At the New School, we know that when your hormones start shifting, it is not just a sprinkle of oestrogen and progesterone with a bit of testosterone here, a functional test there, and a tidy nutrition plan with some weight-bearing kettlebell swings and a few Rapid Relief Homeopathy remedies for the sweaty nights….we believe what is unfolding is far deeper and more complex.
We see it like a recalibration of your body, a rewiring of your brain, and perhaps most overlooked, a renegotiation of identity. It is a reality check with your sense of self, the roles you’ve played, and the ones you are ready to release.
Menopause isn’t a phase to manage. It’s a threshold to honour.
“I’m 45, I still get periods… but I don’t feel like myself anymore”.
Maybe you are waking up at 3 a.m., wired and wide-eyed.
Maybe your clothes fit differently, even though your eating hasn’t changed.
Maybe you find yourself weepy before your period, or enraged by small things.
Maybe you are staring across the dinner table at a partner you no longer recognise
or wonder if they even recognise you.
This is menopauseMenopause is often described as the point at which a woman has gone twelve consecutive months without a menstrual period. Whilst technically correct, it does not provide the bigger ‘picture’. Menopause is a transition, more than an event. For many women, the journey begins years earlier during perimenopause, when hormones start to fluctuate and symptoms such as hot flushes, sleep disturbances, anxiety, brain fog, mood changes, joint pain, weight gain, and irregular periods may begin to appear. It can feel as though the body has decided to ‘pack up and go home’.…and no one may have told you, it would feel like this.
Today we are focusing on peri-menopause…the transitional window before menopause. It can last anywhere from 2 to 12 years, most commonly beginning in your 40s, though some feel the shift in their mid-30s.
Menopause is defined as the absence of periods for 12 months.
Perimenopause is the hormonal tango that leads up to that point, intense, unpredictable, and anything but graceful. One moment you are in sync, the next you are stepping on your own feet. The rhythm keeps changing, and no one is giving you the choreography.
Let’s break it down biologically
1. Progesterone leaves first
As ovulation becomes less consistent, you make less progesterone. And when you don’t ovulate, you don’t produce it at all.
Progesterone is your calm, your sleep, your GABA buffer. When it dips, you may feel:
- Anxious for no reason
- Wired at night but exhausted by day
- Tearful before your period
- Irritated by everything
2. Oestrogen becomes erratic
Oestrogen doesn’t just gradually decline, it spikes, plummets, and ricochets unpredictably, like a hormonal rollercoaster. When oestrogen rises unopposed (because progesterone is low), you CAN become ‘oestrogen dominant, even if your oestrogen is ‘normal’ or ‘low’.
Estrogen dominance symptoms include:
- Heavy, clotty, prolonged periods
- Breast tenderness
- Bloating and puffiness
- MigrainesA migraine is a neurological condition characterised by recurrent attacks of moderate-to-severe headache, often accompanied by symptoms such as nausea, vomiting, sensitivity to light, sound, and smells, as well as visual disturbances known as aura. Whilst many people think of migraines as simply a bad headache, they are actually considered a disorder of the nervous system. There are several different types of migraine, including migraine with aura, migraine without aura, vestibular migraine (where dizziness and balance problems dominate), ocular migraine, menstrual migraine, and chronic migraine.
- Fibroids, endometriosis flare-ups
- Mood swings and crying spells
- Weight gain around hips and thighs
- Increased irritability and anxiety
This is your body’s chemical messaging system in flux. It is not just about periods, it is a neuroendocrine recalibration.
Oh, and by the way… you can still get pregnant
Just because you are in perimenopause doesn’t mean your ovaries have retired, YET.
Ovulation still happens….sometimes.
It is just less reliable, like a flaky friend who says they are coming to brunch and shows up every third time, unannounced, wearing Crocs (come on, we all have one of those friends!)
Some months you will ovulate and some you won’t. Some cycles are long, others short. One month your period ghosts you and the next, it crashes into your life with the emotional weight of a Netflix drama.
And in the middle of all that? You can still get pregnant. Woman, your body is a miracle!
So if you’re not planning on a midlife miracle…
- Don’t assume your fertility is done
- Track your cycles or use protection
- Don’t let hormonal chaos confuse your contraception choices
Because nothing says ‘surprise!’ like a positive pregnancy test at 46 years when you thought the only thing growing in your belly was the visceral fat!
The biology of transition
What is often missed in mainstream menopause conversations is the brain side of all this.
Oestrogen impacts over 400 brain functions. As it swings:
- Serotonin drops, which can create mood instability
- Dopamine drops, which can reduce motivation, libido, and joy
- Acetylcholine drops resulting in memory glitches, word loss
- GABA drops (with progesterone), leading to poor sleep, nervous system overdrive
You are not just moody or forgetful; we like to say that you are ‘neurologically rewiring’.
