A Critical Yet Overlooked Transition
Perimenopausal and menopausal women are in the prime of their lives but often feel held back by uncomfortable and debilitating symptoms. Perimenopause is a natural shift in a woman’s life. It is often marked by fluctuating hormones, irregular cycles, and unexpected symptoms, and offers an opportunity to recalibrate, strengthen resilience, and support future health. This transition, when well-supported, sets the foundation for optimal health and vitality well into the decades beyond menopause.
This is a time of hormonal, physical and psychological change for women. There’s no one right way to experience it – every woman’s experience will be unique. Perimenopause is not widely spoken about. As a result, many women have been left in the dark when it comes to navigating this transitional time of their life. Leaving some feeling isolated or dismissed. At the same time, women are often experiencing one of the busiest times in their lives as they juggle work, parenting teenagers and/or caring for ageing parents – so you may not have even given it much thought, because you simply don’t have the time!
Some describe feeling unprepared for the changes that begin to unfold. Cycles become erratic. Sleep becomes lighter. Irritability sneaks in. And the feeling of being “not quite yourself” grows stronger. Perimenopause is not only a time of hormonal change—it is a critical window of prevention. What we do now matters for our future health. Subclinical symptoms, if left unaddressed, can evolve into more chronic issues later on: insulin resistance, cardiovascular changes, bone density loss, mood disorders, and cognitive decline.
What Is Perimenopause?
Perimenopause is the transition phase leading up to menopause, often beginning in a woman’s early to mid-40s, but sometimes earlier. During this time, the ovaries begin to produce hormones less consistently. Progesterone tends to decline first, followed by more variable oestrogen levels.
This results in a range of symptoms that may include:
- Cycles that are shorter, longer, heavier, or skipped entirely
- Breast tenderness or swelling
- Mood fluctuations or increased anxiety
- Sleep disturbances
- Weight gain and slowed metabolism
- Brain fog, forgetfulness and difficulty concentrating
- Fatigue and lowered stress tolerance
- Changes in libido or vaginal dryness
- Hair thinning or loss
- Heart palpitations
- Aches and pains
- Hot flushes or night sweats (more common in later perimenopause)
Perimenopause can last anywhere from a few months to over a decade, with an average duration of around four years. It ends when a woman has gone 12 consecutive months without a period—at which point menopause is reached.
Understanding the 4 Phases of Perimenopause
- Very Early Perimenopause – Cycles remain regular, but subtle signs of hormonal shifts begin
- Early Menopause Transition – Cycles begin to vary in length; changes in flow may be noticed
- Late Menopause Transition – Periods become increasingly irregular, with gaps of 60+ days
- Late Perimenopause – The final 12 months leading up to menopause
- Menopause – Officially marked one year after the final menstrual bleed
Each phase comes with its own hormonal pattern and symptom profile. Understanding where you are in this process can help guide appropriate testing, treatment, and support.
Testing and Nutritional Considerations
Testing should be personalised. Salivary or urinary hormone testing (such as the DUTCH test) can provide insight into fluctuating hormone patterns and adrenal function, especially when symptoms are significant or not explained by bloodwork alone.
Key nutrients to monitor and support include:
- Magnesium – For sleep, nervous system support, and blood sugar regulation
- B vitamins (especially B6, B9, B12) – To support mood and methylation
- Omega-3s – Anti-inflammatory, mood and cardiovascular support
- Vitamin D – For bone health, mood, and immune modulation
- Protein – Essential to support muscle mass, neurotransmitters, and energy
Herbal Medicine: Nature’s Support System
Targeted herbal support can profoundly ease the perimenopausal transition when prescribed individually. Examples include:
- Withania (Ashwagandha) – For stress, sleep, and adrenal support
- Chaste tree (Vitex agnus-castus) – To balance progesterone
- Sage or Black Cohosh – For hot flushes
- Rehmannia or Schisandra – For adrenal and nervous system restoration
The Opportunity for Prevention
Addressing small issues now can dramatically shift how you feel during menopause and beyond. This is not just symptom management. It’s about optimising vitality, protecting cognitive function, preventing chronic disease, and embracing your next chapter from a place of strength and clarity.
If you’re in this stage of life, know that support is available. You don’t have to navigate this alone, and the changes you make today can shape the health and energy you carry into the decades ahead.
This information has been designed to provide information and insight that can accompany the advice and assistance of your healthcare practitioner.