Perimenopause Specialist in Chorleywood, Hertfordshire
Supporting women through perimenopause with personalised nutrition, functional testing, and evidence-informed lifestyle guidance
Perimenopause is one of the most significant hormonal transitions a woman will experience, yet it is one of the least well supported by conventional medicine. Many of my clients arrive having spent years managing symptoms including disturbed sleep, weight gain, low mood, hot flushes, brain fog, anxiety, erratic periods. It is common to be told by your GP that your bloods are normal and that this is simply what getting older feels like.
It is not, and it does not have to be your experience.
I am Angela Loftus BSc, PGDip, DipION, CFMP — a fully qualified Nutritional Therapist and Certified Functional Medicine Practitioner registered with BANT and CNHC, based in Chorleywood, Hertfordshire. I have spent over ten years working with women at every stage of hormonal change, with perimenopause being one of my primary areas of specialism. I work with clients in person in Hertfordshire and online throughout the UK.
What is perimenopause, and why does it affect us so much?
Perimenopause is the transition phase leading up to menopause, typically beginning in a woman’s early to mid-forties, though for some women it can start in their late thirties. It ends when a woman has gone 12 consecutive months without a period, at which point she is considered to have reached menopause. The perimenopause itself can last anywhere from two to twelve years, and for many women the symptomatic period is at its most intense during this phase rather than after it.
What drives perimenopause symptoms is a pattern of hormonal fluctuation rather than straightforward decline. Progesterone tends to fall first, often from the mid-thirties onwards as ovulation becomes less consistent and luteal phase progesterone output drops. Oestrogen, rather than declining steadily, fluctuates dramatically; rising higher than normal before dropping lower, sometimes within the same cycle. This unpredictability is what makes perimenopause so disorienting and why symptoms can feel so inconsistent from week to week.
These hormonal shifts do not happen in isolation. They affect your sleep, your metabolism, your blood sugar regulation, your gut microbiome, your thyroid function, your bone density, and your cardiovascular risk profile. Perimenopause is a whole-body transition, and it responds best to a whole-body approach.
Supporting oestrogen metabolism and clearance
The liver plays a central role in processing oestrogen, while the gut helps eliminate it from the body through the bowel. When this process is impaired, through poor diet, dysbiosis, or compromised liver function, spent oestrogen can be reactivated and recirculated, worsening oestrogen dominance symptoms such as heavy periods, bloating and breast tenderness. I focus on supporting both pathways through diet, including cruciferous vegetables, fibre, and probiotic and prebiotic foods.
Blood sugar regulation
Oestrogen has a stabilising effect on insulin sensitivity especially in key organs like muscle, the pancreas and the liver and when oestrogen drops at perimenopause, blood sugar regulation becomes more challenging and less stable. This in turn drives a classic weight gain pattern of fat accumulation around the abdomen as well as contributing to energy crashes, mood instability and poor sleep. Stabilising blood sugar is one of the most impactful early interventions I make with perimenopausal clients.
Bone and cardiovascular health
Oestrogen is protective of both bone density and cardiovascular health. Its fluctuation during perimenopause marks the beginning of an elevated risk period for both, which is why this stage of life, not after menopause, is the time to make dietary changes as well as changing your weekly exercise routine to include weight bearing and plyometric exercises like skipping, hopping or investing in a rebounder.
My approach to perimenopause nutrition
No two women experience perimenopause in exactly the same way, and my approach reflects that. I do not offer a generic perimenopause protocol. I work to understand your specific hormonal pattern, your current nutritional status, your lifestyle, your health history. I take into account other factors such as thyroid function, gut health, stress load, and sleep quality, which can influence how you experience this transition.
My starting point is always a thorough assessment of your current diet and lifestyle, your symptom history, and any recent blood results. From there, I develop a personalised nutrition programme that works with the hormonal changes of perimenopause rather than trying to suppress them.
The core nutritional principles I work with during perimenopause include:
Protein and muscle preservation
Declining oestrogen accelerates the loss of muscle mass, which in turn slows metabolism and increases cardiovascular risk. Adequate protein intake – typically higher than most women are currently eating – is central to preserving muscle, supporting energy levels, and maintaining metabolic health through this transition.
Gut health and the oestrobolome
The gut microbiome plays an important role in oestrogen regulation through a group of bacteria known as the oestrobolome. These bacteria produce enzymes that influence how oestrogen is metabolised and recirculated in the body, helping to regulate oestrogen levels. Dysbiosis – an imbalance in the gut microbiome – can disrupt this process, potentially affecting oestrogen levels and hormone balanceI frequently find that supporting and improving gut health can have a meaningful impact on hormone balance during perimenopause, which is why it is an important area I explore with my clients.
About Angela Loftus
Angela Loftus BSc, PGDip, DipION, CFMP is a fully qualified Nutritional Therapist and Certified Functional Medicine Practitioner registered with BANT (British Association for Nutrition and Lifestyle Medicine) and CNHC (Complementary and Natural Healthcare Council). She is based in Chorleywood, Hertfordshire and works with clients both in person and online across the UK.
Angela has spent ten years working with over 1,000 clients, with a specialism in female hormone health across every life stage from PMS and PCOS in younger women, through to perimenopause and menopause using personalised nutrition, targeted supplementation and functional hormone testing.
To discuss your specific goals and learn more about how I can help, why not book in for a FREE no obligations phone call using the form below: