Understanding Perimenopause: how your hormones are changing in your 40’s

By Francesca Liparoti

Registered Nutritional Therapist – dip ION, mBANT, mCNHC

Lower energy, struggling to sleep as well as you used to, gaining extra weight around your middle, feeling irritable or anxious, a foggy brain, headaches, heavier periods, increased or new PMS symptoms…

These are some of the symptoms that women can start to experience as they move into their 40s and they can be attributed to the phase of womanhood known as ‘peri-menopause’.

Let’s take a closer look at what perimenopause actually is and what’s happening with your hormones.

From the time that menstrual cycles begin as a teen, the brain and ovaries are communicating with each other all month long, occurring month after month until menopause, to release various hormones, namely oestrogen and progesterone, at various times and bring about the necessary changes needed to stimulate ovulation and hold a pregnancy. Whether a woman wants to become pregnant or not, this hormonal rhythm, or cycle, is essential to overall female health. 

Perimenopause is the 2 – 12 years leading up to menopause which, for most women, is achieved around age 51. So, for some women perimenopause starts around age 38 and most women are noticing changes by age 42 or 43 onwards. 

Perimenopause a slow and gradual transition towards menopause and the communication between the brain and the ovaries is starting to change, which can result in various symptoms and experiences such as low energy, sleep issues, heavy periods, breast pain, migraines, mood swings, irritability and anxiety, brain fog, increased fat around the middle, shorter or longer cycles and hot flashes and night sweats.

What’s different about your hormones in your 40s 

During this slow and gradual transition, the breakdown in communication between the brain and ovaries puts oestrogen on a rollercoaster, where it can rise to almost 3 times higher than ever before at some points in the cycle and then crash down to really low levels at other points, like a rollercoaster ride, occurring month after month for the duration of perimenopause, while progesterone gradually starts to decline. 

Oestrogen crashes can cause hot flashes, night sweats, headaches, migraines and low mood. Conversely, high levels can cause heavy periods, breast pain, headaches and bloating.

In your 40s, you still have regular periods and you’re still fertile, but the new rollercoaster of oestrogen and decline in progesterone impacts your menstrual cycles, periods, sleep, mood, energy, weight, strength and more.

Why progesterone starts to decline and why we need it

You only make good amounts of progesterone when you ovulate, so the breakdown in brain-ovary communication means less and less cycles where you actually ovulate and more and more ‘anovulatory’ cycles. An anovulatory cycle is simply a cycle where you didn’t achieve ovulation, which means you didn’t make progesterone. This creates a hormonal imbalance in and of itself as it leaves oestrogen to dominate the hormonal show without the balancing effects of progesterone, creating symptoms such as heavy periods, breast pain, PMS, water retention and mood swings. Add to this the rollercoaster of oestrogen during perimenopause and it can be the perfect storm for many women. 

Your body and brain will feel the effects of low progesterone because it is an anti-anxiety, anti-irritability and calming hormone that’s vital for your overall sense of wellbeing and good sleep and it increases your capacity to deal with stress.

The good news is that perimenopause symptoms are temporary and can respond really well to some simple diet and lifestyle interventions. 

Some simple nutrition and lifestyle habits play a significant role in how we feel and in supporting better hormone balance, even during perimenopause.

Why managing stress is the first place to start

Stress is one of the biggest roadblocks for achieving ovulation, some or many months. Your brain is responsible for signalling down to your ovaries to tell them to release and egg which results in progesterone being made. However, if the brain perceives any sort of stress, it will hold back it’s signals to the ovaries and block ovulation from occurring. Ovulation already becomes harder to achieve during perimenopause due to the brain to ovary communication breakdown and so it’s EVEN MORE important to manage your stress and minimise its impact on your ability to ovulate. 

Here are some simple nutrition and lifestyle habits for supporting your body and your hormones during perimenopause:

Incorporate simple stress management practices into your days and weeks such as gentle yoga, walks in nature, deep breathing exercises and meditation, Qi Gong, journaling and writing down or saying the things you are grateful for each day. Now really is the time to prioritise self-care and cultivate more joy and play!

Prioritise your sleep – create a good evening wind down routine that gets your body and brain ready for a good night’s sleep. Dim the lights all over the home from early evening and keep screens, news, and stressful conversations to a minimum. Aim to get to bed a little earlier each night until you are consistently going to bed at a good time that gives you a full 7-8 hours of sleep.

Nourish your body and hormones now more than ever – Perimenopause is NOT a time to restrict calories or follow restrictive diets. Your body wants to be well-nourished each day with ENOUGH food (calories/energy) coming from plenty of quality protein, good fats, colourful vegetables and nutrient dense carbohydrates. You can read more about menopause and perimenopausal nutritional support here.

Get plenty of key nutrients – many smaller nutrients act as ‘co-factors’ in various and many key processes and systems in the body including the endocrine (hormone communication) system. Key nutrients for hormone health include vitamin B12, B6 and folate (B9), magnesium, selenium, zinc, choline, vitamin A (as retinol), vitamin E and iron. Therefore, it’s important to eat a well-balanced and varied diet. Read more about our optimising health and wellbeing support here.

Embrace good fats – Fat is essential for hormone communication, balance and detoxification, and for a healthy menstrual cycle. The omega 3 fats DHA and EPA are especially helpful for hormone health and oily fish such as mackerel, sardines, salmon and herring are rich sources. Other good sources of helpful fats are extra virgin olive oil, avocado, olives, nuts and seeds, coconut and real butter.

Support proper breakdown of used oestrogen – once your body has used your oestrogen it needs to be broken down in your liver and prepared for permanent removal from your body via a bowel movement. Various foods such as cruciferous vegetables, protein, omega 3 fats, colourful vegetables, flaxseed, berries and herbs and spices can support the liver to do its job well. It’s also important to support regular healthy bowel movements by staying well hydrated with filtered water, chewing your food fully before swallowing it and increasing beneficial bacteria in your gut with fermented foods and plenty of colourful vegetables. 

Address possible underlying inflammatory issues such as a blood sugar imbalance and insulin resistance, compromised gut health or thyroid issues and these may impact your body’s ability to ovulate.


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If any of the symptoms mentioned in this blog resonate with you, and you think you might benefit from working with a qualified professional, our team of nutritional therapists are here for you. We look at your overall diet and lifestyle and work with you to make changes to fit with your way of life to sustainably achieve optimal health and wellbeing in the long term.

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