How to support your body during perimenopause.

So often during midlife, when we begin to experience perimenopause symtoms, we feel a change in energy, weight management and start to wonder, why the things we’ve always done, have stopped working.

Perimenopause can feel like your body has started speaking a completely different language. Symptoms may arrive sporadically, shift drasticall from one month to the next, energy shifts unexpectantly, and the things that you used to do, simply don't work anymore. There is so much you can do to support your body, and I want to help you with this.

Perimenopause typically begins in your 40s, though for some women it starts earlier. During this time, oestrogen and progesterone levels fluctuate before gradually declining and those fluctuations ripple through almost every system in your body. Small, consistent changes in four key areas can make a significant difference to how you feel, day to day.

Strength Training

The shift that changes everything

Strength training becomes essential rather tha a nice to have during midlife. It builds and preserves lean muscle mass, supports bone density, improves insulin sensitivity, and can even help with mood. All things that become increasingly important as oestrogen declines.

Why this matters: Women can lose up to 3–5% of their muscle mass per decade from their 30s onwards and this accelerates during perimenopause. Resistance training is one of the most evidence-backed ways to slow this down and avoid carcopenia, osteoporosis. The work has to start here, in your midlife.

You don't need to train like an athlete or spend hours in a gym. Two to three sessions a week, with dumbbells, kettlebells, or bodyweight is enough to make a meaningful difference. If you decide to do a local class or at your gym, or work with a personal fitness trainer, focus on compound movements that work multiple muscle groups: squats, hinges, rows, and presses. Your future body will thank you.

Nutrition

Your body is undergoing a metabolic shift. This affects insulin resistance, fat storage and your nervous system.

Nutrition during perimenopause doesn't need to mean restriction. This is a time to nourish your body more intentionally and to prioritise the foods that support hormonal health, blood sugar balance, and the gut microbiome (which, interestingly, plays a role in how oestrogen is metabolised). What you eat, really matters at this stage of life, and it supports all systems in the body. I’ll do another blog post about the gut soon, and why it is so important to be aware of your food (think hormones - they are made in the gut!)

Note this: Protein needs increase as we age because our body has shifted - we . Aiming for 1.2–1.6g of protein per kg of body weight helps preserve muscle, supports satiety, and stabilises energy. Opt for eggs, oily fish, legumes, greek yoghurt, and good quality meat or plant-based proteins at every meal.

Phytoestrogens are plant compounds found in foods like flaxseeds, edamame, and lentils and can gently support the body's oestrogen activity during this transition. Equally, reducing ultra-processed foods, alcohol, and refined sugar will support your gut, weight, and can help ease symptoms like hot flushes, brain fog, and disrupted sleep. Small shifts, not a full overhaul.

Stress and your nervous system

When you are under chronic stress (whether you realise it or not) your body produces more cortisol, and cortisol and progesterone are made from the same precursor. During perimenopause, when progesterone is already declining, high stress effectively competes for the raw materials your body needs. The result can be worsening symptoms and a nervous system that isn’t being regulated as well as it could be.

The research says: Chronic stress can exacerbate perimenopausal symptoms, including hot flushes, anxiety, and sleep disruption — largely because of the cortisol–progesterone relationship and its downstream effects on the HPA (hypothalamic–pituitary–adrenal) axis.

Supporting your nervous system doesn't have to look like a full mindfulness practice. It can be as simple as building more moments of genuine rest into your day. Consider a walk without your phone in nature, five slow, deliberate breaths before a meeting, a regular wind-down routine in the evening. The nervous system responds to consistency and the repeated signals of safety can often help regulate your nervous system more, than a long weekend away.

Sleep & Rest

Sleep disruption is one of the most commonly reported and most frustrating symptoms of perimenopause. Fluctuating oestrogen and declining progesterone (which has a natural calming, sleep-promoting effect) can mean waking in the night, difficulty falling asleep, or waking early and feeling unrefreshed.

A useful fact: Progesterone has a direct effect on GABA receptors in the brain — the same receptors targeted by anti-anxiety medication. As it declines, some women experience increased anxiety, restlessness, and poorer sleep quality, even without any obvious "reason" to feel that way.

Good sleep hygiene is really important to set the tone for your body to properly rest overnight. Aim for a consistent sleep and wake time, reduce screen light in the hour before bed, keep the bedroom cool, and review your caffeine intake across the day, which could be impacting more than you think. Magnesium glycinate, taken in the evening, is also a supplement many perimenopausal women find supportive for both sleep and anxiety but please discuss this with a qualified practitioner first.

Doing all of this at once, might seem overwhelming or difficult. You don’t need an overhaul, make some small shifts weekly, and give yourself the time to support yourself. Let me know if you’d like some support with this.

With warmth,

Hannah

Naturopathic Health Coach | Elevare