‘Perimenopause is not a hormonal problem, because let’s face it, this is all a natural process, but it is a whole-system shift in identity, biology, and nervous system state.’
This is more than just a hormonal event
Perimenopause is also a psychological transition. One of the biggest in a woman’s life.
It often arrives just as other ‘tectonic’ shifts may be happening:
- Kids growing up or leaving home
- Ageing parents needing care
- Careers feeling stale or unaligned
- Long-term relationships changing or ending
- A body that no longer responds to diet, workouts, or clothes the way it used to
Suddenly, the familiar anchors of your identity begin to loosen. The words you don’t always say aloud, but may feel …
- I don’t know who I am anymore
- I miss the version of me that had energy, drive, and desire
- I feel invisible
- I am grieving the body I used to know
- I don’t want my kids to move abroad, is that selfish?
This is existential recalibration. In other words, it’s about who you are, how you have known yourself, and what happens when those anchors shift.
You are recalibrating:
- Your role in your family and society
- Your values
- Your sense of agency and safety in your body
- Your sexual and relational identity
- Your past, present, and future self
This is the New School’s integrative psychological approach to menopause.
Sure, personalised nutrition, strength training, and circadian rhythm cues matter. But we do not stop there and we certainly don’t ignore the emotional, existential, and identity-level shifts that come with this transition.
The menopausal transition is also a neurobiological state
In neuroscience, we call this liminality, which is the space between who you were and who you are becoming. Let’s repeat that, liminality is the space between who you were and who you are becoming.
It’s not just emotional, as your brain and nervous system are in flux. This is why perimenopause can feel like:
- You are dissolving
- You can’t make decisions
- You are nostalgic for who you used to be
- You are scared of who you might become
And yet …this is also the doorway to emergence.
What we see in coaching at the New School
When we work with women in perimenopause, we don’t just track their cortisol curves or test their oestrogen metabolites.
We ask:
What are you holding onto that is no longer yours?
- A body from 2012?
- A wardrobe that shames you every morning?
- A role you’ve outgrown, but can’t seem to release?
What are you grieving?
- The baby years
- The identity of being needed
- The fire in your belly that used to be there
What is waiting to be born in you, IF you let go?
Perimenopause is NOT a slow death. It is a biological chrysalis.
The caterpillar doesn’t grow wings, it dissolves. In metamorphosis, the caterpillar doesn’t slowly sprout wings. It completely dissolves into imaginal goo. And only then does something new begin to form. That goo phase, we believe, is like the perimenopause stage.
And you are not failing. You are transforming.
What can you do?
From a testing perspective:
- Comprehensive hormone testing, including the hormone metabolites for hormone mapping
- Serum tests for FSH, LH, E2, progesterone, DHEA, testosterone, fasting insulin
- Assess gut health and bile health for oestrogen detox
- Look at HTMA or nutrient status to support methylationMethylation is one of the body's most important ‘behind-the-scenes’ processes. Happening millions of times every second, it helps regulate everything from energy production and hormone balance to detoxification, neurotransmitters, DNA repair, and how we respond to stress. Yes, it is literally involves in every reaction in your body. At its heart, methylation is the process of transferring tiny chemical tags, called methyl groups (one carbon with 3 hydrogens if you like a bit of chemistry), from one molecule to another. To do this efficiently, the body relies on nutrients such as folate, vitamin B12, vitamin B6, zinc, choline, methionine and more. Together, these nutrients help produce a molecule called SAMe, which acts as one of the body's main methyl donors., GABA, serotonin
HORMONE METABOLITES, DUTCH.
From a lifestyle perspective:
- Track your cycles (they still provide information)
- Prioritise nervous system regulation: breath-work, yoga, boundaries, pleasure
- Build strength: literally (weights) and metaphorically (ask for what you need)
- Focus on proteinProtein is one of the three main macronutrients, alongside fats and carbohydrates, yet for many years it was often the forgotten member of the trio. More recently, protein has become something of a celebrity in the nutrition world, appearing in everything from snack bars and cereals to coffee and desserts. Whilst the marketing can sometimes get a little carried away, the truth is that protein is essential for human health. Every cell in the body relies on it. Protein helps build and repair tissues, supports immune function, forms enzymes and hormones, transports nutrients, and helps maintain muscle mass, particularly as we age., crucifers, and healthy fats: for hormone and brain support
- Let go: of clothes, stories, habits that no longer fit the woman you are becoming
Final word
Perimenopause is not a punishment for being a woman. It is a threshold.
A sacred pause where your biology, psychology, and soul ask: What are you ready to release? And who are you becoming on the other side?
Can we stop treating it like a problem to fix and support it as a transition to honour?
From the team at the New School of Nutritional Medicine
Learn about the Founder & Principal of the New School of Nutritional Medicine, Dr Khush Mark PhD HERE.
