Perimenopause doesn't have to suck
Perimenopause is a natural phase of life. It is a time of transition, and it is completely normal for your hormones to be shifting and adjusting - they need to. But for many women, that process is deeply uncomfortable. Sometimes very uncomfortable.
Here's what I want you to know: a certain level of discomfort has always been part of change. Growth, transformation, evolution - it ain't always sunshine and roses. But perimenopause is also your body's way of asking you to slow down, to be more intentional with your wellbeing, and to move yourself up the priority list. Probably at least a few notches.
What is perimenopause, exactly?
Perimenopause is the 2–12 years before menopause — and it's when you're most likely to experience symptoms. Menopause itself is defined as beginning one year after your last period, and the good news is that symptoms typically settle down from there.
Where menopause is a time of low oestrogen, perimenopause is a time of high, low, and everything in between. It's an oestrogen rollercoaster - and at times you may have more oestrogen than you've ever had before.
Here's the key piece of the puzzle: progesterone is made when you ovulate. During perimenopause, your ovarian follicles become less active, so progesterone becomes deficient. Progesterone isn't just a reproductive hormone - it helps regulate your nervous system and your ability to cope with stress. When it drops, your body has to adapt fast. That's why anxiety, low mood, insomnia, hot flashes, and heart palpitations are so common. Your nervous system is recalibrating.
How do you know if you're perimenopausal?
There's no definitive blood test for perimenopause. But if you're in your mid-to-late 30s, 40s or 50s, and you experience any three of the following - even with regular cycles - you're likely in perimenopause:
Where to start: two foundations that matter most
There's a lot you can do to support your body through this transition. Here are two of the most impactful places to begin.
Prioritise restorative sleep
Sleep is essential for hormonal health - it's when your body repairs, consolidates memory, and regulates emotion. Poor sleep also disrupts thyroid function and drives blood sugar instability. Simple starting points:
Stabilise your blood sugar
Blood sugar swings - high peaks and low troughs throughout the day - are extremely common in perimenopause, and they amplify almost every other symptom. Focus on whole, minimally processed foods and make sure every meal includes a good serve of protein and healthy fats. Whether three larger meals or four to five smaller ones works best for you will depend on your body - but this is one of the highest-leverage changes you can make.
One thing worth checking with your practitioner: ask for both a fasting blood glucose and a fasting insulin test at the same time. Your blood glucose can look perfectly normal while your pancreas is working overtime to keep it there - and you won't know without both numbers. You're aiming for fasting glucose under 5 mmol/L and fasting insulin around 4 mU/L.