23/10/2026
Not oestrogen After All: a perimenopause case study
FIT, HEALTHY & EXHAUSTED: WHY PERIMENOPAUSE ISN'T ALWAYS WHAT IT SEEMS.
Being fit is not the same as feeling well.
I recently saw a Fitness Instructor in her mid-forties who was slender, very fit, ate a well-balanced home-cooked diet and took sensible supplements such as vitamin D and magnesium. She came to me for perimenopause support. She had tiredness, irritability, palpitations, breast tenderness and broken sleep around her period, all of which looked like oestrogen dominance.
Her DUTCH test told a different story. DUTCH is an at-home dried urine test that measures your s*x hormones, how your body is breaking them down, and your cortisol rhythm through the day. Her oestrogen was healthy and well metabolised. The real driver was low adrenal output. Her stress-response system had turned itself down, and this in turn reduced the signal to her ovaries to make oestrogen, progesterone and testosterone.
So instead of treating oestrogen, we supported her adrenals. She had a herbal adaptogenic tonic, high-dose vitamin C and more protein across three meals a day, and she slightly lightened her teaching schedule.
Within a month she said she felt like her old self. Her energy was back, she was sleeping through the night, and the palpitations and breast tenderness had gone.
You can read the full blog to which this post relates, on https://thebroadstreetpractice.co.uk/blog/perimenopause-fatigue-and-the-dutch-test
If your energy, sleep or cycle has changed and you want to understand why, I offer DUTCH testing with a full herbal consultation in The Broad Street Practice, Stamford. You can contact reception on 01780480889 if you would like to talk through whether DUTCH testing is right for you, or book a menopause initial consultation.
Helen Shardlow MNIMH, Plant Medicine UK
