Is This Just Your Life Now? Why You Shouldn't Ignore How You're Feeling

You’ve had a good nights sleep but still feel exhausted or maybe it’s the 3am wake ups every night and not being able to get back to sleep. Words sometime not coming as easily as they should or brain fog that hits in the middle of an important meeting. You’re anxious but you’re not really sure why. Weight is creeping on but you’ve not changes what you eat or when you exercise.

You're wondering if you've hit perimenopause, or maybe you're heading for burnout because of all the things you're juggling. Maybe you're worried it's something else entirely.

You know things feel off and you want to feel better, but the information you get on social media is confusing and overwhelming. You know you should probably go see your GP, but it doesn't feel serious enough, and honestly, when would you even find the time?

You’ve got so much going on in your life right now, you don’t have the time to stop and think or even slow down. You decide that this is just your life now and you keep pushing through. But every time you snap at your partner or forget why you just walked into a room, that thought still niggles at you.

If any of this sounds familiar, it's important that you don’t just ignore it. There' is support out there and you don’t just have to resign yourself to feeling like this all the time!

What's actually going on with your hormones?

Understanding what's happening inside your body is the first step.

Perimenopause can begin 10 years before your periods actually stop, and it starts with a gradual decline in progesterone. This is significant, because progesterone is your calming, stabilising hormone. It supports sleep, soothes anxiety and helps regulate your mood. When it starts to drop, you may notice you feel more wired, more reactive, and less able to switch off at night (even when you're exhausted). As progesterone drops is causes an oestrogen dominance.

Oestrogen follows a more erratic path. Rather than declining steadily, it fluctuates unpredictably; surging and dropping in ways that can feel completely random. Oestrogen has receptors all over the body, including in the brain, so when levels become unstable, the effects are wide-ranging: poor concentration, low mood, joint discomfort, changes in weight distribution, and those moments of walking into a room and having absolutely no idea why.

At the same time, your brain is working harder to stimulate your ovaries, they’re less responsive so you produce increasing levels of FSH (follicle stimulating hormone). Elevated FSH is one of the key markers of perimenopause, and while it's your body's way of trying to maintain normal function, it's also a sign that the hormonal landscape is shifting in a significant way. FSH levels can be used as a marker of perimenopause, but levels do fluctuate, making a single test of FSH levels unreliable.

The Impact of Cortisol

Here's where it gets particularly important for women who have spent years operating at high capacity: cortisol.

Cortisol is your primary stress hormone, and it's produced by the same system (the adrenal glands) that plays a supporting role in hormone production as you move through perimenopause. When you've been running on stress and adrenaline for years, that system is already under strain.

Chronically elevated cortisol directly interferes with progesterone, essentially competing with it at a cellular level. So if your progesterone is already declining, chronic stress accelerates and amplifies that effect further increasing the oestrogen imbalance. Cortisol also disrupts oestrogen and impacts thyroid function, which helps explain why so many symptoms like fatigue, weight changes, brain fog, anxiety, can be so hard to pin down..

The result is a compounding effect: perimenopause and chronic stress actively make the other worse. For high-achieving, ambitious women who have been in survival mode for as long as they can remember, this is often why perimenopause hits earlier and harder than expected.

PMDD in perimenopause

PMDD is driven by an abnormal sensitivity to progesterone fluctuations, specifically its metabolite allopregnanolone, which affects the brain's GABA system (your calming neurotransmitter). In perimenopause, progesterone becomes increasingly erratic before declining, meaning those fluctuations become more frequent and more extreme. There's also significant overlap with suicidal ideation risk, which is under reported and under recognised in this group.

ADHD in perimenopause

Oestrogen directly supports dopamine and serotonin production, the same neurotransmitters that ADHD medications target. As oestrogen becomes erratic and then declines, many women with ADHD find their symptoms suddenly feel unmanageable, even on the same medication dose that previously worked. Executive function, working memory, emotional regulation, and focus all worsen. Many women are actually diagnosed with ADHD for the first time in perimenopause, because declining oestrogen removes the hormonal scaffolding that was masking their symptoms for decades.

Other diagnoses that can make perimenopause significantly harder

These conditions interact with the hormonal shifts in ways that compound symptoms:

• Anxiety and depression. Oestrogen has a direct antidepressant and anxiolytic effect. Its decline destabilises mood regulation at a neurological level. Women with pre-existing anxiety or depression often experience a significant worsening, and antidepressants that previously worked may stop being effective without HRT alongside them.

