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Perimenopause & menopause

Perimenopause and menopause support that looks at the whole picture

Hot flushes, poor sleep, anxiety, brain fog and weight gain aren't something you just have to put up with. I look at your hormones alongside your gut, thyroid, stress and blood sugar, because they all shape how you feel through perimenopause and beyond.

Book a free discovery call

Free, no obligation. First consultation £354, including a health coaching session. See fees

20+ years in clinical practiceIFM Certified PractitionerBritish Acupuncture Council member

Smiling woman in her fifties sitting calmly, representing confident midlife health

The short answer

How can functional medicine help with perimenopause symptoms?

By looking beyond oestrogen. Hot flushes, poor sleep, anxiety, brain fog and weight gain are linked to changing hormones, but gut health, thyroid function, blood sugar and stress all affect how strongly you feel them. Charmaine Shepherd tests hormones in more detail, then builds a plan around nutrition, lifestyle and targeted supplements. She doesn't prescribe HRT, but works alongside your GP or menopause specialist.

WhoCharmaine Shepherd, IFM Certified functional medicine practitioner, 20+ years in clinical practice
Where4 Albyn Place, Edinburgh EH2 4NG, or online by video
CostFree 20-minute discovery call. Initial consultation £354, return visits £264
ReferralNot needed. You can book directly

Is this you?

Do these perimenopause symptoms sound familiar?

Hot flushes and night sweats
Waking at 3am, or poor sleep
Anxiety, irritability or low mood that feels new
Brain fog or forgetting words
Heavier, irregular or more painful periods
Weight gain around the middle
Low libido, vaginal dryness or bladder changes
Joint aches, palpitations or tiredness

If any symptoms are sudden or severe, contact your GP, call NHS 24 on 111, or call 999 in an emergency.

Is perimenopause just low oestrogen?

Perimenopause can start in your early forties, often years before periods stop. Hormones swing up and down rather than simply falling, which is why symptoms can change from month to month, and why a single blood test may be described as "normal".

How you experience this transition also depends on other systems. The gut helps your body process and clear oestrogen. Thyroid function, cortisol and blood sugar all affect energy, mood, sleep and weight. Nutrient levels such as iron, B12 and vitamin D matter too.

I'm not against HRT. For many women it makes a real difference, and I'm happy to work alongside your GP or menopause specialist. My role is to understand everything else that is going on, so that whatever route you choose works as well as it can.

Looking for the cause

What makes perimenopause symptoms worse?

Most people have more than one contributing factor. The aim is to find yours, so treatment targets the cause rather than just the symptoms.

Fluctuating hormones

Oestrogen, progesterone and testosterone change at different rates, affecting cycles, sleep and mood.

The gut-hormone link

The gut bacteria that process oestrogen (the estrobolome) affect how your body balances and clears it.

Thyroid & adrenals

Thyroid problems are common in midlife and look very like menopause symptoms.

Blood sugar & weight

Insulin resistance becomes more likely as oestrogen falls, making weight harder to manage.

Brain & mood

Hormone changes affect neurotransmitters, so anxiety, low mood and brain fog are common.

Heart & bone health

Lower oestrogen raises long-term heart and bone risk, so it's a good time for prevention.

How I investigate

Which hormone tests are useful in perimenopause?

Depending on your symptoms and stage, testing may include:

Comprehensive hormone profilese.g. Menopause, Menopause Plus or Complete Hormones (DUTCH-style) testing of oestrogen, progesterone, testosterone, cortisol and how you metabolise them
Full thyroid panelTSH, free T4, free T3, reverse T3 and thyroid antibodies
Oestrogen metabolism and gut testingto see how your body processes and clears oestrogen
Metabolic and nutrient markersblood sugar, insulin, iron, B12, vitamin D
Heart and bone riskCarotid artery scan and bone resorption testing where appropriate

Tests are priced separately and always agreed with you first. Bring any recent NHS or private results to your consultation. See all laboratory tests

How it works

How does working with Charmaine work?

Free discovery call

Free · up to 20 minutes

Tell me what’s going on and find out whether my approach is right for you.

Initial consultation

£354 · includes health coaching

A detailed look at your history, symptoms and lifestyle, with tests recommended only where they will help.

Your plan & follow-up

Return visits £264

A written plan covering nutrition, lifestyle and targeted supplements, reviewed as your results and symptoms change.

In person at 4 Albyn Place, Edinburgh, or online by video. See all fees

Case study

How Charmaine helped Aime avoid disability and live her happiest life yet

3 min readRead →

A patient story

"I thought: I'm perimenopausal, I just need to get on with it"

Aime, in her early fifties, put her tiredness and poor memory down to perimenopause until leg cramps left her on crutches. Targeted testing found low vitamin D, low B12 and a hormone imbalance. Within two months she was back at work and driving. In her words: "I feel happier and healthier than I have done for decades."

Read the full case study →

Everyone is different, and results vary from person to person.

Free PDF guide

The missing link: your gut and perimenopause

How your gut could be driving bloating, brain fog, anxiety and other perimenopause symptoms.

A symptom checklist you can tick through
What the 2026 study of 964 women found
Five ways oestrogen and the gut affect each other
Practical first steps, and when to look further

Questions

Questions about perimenopause and menopause

Can’t see your question? Book a free call or ring the clinic on 0131 235 1232.

See also: Menopause workshops · Health coaching

Do you prescribe HRT?

No. I don't prescribe medication, but I work alongside your GP or menopause specialist. Many of my patients use HRT, and I help with the gut, thyroid, nutrient and lifestyle factors that affect how well it works.

My GP says my hormone blood test is normal. Is it worth testing again?

Often, yes. A single blood test in perimenopause only captures one moment, while hormones fluctuate. More detailed testing also shows how you metabolise hormones and what else, such as thyroid or cortisol, may be contributing.

Can you help if I can't or don't want to take HRT?

Yes. There is a great deal that nutrition, gut health, targeted supplements, stress support and sleep can do. We'll look at your options together.

Is there a group programme?

Yes. I run menopause workshops from time to time. See the events page for current dates.

Can I be seen online?

Yes. Consultations work well by video, and hormone test kits are posted to your home.