Perimenopause and Your Body: The Changes No One Tells You About And How Nutrition Can Help

20 June 2026

Perimenopause symptoms can be confusing, debilitating, and depressing. But you can regain control over the symptoms and reclaim your old “self” with the right diet, exercise, sleep, and mindful use of supplements. Most importantly, you can use these lifestyle changes right now.

What Is Perimenopause?

Also called: Menopausal transition

Perimenopause is the phase preceding menopause. Menopause is when you no longer have periods. Medically, menopause is diagnosed when you go without periods for 12 consecutive months after the last period.

In the UK, menopause usually occurs at 51 years. However, nearly 10% of women may experience menopause before 40 years of age.

Perimenopause can last up to a decade before your periods stop permanently. It occurs due to fluctuations in the levels of estrogen, progesterone, and testosterone. Perimenopause mostly occurs in women in their 40s. According to the NHS, about 13 million women in the UK are peri or menopausal. (1)

Perimenopause and Body Changes No One Warns You About

Fluctuations in the levels of estrogen and progesterone are responsible for most perimenopause symptoms.

Many women describe perimenopause as “not feeling like myself” or a loss of the old “self”, forgetting things like never before, and struggles with daily activities.

Most of these symptoms might feel unexpected, leaving women wondering what really has changed in their bodies. Some may become frustrated because the symptoms were never discussed openly. They may also be confused if their symptoms are normal.

A 2022 study that surveyed over 3,000 UK women revealed women’s attitude to perimenopause. Nearly 40% accepted the changes, while over 30% were in extreme anxiety about something bad might happen to them in the future. (2)

Women often tend to look for information only after they experience the symptoms. They rely on their friends and websites for information. While not inherently bad, these sources can carry a risk of bias and misinformation.

Note: Menopause education is now included in schools starting in 2019, as per the Department for Education guidelines. (3)

Perimenopause Symptoms and Their Potential Mechanisms

Why your energy suddenly drops

Several factors may cause fatigue in perimenopause. For example, estrogen regulates brain chemicals crucial for mood and energy. When estrogen level drops, mood swings and fatigue become noticeable. (4)

Likewise, declining progesterone can lead to sleep-related loss of energy. Moreover, perimenopause-related disruption of the stress hormone “cortisol” can impair sleep quality and cause daytime exhaustion.

Perimenopausal women are more likely to have thyroid problems, which together with iron deficiency, can worsen fatigue.

Also Read: Why Are So Many of Us Tired All the Time? The Nutritional Reasons Behind Fatigue

Lifestyle factors that can worsen fatigue include sedentary lifestyle, poor nutrition, stress, and poor sleep quality.

Why you have brain fog

Brain fog describes a group of symptoms, such as a lack of mental clarity, problem remembering things, and difficulty with concentration.

Both estrogen and progesterone can reach your brain via the highly selective membrane called the blood-brain barrier. Inside the brain, these hormones act on the areas involved in learning and memory. (5)

This might explain why perimenopause may affect how you think, memorise, and learn. However, the exact mechanism still remains unclear.

Why you have the menopausal middle

Perimenopause can cause changes to your shape and midsection. Low estrogen levels and high testosterone levels cause fat from your hips and thighs to redistribute to the stomach, resulting in a bulging belly. (6)

Other factors that can contribute to belly fat in perimenopausal women include high intake of processed foods (often associated with emotional eating to cope with stress), sedentary lifestyle, and poor sleep quality.

Related: How food processing starves our bodies of nutrients, leaving us feeling run down and tired

Why you wake up in the middle of the night

Midnight awakening is common among perimenopausal women. Disrupted sleep has been associated with low estrogen levels and high FSH levels. (7) FSH (follicle-stimulating hormone) helps regulate the menstrual cycle in women. High FSH level is a characteristic feature of perimenopause and menopause.

Some women may find themselves waking up more frequently during the night because they have hot flushes. Hot flushes cause a sudden feeling of warmth in the face, neck, and chest. It can cause excessive sweating, irregular heartbeat, and anxiety.

