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Menopause Blog: 5 Things I wish I'd known before hitting perimenopause

Updated: May 5, 2022

I'll still eat my words: 'I'll coast through the menopause, I'm a therapist'. This is what I said just after my 45th birthday to a lady doing a talk on the menopause. At that age I thought it was a decade away-ish, probably never mentioned the word once in my life before that, and just thought it would be a breeze as I was in a holistic therapy.

What I hadn't thought about was all the little things that were going wrong that I didn't attribute to anything, like my memory taking a nosedive and getting me into trouble, that I was actually battling anxiety every single morning, crying at everything AND had lost the will to socialise or enjoy myself, and not to mention how grumpy, snappy and negative I had become.

I hadn't realised all of this was happening to me, in hindsight and with the knowledge I now have I can piece it all together and it seems blindingly obvious something was going on, but when you don't know..... you don't know!

I know now, 5 years on and numerous 1 to 1 clients later plus all of the ladies that I see posting on social media that there are thousands if not hundreds of thousands of you getting slowly ground down by the same insidious mind and body issues that are creeping in by stealth until you get to a point where you look back and say 'where have I gone?' , 'where is the woman that I was 3 years ago?' and 'what the hell has happened to me?!'.

Here's the thing, pretty much to ALL of us the menopause used to be thought of as 'some embarassing hot flushes that you have a laugh about' and then you keep calm and carry on; all very British. What we weren't told is that 5 years before this we think we're going mad, and our body is literally breaking down on us and we don't know why.

I've had clients call me up so worried that they're getting early onset dementia, or that their marriage is about to fall apart and they can't help behaving like a bitch, when they really don't mean to; it just ... happens. It comes out of nowhere and it hasn't got anything physical or tangible to hold onto and take to a Doctor and be able to say: 'What is wrong with me?'.

Then to top it off probably 1 out of 3 GPs say: 'well you're too young to be menopausal', so that then freaks you out that you really do have dementia or something sinister going on.

I'm 50 now, and I can reflect back over the last 5 to 8 years of perimenopausal and landmark the stages I've been through, when the declines happened, and when changes came in that I didn't know were linked. It wasn't too much of a problem when I noticed my hair getting thinner or my jowels getting more defined, I thought 'well, that's aging...' but I didn't know that the way I was 'feeling' and becoming more irascible were because there were hormonal changes afoot. I wish I'd been prepared, I could have saved myself a few years of grief, and I bet you're feeling that way too.

Now I know this stuff I'm pleased to say it's sorted me out so that I'm happier and healthier now than I've been in a long time, and this is what I help my clients do now.

I'm here to demystify on a daily basis just what the heck is going on with your hormones and emotions and how you can naturally and practically take effective steps to resolving how you feel and the symptoms you have, and to take this transition and make it a positive, healthy and happy one (join my group if you'd like to be in-the-know!)

Here then are the 5 things I wished I'd known well before diving into the murky world of the perimenopause:

1. That the perimenopause starts way before your periods end

Firstly though the word 'perimenopause', I don't think this was a known word 5 years ago, and if it was it was merely associated with the point when your periods start to go 'wonky'. However at 50 my periods are still regular, and they were throughout my 40s so I didn't have an inkling anything was happening in this respect.

Now I see that women are suffering from incredibly heavy periods too, there is a phase for many women where periods do get closer together and heavier, so much so, flooding means they can't leave the house, but with this going on are you even connecting this with menopause change? I doubt it. However it is a very defined phase and is likely to also have fatigue, anxiety, low moods, and lack of libido with it too.

Talking about lidido, yes a majority of womens absolutely nosedive when they're in the thick of the perimenopause, but for some, just before this hits there is a period of time when it's quite the opposite! It's your last chance to have a baby and so many women go through a 6 to 12 month phase of very high libido, but from the case studies I now have that can literally stop overnight, and that's a shock to you and your partner. Loss of libido can also be triggered by a shock, increased stress or an illness that stops it in it's tracks, my symptoms really exagerated one autumn after I'd had a virus, and so for many of you you could have a cold/virus (covid/covid jab) and after that you're in a different phase, left wondering what happened to suddenly switch you off.

This is what they don't tell you about the perimenopause

It's not a phase 'just before your periods end', it is a 10 year journey of your body altering. At first progesterone declines and this takes away a good chunk of your sanity. Remember when you used to feel calmer a few days into your period, this was when progesterone kicked in, it's not doing that so effectively now, so you're wound up for a longer period of time each month, until it becomes a continual cycle of decline.

