Your ultimate guide to nutrition for perimenopause
Perimenopause is a natural part of life. Many Eastern cultures regard this transitional stage of a woman’s life as a time for new beginnings. In traditional Chinese medicine for example it is referred to as the ‘second Spring’ and in Japan ‘konenki’ which is the word for menopause translates as ‘renewal years’. However for many women this time in life and the changes that it brings can be overwhelming. The scale of the hormonal fluctuations and the physical and mental symptoms that it can bring can feel like a rollercoaster for many women. But what role does nutrition play in this transition? Let’s have a look.
What is Perimenopause?
Perimenopause is the phase leading up to menopause, where your body gradually produces less oestrogen. This stage can last anywhere from a few months to several years, typically beginning in your 40's. Hormonal shifts and fluctuations during this time can be severe. Typically our progesterone drops first which can be destabilising for your brain and can create quite dramatic imbalances in neurotransmitter levels leading to puberty-like mood swings, anxiety, aggression (road rage anyone?) and depression.
Oestrogen can go from high to low seemingly randomly and this is what is responsible for the classic symptoms like longer and heavier cycles, night sweats and brain fog—but also many lesser-known symptoms, like increase in migraines, painful joints and itchy skin.
So, whether you opt for HRT or not we also very much need to support the body through this by focusing on the right nutrients and giving the body the care and attention it needs.
The Basics of Nutrition in Perimenopause
Perimenopause and menopause represent a pivotal time in a woman’s life, a true fork in the road for long-term health. Post menopause women are faced with increased risks of conditions like heart disease, diabetes, osteoporosis, stubborn weight gain and cognitive decline. This phase offers a crucial opportunity to start prioritising nutritional health and make proactive choices that can significantly influence well-being in the years to come. Incorporating nutrient-dense foods rich in phytoestrogens, omega-3s, B vitamins, magnesium, calcium, and vitamin D into a foundation of a nutrient rich real food diet is more important than ever. These nutrients not only help manage menopausal symptoms and support everyday wellbeing but also play a vital role in protecting against the increased risks women face post-menopause. By focusing on optimal nutrition now, women can build resilience and support lifelong health, making this a time of empowerment and positive change.
The Impact of Phytoestrogens on Perimenopause Health
Phytoestrogens are naturally occurring plant compounds that resemble oestrogen in structure and function. When you consume foods rich in phytoestrogens, they can bind to oestrogen receptors in your body, mimicking some of the effects of oestrogen. This can help to balance hormone levels, especially during perimenopause when oestrogen production declines. By doing so, phytoestrogens may alleviate some common symptoms associated with this transition, such as hot flushes and mood swings.
In addition to mimicking oestrogen, phytoestrogens can also reduce absorption of certain endocrine disrupting chemicals which are bad news for our hormones particularly those from BPA and pesticides.
You can find phytoestrogens in the following foods:
Flaxseeds: These tiny seeds are one of the richest sources of phytoestrogens, specifically lignans. Try adding ground flaxseed to your breakfast smoothies, oats, or yogurt for a nutrient boost.
Soy Products: Foods like tofu, tempeh, and edamame contain isoflavones, a type of phytoestrogen that has been shown to help manage hot flashes. Incorporating a soy-based meal a few times a week can be beneficial. This could be a tofu and vegetable stir fry or curry, adding some edamame beans to a quinoa salad, a buddha bowl or even blended into guacamole or pesto. Just cook and cool them first. You can easily source frozen edamame or soybeans in Tesco or Dunnes and in Asian stores.
Legumes: Lentils, chickpeas, and other beans are great sources of phytoestrogens and provide additional fibre and protein, making them an excellent addition to your diet.
Sesame Seeds: These seeds are also high in lignans and can easily be sprinkled on salads, added to baked goods, or used in stir fry sauces and dressings.
