Something most of us feel but haven’t had named: perimenopause isn’t something going wrong. The body is preparing for a transition — and how we’ve been living sets the tone for how that transition unfolds. In this conversation, herbalist, naturopath and nutritionist Salena Walker breaks down what’s actually happening — and what we can do about it.
What’s Actually Happening in the Body
A lot of what Salena sees in clinic and with people who come on courses with her is a fear of the unknown — a fear of the transition itself. What is actually happening is the body is transitioning from having a bleed every month to not having one.
That transition is going to create change. But as humans, many of us fear change rather than looking at it as transformation — and those are two very different ways of seeing it.
Society is now more willing to talk about menopause, which is welcome. But we are moving toward fear rather than toward understanding. What we need to remember is that this is a natural transformation in the body. And as soon as we stop fighting it, it can be genuinely transformational — it can change us into a woman who is capable of creating change in the world.
The Endocrine Orchestra
When we are looking at menopausal symptoms, we are looking at the ovaries — which are part of the whole endocrine system. The adrenals are also part of that system. And this system works like an orchestra.
The pituitary gland, the pineal gland, the thyroid, the adrenals, the ovaries — all the glands in the endocrine system work together. If one of them starts playing too fast, all the other parts have to speed up to keep the music going. If our adrenals are going very slow and they’re fatigued, everything else in that endocrine system is going to slow down too. So what we want to do is support the whole system, not just one part of it.
During perimenopause, oestrogen stops being reliant on the ovaries and goes to the adrenal glands. And a lot of the time, the adrenals are exhausted from the lives we live. So when the body asks the adrenals to take on this extra job — producing oestrogen — many of our adrenals are already at capacity. When that happens, we feel it: an intolerance to stress, emotional reactions that feel extreme, an inability to push through the way we used to, fluctuating oestrogen, spotting, heavy bleeds, missed ovulation.
It’s worth looking at all of this from around 35 onwards — before perimenopause begins — because it sets the tone for how the transition unfolds.
Drink — Start With Water
Salena always starts with the simplest thing: water.
When we’re constipated — when our bowels are full and we’re waiting — there’s a conversation that happens between the liver and the bowels. The bowels ask the liver how hydrated the body is. If we’re dehydrated, the liver says: I need every bit of water you can give me. So the bowels allow the liver to pull back the water. And in doing that, it’s also pulling back the hormones. The oestrogen goes back in rather than out. We’re essentially recirculating old hormones through the body instead of eliminating them.
Everyone knows we should drink water, Salena says. But knowledge and action are two different things. During perimenopause, all the knowledge and wisdom we’ve built up — we do need to turn it into action.
Eat — Food As Close to the Garden As Possible
The main principle with food is simple: as close to the garden as possible. Cut out processed foods. Cut out anything that is going to overload the digestive system — because we want things moving through smoothly and being eliminated.
Many women benefit at perimenopause from letting go of gluten, dairy, and sugar — because of the inflammatory effect they can have. If hot flushes are present, it may help to reduce curries and hot spices. Fried foods become carcinogenic in the body and are worth releasing. And if your lifestyle is sedentary, a high-carbohydrate diet isn’t going to serve you well.
The simplest question to ask yourself at every meal: Is this meal going to create the best possible version of me?
Salena Walker
Fill the plate with rainbow vegetables — and aim for 30 different varieties a week to feed the gut bacteria, which also plays a role in processing and eliminating hormones. Berries and grapefruit support the liver. Cruciferous vegetables — broccoli particularly — are great for oestrogen balance. Pulses and legumes. Variety.
Think — Getting the Drama Out of Your Head
The tricky one. The quiet moments can feel like the scariest part — when everything we’ve been pushing down has space to come up.
Salena recommends a technique she loves from The Artist’s Way by Julia Cameron — morning pages. Some practitioners call it rage on the page, or process pages. The practice is this: get an A4 notepad, pick up a pen, and write three sides without stopping. It doesn’t matter what comes out. You might write about the podcast, the shopping list, whatever is there. The point is to get all the drama out of the head and onto the page.
What generally happens — what Salena has experienced herself and with clients — is that after about a page and a half, something shifts. All the drama comes out first, and then your own internal therapist steps in. Nuggets of wisdom start appearing: I need to dance. I need to call my friend. The body telling you what it actually needs. But that can only happen when we allow ourselves to stop and go into that process.
Deep breathing also supports this — making the out breath longer than the in breath sends a message to the nervous system that we are relaxed. Faking it until it becomes real.
Excrete — Loving Your Liver
Our routes of elimination matter enormously in perimenopause. It’s the liver that detoxifies hormones — and in Salena’s experience of working with people, high oestrogen rarely appears from nowhere. It’s usually recirculation. The liver isn’t excreting what should be excreted, or the digestive system is overloaded and not passing things through.
Supporting the liver — through castor packs, enemas, or gentler herbal detoxes — is a core part of supporting the transition. It doesn’t have to be extreme. Meet your body where it’s at.
And this is the foundation everything else rests on. The drink, eat, think, excrete — these are the absolute basics. We have to meet the herbs and supplements halfway. There’s no point taking them in an allopathic way — using them like pharmaceuticals, plastering over a symptom without addressing the root cause.
Herbs We Probably Already Have
Three herbs Salena returns to — because most of us already have them in the cupboard.
Sage — a 65% reduction in hot flushes within eight weeks, according to the studies Salena references. It also supports serotonin and oestrogen. To use: a teaspoon of dried sage in a mug, fill with boiling water, put a lid on so the beneficial compounds don’t escape in the steam, and leave for 10–20 minutes. Some people find it bitter — a small amount of honey is fine, but ideally try to get used to it as it is.
Rosemary — the protector of the liver and the brain. It gets the blood pumping around the brain, supports focus, and is protective for the liver. Once we are in menopause and in the year following, the brain is recalibrating and reforming — and rosemary can support that process. A good alternative to coffee for those wanting to reduce it.
Fennel seed — gentle oestrogenic qualities, making it a useful herb throughout this transition. Fennel seed can be made into a tea, or into an oil and used vaginally to support vaginal dryness. In Salena’s clinic, she makes a fennel seed vaginal balm as a natural alternative to more synthetic vaginal inserts. For the tea: use seeds just before they start to go brown, when they’re still a bright green. The fennel seed is what’s been studied — not the whole plant.
Supplements Worth Looking At
Salena recommends checking contraindications for your own conditions before adding any supplement — and checking against anything else you’re already taking. Two she returns to most often:
B vitamins — stress uses up B vitamins rapidly. Add the extra load of perimenopause on top of an already stressful life, and B vitamins become important support.
Magnesium — the relaxer of the body. Calcium contracts; magnesium relaxes. For period pain, tension, anxiety, headaches, teeth grinding — any tension in the body — magnesium is worth looking at.
Meeting Your Body Where It’s At
Salena’s closing thought — and the one that stays:
It’s going through puberty, but with all the wisdom of being a woman.
The transition of perimenopause is real and it can be hard. But we are going through it with a lifetime of wisdom that we simply didn’t have at puberty. That is something worth holding on to.
Reduce stress wherever possible. Be honest with yourself. Take better care of yourself than ever before. And remember to laugh.
If you want support navigating perimenopause from the inside out — somatically, emotionally, and at the root — explore 1:1 work here or access the free perimenopause practice to begin.
ABOUT SALENA
Salena Walker is a herbalist, naturopath and nutritionist with over twenty years of teaching experience. Her online course Hormones and Menopause is available at salenawalker.earth
