Perimenopause and Immunity: Why Autumn and Winter Can Feel Harder (and How Herbs Can Help)

Have you ever noticed that as autumn arrives, your energy seems to disappear with the daylight?

You wake up tired, even after what should have been a full night's sleep. Your body feels slower to recover from busy days. Perhaps you're reaching for another coffee by mid-afternoon, struggling with broken sleep, or finding the darker mornings particularly difficult.

And if you're in your 40s or 50s, you might be wondering whether perimenopause has something to do with it.

It certainly can.

What many women don't realise is that oestrogen does far more than regulate the menstrual cycle. It also communicates with the immune system, influences inflammation and helps maintain the health of certain protective tissues.

Meanwhile, autumn and winter bring their own physiological challenges: less daylight, changes in circadian rhythms, drier air and increased exposure to seasonal respiratory viruses.

Put these together, and it becomes easier to understand why some women find this time of year particularly demanding.

But here's something important: perimenopause doesn't automatically mean your immune system is weak.

The real story is far more interesting.

1. Your Hormones and Immune System Are Constantly Communicating

We tend to think of oestrogen as a reproductive hormone.

Yet oestrogen receptors are found throughout the body, including on immune cells such as macrophages, T lymphocytes and dendritic cells.

This means that oestrogen is involved in regulating how the immune system responds to potential threats, communicates through inflammatory signals and maintains balance between different types of immune activity.

One particularly important hormone is oestradiol (E2), the main form of oestrogen during the reproductive years.

During perimenopause, oestradiol doesn't simply decline in a straight line. Its levels can fluctuate considerably, sometimes rising higher than expected before falling again.

These changes can influence several physiological systems, including immune regulation.

Research suggests that declining oestrogen signalling around menopause may contribute to changes in inflammatory activity and immune-cell function. However, these effects are complex and overlap with changes associated with ageing, metabolism and body composition.

In other words, it isn't as simple as saying that less oestrogen means less immunity.

The immune system needs balance, not constant stimulation.

An effective immune response must recognise and respond to threats while avoiding unnecessary inflammation.

And this brings us to an often-overlooked part of winter wellbeing: the environment your immune system has to work in.

2. Why Autumn and Winter Change the Way Your Body Functions

As the seasons shift, several things happen simultaneously.

Less daylight influences your internal body clock

Your circadian rhythm is the approximately 24-hour biological system that helps regulate sleep, alertness, body temperature, hormone secretion and aspects of immune function.

One of its most important signals is light.

When natural light reaches your eyes, it helps synchronise the brain's central circadian clock with the external day.

During autumn and winter, shorter days and reduced time outdoors can make that synchronisation more challenging, particularly if you spend most of your day inside.

This doesn't mean everyone needs to wake at sunrise or follow an elaborate morning routine.

But regular exposure to natural daylight, especially earlier in the day, can help reinforce the signals that tell your body when to be awake and when to prepare for sleep.

And during perimenopause, when sleep may already be disrupted, these signals can become especially valuable.

Cold, dry air affects the respiratory tract

Your nose and airways have their own protective system.

A layer of mucus helps trap particles and microorganisms, while microscopic hair-like structures called cilia help move that mucus towards the throat, where it can be cleared.

This process is known as mucociliary clearance.

Cold, dry conditions can interfere with aspects of this protective mechanism. Research also suggests that low humidity can affect local antiviral defences in the respiratory tract.

At the same time, respiratory viruses spread more readily under certain winter conditions, and we often spend more time indoors with other people.

So winter immunity isn't only about what is happening inside your immune cells.

It's also about the physical barriers that help protect you in the first place.

And that is particularly interesting from a herbal medicine perspective.

3. Your Mucous Membranes Deserve More Attention

When we talk about immune health, the conversation usually turns immediately to vitamin C, zinc or supplements.

But some of the body's most important defences are found at its surfaces.

Your mucous membranes line areas including the nose, mouth, respiratory tract, digestive system and urogenital tract.

They do much more than provide a physical barrier.

