Do you sometimes feel like you might be going completely crazy? To the outside world you function fine, but on the inside you feel hyper stressed, anxious, paranoid and completely overwhelmed? Do you dream about running away from it all? I hear you, I’ve been there. Welcome to the perimenopause.

What is the perimenopause?

The perimenopause refers to the years that run up to the menopause. We are officially in menopause when we have gone for twelve months without having a period. This means that technically speaking the menopause lasts just one day while the perimenopause can last for years. Perimenopause symptoms often begin around our mid 40’s although most of us rarely put two and two together in the early stages.

What are the first signs of perimenopause and menopause?

The first signs of perimenopause are likely to be increased anxiety, low mood and reduced confidence. This is because the first hormone to decline is progesterone. Progesterone helps us feel calm and has a mild-antidepressant effect on our brains.

In some predisposed women, reductions in progesterone might look more like unwanted repetitive thoughts, obsessive compulsive behaviour, feeling like we are going mad or crazy and feelings of dread or panic which can border on a panic attack (shortness of breath, tight chest, dizziness or palpitations).

Often these symptoms occur while we are still having regular periods, hence why we don’t think to associate them with the onset of the menopause.

Symptoms of perimenopause and menopause

As we approach menopause, we start to make less oestrogen and this can lead to symptoms of fatigue, insomnia, stubborn weight gain, headaches or migraines, brain fog or “cottonwool head”, depression, joint pain, hot or cold flashes, night sweats, increased facial hair, heavier periods, increased PMS symptoms, vaginal dryness and increased UTI’s. Sometimes the fatigue and pain can be so great that women are misdiagnosed as having chronic fatigue syndrome or fibromyalgia.

Perimenopause finds our weak links and stomps all over them. So, if you are someone who gets PMS you may find symptoms worsen, migraines can increase in frequency, extra weight can become harder to shift and niggly gut issues might start to resemble full-blown IBS.

Fluctuating hormones through perimenopause

We are often sold this idea that as we head towards menopause our hormone levels gradually decline until our ovaries stop making oestrogen and progesterone and we are officially in menopause. It sounds so calm and simple and for some women this is exactly how it plays out, with around 25% of women sailing through the menopause without experiencing any noticeable symptoms at all.

But for many of us, it is a very different story. Through perimenopause our hormones can fluctuate wildly; one minute high and the next minute low – a tumultuous hormonal rollercoaster. It is these crazy fluctuations that can further contribute to symptoms and mean that while one day we might feel on top of the world, the next day it can all come crashing down around us leaving us flattened by desperation and hopelessness.

Genetics, epigenetics (how our environment can alter gene expression), diet, lifestyle and overall state of health, will all determine what kind of perimenopause we have and how bad our symptoms might get.

Will perimenopause symptoms go away?

Yes! Hang on in there because there is light at the end of the tunnel. For most women, the majority of perimenopause symptoms begin to subside in the first few years following menopause. If this sounds like far too long to wait, then some of the solutions listed below can help to bring real relief from many perimenopause symptoms. And if you have absolutely no idea how or where to begin then please do get in touch. I help women, just like you.

The best natural solutions for perimenopause symptoms

Educate yourself and track symptoms

Knowledge is power. Understanding what is happening to us can help to make the whole thing feel a lot less scary. Keeping a journal is a great way to track mood swings and physical symptoms and to help figure out what can make us feel better and what might make symptoms worse. Doing this can help us to feel more in control, this can reduce stress levels which has the knock-on benefit of reducing symptoms.

Keep your blood sugar balanced

The number one rule through perimenopause and menopause is to eat in a way which keeps blood sugar on a nice even keel. When blood sugar swings from high to low it can amplify perimenopause and menopause symptoms.

Eating to balance blood sugar will look slightly different for everyone but a good guide is to eat three meals a day and if needed then one or two planned snacks. Eat protein and good fat with every meal or snack and aim to base meals around plenty of colourful veggies and fruits. Avoid sugar and highly processed foods and replace fast release carbohydrates like white bread and sugary cereals for wholegrains like oats and brown rice.

Up your fibre intake

Once oestrogen has done its’ job it is eliminated from our body in our poop. Staying regular is super important through perimenopause as this can help to keep hormones balanced (constipation can sometimes result in oestrogen being reabsorbed into the body leading to even more hormonal chaos).

We need plenty of fibre to help keep us regular. Try and avoid processed foods marketed as high in fibre (like breakfast bars) and instead choose real whole plant foods like vegetables, fruits, wholegrains, beans, pulses, nuts and seeds. And always stay well hydrated, our poop is around 75% water!

Avoid trigger foods

Trigger foods will vary by individual so do experiment. Foods which might worsen perimenopause symptoms include excess amounts of sugar, chocolate, chilli, caffeine and alcohol. This doesn’t mean you can never again eat these foods, it is about finding your individual level of tolerance.

Include phytoestrogen foods

Phytoestrogen foods can act like a very weak oestrogen in the body. Think of these as the icing on the cake. You need to get the cake right before you start worrying about icing the top. If you’re riding the blood sugar roller coaster then phytoestrogens are unlikely to help much.

Phytoestrogen rich foods include milled linseed, tofu, tempeh, edamame beans, chickpeas, sesame, hummus, mung bean sprouts, garlic and dried apricots.

Move and build strength

Keep moving! Exercise can be really helpful in reducing perimenopause symptoms. Conversely, excessive exercise can drive symptoms, so it is all about figuring out the right type and amount for you. Strength work is important through menopause to help keep bones strong and healthy. Walking in nature and yoga are great perimenopause options and have the added benefit of reducing stress levels.

Manage stress

Stress can drive perimenopause symptoms but managing stress can be really challenging when we are juggling work, children and elderly parents and there are already not enough hours in the day. Prioritising time to switch off and destress is hard but super important. Activities that can help to reduce stress include walking, running or cycling (in moderation), catching up with friends, yoga, mindfulness, listening to music, reading, crafting, or taking a long bath.

Counselling or psychotherapy

Oestrogen is often joked about as being the “hormone of compliance”. As levels decline we can become less tolerant of situations that we may feel we have been putting up with for years. This can lead to huge internal stress when we are battling overwhelming feelings and emotions that are no longer willing to be squashed into the box of conformity. Counselling or psychotherapy can help us to figure this stuff out.


Sleep is critical for our health and wellbeing whatever age we are at. It is helpful to create a bedtime routine and make it non-negotiable. While everyone is different, seven to nine hours of good quality sleep every night is considered optimal. And even if your two or three glasses of wine with dinner made you feel like you sleep better, the research shows they don’t! For great sleep stay we need to stay off the booze.

If you would like support with any of the health issues discussed, please do get in touch. I am passionate about understanding how we can use diet and lifestyle to help us live a full and happy life and become the best version of ourselves that we can possibly be.

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