2. That my emotions and mind would be the first thing to take a kicking

I remember sitting in the boardroom many times around the ages 42/44 when I felt myself welling up for absolutely no reason; it was bloody embarassing and I didn't know why it was happening. I'd had a bad car accident where I was hit from behind when I was 40, and I went for therapy after that to resolve the more obvious symptoms, but when this unexpected emotion took over I was using my chinese medicine theory and applying it to post accident fatigue/trauma; call it what you will. Once I'd had my therapy I didn't feel traumatised anymore and I didn't associate the emotional outburts with it, but now looking back, it's got to be the start of my perimenopause as I just wasn't the old me who'd always been very emotionally robust.

I was getting more and more tired, I didn't have anxiety I was just getting more and more 'what is the point?' I had always hoped to leave my fulltime corporate job to become a therapist but I didn't expect to do it in the way I did. I had an episode, just too much bad news all came together and I woke up, sat up in bed and said 'I'm leaving'.... and that was that. I didn't like it anymore, I thought the new projects pointless, I didn't want to waste my time and energy on things I didn't believe in, I also remember shouting at my mum, when she queried whether I should leave: 'This job is killing me....'. Best thing I did of course, but it was all so out of character that looking back now I think the stress, long hours plus personal life issues was driving me into a perimenopausal state.

The height of perimenopause on average is 47, this is taken from the age of menopause being 51 (in white western females), other ethnicities tend to go into menopause younger and so may experience perimenopause symptoms younger too. 4 years before your periods stop is meant to be the height of the Perimenopause; this according to a male professor. However I think life and lifestyle plays such a massive role that you can be experiencing the symptom set from your late 30s onwards.

This is what is confusing about the perimenopause, and why previous generations may not have suffered from it as much as we are now:

What we're not told is that the perimenopause is a time of fatigue, and all the symptoms that are associated with this depletion.

These are - anxiety, brain fog, aches (muscles and joints) , catching illnesses easily, more allergies, slow metabolism and more gut health issues.

Women who have babies late into their 30s/ early 40s can go straight into this symptom set from giving birth as their body is more exhausted now than if they were to have a child 10/15 years earlier.

Women having a career, jetsetting through time zones, long hours, juggling a family et all are exhausting themselves before the hormonal stress then kicks in to add to it. Suddenly confidence is gone, and self doubt/ anxiety take over.

Women are exercising like never before, boot camps, HIIT n Spin classes, marathons and triathlons, keeping up with the boys; this can only last for so long. What about the women that make fitness their career? This is the highest enquiry group that contact me. We're told to exercise more to help get through the menopause, this is dangerous advice, it should be how to exercise right!

The hormonal stress of your body transitioning is over 10 times more fatiguing on your body than being pregnant, and it goes on for 10 times longer.... no body has told you that.

We're in a generation that was pushed to have it all, and that is now taking it's toll on our health in our 40s. I truly believe this is why celebs who are in their early 50s are speaking out now about how horrendous their symptoms were and how they've resolved them.

This is what they don't tell you about the perimenopause

It shows it's first buds of change as your emotions. Society puts out information about having a flush, and that you can have a fan on your desk, but what you're not told about is that the insidious thoughts of self doubt, worthlessness, guilt, and sheer anxiety from waking up and breathing ARE signs that your body is heading into exhaustion. It's not about 'just putting up with it, it's the menopause', it's about you knowing that the solutions lie in holistically looking after yourself and making lifestyle changes to support your energy through time of your life.

3. That a lot of symptoms are cold, and if you're prone to the cold they can be worse for you in the perimenopause.

My first cut of my chinese medicine theory on what is going on in menopause is that there was a 'hot menopause' (the classic type, flushes and sweats) and a 'cold menopause', and this is what I was experiencing. Chinese medicine is very handy as it helps you group symptoms together so I remember the day I sat back with my lightbulb moment of 'aha.... no one is looking at the cold symptoms'.

Let me ask you a question:

Are you a hot or cold person in life (before things started changing)?

You're a cold person if you wear layers of woolies in the winter, and always take a scarf or coat 'just incase'. You're a hot person if you wear thin clothes, even in winter, and you're always worried about how to keep cool.

Which are you?

This is really important as now I know from all the clients I've helped that if you're a cold person the perimenopause is likely to be far worse for you, and if you're hot, then hang on, the heat and all its associated symptoms are going to just send you over the edge; think mood swings, irritability and emotional outbursts. If this is you, check out my liver detox, it'll really help!

Feeling the cold already means you're on the back foot for the perimenopause, in chinese medicine terms your Kidney Yang Fire isn't quite as stoked as it should be. You may have bad circulation, like your sleep a lot, not be too sporty, may be overweight or very thin, get anxious easily and experience Cold flushes, especially in the early evening. Also lower back problems (where hot people tend to be more neck and shoulders) , then there are migraines, which can often be attributed to cold muscles; do you like warmth when you have a headache?

