Perimenopause: What Your Body Is Trying to Tell You
What is perimenopause?
The average age of menopause is around 51, but the journey towards menopause can begin many years earlier. For many women, perimenopause starts during their 40s, when fluctuating hormones can cause symptoms long before periods stop completely.
Common symptoms
Changes to your menstrual cycle - the length, flow, frequency and timing
Poor sleep
Fatigue
Brain fog
Mood changes
Anxiety/irritability
Changes in body composition
Increased abdominal fat
Hot flushes/night sweats
Headaches
Changes in libido
Joint/muscle aches
‼️ One important caveat ‼️
Although cycle changes are common in perimenopause, don't automatically assume every change is hormonal. Very heavy bleeding, bleeding between periods, bleeding after sex or significant changes in your usual pattern should be discussed with your GP, particularly if they are new or persistent.
How you can support your body through nutrition
🥚 Prioritise protein
Protein becomes particularly important as we age because maintaining muscle mass and strength becomes more challenging.
Aim for +1g of protein per kg of body weight. Healthy sources include eggs, greek yoghurt, cottage cheese, fish, seafood, chicken, lean meat, tofu, tempeh, quinoa, edamame, beans, lentils, chickpeas, nuts and seeds.
Pairing protein with meals can also help with satiety and blood sugar management, which may be particularly useful if you're experiencing changes in appetite or body composition.
🌱 Increase your fibre
Fibre supports gut health, bowel regularity, cardiovascular health and healthy cholesterol levels. It can also help you feel fuller after meals.
Aim to include plenty of vegetables, fruit, wholegrains, beans, lentils, chickpeas, nuts and seeds.
If you're currently eating very little fibre, increase it gradually and drink plenty of fluids to minimise bloating and digestive discomfort.
🦴 Bone support
The decline in oestrogen around menopause can contribute to increased bone loss, making bone health increasingly important.
Include calcium-rich foods such as milk, cheese, greek yoghurt, calcium-fortified plant milks, calcium-set tofu, sardines, leafy green vegetables, sesame seeds and tahini.
Vitamin D is also important. In the UK, supplementation is generally recommended during the autumn and winter months, and some people may need it year-round depending on individual circumstances.
🐟 Include healthy fats
Healthy fats can help build hormones, calm inflammation, protect your heart and support brain health.
Focus on unsaturated fats from foods such as oily fish, extra virgin olive oil, avocados, nuts and seeds.
🌈 Eat the rainbow
Aim for plenty of colourful vegetables, fruit, wholegrains, pulses, nuts and seeds.
Different plant foods provide different vitamins, minerals, fibre and polyphenols, so variety is more important than focusing on one particular "superfood".
A useful goal is to increase the variety of plants you eat across the week, rather than trying to follow a restrictive diet.
☕ Limit stimulants
It’s worth paying attention to how stimulants affect you.
Some women find that caffeine or alcohol can worsen hot flushes, night sweats or sleep, while alcohol can also affect sleep quality and increase sugar consumption.
If you're experiencing symptoms, try reducing your intake and see whether you notice a difference.
Move your body regularly
Strength training becomes particularly valuable during perimenopause. As oestrogen levels fluctuate and eventually decline, women can become more vulnerable to loss of muscle mass and bone density. Resistance exercise can help support both.
Aim for strengthening activities at least 2 days a week.
You don't need to spend hours in the gym. You could use free weights, dumbbells, resistance bands and bodyweight exercises such as squats, lunges and press-ups at home.
If you're new to strength training, start gradually and focus on good technique and progressive increases in resistance.
Don’t forget cardio too! Strength training isn't about replacing cardiovascular exercise. A combination of resistance training, walking and other aerobic activity provides a rounded approach to health during perimenopause.
What about supplements?
There are an overwhelming number of perimenopause supplements promising to support everything from hot flushes and sleep to mood, energy and hormones.
But more isn't necessarily better.
A supplement may contain nutrients you genuinely need, but that doesn't automatically mean you're getting them in a useful form, appropriate dose or in a form that your body can absorb and utilise effectively.
For example, different forms of minerals can have very different absorption and tolerability, while some products contain relatively small amounts of several nutrients simply so they can make an impressive-looking list on the label.
It's also worth considering whether you actually need the nutrient in the first place. If your diet already provides sufficient amounts, taking more isn't necessarily going to provide additional benefit.
Supplements can also interact with medications or be inappropriate for certain health conditions.
It’s always preferable to take advice from a healthcare professional before spending lots of money on supplements.
Final Thoughts
You don't have to simply put up with feeling different. Understanding what is happening in your body is the first step. If you're struggling with symptoms and don't know where to start, personalised nutrition can help you identify the areas that may be worth addressing.