There’s no definitive recommended daily intake for phytoestrogens, but studies suggest that 40–70mg per day of dietary phytoestrogens may have beneficial effects on perimenopausal symptoms, such as hot flashes, mood swings, and bone health. This intake can typically be achieved through a balanced diet rich in soy products, flaxseeds, sesame seeds, and legumes.
Summary of a Daily Phytoestrogen-Rich Meal Plan:
1 cup of soy milk (~25mg)
100g tofu or tempeh (~25mg)
1-2 tablespoons of flaxseeds (~15mg)
100g edamame beans (~20mg)
½ cup chickpeas or lentils (~10mg).
You can of course get lovely supplemental blends of phytoestrogens including red clover, sage and dong quai amongst others. But I do recommend consulting a healthcare professional before taking these who can assess suitability and check for contraindications with other medications and hormone therapy.
Magnesium support during perimenopause
Magnesium, often referred to as the “relaxation mineral,” plays a crucial role in supporting overall wellbeing, particularly during the perimenopause transition. This essential mineral helps regulate the nervous system, easing anxiety, promoting better sleep, and alleviating muscle cramps and tension.
For women experiencing perimenopause symptoms like insomnia, mood swings, and heightened stress, magnesium can be especially beneficial.
How Magnesium Works
Magnesium has a calming effect on the body because it interacts with the nervous system. It regulates neurotransmitters like GABA (gamma-aminobutyric acid), which promotes relaxation and stress reduction. By calming the nervous system, magnesium can help reduce feelings of anxiety and facilitate deeper, more restful sleep.
Additionally, magnesium helps relax muscles, which can be particularly helpful for women experiencing muscle cramps, restless legs, or general tension in the body—a common complaint during perimenopause.
Magnesium-Rich Foods
One of the easiest ways to increase your magnesium intake is through food. Some excellent dietary sources of include:
Leafy Greens: Spinach, kale and bok choy
Nuts and Seeds: Almonds, pumpkin seeds, and sunflower seeds
Whole Grains: Quinoa, brown rice, and oats
Legumes: Lentils, chickpeas, and black beans
Dark Chocolate: Choose chocolate with at least 70% cocoa for a magnesium boost.
Tip: Try almonds and dark chocolate for a magnesium rich snack. You can also add leafy greens to your meals or incorporate quinoa and beans into salads or soups for an added magnesium punch.
Magnesium Supplements
For those who find it difficult to meet their magnesium needs through food alone or are experiencing significant stress, magnesium supplements can be a helpful option. There are various forms of magnesium supplements available, each with slightly different benefits:
Magnesium Glycinate: Known for its calming properties, this form is highly absorbable and gentle on the stomach, making it ideal for managing stress and improving sleep quality.
Magnesium Citrate: This form is easily absorbed and can have a mild laxative effect, making it helpful for relieving constipation, which can sometimes accompany perimenopause.
Magnesium Threonate: This form is often recommended for its ability to cross the blood-brain barrier, making it particularly effective for supporting cognitive function, mental clarity, and stress relief.
Magnesium Malate: Often used for muscle relaxation, this type of magnesium is a good option if you're dealing with muscle tension or cramps. Malate form is also good for energy production as it’s used as a co-factor for the enzymes involved in cellular energy production.
Recommended Dosage
While the recommended daily intake of magnesium for adult women is around 300-400 mg per day, perimenopausal women experiencing increased stress or sleep disturbances may benefit from slightly higher amounts. It’s best to consult with a healthcare professional to determine the appropriate dosage for your specific needs and of course, to check for contraindications with any medication. I had a client who suffered with IBS-Diarrhoea which was exacerbated by her magnesium supplement. I find that many people are taking the incorrect form and sometimes too low dosage to achieve the desired effect.
This week, I worked with a client who experienced significantly improved tolerance to stress and better mood stability after we identified the right magnesium product for her—proving that the right support can truly make a difference in managing life’s challenges.
Magnesium (Epsom Salt) Baths
In addition to dietary sources and supplements, you can also absorb magnesium through your skin. Taking a warm bath with Epsom salts (magnesium sulfate) before bed can relax tense muscles and promote better sleep.
