A Quick Guide to Suffering Through Perimenopause and Beyond

A quick guide to suffering through perimenopause and beyond. Follow these rules carefully if you'd like the experience to be as miserable as possible.

1. Don't lift weights

Who needs strength, muscle or decent bone density? Being able to get off the floor is pretty overrated. While you're at it, ignore the fact that women can lose up to 20% of their bone density in the five to seven years around menopause, according to the Royal Osteoporosis Society. Half of women over 50 in the UK will break a bone because of osteoporosis. Strength training, two to three times a week, is one of the most evidence-backed ways to protect bone, maintain muscle and stay independent later in life.

2. Eat whatever

There is absolutely no way your blood sugar, energy, sleep or mood could be linked to what ends up on your plate. Total coincidence. Except the British Heart Foundation and NHS both flag that cardiovascular risk rises sharply after menopause, partly driven by changes in cholesterol and insulin sensitivity as oestrogen declines. The 2024 NHS Health Survey for England found nearly half of women had raised cholesterol, peaking at 72% in those aged 55 to 64. What you eat, especially protein, fibre and the quality of your carbohydrates, has a direct line to how you feel each day and how your body ages.

3. Stay stressed

You're busy. Who has time for anything daft like switching off, breathing, going for a walk, or going to bed? The Mental Health Foundation reports that women in midlife are among the most stressed groups in the UK, and chronic stress raises cortisol, which in turn worsens sleep, belly fat storage, blood sugar control and the very perimenopause symptoms you're trying to manage. Ten minutes of walking outdoors, slower breathing, or simply putting your phone down before bed is not indulgent. It's medicine.

4. Keep proving how much you can run on empty

Relaxation is indulgent. Much better to lie awake at 3am rehearsing tomorrow's to-do list. The British Menopause Society highlights sleep disturbance as one of the most common and under-treated symptoms of perimenopause, affecting around 60% of women. Poor sleep doesn't just leave you tired. It blunts insulin sensitivity, raises hunger hormones, increases anxiety and slows recovery from everything. Protecting sleep isn't a luxury at this life stage. It's foundational.

5. Skip protein

A cheeky biscuit and a coffee should carry any woman through to the afternoon no problem. Unless, of course, you'd like to keep your muscle, manage your appetite and steady your blood sugar. The British Nutrition Foundation notes that protein needs increase with age, and most UK women over 40 fall short, particularly at breakfast. Aiming for roughly 1.2 to 1.6g of protein per kilo of bodyweight, spread across the day, supports muscle maintenance, satiety and recovery. A palm-sized portion at every meal is a far better friend than another biscuit.

6. Stay seated as much as possible

Mobility is for later. Much later. Ideally when you need help getting up. The UK Chief Medical Officers' physical activity guidelines recommend at least 150 minutes of moderate activity, two sessions of strength work and regular movement breaks each week. Yet Sport England's Active Lives survey consistently finds that women in midlife are among the least likely to meet these targets. Movement isn't just about exercise. It's standing up, walking the stairs, getting onto the floor and back up, carrying the shopping. Daily mobility is what keeps your future self independent.

7. And if your body starts acting up…

Hot flushes, anxiety, brain fog, joint pain. Probably your imagination or an inevitable part of ageing. Definitely not something that might respond to support. The NICE menopause guidelines (NG23) recognise more than 30 symptoms linked to perimenopause and menopause, from mood changes and palpitations to musculoskeletal pain. The Women's Health Strategy for England has explicitly acknowledged that women have been dismissed and under-supported in this stage of life for decades. You are not making it up. You are not being dramatic. There are options, from lifestyle support to HRT, and you deserve a proper conversation about them with a GP or menopause specialist.

The truth

Perimenopause is responsive to input. The way you train, eat, sleep, move and manage stress genuinely changes how this transition feels and how your body holds up on the other side of it. None of it has to be perfect. None of it has to be extreme. Small, consistent choices stack up.

This article is for general information and is not medical advice. If you are experiencing perimenopause or menopause symptoms, please speak to your GP or a menopause specialist.