Why you have mood swings

Low or variable levels of estrogen and progesterone are thought to contribute to mood swings in perimenopausal women. These hormones can increase your sensitivity to stressors. Besides, they can affect brain chemicals that regulate mood. (8)

Other risk factors for mood disorders may include:

  • Hot flushes
  • Being in late perimenopause
  • A history of mood disorder before menopause
  • Chronic inflammation

Also Read: Chronic Inflammation Is Widespread In the UK. Here’s What You Can Do to Keep It At Bay

Why you have sagging skin, thinning hair, and brittle nails

Skin,hair, and nail changes during perimenopause are often the result of declining estrogen levels.

Read our full blog about perimenopause-associated skin, hair, and nail changes and natural remedies for these issues.

What Helps Perimenopause Naturally

The following lifestyle changes can help provide relief from perimenopausal symptoms and improve your quality of life.

Eat to beat fatigue

Your diet plays a crucial role in maintaining energy levels and a healthy gut. Eat a balanced diet high in vegetables, whole grains, good fats, and lean proteins. Aim to eat 30 grams of fibre every day to decrease bloating and cramps.

Related: 4 Evidence-Based Benefits of Soluble Fibre for Intestinal and Overall Health

Because bone health tends to decline with perimenopause, eat calcium-rich foods, such as fish, tofu, leafy greens, and dairy products. Also, get enough vitamin D from your diet and (safe) sun exposure. The NHS recommends daily supplementation with 10 micrograms of vitamin D during the autumn and winter.

The European Menopause and Andropause Society (EMAS) recommends a diet rich in fruits and vegetables to reduce the risk of certain cancers, maintain bone health, and lower depressive symptoms associated with menopause. (9)

Further Reading: Why Leafy and Green Vegetables Should Be on Every Plate

Exercise on most days of the week

Physical activity significantly improves perimenopausal symptoms, such as fatigue, irritability, joint pain, muscle pain, and numbness. (10)

Regular physical activity also helps: (11)

  • Reduce frequency of hot flushes
  • Enhance mental health and wellbeing
  • Lower the risk of weak, brittle bones and fractures
  • Reduces the risk of high blood pressure and diabetes

Adults between 19 and 64 years should exercise for 150 minutes (moderate intensity activity) or 75 minutes (vigorous activity) each week.

Combine aerobic, resistance, and balance exercises. (12) Start with stretching and 5 minutes of brisk walking. Follow with aerobic activity, such as dancing, running, or bike riding for 10 to 15 minutes.

Lift weights two to three times a week, with each session lasting about 20 minutes. You may use free weights, machines, resistance bands, or your own body weight. Include exercises that target multiple joints and large muscle groups. Examples include squats, leg presses, overhead presses, seated rows, and back extension.

Further Reading: Strength Training As We Age: The Importance for Tendons and Ligaments As Well As Strong Muscles and Bones

Get enough sleep to boost your mood

It’s easier said than done, but quality sleep can make a huge difference to how you think, behave, and cope with a stressor. Before speaking to a GP about sleep medication, try adjusting your sleep hygiene with these steps: (13)

  • Maintain a consistent sleep schedule.
  • Do not use screens in the hour before bedtime.
  • Avoid heavy meals near bedtime.
  • Avoid caffeine late in the day.
  • Make sure your bedroom is quiet, cool, and dark.

Limit alcohol

Being in menopausal transition can make you more sensitive to the effects of alcohol. Drinking can make your flushes more severe and sleep terrible. The negative effects of alcohol might also become more prominent due to a lower muscle mass and your liver not being as capable in processing alcohol.

If you choose to drink, stick to the guidelines: No more than 14 units a week, preferably spread over at least 3 days.

Related: How Alcohol Affects Your Metabolism and What You Can Do

Try a supplement but be mindful

In addition to a balanced diet, consider taking high-quality supplements to compensate for the nutrients you might be missing in your foods.

