The Menopause Transition - Part 1
Understanding Your Hormones, Your Body & Your Power
And Why This Matters
Menopause is not a malfunction or a medical failure, it’s a natural, biological, and often spiritual transition. Yet, too many women experience it as a lonely unraveling. The truth is most of us were never taught how menopause unfolds. We weren’t prepared, and often, we were gaslit or ignored.
A 2023 UK survey revealed that over 60% of women felt they were not given enough information about perimenopause or menopause, and many were misdiagnosed with anxiety or depression without discussion of hormones. 1
Misdiagnosis is Common
Women in their 40s often visit GPs with symptoms like
Panic attacks
Insomnia
Brain fog
Rage or tearfulness
Fatigue
Loss of libido
These are frequently labelled as:
Generalised anxiety disorder
Clinical depression
Bipolar disorder
Burnout or stress-related exhaustion
But in many cases, fluctuating oestrogen and dropping progesterone are the underlying cause. These hormonal shifts affect neurotransmitters like serotonin, dopamine, and GABA, creating profound emotional and cognitive effects.
Conditions Linked to Hormonal Imbalance
Anxiety & mood disorders
PMDD (Premenstrual Dysphoric Disorder)
IBS flare-ups
Chronic fatigue
Migraines
Fibromyalgia
Joint and muscle pain
Histamine intolerance
Key Menopause Statistics
Mental Health & Misdiagnosis
Women in perimenopause are about 40% more likely to suffer depression compared to pre-menopausal women pmc.ncbi.nlm.nih.gov+11menoclarity.com+11theguardian.com+11happiful.com+3ucl.ac.uk+3independent.co.uk+3.
Over 50–60% of British women experience anxiety and/or depression during the menopause transition en.wikipedia.org+2pmc.ncbi.nlm.nih.gov+2thetimes.co.uk+2.
Perimenopause has its highest spike in neuropsychiatric symptoms, with over half of women reporting depression and insomnia during this time wellfemme.com.au+5cardiff.ac.uk+5vitality-pro.com+5.
Suicidality & Psychological Risk
Women aged 45–54 (typical perimenopause/menopause stage) have the highest suicide rates among all female age groups, with 7.1 per 100,000 in 45–49 and 6.9 in 50–54 age brackets happiful.com+1itv.com+1.
The perimenopausal and menopausal period sees increased suicidal ideation, likely due to hormonal, emotional, and social stressors verywellhealth.com+15feistymenopause.com+15journals.plos.org+15.
In one survey of ~1,300 women, one in five reported suicidal thoughts within perimenopause / menopause adelaidenow.com.au+1joinmidi.com+1.
Workplace & Economic Impact
Three in five women say menopause negatively affects them at work en.wikipedia.org+1cardiff.ac.uk+1.
Over 370,000 UK women aged 50–64 have considered leaving their job due to menopausal symptoms committees.parliament.uk.
Nearly 14 million workdays are lost annually in the UK because of menopause-related issues vitality-pro.com+4committees.parliament.uk+4en.wikipedia.org+4.
Symptom Prevalence & Preparedness
Roughly 75% of women report hot flushes and night sweats joinmidi.com.
About 84% report sleep difficulties, 73% brain fog, and 69% anxiety or depression theguardian.com+1fawcettsociety.org.uk+1.
94% of women say they received no formal menopause education in school, and 50% of perimenopausal women didn’t discuss symptoms with a healthcare provider joinmidi.com.
Why These Stats Matter
Depression and anxiety in midlife are frequently hormone-driven, not just psychological, yet often misdiagnosed as anxiety or bipolar disorders.
Suicide rates peaking during menopause highlight the urgent need for awareness and support—not just “grinning and bearing it.”
Millions of workdays lost annually due to menopausal symptoms underscore menopause as a public health and economic issue.
Lack of education and communication means many women suffer in silence, rather than accessing timely, hormone-informed care.
The lack of education means too many women are offered antidepressants instead of hormone evaluation or are dismissed entirely.
Let’s change that.
This is a call to reclaim the rite of passage. To understand our physiology. To honour our emotional and spiritual shifts. And to step into a deeper phase of self-leadership.
