Your journey
When perimenopause first hits, it can feel like your body’s playing a game of Jenga—stacking symptoms until everything threatens to topple over. If you’re lucky, you’ll breeze through it. If you’re like me? Buckle up, because it’s a wild ride. It’s confusing, frustrating, lonely, debilitating, disheartening...and that’s just the start.
But here’s the thing—I’ve learned so much on this journey, and if I’d known some of this upfront, it could have made the ride a whole lot smoother. That’s exactly what I’ve done here—broken it down into bite-sized pieces, because I know you’re tired, overwhelmed, and in no mood for a novel.
The most game-changing thing I discovered? Life after perimenopause can be absolutely glorious—if you do the work to find what’s right for you. I am the happiest, strongest, and most secure I’ve ever been, and I want that for every single woman out there
Hidden treasures await in this wild ride! Navigate it well, and you’ll come out the other side richer, happier, and ready to shine. Bon voyage!
Symptoms (the usual suspects)
Hot flushes
Night sweats
Sleep disorders
mood swings
Irritability
Vaginal dryness
Low libido
Fatigue
Weight gain
Muscle tension
Anxiety
Depression
Joint pain
Memory loss
Breast pain and tenderness
Bloating
Lack of concentration
Itchy skin
Irregular periods
Hormonal headaches
Heart palpitations
Hair loss
Osteoporosis
Panic disorder
Dizziness
Digestive problems
Burning tongue
Allergies
Tingling extremities
Note: Doing a once off blood test during perimenopause can be futile, you're hormones are all over the place and won't be able to give you an accurate picture unless done properly. The best way to diagnose perimenopause is through symptoms and a set of blood tests taken at specific times of your cycle. Keeping track of your symptoms and taking this to your doctor can help get you the best treatment.
Understanding your symptoms
and how your body is changing is key to helping professionals help you. Keep track of these changes and note the differences to help explain what's happening.
As you try different treatments keep track of how you're responding to those, there is no one-size fits all so it'll take some trial and error.
Note that there may be more symptoms than these and that you may be experiencing something not listed here.
Some helpful steps to get you through
(If this is all you can manage, this will be enough to start)
01.
Find a GP who specialises in hormones
Your typical GP does not know much, if anything, about it, especially perimenoapuse
03.
Start talking to other women your age
Get the conversation going, sharing it really helps. For example set up regular walking catch ups with friends.
05.
Nutrition can help to alleviate symptoms
Eat well for your health and not your weight, you’ll notice a difference.
07.
Keep stress down
Cortisol can increase the impact of the symptoms on your body, finding calm can help make this journey more manageable.
09.
Educate your family
Tell them what’s happening with you, how it’s affecting you and how you feel. You can help them learn how best to work with you to make it an easier ride for everyone.
02.
See a councilor or psychologist
To help you get on top of the emotional turmoil early and not make rash decisions
04.
Take the time to listen to your body
Everybody experiences it differently and has different needs. What are your symptoms, what do you need to help yourself?
06.
Exercise
Even gentle, can also alleviate symptoms. A 10 minute walk after meals stabilises blood sugar levels. Weight training is the best thing you can do for your body at this time
08.
Understand where you are on the journey
So have a sense of what you can do for yourself, as you move through it you’ll start to get more energy and motivation back to reclaim your body, mind, heart and life.
Three stage of perimenopause
Through my conversation with Kirstin, hundreds of conversations with other women and a lot of reading up on this subject I've come to understand that there are roughly three stages to perimenopause and that knowing where you are in each of these stages can help you better navigate this tricky terrain.
Stage 1: Disintegration
The falling apart stage and only realising half way through it. You’re lost, you’re don’t know who you are, you feel different in almost every way. You likely don’t realise at first it’s perimenopause and search for answers everywhere else.
Physical Experience: Symptoms may start mildly and sporadically here, often catching women off guard. Common signs are irregular menstrual cycles, slight hormonal shifts causing mood swings, early insomnia, and occasional hot flashes. This phase aligns with the initial emotional disorientation, where women may not immediately recognize perimenopause as the cause.
Hormonal Changes: Estrogen and progesterone levels begin to fluctuate more noticeably, contributing to mood swings and the initial feelings of being “off.”
Stage 2: Deconstruction
You’re ‘diagnosed’, or possibly even self-diagnosed. All the parts are on the floor and now you need to try figure them all out. What are the parts you want to keep and what needs to go.
You have started some kind of treatment plan that suits you (HRT, bio-identical HRT, natural remedies, pharmaceuticals etc) but still trying to work out the right doses and approach.
Physical Experience: Symptoms tend to intensify and become more frequent, marking mid-perimenopause. Periods may be more irregular or significantly different from what you’ve known. Hot flashes, night sweats, joint pain, and migraines are common, as are increased irritability and mood changes. This stage can drive women to seek answers, aligning well with the phase of diagnosis and trialing treatments.