What a lovely way to wind down and relax at the end of the day, so if you enjoy a bath do take the time out to do this.
B Vitamins: Essential Support During Perimenopause
The B vitamins are essential for keeping your brain sharp, regulating mood, managing stress, and supporting energy levels. They are a critical part of overall health, particularly in periods of high mental or physical demand.
B vitamins, particularly B6, B12, and folate (B9), play crucial roles in brain health and cognitive function as well as energy production. They are involved in the production of neurotransmitters, which are essential for mood regulation and mental clarity.
Energy production
B vitamins, particularly B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), and B6, are heavily involved in the conversion of carbohydrates, fats, and proteins into energy. They play a key role in helping the body create energy from food.
B12 and folate are crucial for the production of red blood cells, which carry oxygen to tissues, supporting cellular energy production and reducing feelings of fatigue.
Cognitive Function
Hormonal fluctuations, particularly the decline in oestrogen levels, can contribute to changes in your brain such as memory lapses and difficulty concentrating. I get a bit annoyed when this is downplayed as if it isn’t a ‘real thing’. It certainly is a real issue, supported by brain scans and research from experts like Professor Lisa Mosconi.
Oestrogen is known to support brain health by influencing neurotransmitter function and promoting neural connectivity. Research indicates that B vitamins, particularly B6, B9 (folate), and B12, play a crucial role in cognitive function.
B6: Helps in the production of neurotransmitters like serotonin and dopamine, which are vital for mood stabilisation and cognitive function.
B12: Supports the maintenance of myelin, the protective sheath around nerve fibres, promoting efficient nerve signal transmission.
Folate (B9): Important for DNA synthesis and repair, and it works alongside B12 to help maintain brain health and reduce cognitive decline.
Cortisol Regulation
Stress often leads to elevated cortisol levels, which can adversely affect energy, cognitive function and mental health. B vitamins, particularly B5 (pantothenic acid), help support adrenal function and energy production, aiding the body in managing stress and potentially reducing cortisol levels.
Sources of B Vitamins
Food: Whole grains, meat, eggs, dairy products, legumes, leafy greens, nuts, and seeds.
Supplements: B-complex supplements can provide a balanced dose of B vitamins, especially beneficial for those with dietary restrictions or absorption issues.
Omega-3 Fatty Acids: Reducing Inflammation in Perimenopause
Omega-3 fatty acids, particularly EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), are essential fats that have significant benefits for brain health, hormonal health and management of chronic inflammation. While inflammation is a natural response that serves a purpose during infections or injuries, uncontrolled inflammation can be detrimental to overall health.
Omega-3s have powerful anti-inflammatory effects. They compete with omega-6 fatty acids (which can be pro-inflammatory) for incorporation into cell membranes and for reducing the production of substances that trigger chronic inflammation like cytokines and eicosanoids. These are little messengers that run around the body, calling for help when there’s an issue. They play essential roles in managing inflammation, but if they get out of hand, they can create too much inflammation, leading to chaos in the system (or the body you could say) and I don’t know about you but I certainly have enough chaos in my body right now 😉.
Cognitive Function
DHA which is a major structural component of the brain, is critical keeping brain cells healthy and to support the synaptic plasticity or the connections between the brain cells healthy supporting overall cognitive function. Studies suggest that adequate levels of DHA are linked to improved memory, clearer thinking and reduced risk of neurodegenerative diseases such as dementia and Alzheimers.
Hormonal Support
During perimenopause, fluctuating hormone levels can lead to increased inflammation in the body, exacerbating symptoms like hot flushes, mood swings, and even joint pain. Omega-3s help counteract these effects by reducing inflammation, which can help regulate hormone-related symptoms and provide a calming effect on the nervous system.
Regular consumption of omega-3 fatty acids may help lower cortisol levels. Research indicates that omega-3s can enhance the body’s response to stress and improve mood by regulating the pathway which governs cortisol production. Lower cortisol levels are associated with reduced stress and anxiety, contributing to better brain health.
