Most women have a sense that their hormones are doing something. They feel it in the way their energy shifts across the month, in the skin that changes with age, in the sleep that becomes unsettled or in the moods that arrive without an obvious cause. What fewer women have a clear picture of is how those hormones change across different life stages.
For Dr Sonia Davison, Endocrinologist and part of the endota Wellbeing Conversation, women’s hormonal health is a lifelong story. Having spent over two decades working in this field, she has consistently seen women navigate significant hormonal transitions while simultaneously managing everything else life asks of them. “It’s an absolute pleasure to look at women’s hormones,” she says, “to care for their health and help them age gracefully, naturally and safely.”
What follows is a guide, from the first period to menopause and beyond, and an invitation to see the shifts along the way not as problems to solve but as a rhythm worth understanding.
the beginning: puberty and the first cycle
For most women, the hormonal story begins somewhere in early adolescence with the first period. It’s the moment the body’s monthly rhythm starts up for the first time, with oestrogen and progesterone beginning a cycle that will continue in different forms, for decades.¹
Testosterone also enters the picture early and this is something most women don’t know. Dr Davison’s research on over 1,400 Australian women found that testosterone actually peaks in women around the age of 20, shaping mood, energy, sexual function and brain function in ways that go largely unrecognised.²
With so much happening hormonally, the early years can be unpredictable. Cycles may be irregular at first and PMS can emerge as the body settles into its rhythm.³ Understanding these early shifts can be the first step toward a more compassionate relationship with your own body.
the reproductive years: working with the cycle
For most women, their 20s and 30s are often the most hormonally settled decades. Oestrogen and progesterone find a predictable monthly rhythm and many women begin, sometimes without even realising it, to notice the patterns of their own cycle. There might be a particular week where you feel your sharpest or certain days when everything feels heavier. Learning to read those signals, and to be a little kinder to yourself when the harder days arrive, is one of the more useful things hormonal awareness can offer.
What is less visible during this time and what most women are never told, is that testosterone is quietly declining throughout. From its peak at around age 20, it falls gradually through the 30s and into the 40s, reaching roughly half its original level by the time a woman turns 40, with effects on energy, libido and mood that many women may not think to connect to their hormones.²
For some, this stage also includes pregnancy and the postpartum period, when oestrogen and progesterone drop sharply after birth, contributing to mood changes and fatigue that are physiological, not personal.⁴ Dr Davison sees the cumulative weight of all this regularly. “Women are often juggling careers, family, young children, dependents, others with health issues, ageing parents,” she says. “They've got these raging hormones at times.”
the transition: perimenopause
Perimenopause typically begins in the mid to late 40s, though for some women it starts earlier. It is the body’s gradual wind-down of egg production and what makes it particularly unpredictable is that oestrogen doesn’t decline in a straight line. It fluctuates, sometimes significantly and those fluctuations are what drive the range of symptoms women experience during this time.
Recognising perimenopause symptoms is made harder by the fact that many women are not expecting them, or do not immediately connect what they’re feeling to their hormones. Irregular periods, hot flushes, night sweats, disrupted sleep, mood changes, brain fog and breast tenderness can all be part of the picture.⁵ Perimenopause skin changes are also common, as oestrogen’s role in collagen production and skin hydration means skin often becomes drier and less resilient as levels begin to shift.⁶
The experience is highly individual. “20% of women have severe symptoms, 20% have no symptoms at all,” Dr Davison says. “But 80% of women will have symptoms throughout this transition.” What she wants women to know is that support is available, and that navigating it alone is not necessary.
“This phase calls for a slightly different pace or way of caring for ourselves,” Dr Davison says, and that is not a small thing to acknowledge when most women at this stage are also working, caring for others and managing everything else life asks of them. “Women need to rest, to devote time to caring for themselves, otherwise their delicate machine, which is their body, will at some point become dysfunctional.” Rest and ritual carry particular weight here. The Surrender or Rejuvenate Spa Packages offer genuine restoration during a demanding transition, and the Rest & Restore range is created to bring the same intention into evenings at home.