Hormonal Changes: Estrogen surges and dips become more extreme, impacting the brain’s mood-regulating chemicals like serotonin. This phase often brings an amplified sense of chaos.
Stage 3: Reconstruction
Time to put your new self back together exactly how you want to. Decide what goes where and what it looks like. Where are you going? Who do you want to be? This is your confidence era!
You’re either spot on with your treatment or almost there. You feel comfortable with your doctor and supports and feel empowered to move on with purpose and vigour.
Physical Experience: The body is approaching menopause (defined as 12 consecutive months without a period). Hormone levels are generally lower and more stable than during mid-perimenopause, though some women still experience symptoms like hot flashes or sleep disturbances. This stage supports a sense of “settling in” emotionally with fewer surprises and more clarity on treatment.
Hormonal Changes: Estrogen levels stabilize at a lower baseline as the body adapts. With consistency in treatment and support, many women find they have the energy and clarity to rebuild, fitting well with the confidence and direction in your “Reconstruction” phase
Great interview with psychologist Kirstin Bouse
Listen to this interview with Kirstin, she says some gems in here that will help you understand perimenopause and what you're going through. You can also reach out to her at the All About Her Centre, she specialises in midlife women.
Why HRT is better than the pill
According to menopause specialist GP Dr Anna Kowalczyk-Ord (See the podcast on YouTube or on my Podcast page the pill and HRT (hormone replacement therapy) are designed for very different purposes, which is why the pill is not considered the best option for women in perimenopause or menopause. Here’s a breakdown of why HRT is generally recommended instead:
The Hormones Used
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The Pill: Most combined oral contraceptive pills contain synthetic versions of estrogen (like ethinyl estradiol) and progestin (a synthetic form of progesterone). These are designed to suppress ovulation and regulate periods, not to address the hormonal fluctuations of menopause.
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HRT: HRT typically uses bioidentical hormones, which are structurally identical to the hormones your body naturally produces (e.g., estradiol and micronized progesterone). These are better suited to replacing the hormones that decline during perimenopause and menopause.
Long-Term Use
The pill is not meant for long-term use beyond the reproductive years, while HRT is specifically designed for use during and after menopause to manage symptoms and reduce the risk of conditions like osteoporosis.
Dosage Differences
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The hormone levels in the pill are much higher than what a woman’s body needs in perimenopause or menopause. These high levels can cause unnecessary side effects and health risks.
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HRT provides hormones at lower doses tailored to what your body requires during this life stage, making it a gentler option.
Symptom Management
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The pill does not effectively address the symptoms of menopause, such as hot flashes, night sweats, vaginal dryness, and bone loss. These symptoms are caused by estrogen deficiency, which the pill’s synthetic hormones don’t specifically target.
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HRT is designed to relieve these symptoms and protect long-term health by supporting bone density and cardiovascular health.
Health Risks
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The pill is associated with a higher risk of blood clots, stroke, and cardiovascular issues compared to HRT, especially as women age.
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HRT has a better safety profile when prescribed correctly, particularly transdermal HRT (patches or gels), which bypasses the liver and reduces the risk of blood clots.
Exceptions
There may be cases where the pill is used for perimenopausal women, particularly if contraception is still needed or periods are very irregular and heavy. However, this is typically a short-term solution, and transitioning to HRT is often recommended once contraception is no longer required.
This distinction between the pill and HRT highlights the importance of individualised care during perimenopause and menopause and why seeing a menopause specialist is so important. GP's don't know enough, if anything, about this stage in a woman's life.
What's the right treatment for you?
Choosing the right approach to hormone replacement or balancing is deeply personal and depends on your symptoms, health history, and lifestyle preferences.
Some women may benefit from the precision and effectiveness of pharmaceutical or bioidentical hormone replacement therapies, while others prefer the holistic approach of natural or herbal methods. It’s essential to consider your goals—whether you want symptom relief, long-term health benefits, or a more natural path—and consult with a qualified healthcare provider to explore your options. The best choice is the one that aligns with your needs, values, and overall health.
Recommendations
People and organisations
Sexy aging
Fitness and nutrition information for perimenopause with Tracy.
All About Her Centre
Kirstin Bouse's site for menopause. Has many professional contacts and information
Mens Toolbox
A place for men to seek help. They specialise in helping men with relationship difficulties including during the perimenopause phase
Supplements I take
Syntext
For energy, capillary and cardiovascular health and antiaging. Another great side effect is a huge reduction in migraines. Use code VIP5 for a 5% discount
Metagenics
Femme Essentials Multivitamin and Mineral is a well rounded multivitamin for women and is highly recommended by Tanya Dale
Stress Ease
Herbs of Gold stress ease has Ashwagandha and Rhodiola in it and helps me with anxiety when it's feeling overwhelming.
Ageless You
A New Zealand based company that produces these two great anti ageing drinks I take for my skin and to help with energy.