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Perimenopause · 7 min read

5 perimenopause myths that keep women feeling rubbish

Tired, foggy, short-fused and wide awake at 3am — and told it’s just stress? Here’s what’s really going on, and the everyday changes that help.

By The SISTERLY team October 2026

SISTERLY founders Aoife, Jenny and Louise smiling together on the beach
SISTERLY founders Aoife, Jenny and Louise.

Perimenopause — the years of hormonal change before your periods stop — most commonly begins in your 40s, though for some women it starts earlier.2 There are over 100 recognised symptoms, they vary hugely from woman to woman, and early on they can come and go alongside a perfectly normal cycle.

So it’s no wonder many of us spend months, or even years, putting how we feel down to something else. Here are five of the most common myths — and what’s really going on.

SISTERLY The Elevator

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  • 23 vitamins, minerals and nutrients in one daily sachet
  • Vitamin B6 contributes to the regulation of hormonal activity
  • Magnesium, vitamin B12 and vitamin C contribute to the reduction of tiredness and fatigue
  • Free from phytoestrogens, iron and iodine — and can be taken alongside HRT

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Myth 1

“It’s just stress — or I’m just getting older.”

The truthFor many women, these are the first signs of perimenopause.

The SISTERLY Circle gathered in a park for a group walk
The SISTERLY Circle out on a group walk.

Women are experts at juggling, so it’s no surprise that many of us power through the early months — when tiredness, headaches, poor sleep, mood swings, cravings and changes to skin and hair can all be blamed on everything else going on in life.

If you’re in your 40s, still having periods and recognise some of these — regularly or on and off — you could be in the early stages of perimenopause. Our free Perimenopause Symptom Checklist is a simple way to keep track, and a useful thing to bring to your GP.

Since many of the early symptoms can be easily attributed to the side effects of a busy lifestyle, stressful job, frequent long-haul travel, or the demands of parenting, it may take a few months or even years for you to actually realise that the root cause of your general lack of joie-de-vivre, is, in fact, your hormones.

Susie PerryFood Scientist and Nutritional Therapist
Myth 2

“It’s all in my head.”

The truthIt’s in your brain — and that’s not the same thing.

A woman in profile with an illustration of the brain over her head

Oestrogen and progesterone aren’t just reproductive hormones. They also act on the brain, influencing chemical messengers such as serotonin (mood and sleep), dopamine (motivation and focus) and GABA, the brain’s main calming signal.1

As these hormones rise and fall unpredictably, many women notice brain fog, forgetfulness, low mood, anxiety and restless nights.3 You’re not ‘losing it’ — your brain chemistry is shifting.

What helps: regular movement (aerobic exercise is one of the best things you can do for your brain), protecting your sleep, time with the people you love, and meals built around protein, oats, seeds, oily fish and eggs.

Myth 3

“Perimenopause means hot flushes.”

The truthFor many women it starts more quietly — with poor sleep, headaches and a shorter fuse.

Women seated on yoga mats during yoga with Miriam Hussey at the SISTERLY Summit
Yoga with Miriam Hussey at the SISTERLY Summit.

Hot flushes get the headlines, but they’re often not the first sign. Progesterone — known for its calming, soothing effect — is usually the first hormone to change. With progesterone falling while oestrogen stays normal or even runs high, many women first notice headaches, tension, poor sleep, fatigue and feeling on edge.2

Oestrogen’s decline tends to be bumpier and far less predictable, which is why you can feel fine for weeks and then, seemingly out of nowhere, feel completely all over the place. Hot flushes and night sweats often come later.

Myth 4

“You have to choose between HRT and nutrition.”

The truthThey do different jobs.

HRT replaces the hormones your body is making less of, and for many women it makes a real difference.4 Body identical HRT — hormones with the same chemical structure as the ones your body makes — is regulated, licensed and available on prescription. If your symptoms are affecting your life, it’s worth a conversation with your GP.

Nutrition does a different job: HRT isn’t designed to fill nutritional gaps. And not every woman can, or wants to, take HRT or phytoestrogens — particularly anyone with a family history of hormone-related cancer. That’s why The Elevator is made without any phytoestrogens, and why it can be taken alongside HRT.

I have been taking sisterly now for almost 2 months… [I’ve] been on 100 mg HRT patch for the last 5 years which has helped hugely with all menopausal symptoms… The one sachet fits all works for me and I would highly recommend it to anyone.

Jane M.On HRT · Carrick-on-ShannonVerified buyer
Myth 5

“Any multivitamin will do.”