“Women need to rest, to devote time to caring for themselves, otherwise their delicate machine, which is their body, will at some point become dysfunctional.”
menopause and beyond
Menopause is the moment the monthly cycle comes to a stop, defined as 12 consecutive months without a period. In Australia most women reach this point between 51 and 52, though it can happen earlier or later.⁷ The hormone changes at menopause are significant and it helps to understand why. Dr Davison puts it plainly: oestrogen, which sits at around 400 for a reproductive woman, sinks to an average of about 20 at menopause. “No wonder women are getting symptoms,” she says, “because their oestrogen is really just dropping right out.”
The symptoms that follow can range from mild to genuinely disruptive. Night sweats, sleep disruption, anxiety, mood changes, vaginal dryness and urinary changes are all common and well-documented.⁸
Worth knowing too is that testosterone continues its own quiet decline, hitting a further low around age 65 and bringing with it changes to energy, mood and cognition that often go unrecognised.² It is a second shift worth being aware of rather than dismissing.
Post-menopause also brings its own freedoms. “When women shift out of reproductive mode, they're essentially post-menopausal,” Dr Davison says. “These women have valuable life experience, wisdom and are free of the challenges of periods, hormonal fluctuations, PMS, endometriosis, and concerns about fertility.” And as she puts it, “when we start viewing menopause as a natural evolution and we start going with the flow, having knowledge about the changes in our bodies and our hormones, it's a much easier process to deal with.”
This is also a stage where taking time for yourself starts being a genuine act of maintenance. The Hot Stone Massage and Organic Relax Massage offer the kind of restorative warmth that supports nervous system regulation and for skin that needs more nourishment than it once did, the Organic Infusion Facial is a considered place to start.
the thread that runs through it all
Across every stage, Dr Davison returns to the same themes: “Our bodies are like a machine,” she says. “We need to look after that machine. And machines need rituals. They can’t go full bore or they will run out of steam.” The fundamentals that support hormonal health are not complicated: movement, nourishment, rest, reduced stress and reduced toxic load. “We know that if we are more balanced, our hormones actually work better,” she says.
She is also generous in her encouragement to women who feel they have fallen behind or left things too long. “Women do feel empowered when they take hold of their health and when they do make even small changes,” she says.
For women exploring menopause wellness in Australia and wanting to learn more, the endota Wellbeing Conversation offers expert-led guidance from Dr Davison and the other expert contributors.
Wherever you are in your hormonal life, understanding it is a form of care. And that understanding, as Dr Davison has spent over two decades showing, is always worth seeking.
frequently asked questions
What hormonal changes should I expect in my 40s?
The 40s are typically when perimenopause begins and when hormone changes start to become more noticeable. Testosterone has already been declining gradually since its early 20s peak and oestrogen starts to fluctuate more unpredictably as egg production winds down.² Many women are surprised to find that symptoms they attribute to stress or lifestyle are hormonal in origin.
What is the difference between perimenopause and menopause?
Perimenopause is the transition leading up to menopause, typically lasting several years, during which oestrogen fluctuates widely and symptoms can be unpredictable.⁵ Menopause is defined as 12 consecutive months without a period, after which oestrogen stabilises at a significantly lower level.⁷ The years that follow are referred to as post-menopause.
How do I know if my symptoms are hormonal?
Symptoms including disrupted sleep, mood changes, irregular periods, fatigue, brain fog and changes to skin or libido can all have a hormonal basis, particularly from the 40s onward. If something feels different and is affecting your daily life, it is worth raising with your GP rather than dismissing it.
Does testosterone matter for women's health?
Yes and it is often overlooked. It plays a role in energy, mood, libido and brain function throughout a woman’s life and its gradual decline means many women do not recognise its effects until they are already significant.
How do hormones affect my skin as I age?