Here's the kicker about experiencing the misery of cold symptoms, they are chronic and are based on deficiency, this means there is something missing in your body. When things are missing it is a slow journey to replenish them. If you're a hot person, you have excess, and it's easier to remove excess heat, hence the liver detox I pointed you to.

When you are deficient in something (and in this case its vitamins, minerals, hormones, nutrition, and some internal fire, that's a chinese thing) putting it back in and stoking you up again takes time and a lot of supplements, as well as lifestyle and diet changes, and resting more.

I bet you're laughing at the thought of resting more, being on the go ALL day, not a moment to yourself, juggling work, kids, partner, dog, shopping, house, parents, you name it, but this is why you're exhausted, and, it's not going to get better unless you take some action and do something about it.

This is what they don't tell you about the perimenopause

You're doing too much, exhausting yourself at too young an age, and not leaving anything in the tank to help you get through the stress and hormonal upheaval that your body is going through.

I love this quote from Buddha: " The time to rest is when you don't have time to rest..."

I hear a lot of women say, 'yes, but I'm too busy', my answer: 'who'll look after you and your family when you crash?'

4. How bad pms is an indicator that your health needs help, and will make your menopause worse

I always had lousy painful periods, and I put up with them, then in my 30s they were manageable then they started declining again in my 40s. I don't feel as though my PMS was too bad, I'm comparing this against all of the other posts I see about how bad PMS is. However in that I always suffered pain, clotted bleeding, felt miserable, felt like my back wanted to be severed , well that was just a way of life; and I bet so many of you are putting up with all this too. I knew I was a bit snappy at time of the month, but so many women go into rage, and worse feel suicidal and it's put down 'to hormones', but no one has ever bothered to tell you that it is health imbalances and that if resolved these it can give you back your sanity plus a week or two a month of misery, and set you on a far better path to a happy and healthy menopause.

I browsed through a huge book on chinese gynaecology back in my early 30s (which I now own!) and found my symptom set, and went: 'aha!', that's me and that's what I can do about it'. I was lucky, but you'd need a degree in chinese medicine to understand such a book, so you're not so and need me to interpret what to do, and then it boils down to some simple steps; but don't confuse simple with easy, as most of the time your mindset will get in the way.

A few women have tried acunpuncture and my discipline Shiatsu and they do help, incredibly so but they're not the whole solution. Every therapist is earnest in their helping you but they're coming up against western lifestyle. Things that just work in the east, just don't work in the west. So what's getting in the way ? To put it in it's basic form - toxins.

What are toxins, what can you do about it, and why should you take them so seriously?

Toxins are in our food and lifestyle. There isn't a lot we can do about the air we breathe, but we can certainly control what goes into our bodies. The food industry has really done a number on us, we're the first generation through as guinea pigs of convenience foods. Tapping into this market, consuming these goods is what is setting up our liver, gut, blood and uterus to have bad PMS, and more and more menopause symptoms; as well as putting a stress onto our nervous system (by keeping us in alert state - think caffeine and careers!).

Toxins in short dirty your blood, corrode your joints, bung up your liver with fat, and deposit themselves in the soft tissue around your body (like the breasts). There are dirty oestrogens in the food sources too, but not where you would expect. Drink bottled water? They line the bottles with an oestrogen that isn't good for you. Eat low fat products? The replacement food is sugar for bulk and flavour. We're addicted to sugar, and it's in savoury things too, like crisps (Potato turns to sugar on being broken down in the liver).

When you're having bad PMS , what do you reach for ? Sugar, and comfort foods.

What I've learned over the last 6/8 years is too try and have nutritious but comforting foods (and supplements first). If you're feeling grotty in the morning, then have a thick soup and some choice minerals for lunch, before deciding whether you still want chocolate, for me I will still have some chocolate but after the nutrition and so won't feel the need for as much. Stepping into and interupting your mindset so that you don't automatically eat processed comfort foods, and taking nutrition on board could have saved me years and years of miserable monthly's and the onset of perimenopause nutritional depletion, and you too. Good news though, its never too late to start and most bodies are extremely forgiving and will hungrily take the nutrition and when you're topped up you'll see positive changes!

This is what they don't tell you about the perimenopause

That it's such a lack of nutrients in your life that it can send you crazy, PMS is already an indicator this is happening. We're told to eat healthy, but I think the importance is in the why. Your body does NOT get enough nutrition from food. If you're eating 8-10 fruit and veg a day, laying off sugar and stimulants completely, you might be getting there, but that's a big IF. Have a stock of comfort soups or warming foods that you can eat quickly before you reach for the sugar/processed foods. Also pop a multivitamin, extra magnesium and vitamins C and D; you will feel so much better!