You’re not broken. You’re becoming.
The Menopausal Transition – What’s Actually Happening?
This journey often begins years before periods stop. The average age of menopause in the UK is 51, but perimenopause (the hormonal transition leading up to menopause) can start as early as age 35–40.
It is not a straight decline — it is a rollercoaster of fluctuation.
Perimenopause:
Cycles become irregular
Progesterone drops first
Oestrogen spikes and crashes
Testosterone can tank
Symptoms can come and go
Menopause:
Defined as 12 months without a period
Ovarian hormone production declines
Brain and adrenal glands take over
Post-Menopause:
A time of recalibration
Often more stable energy, but long-term support is key (especially for bones, brain, heart, and sexual health)
Hormones: Your Chemical Messengers
Hormones are chemical messengers that regulate everything from mood to metabolism, sleep to sex drive. In the transition from perimenopause to menopause, these messengers begin to shift — and they often don’t go quietly.
Oestrogen
Three types:
Estradiol (E2): Dominant in reproductive years; from ovaries
Estrone (E1): Dominant after menopause; from fat & adrenals
Estriol (E3): Mainly during pregnancy
Functions:
Supports vaginal and bladder health
Maintains bone density
Enhances mood and cognition
Protects the heart
Regulates fat distribution
Improves skin elasticity
Symptoms of Low/Fluctuating Oestrogen:
Hot flushes, night sweats
Vaginal dryness
Brain fog
Mood swings
Joint pain
Support:
Phytoestrogens (flaxseed, soy, red clover, sage)
Healthy fats
Liver support (dandelion, bitters, B-vitamins)
Progesterone
First hormone to drop in perimenopause.
Functions:
Calms the nervous system
Supports sleep and mood
Balances oestrogen
Prepares uterus for pregnancy
Low Progesterone:
Anxiety, restlessness
PMS, breast tenderness
Spotting, short cycles
Insomnia post-ovulation
Support:
B6 and magnesium
Chasteberry (Vitex)
Stress reduction
Cortisol
Produced by the adrenals in response to stress.
Functions:
Regulates energy and stress response
Influences blood sugar, immunity, metabolism
Supports oestrogen post-menopause
Chronic Stress Effects:
Hormone production diverted
Sleep disruption
Blood sugar imbalances
Support:
Adaptogens (ashwagandha, rhodiola, tulsi)
Rest, nature, boundaries
Reduce caffeine, alcohol
FSH & LH
Pituitary hormones that control the menstrual cycle.
FSH: Stimulates egg production
LH: Triggers ovulation
Perimenopause: Levels rise unpredictably
FSH >30 IU/L + 12 months without periods = menopause
But: Values fluctuate daily → one test may not reflect reality
Thyroid Hormones
TSH, T3, T4 crucial for energy & metabolism
Overlap Symptoms:
Fatigue, depression
Weight gain, brain fog
Support:
Request full panel incl. TPO antibodies
Support with selenium, zinc, iron
Testosterone
Often overlooked in women.
Functions:
Libido, arousal
Muscle mass & motivation
Mood, energy
Low Testosterone:
Low sex drive
Muscle loss, fatigue
Flat mood, lack of drive
Support:
Resistance training
Zinc, protein, adrenal support
Hormone Reference
-
Main Functions: Mood, bone, skin, vaginal & heart health
Common Symptoms if Low or Imbalanced: Hot flushes, night sweats, brain fog, vaginal dryness, joint pain
-
Main Functions: Calms nervous system, supports sleep cycle regulation, balances oestrogen
Common Symptoms if Low or Imbalanced: Insomnia, anxiety, PMS, spotting, tender breasts
-
Main Functions: Libido, energy, muscle mass, drive
Common Symptoms if Low or Imbalanced: Low libido, fatigue, flat mood, reduced muscle tone
-
Main Functions: Stress response, metabolism, blood sugar, supports oestrogen post-menopause
Common Symptoms if Low or Imbalanced: Poor sleep, fatigue, blood sugar dips, belly fat
-
Main Functions: Stimulates follicle/egg development
Common Symptoms if Low or Imbalanced: Cycle changes and infertility fluctuate wildly in perimenopause – unreliable as a solo diagnostic tool
-
Main Functions: Triggers ovulation
Common Symptoms if Low or Imbalanced: Anovulation, fertility issues
-
Main Functions: Energy, metabolism, mood, temperature
Common Symptoms if Low or Imbalanced: Fatigue, weight gain, cold sensitivity, depression
Hormone Testing
Useful but must be timed carefully.
