Perimenopause begins when oestrogen levels start to fluctuate unpredictably — often in the mid-to-late 40s, though it can start earlier. Periods become irregular: longer, shorter, heavier, or lighter. It ends 12 months after the final period, at which point menopause is confirmed.
Symptom variability is the hallmark: some women sail through with mild disruption; others experience significant hot flushes, sleep fragmentation, mood shifts, brain fog, and joint aches for years. This variability makes blanket dietary advice unhelpful.
Nutritional priorities overlap with those of menopause: protecting bone density through adequate calcium and vitamin D, supporting cardiovascular health as oestrogen protection wanes, and maintaining energy balance as metabolic rate gradually falls. Iron needs may remain elevated while periods are heavy.
Because oestrogen fluctuates rather than simply declining, symptoms can feel unpredictable and frustrating. If symptoms significantly impact quality of life, speak with your GP or gynaecologist about management options. A registered dietitian can help tailor eating patterns to this changing metabolic landscape.