A guide to diet and nutrition for perimenopause

Why is nutrition important in perimenopause?

Perimenopause can feel overwhelming, but small, thoughtful changes in eating habits can make a big difference.

A nutrient-rich diet can help balance hormones, reduce inflammation, and protect against bone loss and heart disease during perimenopause.

Focusing on balance, variety, and self-care can help a person navigate perimenopause with greater ease and well-being.

Nutrition and diet in perimenopause can help with the following:

• Hormonal imbalances: Estrogen and progesterone levels fluctuate during perimenopause, leading to symptoms like hot flashes, sudden mood changes, and irregular periods. Certain nutrients, like phytoestrogens (soy, flaxseeds), healthy fats, and complex carbohydrates, can help regulate hormone levels and stabilize blood sugar, influencing hormone function.
• Bone health: Declining estrogen levels increase the risk of bone loss, leading to osteoporosis. Calcium, vitamin D, magnesium, and vitamin K2 are important in maintaining strong bones and preventing fractures.
• Inflammation: Anti-inflammatory foods, such as oily fish, leafy greens, berries, and turmeric, can help mitigate inflammation and protect against chronic conditions.
• Heart health: Estrogen plays a protective role in cardiovascular health, and its decline can increase the risk of heart disease. A diet rich in heart-healthy fats, fiber, and antioxidants supports cardiovascular health by reducing cholesterol levels and oxidative stress.
• Weight management: Hormonal changes can lead to a slower metabolism, increased abdominal fat, and weight gain. A balanced diet can help maintain a healthy weight and prevent obesity-related complications.
• Mental health: Mood changes, anxiety, and brain fog are common during perimenopause. Nutrients like omega-3 fatty acids, magnesium, and B vitamins can support brain function, reduce stress, and promote emotional well-being.
• Sleep: Magnesium may play a role in improving sleep quality, which is important during perimenopause. Magnesium-rich foods include nuts, seeds, and leafy greens.

Perimenopause is also a good time to lay the foundation for future health, as the risk of conditions like type 2 diabetes, heart disease, and osteoporosis increases after menopause.

A diet rich in whole, unprocessed foods with plenty of antioxidants, fiber, and healthy fats helps reduce these risks.

Tips for diet and nutrition during perimenopause

The body’s needs change during perimenopause, so focusing on quality over quantity is essential. The following diet tips can help the transition into menopause.

Incorporate anti-inflammatory foods

A diet rich in fruit and vegetables can help combat inflammation and reduce the risk of many chronic conditions, including cancer.

An anti-inflammatory diet also reduces the risk of cardiovascular disease and cognitive decline, making it particularly important for those around perimenopausal age.

Anti-inflammatory foods include:

• whole grains
• nuts, such as peanuts and Brazil nuts
• legumes, such as chickpeas and lentils
• a range of fruits, such as apples, bananas, and avocados
• a range of vegetables, such as carrots, broccoli, and green leafy vegetables
• turmeric

Lean meats, such as chicken and oily fish, are also good protein sources for an anti-inflammatory diet, as they are lower in saturated fats.

Examples of anti-inflammatory diets include:

• the Mediterranean diet
• the Dietary Approaches to Stop Hypertension (DASH) diet
• traditional Okinawan, Nordic, or Mexican diets

Learn more

Learn more about anti-inflammatory diets and nutrition:

• Anti-inflammatory meal plan: 26 recipes to try
• Our guide to the Mediterranean diet
• 8 natural supplements to help fight inflammation

Eat smaller meals more often

Eating smaller, balanced meals more regularly can help balance blood sugar levels and prevent blood sugar spikes, in turn helping stabilize energy and mood.

Choosing complex carbohydrates like quinoa, brown rice, and sweet potatoes over refined carbohydrates can help keep blood sugar at a consistent level and make a person feel fuller for longer.

Include calcium for bone health

Bone density declines with age, especially during perimenopause. Calcium-rich foods can help promote and maintain bone health.

Foods that contain calcium include:

• low fat dairy yogurt and milk
• low fat dairy cheese
• unsweetened soy milk
• tofu
• green leafy vegetables, such as spinach and kale

Vitamin D is also important for calcium absorption and bone health. Foods that contain vitamin D include:

• oily fish and fish liver oils
• egg yolks
• mushrooms

Finally, magnesium and vitamin K2 can help support bone structure. These nutrients are present in:

• nuts
• seeds
• fermented foods

Focus on phytoestrogens

Phytoestrogens are plant compounds that may mimic estrogen in the body. Foods with phytoestrogens may help the body adjust to fluctuating hormone levels during perimenopause and help ease symptoms of estrogen decline.

