Yes they can...
... and you've come to the right place for support. Here are five things you can do to support your body right now and help reduce the symptoms of perimenopause like brain fog, hot flushes and sticky weight.
You probably don't need an expert to tell you perimenopause is a significant journey in a woman’s life, bringing with it a variety of changes (and challenges) both physically and emotionally. These changes can feel overwhelming at times and, although social media is full of memes about how awful the transition to menopause is, it really is true that nutrition and lifestyle medicine can play a powerful role in helping you navigate this stage of life with greater ease.
This isn’t a conversation about whether you should take HRT. That’s a conversation between you and your doctor. Regardless of whether you can, do or even want to take replacement hormones, the answer to hormone harmony lies in the food you eat and how well you look after your body.
In this blog, I’ll share five practical steps you can take right now to support your body during perimenopause. Before we start, there are some things to get straight.
What is perimenopause and am I in it?
You don’t have to wait for hot flushes, brain fog or night sweats to take over to be in perimenopause. ‘Perimenopause’ is the transition to menopause (the latter being when you’ve not had a period for a year) and it can last five to ten years. That might not mean five to ten years of symptoms. Since the average age of menopause is 51, if you’re in your mid 40s, whether you’re experiencing severe symptoms or not, you will be in perimenopause. You do not have to wait for a doctor to ‘diagnose’ you with perimenopause to start making changes that will benefit you.
What comes after menopause? Menopause is a single day - the day you are 12 months since your last period. After menopause, you are postmenopausal. Many women will find their symptoms ease off at this point, while others will experience ‘menopausal symptoms’ for a little longer and some for a lot longer. The key determining factors are your nutrition and lifestyle, and your genes. I'm going to be talking about food and lifestyle in this blog, but you can check out the page on DNA if you want to explore what's going on with your genes.
Is HRT the only way to manage menopause?
HRT involves replacing one or more of the hormones your body used to make in plentiful supply in your younger years. These are commonly oestrogen and progesterone together, sometimes only oestrogen, and sometimes you might be prescribed testosterone as well. While taking HRT is the only way you can actually replace lost hormones, many of the symptoms of menopause experienced at this time can be managed by changing your diet and tweaking your lifestyle.
What are the main changes I need to know about in perimenopause?
Oestrogen, one of the main female hormones, provides you with protection from cardiovascular disease and osteoporosis, among other things. Lower oestrogen levels are also linked to insulin resistance and this, along with declining muscle mass as you age, has an impact on your body’s response to the food you eat. Declining oestrogen also impacts how your body handles stress. Essentially, you become less resilient to stress as you get older. What this means for you is that you will need to do things a little differently than you did before. But the message I want you to take from this blog is that, now knowing where you might be vulnerable, you are forearmed and can tweak what needs tweaking to minimise or improve any symptoms you might be having. Knowledge is power, and all that.
1. Balance your blood sugars to help reduce perimenopause symptoms
Maintaining stable blood sugar levels is crucial during perimenopause. Fluctuating blood sugars can lead to energy crashes, mood swings, and increased cravings, all of which can make menopausal symptoms feel more intense.
How to balance blood sugars:
Eat regularly: aim for balanced meals with a mix of protein, healthy fats, and fibre to slow the release of sugars into your bloodstream. Ideally three meals a day and no snacks.
Limit refined sugars: reduce your intake of sugary snacks and drinks, which can cause spikes and drops in blood sugar levels.
Include complex carbs: focus on whole grains, legumes, and vegetables, which provide sustained energy. Ditch the 'simple' refined carbs like white bread, pasta, rice and sweet stuff (in all its forms).
2. Choose a Mediterranean diet the the menopause years
The Mediterranean diet is renowned for its health benefits for all kinds of ills and especially for women going through perimenopause. It's not the kind of food you get in your local pizzeria. Instead, this way of eating emphasises whole foods that are rich in nutrients, antioxidants, and healthy fats, all of which can support hormonal balance and reduce inflammation (the latter also rises during this stage of your life).
Key components of the Mediterranean diet:
Good quality protein (from chicken, meat, fish, eggs, tofu, chickpeas, lentils, etc) forms the building blocks for many important things in the body, like your muscles and your hormones. It also helps balance your blood sugar levels by slowing down the speed at which sugars (whether they come from fruit and veg, or a bar of chocolate) empty into your bloodstream.
Fruits and vegetables: these are backed with inflammation-quelling, disease-fighting antioxidants. Aim for a colourful variety to get a range of vitamins and minerals plus important phytonutrients that can help reduce inflammation.
