Natural health: I'm a mum in my 40s and feel tired most of the time

Plus: How to pile the pressure onto piles - the natural way

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I know it’s the height of summer but I feel tired most of the time and it’s making me irritable. My life is busy — I have three young children and work full-time in a job I love. I’m in my early 40s — am I too young to be experiencing perimenopause?

You are on target for perimenopausal changes since you are in your early 40s. These changes typically begin around age 35 onwards, as levels of progesterone and oestrogen begin to decline. Fatigue is one of the many symptoms that women experience during this time, along with (but not limited to) hot flushes, night sweats, insomnia, memory loss, headaches, irritability, mood swings, breast tenderness, weight gain, vaginal dryness, bladder problems, bloating, osteoporosis, decreased libido, and changes in skin, hair, teeth and nails.

Maca powder is a remedy that addresses flagging energy levels and helps buffer hormone-related symptoms. Maca (Lepidium meyenii) is an adaptogenic root vegetable found in Peru which helps nourish the body, balance hormones, and restore sex drive. It’s a complete protein high in vitamins and minerals, including calcium and zinc.

Maca also helps to boost energy levels, improves mood, and is a powerful antioxidant, containing approximately 100 times the levels found in other cruciferous crops such as broccoli and cabbage.

Look for activated or ‘gelatinised’ (this has nothing to do with the animal by-product gelatin) maca powder, which has been prepared to release the beneficial nutrients for maximum absorption. The gelatinising or activation process is where the dried root is heated and pressurised (traditionally done by sun drying and boiling) to break the starch bonds and remove the indigestible fibres. This process creates a product ready to be used without any special preparation and is gentle on the gut, making it ideal for those who suffer from intestinal issues.

You can use maca powder in smoothies, hot drinks, porridge, muffins, bliss balls, pancakes, yoghurt or even raw chocolate. Maca pairs well with carob, cacao, chia seeds, berries, honey, nut butters, warming spices, and medicinal mushrooms to take your wellbeing to the next level. Begin with a teaspoon daily and gradually increase this until you consume a tablespoon daily.

It is essential to support your adrenal system and keep on top of your stress levels. Eating clean whole foods, exercising regularly, breathwork and meditation, drinking plenty of water, and making time to do the things you love are all important for your mental and emotional wellbeing along with physical health.

I’ve piles that occasionally flare up — the pain can be excruciating. I find taking a quick cold bath helps. What else would you recommend?

The quick cold bath is an excellent treatment, and not for the faint-hearted. You could add soothing and tonifying herbs to your bath for additional benefit — especially butcher’s broom (Ruscus aculeatus), horse chestnut (Aesculus hippocastanum), calendula (Calendula officinalis), and witch hazel (Hamamelis virginiana). Piles, or haemorrhoids, can appear internally (often the only indication of fresh blood in the stools), externally (generally very uncomfortable, painful, and can itch or burn), or you can experience a combination of both types. It is estimated that around 75% of all adults in the Western world suffer from haemorrhoids at some point in their lives, which suggests that our diets and lifestyle are far from optimal.

Fibre is an excellent way to ensure the colon functions efficiently without causing trauma to swollen veins, enabling them to heal naturally. Take 1-2 tablespoons of psyllium husks/hulls each day mixed well in a large glass of water or freshly pressed fruit/veggie juice, and drink it immediately.