They also contain specialised immune cells, protective secretions and antimicrobial substances that contribute to local defence.

Oestrogen plays an important role in maintaining several mucosal tissues, particularly those of the vaginal and urinary tract.

As oestrogen levels change during the menopausal transition, women may notice dryness, irritation or increased susceptibility to urinary tract infections.

The relationship between perimenopause and respiratory mucosal immunity is less clearly established, so we shouldn't assume the same hormonal effects occur throughout every mucosal surface.

However, the importance of supporting healthy mucous membranes during the colder months is well worth understanding.

Where herbal medicine becomes interesting

In traditional Western herbal medicine, we often select herbs according to their specific actions rather than treating every seasonal symptom with the same so-called 'immune-boosting' blend.

For example, a dry, irritated throat is very different from a productive, mucus-filled cough.

Marshmallow root (Althaea officinalis) contains mucilage, a group of water-loving polysaccharides that form a soothing, gel-like preparation when extracted into water.

Traditionally, marshmallow root has been used to relieve irritation of the mouth and throat and associated dry cough.

Its value lies primarily in its demulcent, or soothing, action — rather than in any claim that it stimulates the immune system.

Thyme (Thymus vulgaris), on the other hand, has a long history of use in respiratory herbal medicine.

Its aromatic constituents include thymol and carvacrol, and thyme preparations are traditionally used for productive coughs associated with colds.

These are two completely different herbal approaches.

And that's something I wish more women understood: the best herb isn't necessarily the one marketed as the strongest immune booster. It's the one that suits the person, the symptoms and the intended therapeutic action.

4. Your Gut Is Part of the Immune Conversation

The digestive system is home to an extensive network of immune cells, tissues and microorganisms.

Your intestinal immune system has a remarkable job: it needs to tolerate food and beneficial microbes while remaining capable of responding to potentially harmful organisms.

Your gut microbiota plays an important role in this balance.

When certain beneficial bacteria ferment dietary fibre, they produce compounds called short-chain fatty acids (SCFAs), including butyrate.

Butyrate provides fuel for cells lining the colon and participates in maintaining the intestinal barrier and regulating immune responses.

This is one reason why I encourage women to think beyond isolated supplements and consider the diversity of foods they eat.

Legumes, oats, vegetables, nuts, seeds and whole grains provide different types of fibre that can nourish different microbial communities.

What about the estrobolome?

You may have heard about the estrobolome — the collection of microbial genes involved in oestrogen metabolism.

Certain gut bacteria produce enzymes, including beta-glucuronidase, that participate in the processing and potential recirculation of oestrogens through the gut.

It's a fascinating connection between microbiology and hormonal physiology.

However, research is still developing, and we don't yet have evidence that one particular diet or supplement can reliably 'reset' the estrobolome or prevent perimenopausal symptoms.

What we do know is that a varied, fibre-rich diet supports important aspects of gut health.

And during autumn and winter, seasonal vegetables make this wonderfully practical.

Think roasted squash, lentil stews, cabbage, leeks, onions, root vegetables and warming soups with generous amounts of culinary herbs.

Sometimes the most useful seasonal practices are also the simplest.

5. The Overlooked Link Between Sleep and Immunity

If there is one area I would encourage women in perimenopause to pay particular attention to during autumn and winter, it's sleep.

Not because sleep is a magic solution to every health concern.

But because sleep is an active biological process that contributes to immune regulation, recovery and metabolic health.

During sleep, the immune system undergoes changes in cell activity and signalling that help coordinate its responses.

Research has also found an association between shorter sleep duration and a greater likelihood of upper respiratory tract infections.

Now consider what happens during perimenopause.

Night sweats, hot flushes and repeated awakenings can interrupt sleep. Some women also develop difficulties falling asleep or staying asleep even without obvious night sweats.

Poor sleep can leave you feeling exhausted, less resilient and more sensitive to everyday demands.

And as the mornings become darker, maintaining a consistent sleep-wake rhythm can become harder.