• Autoimmune conditions Oestrogen is immunomodulatory, meaning it dampens inflammatory responses. As it drops, many autoimmune conditions (such as lupus, rheumatoid arthritis, Hashimoto's and MS) flare more frequently and more severely. This is also why perimenopause itself increases cardiovascular and inflammatory risk.

• Hypothyroidism. Thyroid hormones and oestrogen interact closely. Declining oestrogen can alter how thyroid hormone binds to proteins in the blood, meaning a previously stable thyroid condition can become poorly controlled. Overlapping symptoms of fatigue, brain fog, weight gain and low mood make it very hard to know what's driving what.

• Fibromyalgia and chronic pain conditions. Oestrogen has a pain-modulating effect. Its decline lowers pain thresholds, meaning women with fibromyalgia often experience an increase in pain intensity.

• Eating disorder history. The bone density loss associated with oestrogen decline is significantly accelerated in women with a history of restriction. This group also tends to struggle more with the body composition changes perimenopause brings (fat redistribution, bloating, weight gain), which can trigger relapse or disordered eating patterns.

• Trauma / PTSD. The nervous system dysregulation that comes with declining progesterone (the calming hormone) directly interacts with a trauma-sensitised nervous system. Sleep disruption, hypervigilance, and emotional dysregulation all worsen.

So what can you actually do about it?

The good news is that you're not powerless here. With the right framework around nutrition, movement, sleep and stress management, it's possible to feel significantly better without adding extra pressure or overwhelm to your already busy life.

After 20 years in health research and working daily with women navigating perimenopause in my coaching practice, I've developed an approach that is both effective and genuinely achievable. It's designed to fit into real life, not an idealised version of it.

• Nutrition

  • Prioritise protein at every meal. Declining oestrogen accelerates muscle loss. Aim for 25–30g per meal to maintain muscle, support metabolism, and stabilise blood sugar, which directly reduces hot flushes and mood swings.

  • Reduce ultra-processed foods and alcohol. Both spike cortisol, worsen inflammation, and disrupt sleep. Alcohol in particular is a direct hot flush trigger and depletes the B vitamins needed for oestrogen metabolism.

  • Eat for your gut and liver. Your liver processes excess oestrogen. Support it with cruciferous veg (broccoli, kale), fibre, and ground flaxseed. A healthy gut microbiome also helps regulate oestrogen levels.

• Exercise

  • Strength training is non-negotiable. Resistance exercise is the single most effective way to counter muscle and bone density loss. Two to three sessions a week protects your skeleton, improves insulin sensitivity, and lifts mood via endorphins.

  • Be careful with high-intensity cardio. Chronic high-intensity exercise raises cortisol. If you're already stressed and sleep-deprived, HIIT can make symptoms worse. Swap some sessions for brisk walking, cycling, or swimming.

  • Add daily movement, not just workouts. Walking after meals lowers blood sugar spikes significantly — a key issue as insulin sensitivity declines in perimenopause. Even 10 minutes makes a measurable difference.

• Stress

  • Regulate, don't just relax. Passive rest (scrolling, TV) doesn't necessarily lower cortisol. Try active regulation as well. Like box breathing, cold water on the face, or short walks. These directly activate the parasympathetic nervous system.

  • Protect your capacity. Perimenopause lowers your stress threshold, so there things you could manage a few years ago may genuinely overwhelm you now. Try saying no to the things that drain you.

  • Address the cortisol-sleep loop. High cortisol disrupts sleep; poor sleep raises cortisol. Break the cycle with a consistent wind-down routine and cutting screens 60 minutes before sleep.

• Sleep

  • Keep your bedroom cool and dark. Core body temperature regulation is disrupted in perimenopause. A room temperature of 16–18°C, breathable bedding, and blackout curtains can make a measurable difference to both sleep onset and night sweats.

  • Fix your sleep timing before anything else. A consistent bed time and wake time anchors your circadian rhythm. Irregular sleep timing worsens every perimenopausal symptom, including mood, appetite, and hot flushes.

Ready to feel like yourself again?

If you'd like to find out more about how I can support you, book a free call with me today and let's have a chat. There's no obligation, just an honest conversation about where you are and what might help.