1 hr 3 minEarly Signs of Perimenopause and How to Manage Them
With Hatty McCafferty
Guest on the show
Hatty McCafferty
Hatty McCafferty is a London-based certified menopause consultant, personal trainer, former film and TV producer and host of the Real Menopause Talk podcast.
Episodes with Hatty McCafferty
1 hr 3 minWhat Hatty talks about
Ep. 207: Early Signs of Perimenopause and How to Manage Them
Nikkiey Stott sits down with Hatty McCafferty, a certified menopause consultant, personal trainer and host of the Real Menopause Talk podcast. Hatty went from a single mom who felt like she was 241 at age 41 to someone who trains four to six times a week. She only recognized her own perimenopause symptoms after studying menopause to support her clients. Together they tackle the biggest myths: that HRT is a silver bullet, that strength training will make you bulky, and that midlife is the doom years.
Hatty walks through the early signs that often show up before your cycle changes: sleep disruption, especially waking between 1 and 3 a.m., skin changes, digestive shifts and fatigue. Her advice is to track your cycle in detail. She shares simple stress tools you can use anywhere, like a four-in, two-hold, six-out breath and a two-minute body scan. For physical symptoms, she explains how she uses cruciferous vegetables, enough protein from breakfast onward, steady blood sugar and strength training.
The episode closes with Hatty's first season as a bikini masters bodybuilder at 51, where she won Welsh and British titles. She shares why she did it, what it taught her about discipline, and why any woman who wants to compete should find a prep coach who knows how to look after older women.
- Track your menstrual cycle and symptoms in as much detail as you can, even with a free app, because early perimenopause changes can be as small as one day's difference in cycle length.
- Hatty says sleep disruption, often waking between 1 and 3 a.m., is usually the first sign of perimenopause, ahead of noticeable cycle changes, along with skin changes, digestive shifts and fatigue.
- In moments of stress, breathe in for four counts, hold for two and breathe out for six to calm your nervous system. You can do it anywhere, including when you wake in the night.
- Try a two-minute meditation: sit against a wall with a timer and slowly scan your body from the top of your head to the soles of your feet.
- When symptoms come in clusters, pick the three that trouble you most, research every option, and remember you can change your mind at any point.
In Hatty's words
Questions Hatty helps answer
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Menopause & Perimenopause Weight Loss
What are the first signs of perimenopause?
According to guests on The WarriorBabe Show, the first signs usually aren't hot flashes or missed periods. Dr. Jolene Brighten says falling progesterone shows up first as worsening PMS, irritability, breast tenderness and waking at night before your period, sometimes from 35. Hatty McCafferty adds sleep disruption, skin changes, digestive shifts and fatigue.
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Menopause & Perimenopause Weight Loss
How much protein do women in menopause need?
Nikkiey's recommendation is about one gram of protein per pound of body weight, so a 150-pound woman aims for roughly 150 grams a day, and that target stays the same through menopause. Guests on The WarriorBabe Show land in a similar range, and several say most women are eating far too little.
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Common questions
What are the first signs of perimenopause?
Hatty says cycle changes are rarely the first thing women notice. Sleep disruption usually comes first, often waking between 1 and 3 a.m. Other early signs include drier skin or unexpected breakouts, digestive changes, shifts in your circadian rhythm and fatigue.
How long does perimenopause last?
Hatty explains it can last roughly four to 12 years. She says it can begin up to four years earlier for Black, Latina and Asian women, and symptoms can continue for years after menopause.
Is HRT the answer to menopause symptoms?
Hatty, who notes she is not a doctor, says HRT can be transformative for some women and has a place in the toolkit, but it isn't a silver bullet and doesn't suit everyone. She says finding the right practitioner, dose and method matters, and diet, exercise and lifestyle habits still do the heavy lifting.
How much protein should women in perimenopause eat?
Hatty says most of her clients don't eat enough protein. Her rough guide is about one gram per pound of body weight, so a 160-pound woman would aim for about 160 grams, spread across four or five palm-sized portions a day starting at breakfast.
Can diet help with hot flashes?
Hatty explains that big blood sugar spikes and drops make night sweats and hot flashes more likely. Starting the day with protein and avoiding a pattern of sugary snacks helps keep blood sugar steadier.
Can you compete in bodybuilding after 50?
Hatty competed in her first season as a bikini masters bodybuilder at 51 and won titles. Her advice is that you have to really want it, and you should find a prep coach with real experience looking after older women's heart, thyroid and gut health.