Progesterone decline
Falls first, often starting in your mid-30s. The brake on oestrogen + the cofactor for sleep, GABA, mood.
+ Symptom 08
Perimenopause · Hormones · HRT
I don't feel like myself after 40.
The body that worked for 35 years stopped recognising itself. Sleep is broken. Mood is volatile. Weight settled in places it never used to. PMS is now PMDD. Anxiety arrived without an invitation. Everyone tells you it's "just perimenopause" — as if that's an answer.
Perimenopause isn't one thing happening — it's progesterone falling first, oestrogen swinging wildly, cortisol chronically elevated, insulin sensitivity changing, thyroid wobbling, gut shifting. It can be navigated brilliantly when you know what's actually moving. We test, then build.
The Picture
If this is you,
it might sound like —
Read these the way you'd read a letter from someone who already knows. If three or more land hard, you're in the right place.
- I don't sleep through the night anymore.
- Hot flushes I never had before.
- PMS used to be mild. It's now PMDD.
- Brain fog so bad I can't find words.
- Weight in my belly that wasn't there.
- Anxiety I never used to have.
- Joint aches, dry skin, falling libido.
- The same workout, the same food — different result.
+ Key Drivers
What's actually shifting.
"Just perimenopause" isn't a treatment plan. The shifts are measurable, and most respond meaningfully to addressing them directly.
Oestrogen volatility
Not just falling — swinging. The wide swings drive hot flushes, mood crashes, heavy bleeds.
Cortisol rise
The adrenals try to compensate as ovaries step back. The result is chronic low-grade stress chemistry.
Insulin sensitivity loss
Falling oestrogen reduces insulin sensitivity. The same diet now spikes you.
Thyroid load
Thyroid antibodies often appear or rise in perimenopause. TSH alone misses it.
Bone, muscle and brain shift
Oestrogen is structural — bones, brain, muscle. Loss accelerates from year one of perimenopause if not actively defended.
+ Key Tests
How we see the transition.
The right testing turns 'just perimenopause' into a navigable, year-by-year plan. The wrong testing leaves you guessing.
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DUTCH · Full hormone + cortisolOestrogen, progesterone, testosterone, DHEA, full cortisol + melatonin curve, oestrogen clearance pathways. The single most useful test in this decade.
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Comprehensive thyroidFree T3, free T4, reverse T3, antibodies. Perimenopause is when subclinical thyroid often becomes clinical.
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Comprehensive bloodsFasting insulin, HbA1c, full lipid panel, vitamin D, ferritin, B12, inflammation, fasting calcium.
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HTMA · Mineral panelMagnesium, calcium, sodium, copper:zinc — the minerals that decline alongside oestrogen and matter most in this decade.
+ Foundational Must-Haves
What you can start today.
Six daily moves designed specifically for the perimenopause decade. They compound — and they're protective whether you go on HRT or not.
- Strength training twice a week, non-negotiable. The #1 lever for body composition, bone density, insulin sensitivity, mood.
- 30 g protein per meal — minimum 100 g across the day. Muscle protein synthesis becomes harder; you need more fuel to maintain it.
- Magnesium glycinate 400 mg at bedtime. Sleep, mood, hot flushes, blood pressure. The single most useful mineral in this decade.
- Cap alcohol — 4 standard drinks per week or less. Alcohol drives hot flushes, broken sleep, and weight gain in this decade specifically.
- Daily morning daylight + a wind-down routine. Circadian rhythm becomes fragile. Defending it pays compound interest.
- A real conversation about HRT. It's not for everyone — but it's also not the bogeyman the headlines made it. We help you weigh the actual risk-benefit on your data.
+ The Process with How It Heals
Perimenopause is navigable.
For most women, this is the most under-supported decade of their life. The advice is contradictory, the testing is incomplete, the symptoms get dismissed. It doesn't have to be that way.
A 22-week reset built on full hormone, thyroid, metabolic and mineral testing typically shifts every symptom on the list above. By month four, "I don't feel like myself" stops being the daily experience.
+ From the women in front of us
What changed.
Selected from clients who started here — deep into perimenopause, dismissed by GPs, no clear plan — and worked through the 22-week reset.
I've been on HRT for two months — but only because the testing made me confident it was the right call. The 22-week reset gave me my brain back.
V.S. · 44 · Bulimba
Three months ago I told my husband I felt like I was losing my mind. I'm not on HRT, just the protocol. I'm me again.
L.B. · 41 · Telehealth