Perimenopause in Your 40s: Natural Support That Fits Your Life

Snapping at the people you love. Waking at 3am for no reason. Periods that arrive whenever they please. Forgetting why you walked into a room. If you’re in your 40s and wondering what on earth is going on, you’re not imagining it. It may well be perimenopause.

In my book Beautiful Aging, I describe how many women mistake these years for a “midlife crisis”, when much of what they’re feeling is shifting hormones. Once you know what’s happening, you can do something about it.

What is perimenopause?

Perimenopause is the transition leading up to menopause, when your periods stop for good. According to Cleveland Clinic:

• It usually starts in your mid-40s, but can begin as early as your mid-30s.
• It lasts about four years on average, and can last up to eight.
• It’s driven by fluctuating hormones, especially oestrogen, which can rise and fall unpredictably.

Signs of perimenopause

Common signs include:

• Irregular periods: shorter or longer cycles, or heavier or lighter bleeding
• Hot flashes and night sweats
• Trouble sleeping
• Mood changes: irritability, low mood or mood swings
• Brain fog and forgetfulness
• Lower sex drive and vaginal dryness
• Needing to wee more often

Good to know: you can still get pregnant during perimenopause. The US Office on Women’s Health recommends using contraception until you’ve gone a full year without a period.

When to see your doctor

Perimenopause is natural, but some symptoms need checking. Cleveland Clinic advises seeing your doctor if you have:

• very heavy periods, or large clots
• bleeding that soaks a pad or tampon every 1–2 hours
• periods lasting much longer than usual
• spotting between periods or after sex

It’s also worth booking a chat if your symptoms are affecting your work, relationships or wellbeing. You don’t have to just put up with it.

Natural, pill-free support for perimenopause

Many women in their 40s like to add some natural support to their routine. Here’s how our patches can fit in. There’s nothing to swallow, and it’s one patch a day.

For hormonal ups and downs: Menopause Support Patch

Our Menopause Support Patch is designed for both perimenopause and menopause. It combines black cohosh and ashwagandha with other traditional herbs and DHEA. Please read the safety notes below, as DHEA isn’t right for everyone.

See Menopause Support Patch → 

For restless nights: Melatonin & GABA Sleep Patch

Sleep is often one of the first things to change. Our overnight patch has 5 mg melatonin and 5 mg GABA.

See Sleep Patches → 

For tension and winding down: Magnesium Patches

Magnesium supports muscle and nerve function and is a favourite for winding down in the evening.

See Magnesium Patches → 

For busy, stressful days: Relax & Unwind

Valerian, passionflower and hops are herbs traditionally used to support relaxation.

 See Relax & Unwind Patches → 

For your bones: Calcium, Magnesium & Vitamin D3

Bone loss speeds up around menopause, so your 40s are the time to start looking after your bones. Read our Bone Health From 40 Onwards guide →

An honest note: supplements, including our patches, work best alongside the habits above, not instead of them. They aren’t a replacement for medical advice or treatment such as HRT.

Is it safe for me?

Please talk to your doctor before using our Menopause Support Patch if you:

• have had breast cancer or another hormone-sensitive condition (DHEA isn’t recommended)
• have PCOS, diabetes, a thyroid condition or liver problems
• take HRT, the contraceptive pill or other hormone medicines
• take sleep medication or sedatives
• are pregnant, trying to conceive or breastfeeding

For all our patches: if a patch irritates your skin, remove it and try a different spot next time.

In my book Beautiful Aging, I talk about how these years are about much more than hormones. They’re about how you move, how you see yourself, and how you share out your time and energy. These three areas make a big difference.

The benefits of staying active

Movement is one of the most powerful things you can do for yourself in perimenopause:

• It lifts your mood. Exercise releases feel-good endorphins and helps take the edge off stress and irritability.
• It helps you sleep. Women who move during the day often find it easier to fall asleep at night (just avoid hard workouts right before bed).
• It protects your bones and muscles. Bone and muscle loss speed up around menopause, so weight-bearing exercise and strength training matter more than ever.
• It supports your heart and weight. Metabolism tends to slow in midlife, and staying active helps.
• It calms body and mind. The NCCIH reports that yoga can help with both physical and emotional menopause symptoms.

Make it easy: a brisk 30-minute walk most days, two short strength sessions a week (bodyweight, bands or light weights), and something you enjoy, such as dancing, swimming, tennis or a walk with a friend. The best exercise is the one you’ll keep doing.

Embracing a positive body image

Perimenopause can change your body in ways you didn’t expect: a softer middle, changes to your skin and hair, and clothes fitting differently. It’s completely normal to find that hard. Some gentle shifts can help:

• Be as kind to yourself as you would be to a friend. Notice the inner critic, and talk back.
• Focus on what your body can do, not just how it looks: walking, dancing, carrying the shopping, hugging the people you love.
• Dress for the body you have today. Clothes that fit well and feel good make a big difference to how you carry yourself.
• Curate your feed. Follow women your age who inspire you, and unfollow anything that makes you feel less than.
• Celebrate the wisdom and confidence that come with this stage of life. Beautiful aging is about feeling good in your own skin.

Balancing commitments: life and work

Many women in their 40s are juggling it all: career, children or teenagers, ageing parents, relationships, and their own changing health. No wonder stress runs high. A few things help:

• Set priorities. You can’t do everything, so decide what matters most this week.
• Learn to say no (or “not right now”) without guilt.
• Set boundaries between work and home, such as a set finish time and no emails after dinner.
• Ask for help and share the load at home and at work.
• Schedule time for yourself like any other appointment. Even 15 minutes a day for a walk, a bath or a book counts.
• Try mindfulness. The NCCIH reports that mindfulness meditation can reduce how much hot flashes bother you, and can help with stress and sleep.
• Talk to your employer if symptoms are affecting your work. Many workplaces now offer menopause support.

Want more? These ideas are explored in depth in my book Beautiful Aging →

Simple habits that really help

These everyday changes can make a real difference:

• Move every day. Walking and strength training support your mood, sleep, bones and heart.
• Eat well. Plenty of vegetables, fruit, whole grains, lean protein and healthy fats such as oily fish, nuts and olive oil.
• Go easy on alcohol and caffeine, especially later in the day. Both can affect sleep and trigger hot flashes.
• Dress in layers and keep your bedroom cool.
• Manage stress. The NCCIH reports that yoga and mindfulness meditation can help with both physical and emotional menopause symptoms.
• Protect your sleep with a regular bedtime and screens off an hour before bed.
• Find your people. Talking with friends going through the same thing helps more than you’d think.

Find the right support for you

Find My Perimenopause Support →

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Further along the journey? Read our Natural Menopause Support guide →