Hormonal Health
Perimenopause support
nutrition & lifestyle for hormone balance
What is perimenopause and when does it begin?
Perimenopause is a medical term describing a stage of metabolic ageing characterised by changes in a woman’s hormone levels, but where menstrual periods have not yet stopped. Typically, women will experience a spectrum of symptoms related to these changes. Fluctuating levels of the hormones oestrogen, progesterone and testosterone lead to “good and bad” days, with no predictable pattern. This can affect how you feel, how you think and your overall quality of life.
Perimenopause typically starts in your 40s, but the timing can be highly variable depending on your genetics, or medication and/or surgery history. If you think you’re experiencing perimenopause before 40, you should speak to your doctor. Perimenopause can last from 2 to 10 years, but it can be highly variable with average duration from 4 to 8 years.
Currently, 1 in 3 women in the UK (that is about 13 million women) are in the peri-or menopausal stage.
It is commonly reported that women feel uncertain about whether these changes are hormonally driven or require further support. Understanding perimenopause symptoms and knowing where to access appropriate, evidence-based guidance is an important step in protecting both short- and long-term health.
One month in - the feeling of exhaustion was gone. Two months into the program, I got pregnant again. My family and myself can't thank her enough.
Natalie was highly recommended by my consultant in July 2020, who suspected that I was experiencing burn out. After working as an entrepreneur 15 hours a day, 6 days a week for a couple of years, I started to feel exhausted around 5pm every day. Quitting or slowing down was not an option. I experienced a few chemical pregnancy (very early miscarriage) as well, not feeling hopeful about having a baby any time soon, or ever, given my age approaching 40. One month into the program suggested by Dr Gillan I felt much more energetic, slept better, and exercised better. The feeling of exhaustion was gone. Two months into the program, I got pregnant again. And this time it continued all the way through, and I had a healthy baby in April this year. The only variable changed in my life around the time when the baby was conceived, was Dr Gillan's nutrition recommendation. My family and myself can't thank her enough.
QL, 2020
Symptoms & signs of perimenopause
Remember, you are biologically unique and may experience a variety of perimenopausal symptoms, or have none at all.
Symptoms may include:
Mental & wellbeing
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hot flashes and night sweats
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headaches and increased migraine attacks
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dizziness
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brain fog
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anxiety and depression
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flat mood
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loss of self-confidence
Cycle & intimacy
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changes in your menstrual cycle e.g. intensity of flow or duration of bleeds
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intimate area dryness
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loss of libido
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incontinence, bladder problems and recurrent urinary tract infection
Physical body & gut health
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weight gain
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joint and muscle pain and joint swelling
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difficulty sleeping
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reduced muscle strength
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pins and needles
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fatigue
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acne
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irritable bowel symptoms
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increased inflammation
This list is not exhaustive. Oestrogen receptors are present throughout the body, leading to a wide range of symptoms during the perimenopause.
Why many women feel uncertain during perimenopause
Understanding perimenopause symptoms, current support in the UK and primary challenges
Many women across the UK experience uncertainty during the perimenopause transition, particularly around whether the symptoms they are noticing are hormonally driven or related to another health issue.