The connection between hormones and ageing women is particularly visible in the skin. Oestrogen plays a direct role in collagen production and hydration, which is why skin often becomes drier and less resilient as levels decline through perimenopause and beyond.⁶ Adapting skincare to meet those changing needs is one of the most practical responses available.
When should I see a doctor about my hormonal symptoms?
If symptoms are affecting your sleep, mood, relationships or daily function it’s worth having a conversation with your GP or women's health specialist.
Can lifestyle changes really make a difference to hormonal health?
Yes. Movement, nourishment, adequate rest and reduced stress all contribute to a hormonal environment that functions better.
references
¹ Biro, F. M., & Dorn, L. D. (2005). Puberty and adolescent sexuality. Pediatric Annals, 34(10), 777–784. https://doi.org/10.3928/0090-4481-20051001-11
² Davison, S. L., Bell, R., Donath, S., Montalto, J. G., & Davis, S. R. (2005). Androgen levels in adult females: changes with age, menopause, and oophorectomy. The Journal of Clinical Endocrinology & Metabolism, 90(7), 3847–3853. https://doi.org/10.1210/jc.2005-0212
³ Direkvand-Moghadam, A., Sayehmiri, K., Delpisheh, A., & Kaikhavandi, S. (2014). Epidemiology of premenstrual syndrome: a systematic review and meta-analysis study. Journal of Clinical and Diagnostic Research, 8(2), 106–109. https://doi.org/10.7860/JCDR/2014/8024.4116
⁴ Hendrick, V., Altshuler, L. L., & Suri, R. (1998). Hormonal changes in the postpartum and implications for postpartum depression. Psychosomatics, 39(2), 93–101. https://doi.org/10.1016/S0033-3182(98)71355-6
⁵ Jean Hailes for Women’s Health. (2023). Perimenopause. https://www.jeanhailes.org.au/health-topics/menopause/perimenopause
Peer-reviewed support: Hickey, M., Schoenaker, D. A. J. M., Joffe, H., & Mishra, G. D. (2016). Depressive symptoms across the menopause transition. Menopause, 23(12), 1287–1293. https://doi.org/10.1097/GME.0000000000000712
⁶ Thornton, M. J. (2013). Oestrogens and ageing skin. Dermato-Endocrinology, 5(2), 264–270. https://doi.org/10.4161/derm.23872
⁷ Jean Hailes for Women’s Health. (2023). Menopause. https://www.jeanhailes.org.au/health-topics/menopause
Peer-reviewed support: Deeks, A. A. (2003). Psychological aspects of menopause management. Best Practice & Research Clinical Endocrinology & Metabolism, 17(1), 17–31. https://doi.org/10.1053/beem.2003.0214
⁸ Avis, N. E., Crawford, S. L., Greendale, G., Bromberger, J. T., Everson-Rose, S. A., Gold, E. B., Hess, R., Joffe, H., Kravitz, H. M., Tepper, P. G., & Thurston, R. C. (2015). Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Internal Medicine, 175(4), 531–539. https://doi.org/10.1001/jamainternmed.2014.8063
⁹ Cauley, J. A. (2015). Estrogen and bone health in men and women. Steroids, 99, 11–15. https://doi.org/10.1016/j.steroids.2014.12.010
¹⁰ Muka, T., Oliver-Williams, C., Kunutsor, S., Laven, J. S. E., Fauser, B. C. J. M., Chowdhury, R., Kavousi, M., & Franco, O. H. (2016). Association of age at onset of menopause and time since onset of menopause with cardiovascular outcomes. JAMA Cardiology, 1(7), 767–776. https://doi.org/10.1001/jamacardio.2016.2415
¹¹ Jean Hailes for Women’s Health. https://www.jeanhailes.org.au
Dr Sonia Davison is an endocrinologist and women’s health expert. She is part of the endota Wellbeing Conversation, a group of experts who share evidence-based insights to help people better understand how their bodies and minds work.
