Episode 42: Perimenopause, Progesterone & the Nervous System
Healthily | 07/31/26
In Episode 42 of Healthily, Nicola is joined by nutritional therapist and functional medicine practitioner Gemma McGuigan to explore what's really going on in perimenopause. Together they unpack why progesterone is so often the first hormone we lose, why the nervous system tends to reveal underlying health issues during this transition, and why so much mainstream advice around fasting, cold exposure and cortisol doesn't serve women well. Gemma also shares practical, evidence-informed guidance on eating for metabolic flexibility and supporting natural progesterone production.
"Perimenopause is a stage of life. It's not a condition." Gemma McGuigan joins Nicola to explain why progesterone — not just oestrogen — deserves our attention first, and why the nervous system is so often where perimenopause shows up before anywhere else.
TAKEAWAYs
✔️ Perimenopause is a temporary, transitional life stage — not a diagnosis — and can begin from age 35 onwards
✔️ Progesterone is typically the first hormone to decline, often linked to anovulatory cycles
✔️ Progesterone and progestin (as used in the Mirena coil) are not the same, and have different effects on the body
✔️ The nervous system often reveals underlying health issues during perimenopause, from thyroid function to gut health
✔️ Cortisol's primary role is blood sugar regulation and stress management — not something to fear, but something to understand
✔️ Fasting, cold exposure and other biohacking trends designed with male physiology in mind can push women into a hypercortisol state
✔️ Metabolic flexibility can be supported through a "keto-flexi" style plate: good quality fats and proteins, a small portion of low-GI complex carbohydrate, and half the plate as fibre-rich vegetables
✔️ Fuelling before exercise — rather than training fasted — helps prevent unnecessary muscle breakdown
✔️ Ovulation can be supported through balanced blood sugar, good sleep, stress reduction, and (where appropriate) herbal support.
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