, important for both symptom management and long-term health risk assessment.
Oestrogen metabolism matters as much as oestrogen levels during perimenopause. The DUTCH Complete shows which oestrogen metabolic pathways are active and whether they are protective or potentially problematic, information that is critical for long-term health decisions.
View DUTCH testingPerimenopausal symptoms can begin in the late thirties. If your cycles are changing, your sleep is disrupted and your mood feels different, perimenopause is worth considering even if you are in your early forties.
Nutritional therapy is not a replacement for HRT. It can, however, significantly reduce symptom severity and support the body through the transition, whether or not you choose HRT. Many women find that nutritional support makes HRT more effective.
Yes, and the perimenopausal period is exactly the right time to start. Specific nutrients (calcium, magnesium, vitamin D, K2, omega-3) alongside dietary and lifestyle strategies can significantly reduce long-term risk. This is addressed as part of any perimenopause plan.
Book a free call to talk through your perimenopause symptoms and find the right path forward.
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