There is also evidence to suggest that foods with phytoestrogens can lower the risk of breast cancer and reduce the rates of breast cancer reoccurring.

Some foods that may be high in phytoestrogens include:

• soy products, such as tofu
• flaxseed
• legumes, such as chickpeas and lentils
• some fruits, including grapes, apples, and pomegranates
• some vegetables, including garlic, celery, carrots, and potatoes
• peanuts
• rice
• wheat

Maintain a healthy weight

Metabolism may slow during perimenopause. To manage and maintain a healthy weight, a person can:

• Focus on high fiber foods: Foods such as vegetables, beans, and whole grains can help a person feel fuller for longer.
• Exercise: Incorporate some physical exercise into their routine, including strength training and cardio. According to the Centers for Disease Control and Prevention (CDC), adults need at least 150 minutes of moderate intensity physical activity per week and 2 days of muscle-strengthening activity per week.
• Limit or avoid processed and sugary foods: Processed foods, sugary foods, and foods high in saturated and trans fats can contribute to weight gain and energy crashes. Examples of these foods include potato chips, cakes, deep-fried foods, candies, and french fries.

Address specific symptoms

A person can try modifying their diet and nutrition to address the following perimenopause symptoms:

• Hot flashes: Avoiding spicy foods, caffeine, and alcohol can help alleviate and reduce hot flashes. Eating cooling foods like cucumber and melon may also help.
• Difficulty sleeping: Magnesium-rich foods such as nuts, seeds, and leafy greens may help improve a person’s sleep quality. Eating melatonin-promoting foods such as cherries, almonds, or oats in the evening may also help promote sleep.
• Sudden mood changes: Including omega-3-rich foods, magnesium, and B vitamins may support brain health and alleviate anxiety and depression.

Consider supplementation

Supplements can help ensure a person meets their daily requirements of vitamins and nutrients.

A person may wish to consider the following supplements alongside a balanced diet:

• calcium
• vitamin D
• magnesium
• omega-3 fatty acid supplements, such as fish oil or algae
• B vitamins, especially B6 and B12
• vitamin E
• probiotics for gut health
• evening primrose oil

Recipes for perimenopause nutrition

Preparing meals in advance can help make healthy eating more manageable.

This section looks at some easy-to-prepare recipes tailored to support hormone balance, reduce inflammation, and promote overall health during perimenopause.

Flaxseed and berry smoothie

Ingredients:

• 1 cup unsweetened almond milk
• 1 cup mixed berries (blueberries, raspberries, strawberries)
• 1 tbsp ground flaxseeds
• 1 tbsp chia seeds
• 1 scoop protein powder (plant-based or whey)
• 1/2 tsp cinnamon
• ice cubes

Instructions:

1. Blend all ingredients until smooth and serve immediately.

Salmon Buddha bowl

Ingredients:

• 4 oz grilled or baked salmon
• 1 cup quinoa, cooked
• 1 cup steamed broccoli
• 1/2 cup shredded carrots
• 1/4 avocado, sliced
• 1 tbsp sesame seeds
• Dressing: 2 tbsp tahini, juice of 1 lemon, 1 tsp turmeric, and water to thin

Instructions:

1. Assemble the quinoa, broccoli, carrots, avocado, and salmon in a bowl.
2. Drizzle with the tahini-turmeric dressing.
3. Sprinkle sesame seeds on top and serve warm.

Sesame tofu stir-fry

Ingredients:

• 1 block of firm tofu, pressed and cubed
• 2 cups mixed vegetables (e.g., bell peppers, snap peas, mushrooms)
• 2 tbsp sesame oil
• 1 tbsp soy sauce or tamari
• 1 tbsp rice vinegar
• 1 tsp grated ginger
• 1 tsp honey or maple syrup
• 1 tbsp sesame seeds

Instructions:

1. Heat sesame oil in a skillet or wok over medium heat.
2. Sauté tofu until golden, then set aside.
3. Add vegetables to the skillet and stir-fry for 5 to 7 minutes.
4. Combine soy sauce, rice vinegar, ginger, and honey. Add tofu and sauce to the skillet. Stir until coated and heated through.
5. Sprinkle with sesame seeds before serving.

Summary

Diet and nutrition are an important tool in the transition into perimenopause.

A diet rich in whole foods, healthy fats, fiber, and key nutrients can help a person manage symptoms of perimenopause and set them up for long-term health.