Empowering Perimenopause: A Dietitian Nutritionist's Guide to Optimal Nutrition and Lifestyle
A Major Life Transition
Life is full of transitions like puberty, graduations, becoming a parent, etc. Perimenopause, the transition away from our reproductive years, is perhaps the least anticipated and least celebrated life transition. A lot of information about perimenopause on the web is packed with negativity and a sense that women in this phase are past their prime. I’m here to tell you that you can take charge of this period of your life. Own this new freedom and navigate this period with grace and strength. Reject the negative noise and celebrate your strengths. At this point in your life, you are smarter, you have wisdom and experience, you do what you want, and you care less about what other people think. That is sexy and badass. Rather than seeing our bodies as failing and problematic, we can prioritize listening to our bodies and nourishing our symptoms for optimal strength and well-being during this time.
Perimenopause is a unique journey for every woman. During this time hormonal fluctuations can bring about many physical and emotional changes. These changes are signals that some things need to change in order to support our bodies in this next season of life. As a registered dietitian nutritionist specializing in women's health, I'm here to guide you through this transformative phase. In this blog, we will explore essential nutrition and lifestyle strategies to help you thrive and own your power in perimenopause.
Understanding Perimenopause
Perimenopause typically starts in a woman's late 30s to early 40s but can begin earlier or later. It is marked by irregular menstrual cycles, hormone fluctuations, and the onset of various symptoms, including hot flashes, mood swings, changes in sleep patterns, vaginal dryness, and weight gain (especially around the middle). During the perimenopause phase, the ovaries begin producing fluctuating amounts of estrogen and progesterone until they no longer produce these hormones. Many of the symptoms of perimenopause are due to this fluctuation. Cycles typically start to get shorter in the early stage of perimenopause and then they get further apart until they cease completely. Perimenopause continues until menopause, which is defined as 12 consecutive months without a menstrual period.
One important function of estrogen is to assist with blood sugar balance. When estrogen is in a state of fluctuation and decline, it causes insulin resistance. What this means is that glucose is not able to enter our cells to give us energy and it gets stored instead as fat, particularly around our middle. Fluctuations in blood sugar cause fatigue, cortisol spikes, cravings, more frequent hunger and worsen symptoms of perimenopause. It is especially important during this phase of life to stabilize blood sugar levels. This is something I can help with. Teaching women to understand their bodies and how to choose foods to support their symptoms and biology is my passion.
Before we take a look at nutrition and lifestyle strategies to improve symptoms, it’s important to understand that no one expects you to take on all these changes at once. Life is busy enough during this time and making too many changes can be overwhelming. Pick one area to work on over the next few weeks or months. Commit to one achievable goal and after you have mastered this goal, start thinking about what you can work on next.
Nutrition During Perimenopause
Balanced Diet: A well-balanced diet is the cornerstone of good health during perimenopause. A balanced meal balances blood sugars. Prioritize whole foods like fruits, vegetables, whole grains, lean proteins, and healthy fats. Eat 3 balanced meals per day. Fill half your plate with non-starchy vegetables. Fill 1/4 of your plate with starchy vegetables or grains. Fill 1/4 of your plate with protein.
Protein: Increasing your protein intake can help preserve muscle mass, which tends to decline with age. Opt for lean sources like poultry, fish, beans, and tofu. Include protein foods with all meals. Breakfast is the meal most likely to be skipped or exclude protein, but starting your day with protein lowers your risk for blood sugar spikes and crashes throughout the day.
Calcium and Vitamin D: These nutrients are critical for bone health, especially during perimenopause when the risk of osteoporosis increases. Incorporate dairy products (if tolerated), leafy greens, broccoli, seeds and nuts into your diet. Sunlight and supplements can provide vitamin D.
Phytoestrogens: Phytoestrogens are incredibly helpful for managing symptoms. They have a similar structure to estrogen. Sources include edamame, organic tofu, organic soy milk, flaxseed, sesame seeds, garlic, and cruciferous vegetables.
Omega-3 Fatty Acids: Found in fatty fish, flaxseeds, and walnuts, these healthy fats can reduce inflammation, support heart health, and potentially alleviate mood swings.
Eat More Seeds: Consume some combination of seeds every day. Vitamin E and Omega fats in flaxseeds, sesame, pumpkin and sunflower seeds can support healthy hormone levels.
Eat More Fiber: Increasing your fiber keeps your bowels moving, your microbiome nourished, blood sugars balanced, reduces inflammation and keeps your cholesterol in check. It also helps balance your hormones and can help with weight management. Fruits, vegetables, psyllium husk and flaxseeds are good sources of fiber to add to your diet. Increase your daily fiber a little more each week.