Common concerns include the true cause, severity of symptoms and where to get the right support:
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Uncertainty about whether symptoms such as fatigue, mood changes, weight changes, sleep disruption, or cycle changes are linked to perimenopause
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Not knowing which changes are considered normal during perimenopause and which may require further investigation
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Difficulty accessing clear, reliable, clinically grounded information that reflects their individual health history and symptoms
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Confusion from AI generated one-size-fits-all diagnoses
Many women feel under-informed, rely on internet searches and encounter conflicting information. According to evidence from UK surveys and community reports, women report:
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Feeling under-informed about perimenopause and the full range of physical, cognitive, and emotional symptoms that may occur
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Rely heavily on internet searches, social media, or peer advice due to limited access to structured clinical guidance
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Encounter mixed or conflicting information e.g. from AI, making it difficult to know which advice is evidence-based or appropriate for them
Women also commonly report challenges when seeking professional support for perimenopause, including symptoms being misdiagnosed or dismissed:
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Symptoms not being fully recognised, explored, or clearly explained
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Limited guidance on nutrition, lifestyle, and preventative strategies that can support hormonal health
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Uncertainty about how to take a proactive, informed approach to managing perimenopause and long-term health
The science of
feeling better
Evidence supporting nutrition and lifestyle approaches during perimenopause and menopause
Clinical research shows that lifestyle medicine approaches, including personalised nutrition, physical activity, stress management, and sleep optimisation, are associated with improvements in common perimenopause and post-menopause symptoms:
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Nutrition-focused reviews emphasise the vital role of a balanced, health-supportive diet in helping preserve metabolic health, bone health and body composition during perimenopause and menopause. [Ref1]
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Systematic reviews of randomised controlled trials report that exercise is strongly linked with reductions in overall symptom burden, improvements in sleep quality, and enhanced psychological wellbeing among perimenopausal and menopausal women.[Ref2]
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Combined lifestyle interventions, which include exercise, nutrition counselling, and health education, have been shown to offer benefit in symptom management and overall wellbeing in perimenopause and menopause. [Ref3]
Together, this evidence supports the role of personalised nutrition and lifestyle guidance as a meaningful, evidence-informed component of perimenopause support, particularly when delivered alongside appropriate medical care where required.
How we support women through perimenopause
Evidence-based laboratory testing, nutrition and strength training for perimenopause and menopause
Evidence shows that appropriately tailored changes to nutrition and lifestyle can support hormonal health, help reduce symptom burden, and improve quality of life during perimenopause. Our approach focuses on applying this evidence in a structured, individualised way that reflects each woman’s symptoms, health history, and circumstances.
We understand that being advised to make changes to nutrition or lifestyle can feel overwhelming, particularly when symptoms are already affecting how you feel day to day. Our approach is to provide clear, structured, and realistic guidance, offering support throughout each stage of your journey rather than expecting you to manage this alone.
All support is delivered following a comprehensive assessment and within our professional scope of practice. Where appropriate, we work alongside, and encourage collaboration with, primary care or other healthcare professionals to ensure care is coordinated and well-informed.
By focusing on informed, personalised adjustments rather than generic advice, we aim to help women feel better supported, more confident in your decisions, and more able to manage this stage of life effectively.
NRG Matrix Health Clinic is a London-based practice, supporting women across the UK through in-person and online consultations.
I felt nervous about making changes to my diet and routines since I have the kids and partner. Natalie made it completely manageable, and i think we are all actually better off as a result.
I felt nervous about making changes to my diet and routines since I have the kids and partner to also look after and cook for, but working with Natalie made it completely manageable, and i think we are all actually better off as a result. She provided personalised advice and explained the reasons behind each recommendation which has made it easy to follow without overwhelming. Ashley’s approach to strength training also felt very different to anything I’d done before. Sessions were adapted to how I was feeling week to week, with a strong focus on building strength safely and enjoyably and improving energy rather than pushing through fatigue.
Fiona, 2025
Get our clinicians' blueprint
Free download and opportunity to learn how this guidance applies to you.
The guide:
Navigating Perimenopause;
clinical insights from over 20 years' experience supporting women through this stage.
Includes:
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The top perimenopause health saboteurs
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What nourishment actually looks like
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Supplements that are worth the spend
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Movement that works and types that don't
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Symptom trackers & planners for printing
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Next steps
References:
1. Erdélyi, A. et al. 2024. The Importance of Nutrition in Menopause and Perimenopause—A Review 2024. Nutrients. 2024 16(1), 27; https://doi.org/10.3390/nu16010027
2. Choudary, A. et al. 2025. Menopause and movement: exercise for better sleep and psychological well-being-a systematic review. Menopause. 2025 Nov 1;32(11):1063-1071. https://pubmed.ncbi.nlm.nih.gov/40694785/
3. McNulty, KL. et al. 2025. The Effectiveness of Lifestyle Interventions, Including Exercise, Diet, and Health Education on Symptoms Experienced During Perimenopause: A Systematic Review of Randomized Controlled Trials. J Aging Phys Act. 2025 Sep 23:1-24.