Perimenopause & Menopause Diet: Nutrition and Lifestyle Tips
Dietary recommendations
Phytoestrogens and hormonal balance
Perimenopause is a transitional phase with fluctuating hormone levels, and eating a well-balanced diet with nutrient-rich foods can support overall wellbeing. Phytoestrogens are plant compounds that mimic oestrogen and may help regulate hormones and improve symptoms of hormonal decline.1 Include foods rich in phytoestrogens, such as soya (tofu, tempeh, edamame, miso), flaxseeds, sesame seeds, chickpeas, lentils and other legumes.
Stabilise blood sugar levels
Blood sugar fluctuations can impact mood, energy levels and weight. Focus on whole foods, fibre-rich meals, and balanced protein intake to maintain stable blood sugar levels. Avoid refined sugars and processed foods that cause spikes and crashes in blood sugar.
Reduce inflammation
Chronic inflammation can worsen symptoms like fatigue and joint pain. Include anti-inflammatory and antioxidant-rich foods such as leafy greens, berries, nuts, seeds, turmeric and ginger to help reduce the oxidative stress and inflammation associated with menopause.2
Optimise gut health
A healthy gut supports hormone metabolism and overall health. Incorporate probiotic-rich foods like yoghurt, kefir, sauerkraut, and kimchi, along with prebiotic foods like garlic, onions, and asparagus.
Hydration
Drink plenty of water throughout the day. Hydration modulates vasomotor symptoms, aids thermoregulation, supports digestion, and counteracts skin dryness and transepidermal water loss caused by low oestrogen.
Limit triggers (spicy foods, alcohol, caffeine and sugar)
Reduce or avoid spicy foods, caffeine, alcohol and excess sugar. These can trigger or worsen hot flushes and night sweats, disrupt sleep, contribute to mood disturbances and swings, disrupt hormone balance and raise the risk of cardiovascular disease.
Manage weight and metabolism
Hormonal changes can slow metabolism and lead to weight gain. Stay active and focus on a high-quality diet.
Focus on protein intake
Protein is needed for the creation of hormones and for maintaining muscle health and mass. Ageing women require enough protein to prevent sarcopaenia – aim for 1.0-1.2 grams per kilogram of body weight per day, from sources such as beans, lentils, nuts and seeds.
Increase fibre-rich foods
Fibre from vegetables, fruits, legumes and whole grains supports digestion, heart health, satiety and weight management.
Healthy fats and omega 3 fatty acids
Cardiovascular health is a priority after menopause, as the risk for heart disease increases. Healthy fats from avocados, olive oil and nuts help balance hormones. Omega 3 fatty acids found in flaxseeds, chia seeds and walnuts have heart protective properties, support brain health and hormone balance, and reduce inflammation.3
Consume foods rich in calcium & magnesium
Calcium and magnesium ensure bone health and reduce the risk of osteoporosis, which increases with age and declining oestrogen levels. Sources include leafy greens, nuts, seeds and fortified plant milks.4
Vitamin D and K2-rich foods
Supports calcium absorption and bone strength. Found in fortified leafy greens and fermented foods.5
Lifestyle recommendations
Weight-bearing, strength training and regular exercise
Physical activity helps with weight management, mood, stress, metabolism and heart and bone health. Weight-bearing and strength training exercises are essential for musculoskeletal health, especially during and after menopause. These include resistance training, weight lifting and bodyweight exercises (such as squats, lunges and push-ups), as well as weight-bearing activities such as walking, jogging and dancing. This mechanical load stimulates muscle growth and enhances bone density, helping to maintain strength and stability and reduce the risk of osteoporosis and sarcopaenia.6 Yoga and stretching improve flexibility and reduce stress, aerobic exercise supports heart health and mood, and regular exercise such as walking or yoga can reduce the frequency and severity of hot flushes.
Manage stress and practice relaxation techniques
High and chronic stress has a negative effect on hormones, exacerbating hormonal fluctuations and symptoms like hot flushes, mood swings, anxiety, irritability and fatigue. Active relaxation techniques such as mindfulness, meditation, deep breathing and journaling help reduce stress and anxiety, regulate cortisol levels and promote hormonal balance.7
Prioritise good-quality sleep
Perimenopause can bring sleep disturbances, and poor sleep can worsen hormonal fluctuations and increase fatigue. Aim for 7-9 hours of quality sleep per night.8 Improve sleep hygiene by maintaining a consistent sleep schedule, keeping your bedroom cool and dark, limiting screen time before bed, avoiding stimulants like caffeine in the evening and avoiding heavy meals late at night.
Support brain and mental health
Cognitive changes, brain fog and mood swings are common. Engage in mentally stimulating activities, stay socially connected, and ensure adequate intake of brain-supporting nutrients like Omega 3 fatty acids, B vitamins and magnesium.
Social connection and emotional wellbeing
A supportive network provides emotional support, reduces isolation, enhances quality of life, improves cognitive function and reduces the risk of dementia. Stay socially active and connected with friends, family and support groups to share experiences and receive support. Empowerment and coping strategies, and education and awareness about menopause, can help women understand their current life stage and make informed decisions about their health. Support and professional guidance from healthcare providers or a therapist can help women cope with the emotional and physical changes of this life stage.
Monitor health changes
Regular health check-ups are helpful to keep an eye on hormone levels, bone density and cardiovascular health.
Support diurnal rhythms
Exposure to morning sun and regular meal timing helps regulate cortisol and melatonin production and anchors metabolic activity.
Reducing xenobiotic exposure
This minimises the impact of environmental toxins on health for menopausal women who may be more sensitive to endocrine disruptors.
Weight management
Maintaining a healthy weight reduces the risk of cardiovascular disease, insulin resistance and joint pain, which are more common postmenopause.9
Quit smoking
Smoking accelerates oestrogen depletion and increases the risk of cardiovascular disease, while excessive alcohol consumption can worsen sleep disturbances and hot flushes.10