5. That supplements really are a pivotal part in helping resolve symptoms!

I resisted supplements for a long long time. I was a useless supplement taker. Anyone who knows me now will not believe this, I could go so far as to say I was anti-supplement. Even when studying chinese medicine (theory of) I shunned the herbal side - completely. I learned that we have everything in us to heal us, so I battled on, I had my regular therapy (shiatsu, wouldn't be without it!) and I thought: "this is the best I can be, I'm aging, things are changing, it's out of my control, I'll just manage as best I can". If things hadn't gone wrong physically I may still be in that mindset.

Magnesium was my first supplement, as is the case for so many as we all hear it helps with sleep, so I took it, and it helped with my sleep, so I consider myself lucky to have got such a clear result. What is did though was open my eyes to taking a supplement to resolve a deficiency. As I said earlier, a deficiency is something that is missing, and oh boy we are missing a lot of nutrition in the menopausal change.

Excess Cortisol leeches your nutrition, so you need more of it now!

One of the main issues is excess Cortisol, your stress hormone, it's here to do a good job, to replenish your nervous system as you rest, but it needs minerals and nutrients to do this. It leeches all your current nutrients to try and do it's job, and this increases as you transition through the stages, but this leaves you with aching joints, anxiety and brain fog to name a few.

Don't overlook the power of a multivitamin, this is just your opening gambit in supplements at this time, its a basic but very necessary one as it's packed with trace nutrients that your body requires. Then there are those your body needs more of, Magnesium being the number 1. You only need to google magnesium to find out its the #1 mineral we are most lacking in in life before we even hit this time of change; then you'll see it's Vitamin D, Iron, Iodine and Vitamin B12 are all prevalent and very very involved in women's health.

Then you can dip your toes into herbal supplements that help, my first go to is Ashwaganda, a known ancient root that is a stress adaptogen, it's up there in helping relieve anxiety and fatigue, and all the associated symptoms. The relief I felt from anxiety when I took it was a game changer for me. Many clinical trials have proved that Ashwaganda reduces tension and anxiety, and a Canadian study in 2009 proved that paired with dietary advice and multivitamins it was found more effective at reducing anxiety than psychotherapy and a placebo. Yet women are still fobbed off by doctors with anti-depressants for this symptom, and that really angers me. I had anxiety on and off all my life but menopausal anxiety confused me as there was seemingly no emotional reason for it; read more here.

This is what they don't tell you about the perimenopause

That a modern woman is going to suffer if she is lacking in certain vital minerals, in fact a regular blood test for the full spectrum really should be mandatory for our optimal health all our lives, but especially as we hit 40 (you can also get a hair analysis for mineral deficiencies privately here). If they checked our bloods regularly there may very well be less need for expensive and/or intrusive tests at various stages of life as it could have been pre-empted and prevented simply by having the right body chemistry.

This is why this has become my passion! Shiastu and the associated philosphy is very much about keeping you in good health and preventing serious illness, and so I now turn my learnings towards helping women do the same, before, during and after menopause,

In learning your symptoms I can predict your deficiencies and so this is a pretty good alternative to getting an actual mineral deficiency test, however a test may avert these symptoms from ever arising.

At the end of the day this is about your health, keeping you in balance emotionally and physically and aiding your own happiness through health... all from a chinese medicine point of view; it's powerful stuff.

Do you want to know more about the supplements that your mind and body are craving?

Read last months blog here.


I can help you choose the right support for you, I have a selection of ways to help you resolve your symptoms and feel so much better. Look at my support page and choose whether you want to contact me for a free clarity call, book a consult, read what to do, watch video explanations or resolve anxiety with a great guide, check out all the options available to you here:

I published my first book on Amazon in March 2021, and I'm so thrilled that it's reaching so many women that really need it. It's available in your local amazon market around the world, and I'm pleased to have helped women from America to Australia understand their menopause better and start to resolve their symptoms naturally and effectively. It's your health under a microscope as you go through the menopause change, so let's make your health better :)

Andrea Marsh is a Shiatsu and Chinese medicine practitioner of over 15 years. After nearly 5 years of researching and testing natural , practical menopause solutions she offers online consultations, has a growing community on facebook (join here) and to read more about her book to give you the knowledge you need to resolve your symptoms yourself, check out her book here.



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Beware Menopause-branded supplements

There is very little scientific backing on most of the supplements that are currently flooding the market at present - you are being sold to; you are being promised that this one pill will solve everything. I look at the ingredients and percentages of all supplements that I'm notified about or come across. Do not believe any menopause expert endorsement; I don't know who these women are.


The menopause experts that I trust don't endorse any of the products I've looked at. Some supplements will help with some symptoms; it's better if the supplement is targeted to a small set of symptoms that are linked; it's more likely to be effective.  They can be a good starting place but over time will become less effective; don't be disheartened it's likely that they don't have enough dosage in for what you now need. I have a Starter Supplement Guide that  explains what you need and why you need it i effective levels to help relieve your symptoms naturally.

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