Over the last few years, perimenopause and menopause have rightly become much more visible topics in women’s health, wellbeing, and even the corporate space. And that’s a really positive thing.
For a long time, this stage of life was minimised, misunderstood, or simply not talked about enough. Now there’s far more awareness around what typically happens, the common symptoms, and how women can be supported – not just the women themselves, but also healthcare professionals, partners, family members, friends, and organisations.
However, despite all of this increased awareness, there’s one crucial piece that I don’t see talked about enough. And because of that, I see many women unknowingly making this transition much harder for themselves than it needs to be.
The overlooked factor: stress tolerance
During perimenopause, which for many women begins in their late thirties or early forties, hormonal changes mean the body becomes far less tolerant to stress.
And that includes all stress: mental, emotional, and physical.
When we talk about stress, most people automatically think of mental and emotional stressors that come from external sources: work stress, relationship challenges, the constant stream of global news for example. What’s often overlooked is how physical stressors impact our mental and emotional health.
So, any kind of stress, wherever it comes from, becomes harder for the body to cope with during perimenopause. And this one shift has a huge impact on how women feel day to day, as well as on their overall health during this transition.
What you used to “get away with” starts to matter more
One of the simplest ways to understand lower stress tolerance is this:
What you could “get away with” in your teens, twenties, and even thirties, you usually can’t once your hormones start changing.
I’m talking about anything that places stress on the body. For example:
- Skipping meals or not eating enough
- Relying on sugar or refined carbohydrates
- Over-exercising or doing too much high-intensity exercise
- Fasting or cold exposure
- Inconsistent sleep patterns, or scrimping on sleep during the week and catching up at weekends
- Big nights out, heavy drinking, or too much caffeine
- Constant rushing and never allowing yourself to properly rest
All of these are stressors to the body.
I’ve talked about this in other episodes, so I won’t go into the specific physiology here. The key thing to remember is that these very common habits are still stressors, even if they’ve felt normal for years, or are promoted as “healthy” in certain contexts.
And to be clear, these things affect us at any age. It’s not that they didn’t matter before, it’s that they didn’t impact us anywhere near as much as they tend to once hormones start shifting.
Hormonal change plus life pressure
On top of this reduced stress tolerance, this stage of life often comes with more pressure…
Many women are at more senior stages in their careers or running businesses. They may have children, be supporting ageing parents, managing mortgages, and carrying more responsibility overall.
Of course, this isn’t true for everyone, but it is the reality for many. So you often have hormonal change and increased life stress happening at the same time.
What this looks like in real life
I’ve always been relatively healthy when it comes to food, movement, and sleep. But even for me, I’ve had to become far more intentional with my routines as I’ve moved into this stage of life.
For example, if I skip a meal, it affects my sleep almost without fail. What’s really happening is blood sugar disruption and not consuming enough energy during the day, which increases stress, can trigger anxiety, and then impacts sleep.
If I have a very stressful day and don’t intentionally do things to bring my stress levels down, I stay far more wired and find it much harder to come out of that state than I used to.
I’m also much more mindful of caffeine now. I usually only have one coffee a day, but on particularly high-pressure days, I’ll often avoid it altogether.
And I rarely do high-intensity exercise anymore, because I can feel the impact it has on my nervous system.
Now imagine someone who’s carried many of these habits into their forties: skipping meals, poor sleep hygiene, high stress, lots of caffeine, intense exercise or overtraining (or the opposite: very little movement).
If their body is now far less able to tolerate those stresses, it’s not surprising that perimenopausal symptoms become more severe.
Why symptoms escalate
This often shows up as:
- Disrupted sleep, especially waking between 2–4am
- Difficulty falling asleep
- Anxiety that feels hard to come down from
- Significant hot flushes
- Weight gain that won’t shift
- Mood changes
- Thinning hair
- Other health-related issues
You can see how this easily becomes a vicious cycle.
The women who fare better
Women who tend to navigate perimenopause more smoothly usually have what I call the wellbeing foundations in place.
They:
- Eat regular, balanced meals
- Prioritise sleep
- Move their body without overdoing it
- And perhaps most importantly, listen to and honour their body
They respond to tiredness rather than pushing through it. They understand symptoms as signals and know how to support themselves accordingly.
Some women develop this relationship with their body early in life. Others learn it later, sometimes through difficult experiences. And some haven’t learned it yet, which isn’t a failing; it’s simply about education, awareness, and support.
In previous episodes, I’ve talked about self-care and how modern Western life encourages disconnection from the body. When I say “disconnected,” I mean not understanding what symptoms are signalling, or overriding them rather than responding with what the body needs.
Why the foundations matter even more now
All the things I talk about regularly – balanced meals, adequate protein, appropriate movement, consistent sleep, and understanding stress – matter at every age.
But during perimenopause and menopause, they become even more important, because they play such a significant role in how severe symptoms are and how manageable this transition feels.
Of course, there’s also the topic of HRT and supplements, which can be incredibly helpful for many women. But it’s always important to start with the wellbeing foundations, the things you’re fully in control of.
These foundations help keep the body as calm and supported as possible, which allows it to better handle both hormonal changes and external stress.
A final thought
If there’s one thing I hope you take from this, it’s this:
As your hormones change, your body becomes far less tolerant to stress, which means looking after yourself well isn’t optional anymore if you want to feel good day to day.
The reassuring part is that it’s the simple, foundational things, fully within your control, that make the biggest difference. And when you get these right, they support you not just through this transition, but for the rest of your life.
Kate x
If you’re going through perimenopause and you feel you might need support navigating this stage, get in touch to apply for a consultation, email: info@katehorwood.com. And as always, if you found this helpful, please share it with someone who might benefit.