Joint Health
Chronic inflammation can worsen joint discomfort, which some women experience more during perimenopause due to declining oestrogen levels. Omega-3s help to reduce inflammation in the joints, potentially alleviating joint stiffness and pain, improving mobility and comfort.
Skin Health
Inflammation also plays a role in skin changes during perimenopause, such as dryness and loss of elasticity. Omega-3s support skin hydration and elasticity by maintaining the health of cell membranes, which are critical for retaining moisture. Their anti-inflammatory action can reduce redness, itchiness, and other skin irritations associated with hormone fluctuations.
Sources
As the body cannot produce these fatty acids on its own, it's imperative to obtain them through dietary sources.
Food: Oil rich fish (like salmon, mackerel, trout, anchovies, sardines), flaxseeds and flaxseed oil, chia seeds, walnuts, and algae-based supplements for those following a plant-based diet.
Supplements: Fish oil or algae supplements are popular sources of omega-3s, providing concentrated doses of EPA and DHA. If don’t regularly consume oily fish which are the most direct source of EPA and DHA then you might do well to supplement but again, check contraindications with medications.
Calcium and Vitamin D: Vital Nutrients for Bone Health in Perimenopause
One of the biggest concerns during perimenopause and menopause is maintaining bone health. The decline in oestrogen levels significantly increases the risk of osteoporosis, a condition characterised by brittle and fragile bones. As oestrogen is so important for maintaining bone density, it's essential to focus on nutrients that support bone strength.
Calcium is the primary building block of strong bones, and it's crucial to meet your daily intake to help mitigate bone loss. Vitamin D is equally important, as it enhances the body's ability to absorb calcium effectively. Without sufficient vitamin D, even adequate calcium intake may not fully support bone health. Together, these nutrients work synergistically to help maintain bone density and overall skeletal integrity during this life stage.
To support your bones, aim to incorporate foods rich in both calcium and vitamin D into your diet.
Sources of Calcium
Dairy Products: Greek yogurt and hard cheeses like parmesan are excellent sources, providing not only calcium but also protein, which is vital for overall health.
Fortified Plant Milks: Many almond, soy, and oat milks are fortified with calcium, making them great alternatives for those avoiding dairy.
Leafy Greens: Vegetables like kale, spinach and bok choy offer calcium, along with beneficial vitamins and minerals.
Broccoli: This cruciferous vegetable is not only a source of calcium but also rich in antioxidants.
Legumes: White beans are packed with calcium and also provide fibre, which is beneficial for digestive health.
Nuts and Seeds: Almonds and chia seeds are excellent options that offer calcium and healthy fats.
Citrus Fruits: Oranges provide a small amount of calcium and are rich in vitamin C, which supports overall health.
Tofu: Calcium-set tofu is a versatile source of this essential mineral, making it a great option for various diets.
Sources of Vitamin D
Fatty Fish: Fish like salmon, mackerel, and sardines are among the best natural sources of vitamin D, supporting not only bone health but also heart and brain health due to their omega-3 content.
Egg Yolks: These contain small amounts of vitamin D, but they're also a source of protein and healthy fats.
Mushrooms: Certain types of mushrooms, particularly those exposed to sunlight, can provide a decent amount of vitamin D.
Supplements: Given that many people do not get sufficient vitamin D from food alone, especially in regions with limited sunlight during the winter months, considering a vitamin D supplement can be beneficial. Either that or decide to ‘Winter’ in a warm country although the supplement option might be cheaper.
Perimenopause is a distinct journey for each woman, but it doesn’t have to be daunting. By prioritising nutrition and incorporating essential nutrients into your daily routine, you can empower yourself to ease the transition and truly thrive during this phase of life.
Remember, small, consistent changes in your diet and lifestyle can lead to significant improvements in your overall well-being. Embrace this opportunity to nourish your body and mind, and take charge of your health. With the right strategies in place, you can navigate perimenopause with confidence and emerge stronger than ever.
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