This is why I don't believe seasonal wellbeing should begin and end with a cupboard full of immune supplements.

If you're waking at 3 am, struggling through the afternoon and relying on caffeine to function, your sleep deserves just as much attention as your vitamin intake.

Importantly, persistent sleep problems shouldn't simply be dismissed as a normal part of getting older. They deserve proper assessment and support.

6. Five Ways to Support Your Body Naturally This Autumn and Winter

Rather than trying to stimulate your immune system, I prefer an approach that supports the conditions in which it functions.

1. Make morning daylight part of your routine

Try to spend some time outdoors during the first part of the day, even when it's cloudy.

Natural outdoor light is generally much brighter than ordinary indoor lighting and helps provide a useful signal to your circadian system.

2. Nourish your gut with seasonal diversity

Aim for variety rather than perfection.

Try adding lentils to soup, oats to breakfast, roasted root vegetables to dinner, or a small portion of fermented food if you tolerate it.

The goal is to provide the nutrients and fibres that help support normal gut function.

3. Consider your vitamin D intake

In the UK, sunlight between October and early March is generally insufficient for the skin to produce adequate vitamin D.

The NHS recommends that adults consider a daily supplement containing 10 micrograms (400 IU) during autumn and winter.

Vitamin D is important for normal immune function, as well as bone and muscle health, but larger doses are not automatically better.

4. Choose herbs for their actions, not their marketing

A few botanicals worth getting to know this season include:

• Thyme (Thymus vulgaris) — traditionally used for productive coughs associated with colds.

• Marshmallow root (Althaea officinalis) — rich in mucilage and traditionally used to soothe dry throat irritation.

• Ginger (Zingiber officinale) — a warming aromatic herb containing gingerols and other biologically active compounds.

• Rosehips (Rosa canina) — a seasonal source of polyphenols, carotenoids and variable amounts of vitamin C.

Each brings something different.

None needs to be presented as a miracle immune booster.

Medicinal doses, concentrated extracts and multi-herb preparations may not be appropriate for everyone, particularly during pregnancy or when taking medication.

5. Give your sleep the same attention as your nutrition

If your sleep has become fragmented, consider what might be contributing.

Are night sweats waking you?

Has your bedtime become irregular?

Are you getting enough daylight?

Is late-afternoon caffeine interfering with sleep?

Or are you spending eight hours in bed but waking unrefreshed?

Different causes call for different solutions.

And that is exactly why personalised approaches matter.

A Final Thought: Your Body Doesn't Need to Be Pushed Harder

Autumn can be a beautiful season for slowing down, enjoying warming foods and reconnecting with familiar herbal traditions.

But if you're navigating perimenopause, it can also be a time when existing sleep and energy difficulties become more noticeable.

The answer isn't necessarily another supplement, a more restrictive routine or a complicated wellness protocol.

Sometimes, it begins with understanding what your body is experiencing.

Your hormones, immune system, digestive health and circadian rhythms don't operate independently. They're constantly interacting.

And while we can't control every seasonal change, we can support the foundations that help our bodies function well.

For me, that's what thoughtful herbal medicine is about.

Not forcing the body to do more, but understanding its physiology and choosing supportive interventions with intention.

Struggling With Sleep and Low Energy in Perimenopause?

If you're waking in the middle of the night, feeling exhausted despite spending enough time in bed, or wondering why your energy has changed so much, I've created something to help you take the first step.

My free Sleep & Energy Guide explores practical ways to better understand your sleep and energy during perimenopause, with a focus on gentle, realistic strategies you can begin incorporating into everyday life.

Because supporting your body isn't about doing everything at once.

It's about knowing where to begin.

Get your free Sleep & Energy Guide →

With care,

Aleksandra
Founder of Herbedies | Biologist, Certified Herbalist & Naturopath, Menopause Caoch 

Educational note: This article provides general information and is not a substitute for individual medical advice. Persistent fatigue, repeated infections or significant sleep problems should be assessed by an appropriate healthcare professional. Herbal medicines may have contraindications and interactions.