The truthIn midlife, what’s in it — and what’s left out — matters.

The nutrients women need more of in midlife: vitamin D, selenium, B12, magnesium and CoQ10 shortfalls after 50, and how The Elevator closes the gap.

Nutritional needs shift in midlife, and studies have found low levels of vitamin D, selenium, vitamin B12 and magnesium are common in women in their 50s and beyond. So it’s worth reading the label:

  • Forms your body can use. The Elevator uses methylfolate rather than folic acid, methylcobalamin (B12) and the active form of vitamin B6.
  • Doses that mean something. Including 30µg vitamin D3 (1,200 IU), 150µg vitamin K2 (MK-7), 640mg vitamin C and 83µg selenium.
  • What’s deliberately left out. No iron — iron needs drop after menopause, and Ireland and the UK have some of the highest rates of genetic iron overload in the world. No iodine, which would rule it out for many women with autoimmune and thyroid conditions. And no phytoestrogens.

See everything in The Elevator

Dr Mandy Leonhardt, GP and female health expert, smiling outdoors under trees.
Dr Mandy Leonhardt, GP and female health expert, is one of the six experts who helped develop The Elevator.

What our customers say

Rated 4.9 out of 5 from 217 reviewsRead all reviews

I’m a 51 year old menopausal woman. I was constantly tired and brain-fogged. Having taken Sisterly for about 4 months now I am amazed at the effects. I have so much more energy… Also it is great to be able to do a monthly subscription, no fear of running out.

ChristineAge 51 · LimerickVerified buyer

I cannot speak highly enough about this product. I have tried so many supplements over the years… as a female who went into early menopause at 40, now 47 years old! I now feel after 2 months on sisterly that my energy is better… and more visibly my hair, skin and nails.

Georgie D.Age 47Verified buyer

I took The Elevator for most of 2025 trying to address a host of possible perimenopause symptoms. My energy levels… improved very rapidly… Thank you Sisterly for an excellent, convenient supplement. I can highly recommend.

Laura K.PerimenopauseVerified buyer

I love this supplement… This has helped my energy so much… More importantly it’s made for women over 30 so I know it’s not a generic product for everyone.

NatalieWitney, UKVerified buyer

Your questions, answered

Can I take The Elevator if I’m on HRT?

Yes. The Elevator contains no phytoestrogens and can be taken alongside HRT. If you take any prescribed medication, check with your GP or pharmacist before starting a new supplement.

Who is The Elevator for?

The Elevator is a daily multivitamin for women aged 18 and over, formulated with every phase of womanhood in mind — including perimenopause and the years after menopause.

How do I take it?

Mix one sachet with 100ml of water or juice each day. We purposefully left out synthetic suspension agents, so stir, shake or whisk it well before knocking it back.

Why doesn’t The Elevator contain iron?

We left iron out on purpose, because iron supplements aren’t right for every woman. The body can’t easily get rid of excess iron, and iron needs drop after menopause, so post-menopausal women are generally advised to avoid iron supplements unless they’ve been diagnosed with a deficiency. If you think you need iron, speak to your GP or pharmacist.

Can I take it during pregnancy or while breastfeeding?

No — we recommend you switch to The Booster, our multivitamin specifically designed for pregnancy and breastfeeding.

Can I pause or cancel my subscription?

Yes. You can pause or cancel anytime from your account.

One sachet. 23 nutrients. Every day.

A simple daily habit, formulated with every phase of womanhood in mind.

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Sources

  1. Barth C, Villringer A, Sacher J. Sex hormones affect neurotransmitters and shape the adult female brain during hormonal transition periods. Front Neurosci. 2015;9:37.
  2. Delamater L, Santoro N. Management of the perimenopause. Clin Obstet Gynecol. 2018;61(3):419–432.
  3. Baker FC, de Zambotti M, Colrain IM, Bei B. Sleep problems during the menopausal transition: prevalence, impact, and management challenges. Nat Sci Sleep. 2018;10:73–95.
  4. Chester RC, Kling JM, Manson JE. What the Women’s Health Initiative has taught us about menopausal hormone therapy. Clin Cardiol. 2018;41(2):247–252.

Food supplements should not be used as a substitute for a varied, balanced diet and a healthy lifestyle. Do not exceed the recommended daily intake. Suitable for adults aged 18 and over. Not recommended during pregnancy or breastfeeding. If you take medication or anticoagulants, or are under medical supervision, consult your doctor before use. This article is for general information only and is not a substitute for advice from your doctor.

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