Eat more anti-oxidants: Cherries, Blueberries, Raspberries, Blackberries, Granny Smith Apples, Oranges, Cherry Tomatoes, Beans, Seeds, Green Tea, Dark Chocolate, Pomegranates. Lower inflammation and oxidative stress (both promote aging) with these foods.
Meal timing: Consuming a higher proportion of energy early in the day, limiting meals to 3 per day, and fasting in the late evening are associated with reduced inflammation, improved circadian rhythms, stress resistance, and improved gut microbiome in the perimenopause phase.
Hydrate: Proper hydration is essential for overall health and can help relieve hot flashes. The sensation of thirst can diminish with age. This means you may not feel thirsty when your body is actually needing more fluid. Aim for at least eight glasses of water per day.
Don’t hate me, but I have to include this one. Consider limiting sugar, processed foods, alcohol and hot beverages: Reducing sugar, processed foods and alcohol in your diet can reduce inflammation. Inflammation is the root cause of many health issues and is particularly damaging to our ovaries. Hot beverages can cause increased and more severe hot flashes.
Lifestyle during Perimenopause
Build a positive relationship with your body. There is so much negativity and insecurity surrounding bodies in this phase of life thanks to a culture that celebrates thin bodies. We were not meant to look like 20-year-olds throughout our entire lives. You don’t have to love your body, but you can make peace and let go of impossible expectations for your body. You can intentionally provide loving care for your body. Your body has carried you all over this amazing life and supported every physical action along with all your life experiences. It may have created and nurtured your children. It may have taken you on adventures. It may have supported you through good and bad times. It deserves kindness and compassion. It deserves loving care. Start each day with a moment of appreciation for everything your body has supported. Then create an intention of caring for your body in some way.
Keep Moving: All movement supports mental health, sleep, libido and cardivascular risk. High intensity interval training has been shown to be especially effective in these areas for perimenopausal women. Strength training improves muscle mass, metabolism, blood sugar balance and bone density which are all particularly important during perimenopause and beyond. Improving your strength and mobility can help you build a positive relationship with your body. Alternate between cardiovascular exercise, and strength training.
Mind Your Stress: Chronic stress can exacerbate perimenopausal symptoms. The body prioritizes making stress hormones above producing estrogen and progesterone. There is a lot going on during this time as we juggle aging parents, transitioning children and busy careers. Finding time for movement can both strengthen your body and reduce your stress. Incorporate relaxation techniques such as meditation or breathwork when you can. For example, you can do breathwork while you are showering or waiting in line. Even a few minutes per day makes a difference. Staying present and practicing mindfulness can lower your stress as well.
Prioritize Sleep: Hormonal changes can disrupt sleep patterns during perimenopause. Prioritize sleep hygiene by establishing a regular bedtime routine, avoiding blue light before bed, and creating a cool and comfortable sleep environment.
Mind-Body Practices: Massage, tai chi, and acupuncture are practices reported to help alleviate perimenopausal symptoms. Consider these holistic approaches if they resonate with you.
Supplements for Perimenopause
Black Cohosh - This a very well-studied herbal supplement that has been shown to improve hot flashes, sleep, and mood.*
Phytoestrogens - Has been shown to reduce hot flashes, improve insulin resistance, reduce weight gain, and may improve vaginal dryness.*
Adaptogens - There are a variety of adaptogens that can improve, memory, stress levels, and well-being in perimenopause and beyond.*
There are a variety of herbal supplements that can relieve symptoms of perimenopause.*
Targeted supplements based on nutrient deficiencies, and lab values. It is extremely common for women to have nutrient deficiencies that contribute to fatigue and poor health.
*A dietitian nutritionist can help you choose targeted supplements in the correct doses that are best for your symptoms, and health status and compatible with current medications.
Embracing Change with Confidence
Perimenopause is a natural and inevitable phase of life, offering opportunities for growth, self-discovery, and new adventures. By nourishing your body with specific nutrients, staying active, managing stress, and seeking support when needed, you can transition through perimenopause with confidence and grace. If you feel like you are ready to make some changes, but don’t know where to start, book an appointment with me. I would love to help guide you in making changes that fit into your life’s framework.
Remember that everyone's experience is unique, and what works for one person may not work for another. Listen to your body, be patient with yourself, and seek guidance from a dietitian nutritionist who can help tailor your nutrition and lifestyle choices to your individual needs. With the right strategies in place, you can own this transformative phase of life and emerge stronger and more vibrant on the other side.
Georgina accepts many insurance plans including Aetna, Blue Cross Blue Shield, Cigna and United Healthcare. Coverage varies with each individual plan, but many plans provide nutrition counseling benefits. Call your insurance company and ask if you have nutrition counseling benefits.