Perimenopause Diet: What to Eat and What to Avoid

Navigating the transitional phase before the onset of menopause can be challenging, but a perimenopause diet offers a beacon of hope in managing its symptoms. 

As women approach menopause, hormonal fluctuations lead to various physical and emotional changes. Fortunately, a balanced and nutritious diet can work wonders to help alleviate bothersome symptoms, such as unwanted weight gain, vasomotor symptoms, and body mass loss.

Before we explore what to eat and what to avoid for a perimenopause diet, let’s first review what perimenopause is and the connection between it and nutrition. 

What Is Perimenopause?

Perimenopause is the period leading up to full menopause, marking the time when a woman's body begins to produce less estrogen and progesterone. During this transition, a woman's body undergoes changes that mark the end of her reproductive years. Perimenopause can last for several years and is marked by irregular menstrual cycles until they cease altogether. Hot flashes, mood swings, weight gain, and changes in sleep patterns are common symptoms during this time. It typically starts in a woman's 40s but can begin earlier for some individuals.

Can a Healthy Perimenopause Diet Alleviate Symptoms? 

During perimenopause, the ovaries produce less hormones. Estrogen levels fluctuate and eventually decrease as a woman's body heads toward menopause. These falling estrogen levels have various effects on the body. One is a decrease in leptin, the hormone that suppresses appetite. This drop can lead to an increase in hunger and cravings and subsequent weight gain and body composition changes.

Diet can significantly impact perimenopause and vice versa. The effect of hormones on food preferences, cravings, and overall dietary habits can have an impact on a woman’s overall health. Some women may experience changes in appetite, while others may experience decreased appetite. Fortunately, food intake holds an invaluable key for managing common symptoms. 

Proper nutrition, staying hydrated, and maintaining a healthy weight can positively impact the perimenopausal experience for women. Additionally, avoiding certain foods and beverages that can exacerbate symptoms is paramount. Next, we'll explore how to feel your best with a healthy perimenopause diet.

Perimenopause Diet: What to Eat and What to Avoid

What to Eat on a Perimenopause Diet:

1. Protein: During perimenopause, it's important to maintain a healthy and balanced diet that includes an adequate amount of protein. Primal protein sources such as red meats, lean meats, fish, eggs, and nuts can help support muscle mass, bone health, and overall well-being during this transitional phase. A review published in Nutrients in January 2024 found that optimal protein intake is between 0.8 to 1-1.2 g/kg/day. A paper published in 2022 from the University of Sydney concluded that hormonally-induced tissue protein breakdown can contribute to menopause weight gain. The researchers found that increasing the proportion of protein in your diet by around three percent of daily energy intake helps counteract this.
2. Omega-3 fatty acids, known for their anti-inflammatory properties, may help alleviate symptoms of perimenopause, such as mood swings and joint pain. Consuming foods rich in omega-3 fatty acids, such as fatty fish (salmon, mackerel, sardines), flaxseeds, and chia seeds, or taking omega-3 supplements may offer some relief during this stage. The recent review in Nutrients recommends at least two servings per week of deep-sea fish with fatty meat (e.g., salmon, mackerel, tuna, herring, and sardines) or freshwater fish (e.g., trout and silver carp).
3. Calcium: During perimenopause, calcium becomes particularly important for maintaining bone health. As estrogen levels decrease, the risk of osteoporosis and bone fractures increases. Adequate calcium intake, vitamin D, and regular weight-bearing exercise can all help support bone health during this stage of life. Good primal dietary sources of calcium include sardines with bones, leafy greens, almonds, and sesame seeds.
4. Vitamin D can be particularly important for women going through perimenopause. It plays a vital role in hormone regulation and can also help support bone health. Ensuring you get enough through sunlight exposure and/or supplementation is essential. Additionally, some research suggests that adequate vitamin D levels may help alleviate symptoms of perimenopause.
5. Fiber: It's common for women to experience changes in their digestive health during perimenopause. Hormonal fluctuations can impact digestion and lead to symptoms such as bloating, constipation, or diarrhea. Including high-fiber foods in your diet can help support digestive health during this time. Fiber can help manage weight, reduce cholesterol levels, and regulate bowel movements. Some good primal sources of fiber include berries, avocados, apples, different vegetables like sweet potatoes and kale, and cruciferous vegetables such as broccoli and Brussels sprouts. Nuts and seeds like almonds, chia seeds, and flaxseeds are also good primal sources of fiber.
6. Hydration: Staying well-hydrated is critical during perimenopause. The hormonal changes during this time can lead to an increased risk of dehydration, so it's essential to drink plenty of water throughout the day. Dehydration can exacerbate symptoms such as hot flashes and mood swings. Maintaining good hydration levels can help manage any discomfort. It is helpful to be mindful of your fluid intake, especially if you're experiencing symptoms like night sweats or increased urination. Additionally, consuming hydrating foods such as fruits and vegetables can also contribute to your overall hydration. Estrogen and progesterone also significantly impact fluid and electrolyte balance. It's recommended that an intake of 33 mL/kg/day of water is required to maintain hydration and balance during perimenopause.

What to Avoid on a Perimenopause Diet:

1. Sugar: During perimenopause, you must be mindful of your sugar intake and aim to mitigate blood sugar spikes. Hormonal fluctuations and imbalances during this time can lead to increased cravings for sugary foods. Additionally, excessive sugar consumption can impact insulin levels and contribute to weight gain. A diet high in sugar may also worsen perimenopausal symptoms and exacerbate mood swings, fatigue, and hot flashes. A study published in The American Journal of Clinical Nutrition found that a diet high in sugar increased the risk of hot flashes and night sweats. Maintaining a balanced diet with little to no sugar is crucial to help manage these symptoms and support overall well-being during perimenopause.
2. Alcohol consumption can have a significant impact on perimenopause due to shifting hormones. It can aggravate symptoms such as hot flashes, night sweats, and mood swings. Additionally, alcohol can interfere with hormone levels and disrupt sleep. Sleep is already a common issue during perimenopause. It's important to be mindful of alcohol intake during this stage and to prioritize overall health. Many women also find they have a reduced tolerance to alcohol during perimenopause and in menopause.
3. Excess Caffeine consumption can have different effects on women going through perimenopause. What was once a routine pick-me-up may become a bothersome boost for your symptoms. While some women may find that caffeine exacerbates their perimenopausal symptoms, such as hot flashes and insomnia, others may not notice a significant impact. Many women may find that their sensitivity to caffeine changes as they go through perimenopause. It's essential to pay attention to how caffeine affects your body during this time and make adjustments as needed. Green tea is lower in caffeine and has been shown to help improve bone density, an added bonus.
4. Processed foods can have a significant impact on perimenopause. The high levels of refined sugars, unhealthy fats, and artificial additives in processed foods can intensify perimenopausal symptoms and lead to increased belly fat and weight changes. Opting for whole, unprocessed foods can support hormone balance and overall well-being during this transitional phase. Additionally, trans fats are believed to reduce serotonin, which can lower mood and cause memory problems, both common complaints during perimenopause.

Summary 

Perimenopause does not need to be the nightmare it is made out to be. Symptoms are bothersome and unwanted, but they are manageable and easily reduced with modifications to diet and lifestyle factors. Nutrition counseling and following the simple healthy eating guidelines outlined above can help relieve symptoms and make this period of life for middle-aged women much easier than it’s made out to be.