Understanding perimenopause

Perimenopause is considered a precursor to menopause. This phase can last years before your period ceases for good. Although the length of time women spend in this transitional phase varies, the natural body processes at play are largely the same.

During perimenopause, a woman’s estrogen and progesterone start to fluctuate. Overall, these hormones levels are decreasing. Estrogen levels may go up and down a bit more before leveling out as your body settles into menopause. These natural hormone fluctuations of perimenopause can often cause different symptoms for different women.

Some common symptoms of perimenopause include:

  • irregular periods, which includes changes in flow or frequency
  • vaginal dryness
  • mood changes, including irritability or depression
  • hot flashes
  • night sweats, which may inhibit sleep

After you have gone 12 consecutive months without a menstrual period, you’ve reached menopause.

Although you can’t stop nature from taking its course, you can take this time to reflect on your diet and lifestyle habits. What you eat and do to stay active can help you live a happy and healthy life through perimenopause and beyond.

Diet and lifestyle may not be a cure-all for everything that ails you. Still, the choices you make each day about how you eat and how you live can make a big difference in your quality of life. Focusing on the right foods and making the right choices can help prepare you for long-term health as you enter this phase of your life. You may even find relief from some of the uncomfortable symptoms that perimenopause can cause.

First, you should assess your overall lifestyle. If you smoke cigarettes, now is a great time to quit. If you don’t exercise regularly, now is the time to start. It can do your body a world of good.

Take a brisk walk on your lunch. Do some lunges while you’re watching your favorite TV show. Small steps are the best way to long-term success. Each step will get you that much closer to a healthy weight, if you’re looking to lose a few pounds. If you’re overweight, moving more may help you see results faster than dietary changes alone.

What to add

  1. Protein
  2. Omega-3 fatty acids
  3. Fiber
  4. Calcium
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When it comes to healthy eating, it’s helpful to look at all the foods you should be eating versus the few foods that lack nutritional value. Fruits, vegetables, whole grains, and low-fat dairy are all good choices.


Perimenopause is a time when your body is going through numerous changes. Because of those changes, your body could use a little bit more of certain nutrients. For example, your muscle mass starts to decrease during perimenopause. So you’ll want to up your daily intake of protein, says Sonya Angelone, M.S., R.D.N., C.L.T., a San Francisco-based dietitian. Protein can assist in maintaining muscle mass.

With fluctuating hormones, balance is the name of the game. Protein can also help by regulating appetite and blood sugar levels. It may even help balance your hormone levels.

To get maximum benefits, Angelone recommends spreading your protein intake out over three meals and a snack. Instead of plain toast, top it with some peanut butter. Add baked salmon or chicken to a salad for a protein boost at lunch. For dinner, beans are a great protein add-in for any number of entrees, including tacos. Make your own nut mix, with your flavor of spices, for a perfect anytime snack. Eggs, lentils, and yogurt are other great high-protein choices.

Omega-3 fatty acids

Omega-3 fatty acids have been associated with decreased inflammation, as well as improved moods. Omega-3s have also been linked to decreased depression, which is something many women experience during perimenopause.

Angelone recommends two 4-ounce servings of fish per week. You can also talk to your doctor about taking fish oil supplements. Another option is adding flaxseed oil into your diet to combat mood swings and irritability.


Fiber is another go-to during perimenopause. It helps keep you feeling full longer, which can curb cravings. This will go a long way toward weight-loss efforts, which can be especially tough as you age and your metabolism slows down.

Fiber has also been shown to decrease your risk of certain diseases of aging, notes Angelone. These include heart disease, stroke, and cancer.

You should aim for at least 21 grams of fiber each day. Fruits and vegetables are a great place to find fiber. Whole grains and beans are also good source. In general, the more processed an item is, the less fiber it’ll offer.


As you age, your risk of osteoporosis increases. To keep your bone health in check, up your intake of calcium to 1,200 milligrams daily. Vitamin D is also important in this regard. You’ll want to check with your doctor for individualized recommendations, as not all physicians agree on the optimal intake for bone health.

What to limit

  1. Saturated fats
  2. Highly refined carbohydrates
  3. Caffeine
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No one wants to be given a long list of foods they can’t have, but let’s face it: Not all foods do your body good. In general, saturated fats from meat and dairy products increase your risk for heart disease. Choose plant-based fats when you can.

Also limit highly refined carbs, such as white breads, pasta, and baked goods, to avoid blood sugar spikes and constant cravings. Substitution is an important factor here. For example, you can make it a habit to substitute whole grain brown rice for white rice.

Sugar, caffeine, and alcohol can exaggerate hormone symptoms, Angelone says, so limit these whenever possible.

As you enter perimenopause, there are a few things you can do to stay healthy and relieve symptoms:

  • Quit smoking if you smoke cigarettes.
  • Exercise regularly.
  • Eat more protein, omega-3 fatty acids, fiber, and calcium.
  • Limit saturated fats, highly refined carbs, and sugar.
  • Limit caffeine and alcohol.

In this phase of your life, your body will go through a number of hormonal changes. These changes may also be accompanied by symptoms such as hot flashes and mood swings. Eating well and being active can help make this transition as smooth as possible.