Understanding Perimenopause and Menopause

Menopause is a major milestone in a woman's life, but the journey leading up to it can be filled with uncertainty, physical changes, and a whole range of symptoms that are often hard to predict or manage. The good news? Understanding what’s happening in your body and preparing for those changes can make all the difference in how you experience this transition.

Perimenopause, meaning "around menopause," is the natural transition phase when a woman shifts from her reproductive years to menopause — officially marked by going 12 consecutive months without a period. This phase can begin as early as your late 30s or early 40s and usually continues until menopause, which typically occurs around age 52.

One of the hallmark features of perimenopause is anovulatory cycles, which means your ovaries stop releasing an egg every month. Without ovulation, your body doesn’t produce progesterone — the hormone that helps balance oestrogen. This leads to hormonal imbalances such as:

• Low progesterone (often the first hormone to drop)
• Fluctuating oestrogen (can be low or even too high at times)
• A state called unopposed oestrogen, where oestrogen acts without the calming influence of progesterone

This imbalance can result in:

• Heavy, clotty, irregular periods
• Worsening PMS
• Mood swings, fatigue, and headache
• Sleep disruption
• Hot flushes and night sweats
• Breast tenderness and fluid retention
• Increased risk of oestrogen-sensitive cancers

Testosterone, though typically associated with men, is also vital to women's health — supporting libido, motivation, energy, and muscle tone. As women age, testosterone levels gradually decline due to decreased ovarian and adrenal production, often leading to low sex drive, fatigue and brain fog as well as loss of muscle mass and strength.

Many elements can shape how a woman experiences perimenopause. Some women may breeze through with minimal discomfort, while others face more disruptive changes. Things that can have an impact are:

• Genetics
• Thyroid function
• Underlying conditions
• Number of pregnancies
• Lifestyle: Stress, diet, and physical activity
• Environmental toxins: Exposure to hormone-disrupting chemicals like BPA, phthalates, and heavy metals can interfere with hormonal health.

These hormonal shifts aren’t just about periods and hot flushes. They can have ripple effects throughout the body, increasing your risk for several long-term health issues.

Bone health: Oestrogen plays a key role in maintaining bone density. As levels drop, bone breakdown (osteoclast activity) increases whilst bone-building (osteoblast activity) decreases, leading to a loss of bone density which increases the risk for osteoporosis and fractures.

Heart health: As oestrogen levels drop, a woman’s risk of cardiovascular disease rises, with the leading cause of death in postmenopausal women being heart disease (atherosclerosis, high blood pressure and heart attack). Oestrogen helps keep blood vessels flexible and supports healthy cholesterol levels.

Metabolic health: Oestrogen plays a critical role in regulating your metabolism and maintaining blood sugar balance. As oestrogen levels decline during perimenopause and menopause, insulin sensitivity decreases, which can lead to blood sugar imbalances, deposition of adipose especially around the abdomen, and increased risk of type 2 diabetes and metabolic syndrome.

Brain health: Oestrogen is a neuroprotective hormone that reduces inflammation within the brain, boosts neuroplasticity — enhancing your brain’s ability to grow new cells and strengthen existing connections — and influences levels of serotonin and dopamine, both of which impact mood, motivation, focus and emotional regulation. Oestrogen boosts BDNF (brain-derived neurotrophic factor), which helps your brain grow new neurons and maintain healthy communication between them – hence, lower oestrogen means lower BDNF, contributing to brain fog, forgetfulness, and even depression.

✅ Do not ignore your symptoms!
✅ Eat a whole-food, anti-inflammatory diet with lots of colourful plants, healthy fats and quality protein
✅ Reduce toxins (eliminate refined sugar, alcohol, and ultra-processed foods) and support your liver to detox excess hormones
✅ Limit exposure to endocrine-disruptors such as plastics, synthetic fragrances, pesticides
✅ Hydrate well – add a pinch of sea salt and a squeeze of lemon for natural electrolytes
✅ Prioritize daily movement and exercise — especially strength training for muscle and bone health
✅ Prioritize sleep and circadian rhythms
✅ Build stress resilience – deep breathing, yoga, walking in nature, adaptogenic herbs like ashwagandha, rhodiola, lemon balm
✅ Use targeted supplements to fill nutritional gaps – methylated B vitamins, Omega 3, magnesium, vitamin D for example
✅ Explore bioidentical hormone therapy when appropriate — with the right practitioner
✅ Functional medicine can help assess hormone, nutrient, and metabolic health via blood tests which can help drive a targeted, personalised approach
✅ Build a community — don’t go through this alone

Menopause is not a disease or just a phase to ignore! It is a natural phase of life. When we understand the underlying hormonal shifts and how they impact everything from your skin to your metabolism, your mood to your bones, we can take proactive steps to manage symptoms and support long-term health.

Perimenopause and menopause don’t have to mean slowing down. At REVIV, our expert medical teams specialize in IV and IM nutrient therapies designed to help you feel your best through every stage of life. From targeted vitamin blends that support energy, mood, and metabolism to NAD+ and hormone-supporting nutrients that promote cellular health and recovery — our therapies can complement your wellness plan and help you regain balance from the inside out.

Your journey is unique, and so is our approach, our clinicians can guide you toward the right solution for your body’s changing needs.

Find your nearest REVIV clinic today and take the first step toward feeling refreshed, resilient, and in control of your hormonal health.