Healthy fats: include sources like olive oil, nuts, seeds, and oily fish such as salmon, fresh tuna, mackerel and trout to support heart and brain health. The omega 3s in oily fish, flaxseeds, chia seeds and walnuts are also great for dampening inflammtion that runs riot at this stage of life.
Whole grains and legumes: provide fibre for digestive health and help regulate blood sugar levels - but eat these with a source of protein.
3. Eat phytoestrogens
Phytoestrogens are plant-based compounds that can mimic the effects of oestrogen in the body, helping to balance hormone levels naturally during menopause. Including these in your diet may help reduce hot flushes and other menopausal symptoms.
Sources of phytoestrogens:
Soy products: tofu, tempeh, and edamame are excellent sources.
Flaxseeds: ground flaxseeds can be added to smoothies, salads, or yoghurt.
Legumes: chickpeas, lentils, and beans are rich in phytoestrogens.
4. Prioritise stress relief
Your body in perimenopause is less resistant to stress so you will need to ensure you make stress relief important in your daily life rather than something you will add to your list of chores and get to it if you have time.
Stress can exacerbate perimenopausal symptoms, so it’s important to find ways to counteract its effect. Chronic stress can lead to hormone imbalances, sleep disturbances, and weight gain. When I say stress, this does not have to mean the ‘big stuff’ like bereavement, divorce or a house move. The relentlessness of day-to-day worries is just as important.
Stress relief techniques:
Mindfulness and guided meditation: incorporate deep breathing or mindfulness practices to calm the mind. These encourage slowing down your breathing while you do them which can have an impact on your heart rate variability (HRV). If you have wearable devices like a smart watch, or smart ring, or even use wellness apps that measure HRV, you will be able to see for yourself how the magic works by testing before and after meditation.
Guided meditation is - hands down - the quickest and most effective way of reducing stress, and it takes just 10 minutes.
Physical activity: regular exercise, like walking, yoga, or swimming, can reduce stress and improve mood. While running and high intensity training is good for your cardiovascular system, it does place additional stress on your system so this doesn’t count for the purposes of stress relief. In midlife, think getting your steps in, lifting weights (at home or in the gym) and pilates or yoga for staying stretchy.
Connect with others: social support is key; spend time with friends or join a community group. You might have heard the saying, it takes a village to raise a child. Consider, it takes a village to get through the transition to menopause, too. I'm not just talking about finding besties to bitch about your symptoms with but friends to laugh with for the bants and for relieving stress.
5. Ensure you get quality sleep to improve perimenopause symptoms
Sleep disturbances are common during perimenopause, but getting adequate rest is essential for overall health. Sometimes middle-of-the-night waking is down to your blood sugar levels, and this is why eating as I described earlier, is helpful for getting better sleep as well as flushes and so on.
Poor sleep can worsen symptoms like mood swings, fatigue, and weight gain. It’s not just the amount of time you geographically spend in bed that matters but the sleep you’re actually getting and the quality of your sleep. The most restorative sleep is deep sleep, and you stand the greatest chance of getting more of this when you go to bed before midnight, according to The Sleep Foundation. If you have a sleep app on your phone, or you have a smart ring (like Oura), you will be able to see how diet and lifestyle changes you make affect the different sleep sages.
Tips for better sleep:
Create a sleep routine: go to bed and wake up at the same time each day to regulate your body’s internal clock.
Limit caffeine and alcohol: both can interfere with sleep quality, especially when consumed later in the day.
Relax before bed: wind down with a relaxing activity like reading, stretching, or taking a warm bath. TV is not on this list as the blue light can impact how well you sleep.
Limit scrolling on your phone before bed: this might seem a good way to wind down but the blue light from your phone may disrupt sleep hormones. Scrolling also provides a dopamine hit, and this keeps you scrolling longer. The reason this is important is that dopamine is a daytime hormone - the opposite of what you want when you’re trying to wind down. It leaves you looking for 'what's next', which also keeps you scrolling for far longer than you initially intended.
As you navigate perimenopause, remember that your body has unique needs, and small changes can make a big difference. Nutrition and lifestyle medicine can help support your body through this transition and improve your overall wellbeing.
Just as a little reminder, if we've not met before and you've navigated to this page from Google, my name is Ailsa Hichens and I’m a midlife nutritionist & nutrigenomics expert dedicated to supporting women through perimenopause, menopause and post menopause.
All my programmes are designed to help you feel great. Here's an overview of the programmes and products I offer.
My signature high-level 1:1 programme The Midlife Method runs over three months and is a truly transformational experience. We have 7 consults to work on your diet and lifestyle as a whole. It's a completely personalised experience designed to work on every aspect of your health,so that you can regain your confidence and getting ready for your better second half. Find out more and apply here.
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