Perimenopause nutrition, built around your genetics

Perimenopause is not a condition to be fixed. It's a transition — one that can last a decade, and one that most women navigate with remarkably little useful information.

What I offer is not a protocol. It's a plan built from your data: your symptoms, your functional test results, and where useful, the genetic traits that shape how your body is handling this particular stage of life.

What's actually happening

In the years before your periods stop, oestrogen and progesterone stop moving in a predictable monthly rhythm and start fluctuating. Those two hormones don't only regulate your cycle — they influence bone density, insulin sensitivity, neurotransmitters, temperature regulation, muscle maintenance and how your gut moves.

Which is why the symptom list is so scattered, and why it so often gets treated as several unrelated problems:

• Weight settling differently, particularly around the middle, on the same diet as always
• Waking at three or four in the morning
• Brain fog, and losing words mid-sentence
• Anxiety or irritability that feels chemical rather than circumstantial
• Hot flushes and night sweats
• Joints that ache without an injury
• Bloating, reflux or a gut that has become unpredictable
• Training as hard as ever and getting less back from it

Why the standard advice stops working

Most general nutrition advice was written for a body that isn't going through this. Eat less, move more, cut carbohydrate — much of it either does nothing now, or actively works against you.

Under-eating during perimenopause tends to cost you muscle, which is the tissue you most need to protect. Cutting carbohydrate too hard can worsen sleep and mood at precisely the point both are already fragile. And long fasting windows suit some women in this stage and clearly don't suit others.

The variable that general advice can't account for is you.

What your genetics add

Genetic testing doesn't predict your future or diagnose anything. It describes tendencies — how your body is built to handle particular jobs. A few that matter here:

• Oestrogen clearance. Some women clear oestrogen quickly, others slowly. That affects which foods and nutrients are worth prioritising while levels are fluctuating.
• Methylation. This pathway supports hormone processing, detoxification and neurotransmitters. Common variants such as MTHFR affect how efficiently you use folate and B12.
• COMT and MAO-A. These influence how you break down adrenaline, dopamine and oestrogen — which shows up as how you handle stress, caffeine and sleep.
• Vitamin D receptor and bone-related traits. Relevant because bone loss accelerates around this stage, and because some women need considerably more vitamin D than the standard recommendation.
• Inflammation and insulin traits. These shape how your body responds to particular fats and carbohydrates.

None of this is deterministic. Genes describe the terrain, not the destination — but knowing the terrain means we stop guessing.

How we'd work together

Every programme follows The DECODE Method — six pillars, addressed in the order that makes sense for you rather than all at once:

• DNA & Diagnostics — where we establish what's actually going on
• Eat — nutrition matched to your traits and your life, without deprivation
• Cleanse — supporting the pathways your body uses to clear hormones and by-products
• Outlook — the mindset and habit work that makes the rest stick
• Downtime — sleep and recovery, usually the highest-leverage pillar at this stage
• Exercise — strength-led movement to protect muscle and bone

A typical first six weeks: an initial consultation and full history, any testing we agree is worth doing, then your personalised plan and the first round of changes. From there we review, adjust, and build.

Read more on perimenopause

• Navigating perimenopause and menopause with personalised nutrition support
• Why your training isn't working in perimenopause — and what to do instead
• Bone health in perimenopause and menopause
• Fuelling your workout in perimenopause

Start with a free call

Thirty minutes, no obligation. We'll talk through what's changed for you, and I'll tell you which of the six pillars I'd start with — whether or not you go on to work with me.

Nutritional therapy supports your health alongside medical care and is not a substitute for it. If you are considering or already taking HRT, that's a conversation for your GP or menopause specialist — nutrition works well alongside it, not instead of it.