That menopause is purely a reproductive shift, when in fact it’s a whole body shift! Oestrogen receptors are found throughout the body, so changing hormone levels can influence everything from the brain and bones to metabolism, cardiovascular health and the gut. Perimenopause can begin years before your final period and symptoms can show up in ways you might not immediately connect to hormones, from changes in mood and sleep to energy, body composition and brain fog. Knowledge really is power here. Understanding what’s happening can help you feel far more in control.

Think of them as creating a landscape that helps your body manage this hormonal shift. In particular, as oestrogen declines, mechanisms including blood sugar regulation, bone turnover and cardiovascular health come under greater pressure. Nutrition, strength training, sleep and supporting a healthy gut microbiome all become incredibly valuable. Essentially you want to create the best environment for your body to navigate this shift!

As hormones fluctuate during perimenopause, the brain is adapting too, making this a recognised window of vulnerability for changes in mood, anxiety and mental health. Oestrogen interacts with brain chemistry, including serotonin pathways involved in mood and emotional wellbeing. Progesterone’s by product allopregnanolone is very calming too! As your sex hormones fluctuate, they can also influence the HPA axis, which regulates our cortisol stress response. Throw in disrupted sleep and the demands of midlife, spinning plates on top of this, it can be a pretty hostile environment for your mental health.

HRT replaces hormones that decline through menopause, primarily oestrogen, and progestogen is usually added to protect the womb lining. Testosterone may also be considered for some women experiencing low libido. It can be highly effective for symptoms including hot flushes, anxiety, night sweats, sleep disturbance and menopause related low mood, while oestrogen also helps protect against bone loss. But it isn’t suitable for everyone, and it doesn’t replace the foundations of good health. Nutrition, movement, sleep and stress support remain incredibly important for helping the body navigate this whole body hormonal shift.

Perimenopause is not a linear hormonal decline, it’s more of a rollercoaster. Ovulation becomes less predictable, progesterone can decline and oestrogen can fluctuate considerably. At menopause, ovarian oestrogen and progesterone production falls significantly. It’s a biological transition that can impact the whole body, not just your periods!