Perimenopause has become the go-to explanation for symptoms like fatigue, mood swings, body fat increases, heavy periods and anxiety for women aged between about 38 and 55. And while this transitional phase can certainly influence how we feel, the truth is, changing hormones are rarely the sole cause.

Let’s take a step back and look at the bigger picture.

Imagine a young woman starting her menstruation journey. Over time, monthly blood loss, combined with a diet lacking in iron-rich foods, leads to gradual iron depletion. As she moves into adulthood, life gets fuller. Responsibilities increase, stress builds and her nervous system begins to bear the weight of the constant pressure she perceives. Elevated stress hormones can start to interfere with ovulation, which disrupts progesterone production – a hormone that supports calmness, restorative sleep and nervous system balance.

Fast-forward a few more years, and the demands of modern living take a deeper toll. Too much reliance on ultra-processed foods, frequent takeaway meals, excess alcohol at times and irregular eating patterns become more common. These dietary and lifestyle factors can contribute to:

• The development of fatty liver, which impairs estrogen metabolism
• Unfavourable gut microbiome changes that further disrupt hormonal harmony
• Insulin resistance, which disrupts estrogen and androgen (male sex hormones) metabolism

This excess estrogen often causes heavier periods, further draining iron stores and worsening an already depleted state. And with low iron comes a cascade of symptoms – fatigue, poor mood, brain fog, increased susceptibility to illness and compromised thyroid hormone production.
Then perimenopause arrives. Ovulation becomes irregular or absent altogether, meaning progesterone production becomes unreliable. The body loses the soothing, calming effect this hormone once provided. Symptoms that were previously manageable – or lying just beneath the surface – begin to rise.

But here’s the part many women are never told: these “imbalances” didn’t begin with perimenopause. The transition simply shines a light on what was already there.

This is why the experience of perimenopause is so different for every woman. Some breeze through with barely a symptom. Others feel like they’re unraveling. It’s not just about hormones. It’s about the broader landscape of your health – your nutrient status, nervous system, stress, liver function, gut health and insulin regulation, just to name a few.

So if you’re finding this phase particularly challenging, I encourage you to take a moment to reflect:

What were your iron levels like before now?
Have stress hormones been quietly running the show for years?
Was your gut in good shape before your cycle started to shift?

Yes, hormonal fluctuations are real and valid. But lasting relief often lies in addressing the layers beneath the surface – the nutritional, biochemical and emotional factors that have been building long before perimenopause took the blame.

Supporting your body through this transition is about more than just managing estrogen or progesterone. It’s about restoring what’s been lost, nourishing what’s been overlooked and making space for your body to feel supported again.

You deserve to feel steady, energised and clear. And that starts with understanding what your body truly needs. Not just now, but what it’s been asking for all along.