For Cycling Women:
Day 3-5: Oestrogen, LH, FSH
Day 19–21: Progesterone/ Oestrogen/ Testosterone
Count Day 1 from first day of bleeding
Limitations:
Snapshot only
Stress & illness affect accuracy
Hormonal chaos in perimenopause
Alternatives:
DUTCH (urine): full hormone + adrenal insight
Saliva: daily rhythms
Symptom tracking often most accurate
Top Tips for Managing Perimenopause & Menopause
1. Nourish with Whole Foods
Eat plenty of colourful vegetables, especially cruciferous (broccoli, kale, cauliflower) to support liver detox.
Include healthy fats (olive oil, avocado, seeds) for hormone production.
Prioritise protein at every meal to support muscle mass and blood sugar stability.
Limit ultra-processed foods, sugar, and alcohol — they aggravate inflammation and hormone imbalance.
Try incorporating flaxseed, fermented soy, and red clover tea for gentle phyto-oestrogen support.
2. Move Your Body – Intelligently
Combine resistance training (weights, bodyweight exercises) with gentle cardio (walking, cycling, swimming).
Aim for strength training 2–3x per week to maintain bone density, reduce visceral fat, and boost mood.
Don’t overdo high-intensity workouts — during perimenopause, less is often more when it comes to stress hormones.
3. Support Your Nervous System
Breathwork, yoga, Tai Chi, and meditation help regulate cortisol and restore calm.
Create boundaries around rest. Rest is productive.
Epsom salt baths (magnesium-rich) can relieve tension and improve sleep.
4. Use Aromatherapy & Sensory Rituals
Essential oils like clary sage, lavender, bergamot, and geranium can support mood, hormones, and sleep.
Use a diffuser, apply to pulse points with a carrier oil, or add to a bath.
Try applying oils while saying affirmations (e.g. “I am grounded in this transition”).
5. Prioritise Sleep
Aim for 7–9 hours per night, and protect sleep like a sacred ritual.
Support circadian rhythm with morning light exposure, evening wind-down rituals, and turning off screens an hour before bed.
Herbs like passionflower, valerian, lemon balm, and magnesium glycinate may help regulate sleep.
6. Support Liver and Gut Health
The liver metabolises excess hormones, so support it with bitter greens, dandelion tea, lemon water, and adequate B-vitamins.
Your gut microbiome (estrobolome) plays a huge role in clearing oestrogen — feed it with fibre, fermented foods, and probiotics.
Address constipation to prevent hormone recirculation.
7. Track Symptoms and Cycles
Use a journal or app to track mood, sleep, cycle patterns, and energy.
This can reveal patterns that help tailor your nutrition and support.
8. Connect in Community
Share your journey. Speak your truth. Being witnessed is medicine.
Join women's circles, talk to friends, or engage in group programs.
Understanding Oestrogen Dominance
Oestrogen dominance doesn’t mean you have too much oestrogen — it means there’s too much relative to progesterone. This can happen even if your oestrogen is normal or low. In perimenopause, progesterone is often the first hormone to drop, leaving oestrogen unopposed.
Common Symptoms:
Breast tenderness
Heavy or painful periods
Water retention, bloating
Irritability or mood swings
PMS and cyclical migraines
Fibroids, endometriosis, and weight gain (especially hips and thighs)
Causes Can Include:
Poor liver detoxification
Constipation
Chronic stress (depletes progesterone)
Xenoestrogens (from plastics, cosmetics, cleaning products)
Blood sugar imbalances and insulin resistance
What Helps:
Support progesterone naturally with Vitex, magnesium, B6, and stress reduction
Improve liver clearance with cruciferous veg, dandelion, bitter foods
Reduce xenoestrogen exposure (use glass not plastic, natural skincare)
Balance blood sugar to reduce inflammatory signalling and insulin resistance
