Perimenopause: 10 diet and lifestyle hacks to get your life back

There’s a lot to like about getting older, largely revolving around greater independence and feeling more comfortable in your own skin. Then there’s this curve ball called perimenopause.

It’s the transition to menopause, a time when you haven’t had a single period for at least a year. Some folk barely notice it. If this is you, many congratulations. Frankly, you deserve some kind of street party. For most, perimenopause is a phenomenal test designed to push us to the very limits of what we considered possible to endure. In this article, I'm going to share ten things you can start to do today to turn things around.

Hot flushes and night sweats become an everyday feature. Sleep problems, mood swings, irritability, increased anxiety or even depression, brain fog that hangs like a raincloud, stealing your memory… UTIs like cystitis, vaginal dryness, unpredictable periods – one minute they’re light, the next it’s like you’ve been killed in your bed. Then there’s the weight that won’t seem to shift no matter what you try. Welcome to your new reality. 

HRT (hormone replacement therapy) is one way to go and sometimes it really is what your body needs, but it’s not magic. As a nutritionist and health coach specialising in this area, I can tell you there’s a lot to be said for making some changes to what you eat, when you eat, and how you take care of the rest of your life rather than relying on advice from Doctor Google to fix yourself symptom by symptom.

So, here are my top nutrition and lifestyle suggestions to get you back to feeling human again.

10 hacks to support perimenopause

1. Start with what you eat

What lurks behind many of the ugly symptoms of perimenopause is insulin resistance. Around this time, you often become less sensitive to insulin and can no longer deal with the same amount f carbs in your diet that you used to be able to handle, whether that’s food containing actual sugar or foods that readily get converted to sugar in the bloodstream like bread, pasta, potatoes and rice. This may be the worst news, and I’m sorry for that.

2. Calorie counting is not your best option...

...even if you want to lose perimenopausal weight gain. Those old tricks you might have wheeled out in decades gone by are not going to cut it. The new rules are that healthy fats like olive oil, oily fish, nuts and seeds are good. Lowering the starchy carb content of your meals is the key to dropping pounds, banishing brain fog and getting those hot flushes back under control.

3. Eat real food, three meals and day and ensure you have protein at every meal

That means meat and poultry, fish and seafood, tofu, eggs, beans, lentils, chickpeas, nuts and seeds – ideally nothing in batter or breadcrumbs.

4. Eat your veg

The fibre in vegetables slows down the rate at which sugars – natural or otherwise – enter your bloodstream. They also fill you up, mop up excess hormones and keep you regular. Going to the loo at least once a day is important and is one of your body’s main ways to get rid of all the toxins you accumulate as you go through life.

Eat a minimum of five portions (three heaped tablespoons) of non-starchy vegetables/salad per day. Always have vegetables/salad with lunch and dinner, and breakfast too if you wish. There is no upper limit on how many vegetables you can eat. The ideal options are anything that grows above ground.

5. Some foods have almost magical powers

Nutritionists call them functional foods. Simply, they are foods that do stuff in the body. In this case, the winners are stinky veg – literally anything that smells, like broccoli, cauliflower, cabbage, kale, onions and garlic. These smelly vegetables contain sulphur. That’s what makes them smell. And, since you asked, the reason it’s good to eat them is they are excellent at helping the body break down toxins so they can be excreted – either in your poo, your wee or your sweat.

Other functional foods that are really worth knowing about are phytoestrogens. These are naturally occurring plant-based chemicals, which are structurally similar to oestrogen and exert a weak oestrogenic effect. Phytoestrogens are particularly helpful for women because they are adaptogens. This means they can either replicate or counteract the effects of oestrogen.

You’ll find them in all kinds of foods but top on my list would be soybeans (and related products like tofu, tempeh, and miso), flaxseeds, chickpeas, lentils, beans (black beans, aduki beans, broad beans, pinto beans) as well as pumpkin and sesame seeds.

6. You have to take stress relief seriously

This is so important. At this stage of your life, it is a must if you want your body to feel any kind of normal. 

There are various reasons for this but, to start with, consider that as oestrogen decreases, the body is also less well able to regulate cortisol, which means you experience stress more readily. More stress equals chemical signals to eat more carbs and also comfort eat.

7. Prioritise self-care

There are all kinds of things you can do to de-stress but the top of my list when I’m working with my private clients is prioritising self-care. Self-care is an acknowledgement that you are 100% responsible for your own happiness (though others can, of course, contribute to it).

Self-care in my book means spending at least 30 minutes every day doing things just for the sheer joy of doing them rather than in order to achieve something. However much of a fan you are of a nicely pressed sheet, laundry does not hit the mark.

Why is it so essential? Self-care reduces stress and it helps your life work. When your life works (most of the time), you are more inspired and motivated to eat well. It sounds as though I might have made that up but I promise you that it’s true.

8. Move in the right way

Moving in the right way is good for everything in the world of health, but – at this stage in life – rather than punish your body with the rituals of spinning, HIIT training and long runs (often embarked on as a way to shift stubborn weight – which doesn’t work, just so you know), try something that won’t add to stress levels in your body.

Yoga, Pilates, Zumba and other dance-based classes are good and don’t knock a decent walking workout. Weight-bearing exercise, including resistance work/weights is also good to help with the loss of muscle and helps shore up bones for later years.

9. Don’t bathe your skin in fake hormones

I’m talking here about xenoestrogens, which are synthetic oestrogens found in plastics and the shelf-life-extending chemicals added to personal care products like shampoos, conditioners, body wash, body creams, and so on. These clog up your body’s oestrogen receptors, meaning what little real oestrogen you have has nowhere to go, plus they place extra stress on the body.

Nasties to look out for in these products include parabens, sodium lauryl/laureth sulphate and urea. Thankfully, even supermarkets now stock more of these hormone-friendly products – but do make sure you check the labels before you buy. 

10. Don’t forget about what’s going on ‘down there’

One of the least talked about aspects of the transition to menopause is the troublesome vagina. You might have heard already about vaginal dryness. It is what it sounds like, a lack of lubrication in your nether regions but boy that is only the start of your worries. Thanks to a phenomenon called ‘vaginal shortening’ your ladybits literally shrink and shrivel. Yes, the vagina is the Thumbelina of body parts and this is huge if you planning on having sex any time soon. Hello, pain and bleeding. Truly, one day you might just feel you are about to break in two.

My clinical experience tells me that, while you can do a huge amount to improve hot flushes, weight gain, brain fog and many other common symptoms of perimenopause with food and supplements, this is one thing you cannot fix with a piece of salmon and a handful of chickpeas. This is where a conversation with the doctor (and possibly a subsequent prescription for vaginal oestrogen) is a must if you ever fancy having sex again. 

So there you have it, my top 10 tips for getting your life back on track. Everyone experiences menopause differently but there are some common themes. Finding your own magic formula will take some work and possibly also some uncomfortable conversations. What I want you to know is that finding a resolution is possible and that your mid-life can really become the best time of your life.

I’m going to join the choir of voices saying we need to talk more openly about it. It’s not something to be ashamed of. It’s a phenomenon half of the population will go through at some stage in their lives and, by working with your GP and a nutrition professional like me, the sun will really rise tomorrow and it will be a lovely day.