The subtle hormone changes that can mean the big 'P' may be here (Perimenopause)
When most people hear the word “perimenopause,” hot flushes and night sweats often come to mind. While these can occur, they are usually not the first signs, and for many women, they are far from the most troublesome.
Perimenopause is the transitional phase leading up to menopause. It can begin in your late 30s or 40s and last several years. Clinically I have seen this as young as 37 but there is evidence to suggest hormonal changes can start earlier. During this time, your hormone levels fluctuate, sometimes unpredictably, rather than simply declining. These shifts affect not only your menstrual cycle but also your sleep, mood, energy, and overall wellbeing. Often I hear “I feel crazy” and “ I don’t feel like me”, “I am getting angry at my family”, and “ “I do not have patience anymore”.
Many women notice changes long before hot flushes appear.
Common early signs include:
Mood changes or increased anxiety
Sleep disturbances or waking at night
Fatigue and reduced stress tolerance
Brain fog or difficulty concentrating
Irregular, shorter, or heavier menstrual cycles
Breast tenderness or worsening PMS, or even PMDD developing.
Weight changes, particularly around the abdomen
Because these symptoms can be subtle or attributed to stress or lifestyle, they are often dismissed. This is where our ‘women’s intuition’ is so important and speaking to an informed practitioner who specializing in women’s health. Yet these early signs are your body’s way of signaling that support is needed to navigate this transition more comfortably.
Supporting Your Body Through Perimenopause
In my clinical practice, I focus on three key areas that can significantly influence how women experience perimenopause: hormone detoxification, mineral balance, and the stress response.
Hormone Detoxification
Fluctuating hormones place extra demands on the liver and digestive system, which are responsible for metabolising and clearing oestrogen. When these pathways are sluggish, certain hormone metabolites may recirculate, contributing to breast tenderness, heavier periods, mood swings, and worsening PMS. Whether we drank a lot in our 20s or 30s, had medication use including oral contraceptive pills, or just have been existing in this world with microplastics, endocrine disruptors and chemicals, most of our detoxification systems need a little extra support.
Supporting detoxification naturally can make a real difference. Herbs such as milk thistle have been studied for their liver-supportive properties, helping the body process hormones more efficiently. Paired with mineral balancing and regular elimination, these strategies can reduce the burden on the liver and improve symptom management.
Mineral Balance and Nervous System Support
Minerals are the unsung heroes of perimenopause. Magnesium, boron, zinc, potassium, and sodium are crucial for nerve function, hormone signaling, energy production, and stress resilience. During perimenopause, the body’s mineral requirements often increase, yet modern diets, stress, and poor sleep can deplete these vital nutrients.
A functional test such as Hair Tissue Mineral Analysis (HTMA) can reveal long-term mineral patterns and imbalances. Using this information, I prescribe personalised mineral support through compounded formulations which can help restore balance, improved detoxification, improve energy, and support the nervous system during this transitional phase.
Supporting the Stress Response (HPA Axis)
Perimenopause is a time of change, and the body’s stress system the HPA axis can become dysregulated. Chronic stress, poor sleep, or hormonal fluctuations can lead to fatigue, anxiety, sleep disruption, and increased sensitivity to stress.
Adaptogenic herbs such as Rhodiola, Green Oats and Siberian ginseng have evidence supporting their ability to help regulate stress responses, improve energy, and enhance resilience. Supporting the nervous system in this way can make perimenopause feel less overwhelming.
A Holistic Approach to Perimenopause
Perimenopause doesn’t need to be approached as something to “get through.” By focusing on the body’s underlying systems detoxification, mineral balance, and stress regulation it is possible to support smoother transitions, reduce symptom intensity, and improve overall wellbeing. And help you head into menopause stronger and more resilent.
Hot flushes may get the most attention, but the early, subtler signs often have the greatest impact on daily life. Working with your body’s natural rhythms, supporting liver and mineral function, and addressing stress proactively can make this stage more manageable and even empowering.
If you are noticing subtle shifts in mood, energy, or your cycle, taking a proactive, personalised approach now can make a significant difference in your perimenopause journey.
If you’re looking for personalised perimenopause support that integrates natural medicine working with a practitioner who respects both approaches can make all the difference. Book a free call to see what approach may be best for you.
