More women are talking to their managers, more companies are putting policies in place, and the stigma is slowly lifting. (If you’re looking for guidance on the workplace side of things, from flexible working to starting the conversation with HR, Rockmy’s guide to menopause in the workplace and employee top tips are well worth a read.)
But alongside those external changes, there’s something else that can make a real difference to how you feel day to day, and it starts with what’s happening inside your body.
I’m a functional medicine practitioner and nutritionist specialising in women’s health, and many of the women I work with are high-achieving, ambitious and used to performing at a demanding level. They arrive in perimenopause having often spent years pushing through fatigue, brain fog, anxiety and crashing energy without connecting those experiences to what’s shifting hormonally.
What I want to offer here isn’t a long list of things to add to an already full day. It’s a shift in approach built on one skill most of us were never taught: body literacy. Not just noticing what your body is telling you, but actually responding to it. Because truly listening means more than hearing your symptoms and carrying on regardless. It means giving your body what it’s asking for.
These are the strategies I come back to again and again with the women I work with, because they’re the things that consistently make the biggest difference to how they feel and perform at work through perimenopause and beyond:
Read your own patterns, then act on them
Body literacy begins with noticing. In perimenopause, the signals your body sends can feel unpredictable: a wave of self-doubt that seems to come from nowhere, a week where your focus is razor-sharp followed by one where you can barely finish a sentence, energy that drops off a cliff mid-afternoon without warning. These shifts aren’t random, even when they feel like it.
The first step is simply to start tracking. Not just your cycle, but your experience: your energy, your mood, your focus, your sleep. When do you feel sharp? When does everything feel harder? When does the self-doubt creep in? You might notice patterns across the week, across the month, or across your 24-hour rhythm. The point isn’t to map it perfectly. It’s to start seeing what your body is telling you instead of overriding it.
But here’s where body literacy goes beyond a tracking exercise. Once you can see the patterns, the next step is to actually respond to them. If you know certain days or weeks bring a dip, that’s the time to protect your diary, go to bed half an hour earlier, and stop berating yourself for not feeling on top of the world. If you notice a window of high energy and clarity, that’s when to schedule the big presentation, the difficult conversation, the creative work. If your body is telling you it needs rest, the powerful thing isn’t to push through it. It’s to listen and adjust, even in small ways.
So many of the women I work with have spent years hearing their body’s signals and ignoring them until those signals become impossible to ignore. Perimenopause tends to turn the volume up. Rather than continually pushing through and waiting until your body is shouting to take action, the key is to start responding proactively while the signal is still a whisper.
Rethink your breakfast
This is one of the single highest-impact changes I see in practice, and it’s the one most women aren’t expecting. A breakfast built around cereal, toast or a quick bar sets you up on a blood sugar rollercoaster before you’ve even opened your laptop. You’ll crash mid-morning, reach for something sugary, crash again in the afternoon, and your focus, mood and decision-making take the hit all day.
And in perimenopause and post-menopause, blood sugar regulation starts to shift. Research from the ZOE PREDICT study found that postmenopausal women showed higher blood sugar responses after eating than premenopausal women, even when matched for age, and a separate study of over 500 non-diabetic women found that being menopausal itself, independent of age, was a risk factor for elevated fasting glucose. The differences in the research are modest, but they reflect something I see clearly on continuous glucose monitors with the women I work with: the same breakfast that kept you steady in your twenties and early thirties can send your blood sugar on a rollercoaster in your forties. And when we address that, the difference in energy, focus and mood across the day is significant.
Shifting to a breakfast based around protein and good fats, think eggs, nuts, seeds, Greek yoghurt and avocado, stabilises blood sugar from the start. What you eat at 7am will shape how you feel at 3pm. And over time, that daily stability starts to support hormonal balance across the whole month.
Build micro-moments into your working day
Through perimenopause and post-menopause, a whole accumulation of hormonal shifts, from progesterone and oestrogen to the neurotransmitters they influence, can impact our stress resilience: how well we’re able to cope with and bounce back from stress. Layer that on top of years of high performance, disrupted sleep, and the mental load that most women are already carrying, and it’s not surprising that many women end up spending their working day in a low-grade fight-or-flight state without realising it.
But thankfully, there’s more we can do about this than you might think. Research increasingly supports the idea that resolving the source of your stress and releasing that stress from your body are two separate processes. You can finish the deadline, get through the meeting, handle the difficult conversation, and your body can still be holding that tension because the physiological stress cycle was never completed.
This is why I recommend micro-moments: small, deliberate pauses during the day, two or three minutes at most, that give your nervous system a signal of safety. One technique I use with executive clients is simply lying flat, even under a desk, for two minutes. It sounds almost too simple, but lying horizontal takes you out of the fight-or-flight posture and the women who do this regularly, particularly those experiencing anxiety, say it has been transformative.
If that’s not practical for your workplace, a physiological sigh works well: a double inhale through the nose followed by a long exhale through the mouth. Research from Stanford found that practicing this for five minutes reduced stress more effectively than mindfulness meditation, but even a single breath can help in the moment.
These practices may seem like luxuries that you don’t have time for. But they’re how you complete a stress cycle your body has been holding open, possibly for hours. And that is body literacy in action: noticing the tension, and then actually doing something about it.
Pick one thing and let it compound
If there’s one message I give every woman I work with, it’s this: don’t try to change everything at once. You already have enough to manage. The compounding effect of one small, consistent shift is more powerful than a dozen changes abandoned after a week.
Maybe it’s the breakfast. Maybe it’s two minutes of lying flat between meetings. Maybe it’s simply starting to notice where you are in your cycle before you judge your own performance. Pick the one that feels achievable right now, not the most impressive one, the one you’ll actually do, and build from there.
Your body has been communicating with you for a long time. Body literacy is learning to hear it, and then learning to respond.