Collagen supplements increase skin elasticity and reduce the appearance of wrinkles. Likewise, they support hair growth and lower the risk of nail breakage.

Vitamins and essential minerals in selected collagen supplements can help improve energy levels and improve bone health.

Try our high-dose collagen liquid supplements Cutizana and Physicoll to ease perimenopausal symptoms and regain your confidence. Why? They absorb faster than the traditional tablets, deliver more nutrients per dose, and are easy to integrate into your daily routine.

Perimenopause and Your Body: Frequently Asked Questions

  1. What are the first symptoms of perimenopause?

Hot flushes and irregular monthly periods are usually the first symptoms of perimenopause.

  1. Can nutrition help perimenopause symptoms?

A diet rich in whole grains, lean meats, fruits, vegetables, healthy fats, and key minerals can help manage perimenopause symptoms.

  1. Why do women gain weight during perimenopause?

Fluctuating hormones, especially estrogen, can cause fat accumulation in the stomach. 

  1. How long does perimenopause last?

Perimenopause can last up to 10 years before your periods stop forever.

  1. What vitamins help during perimenopause?
  2. B vitamins for energy and improved mood
  3. Vitamin D for strong and healthy bones

References:

  1. Menopause in the workplace. NHS England.
    https://www.engage.england.nhs.uk/safety-and-innovation/menopause-in-the-workplace/
  1. Harper, Joyce C et al. “An online survey of perimenopausal women to determine their attitudes and knowledge of the menopause.” Women’s health (London, England) vol. 18 (2022): 17455057221106890. doi:10.1177/17455057221106890
  2. Ucl. (2025, September 17). Nine in ten women were never educated about the menopause. UCL News. https://www.ucl.ac.uk/news/2023/apr/nine-ten-women-were-never-educated-about-menopause
  3. Vohra, A. (2025). Endocrine and metabolic mechanisms underlying fatigue in perimenopausal women. International Journal on Science and Technology, 16(2). https://doi.org/10.71097/ijsat.v16.i2.6657
  4. Gurvich, C., Spector, A., & Hickey, M. (2026). Advances in understanding of cognitive symptoms during menopause. The Lancet Obstetrics Gynaecology & Women S Health, 2(4), e335–e345. https://doi.org/10.1016/s3050-5038(26)00043-9
  5. Chopra, Sakshi et al. “Weight Management Module for Perimenopausal Women: A Practical Guide for Gynecologists.” Journal of mid-life health vol. 10,4 (2019): 165-172. doi:10.4103/jmh.JMH_155_19
  6. Summer, J. V. (2026, May 29). Perimenopause and sleep. Sleep Foundation. https://www.sleepfoundation.org/women-sleep/perimenopause-and-sleep
  7. Musial, Natalie et al. “Perimenopause and First-Onset Mood Disorders: A Closer Look.” Focus (American Psychiatric Publishing) vol. 19,3 (2021): 330-337. doi:10.1176/appi.focus.20200041
  8. Cano, Antonio et al. “The Mediterranean diet and menopausal health: An EMAS position statement.” Maturitas vol. 139 (2020): 90-97. doi:10.1016/j.maturitas.2020.07.001
  9. Philip, Ashima Elsa et al. “Impact of Exercise on Perimenopausal Syndrome: A Systematic Review of Randomized Controlled Trials.” Cureus vol. 17,3 e80862. 19 Mar. 2025, doi:10.7759/cureus.80862
  10. Janine. (2026, March 22). Physical activity during perimenopause. Health and Wellbeing Queensland. https://hw.qld.gov.au/blog/physical-activity-duringperimenopause/
  11. Mishra, Nalini et al. “Exercise beyond menopause: Dos and Don’ts.” Journal of mid-life health vol. 2,2 (2011): 51-6. doi:10.4103/0976-7800.92524
  12. Mood changes during perimenopause are real. Here’s what to know. (n.d.). ACOG. https://www.acog.org/womens-health/experts-and-stories/the-latest/mood-changes-during-perimenopause-are-real-heres-what-to-know