As part of our Menstrual March focus, this week I’d love to talk about a topic I am often asked about when it comes to women’s health: the body’s transition into perimenopause and menopause.

This phase marks a significant period in our lives, symbolising strength, wisdom and the natural cycle of our bodies! It’s so important to approach this stage of life with understanding, so we can equip ourselves with the tools to navigate through it with awareness and grace.

To provide you with the most insightful and practical advice, I had the wonderful opportunity to sit down for some questions with Lara Briden, our JSHealth hormone expert and the author of Period Repair Manual and Hormone Repair Manual. 

Remember, this phase of the feminine journey is beautiful, and a time to be celebrated. If you’re experiencing symptoms, you are absolutely not alone. Read on for expert nutrition and lifestyle advice to help you care and support yourself with compassion during this stage of life.

“What is happening during perimenopause and menopause?”

Perimenopause is the two to ten years before menopause. It is the time of greatest symptoms, but it is temporary. Menopause is the life phase that begins one year after the final period. It is usually the time of almost no symptoms.

The normal age for menopause (periods stopping) is anywhere from 45 to 55, and the normal age for perimenopause is up to ten years before that—as young as 35! That’s why perimenopause is not about ageing. Instead, it’s about the recalibration of the entire hormonal system and the support you may need during that temporary process.

Women born before 1985 are likely to be in perimenopause currently.

“What are the main symptoms women going through perimenopause may experience?”

• Heavier periods
• Worsened period pain
• Shorter (at first) menstrual cycles (< 26 days)
• Painful, lumpy breasts
• Difficulty sleeping, including mid-sleep waking
• Premenstrual night sweats or hot flushes
• Vaginal dryness and changes in libido 
• New or increased premenstrual mood swings
• New or markedly increased migraine headaches
• Weight gain without changes in exercise or eating

“Can you share some tips on how to manage these symptoms?”

Your nutrition and lifestyle habits play a powerful role in supporting your body during this time of transition! In your diet, aim to include: 

• Healthy fats + proteins: Think tofu, walnuts and lean chicken breast – these can help to support gut health1 and provide comfort. They also play a crucial role in maintaining hormone balance and ensuring your body functions at its best.
• Iron-rich foods: This is especially important during perimenopause when heavier menstrual flows can deplete your iron levels2! Include red meat, poultry, fish, lentils, spinach and fortified grains to help maintain healthy iron levels. Your iron levels also impact on how your body sustains energy as well as your cognitive health2.
• Organic fresh produce: Opt for whole grains, lean protein, fruits and vegetables. This ensures you’re nourishing yourself with a variety of essential vitamins, minerals and antioxidants that support your wellbeing.
• Fermented foods: Include kimchi and sauerkraut, which are full of probiotics that are beneficial for gut health and may contribute to hormone balance1. 
• Calcium-rich foods: Your bone health is most important during this time as vitamin D stores become naturally depleted due to a decline in levels of oestrogen3! With lower levels of oestrogen, bone resorption is increased – a process where calcium leaves the bone tissue and enters the blood, leading to weakened bones and potentially osteoporosis4. Additionally, the decline in oestrogen may also reduce your body’s ability to absorb calcium4. This makes getting enough calcium and vitamin D even more important during this time! Reach for dairy, leafy greens and fortified cereals to maintain your bone density and strength. 
• Phytoestrogens: These plant compounds mimic the effects of oestrogen in the body, and have been effective in relieving perimenopausal or menopausal women experiencing symptoms5. Foods such as flaxseeds, whole grains, legumes and soybeans provide a natural way to help balance hormones during this period.

Be mindful of potential inflammatory triggers such as processed foods, alcohol and refined sugars. These can worsen inflammation in the body and exacerbate any symptoms you may be feeling. 

Dr Lara Briden also suggests that there are lots of other ways to feel better including body-identical hormonal therapy (both progesterone and oestrogen). Try outdoor exercise (what researchers call “green exercise”) and movement that is gentle yet empowering to help combat the effects of stress during this time. Stress impairs the brain’s ability to recalibrate and rewire during the perimenopause transition, so practising stress relief techniques such as yin yoga or deep belly breathing is also important. Focus on low-impact movements to enhance flexibility such as Pilates, tai chi and light walking. 

Also consider nutritional supplements such as magnesium! In a paper called “Magnesium in the gynaecological practice: a literature review,” researchers conclude that magnesium is an effective treatment for menopause and perimenopause because it helps to “normalise the action of hormones on the central nervous system.” It works well in combination with the amino acid taurine, which helps to calm the brain and prevent hot flushes. 

“Which nutrients and herbs can support those going through perimenopause?”

It very much depends on the symptom(s), but supplements discussed in Dr Lara Briden’s perimenopause book Hormone Repair Manual include: 

• Magnesium 
• Taurine
• Zinc
• B-complex
• Vitamin B6
• Iodine
• Ashwaghanda
• Vitex
• Inositol

For more on any of the topics, there is lots of free information available on Lara Briden’s blog, as well as in her 2 incredible books. Head to www.larabriden.com.

Remember this is general advice only and is not intended to diagnose, treat or cure. Please always consult a health professional before making changes to your supplements and diet.

References: 

1. Erdélyi, A., Pálfi, E., Tűű, L., Nas, K., Szűcs, Z., Török, M., Jakab, A. and Várbíró, S. (2024). The Importance of Nutrition in Menopause and Perimenopause—A Review. Nutrients, [online] 16(1), p.27. doi:https://doi.org/10.3390/nu16010027.
2. Beck, K.L., Kruger, R., Conlon, C.A., Heath, A.-L.M., Matthys, C., Coad, J. and Stonehouse, W. (2012). Suboptimal iron status and associated dietary patterns and practices in premenopausal women living in Auckland, New Zealand. European Journal of Nutrition, 52(2), pp.467–476. doi:https://doi.org/10.1007/s00394-012-0348-y. 
3. Mei, Z., Hong, H.-C., Zeng, Y. and Li, D. (2023). The role of vitamin D in menopausal women’s health. Frontiers in Physiology, [online] 14. doi:https://doi.org/10.3389/fphys.2023.1211896. 
4. Cheng, C.-H., Chen, L.-R. and Chen, K.-H. (2022). Osteoporosis Due to Hormone Imbalance: An Overview of the Effects of Estrogen Deficiency and Glucocorticoid Overuse on Bone Turnover. International Journal of Molecular Sciences, 23(3), p.1376. doi:https://doi.org/10.3390/ijms23031376.
5. Chen, M-n., Lin, C-c. and Liu, C-f. (2014). Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review. Climacteric, [online] 18(2), pp.260–269. doi:https://doi.org/10.3109/13697137.2014.966241.