Women's Health Series: Basic Advice Around Lifestyle and Nutrition for Perimenopause

In the last few years it has hardly been possible to pick up a magazine, or look in the health section at a bookshop, or even switch on the television and listen to the news, without hearing something about perimenopause. Large companies are running workshops for their female staff on what they might be going through (and some of them are even running separate workshops for their male staff to promote understanding) and HR departments are being forced to take stock of the age / life stage of their female employees for both employee and company wellbeing. But why? Why is this such big news now?

Women of course, have been going through menopause as long as our life expectancy has been above about 40, so it is not a new phenomenon, but we are only now coming to see it and the toll it takes.

Much of this is to do with the fact that for many generations most studies have been run by and designed by men and only in the last 20-30 years has that started to change. The things that related solely to women (such as period cramps, endometriosis or PMT) and the things that presented differently in women (eg ADHD, Autism etc) just weren't studied as much, or weren't given the proper consideration (think "women are neurotic and overemotional" stereotypes and misunderstandings). This led to an under-reporting and under-recognition of the perimenopausal state for a long time that we are only just reversing in the last few years.

So mostly I think the reason it is big news now is that it is recognised. However, I am also aware that symptoms seem to have increased. Some of this will be due to the increased recognition and reporting, but I believe a significant amount may also have to do with our changed lives: from later childbirth, to longer working hours; from increased home pressures to decreased community; and from environmental toxins and phone use to the lower nutrition of the food on our plates. All are likely to be having an impact on our resilience to the significant changes our bodies undergo in this time of life, and all therefore are likely to change (increase) the symptoms we feel and exhibit.

So what can we do to help ourselves?

There are so many things I could write about here it is difficult to know where to start. Working on the premise that we are not going to change our culture or economic situation overnight and that we can't go back in time to have children earlier we need therefore to look at our food, our sleep, our exercise and (often overlooked) our social connections.

There is much written on all of these, so I am not going to delve deeply into any of them. Instead I will give you my 10 top tips of things that are easy to implement and done consistently will make small but significant differences.

My top tips

Increase protein intake: I cannot stress enough how much difference this can make. It is the building block by which many of the other changes become possible. In perimenopause and beyond women's protein needs go up by around 50% compared to their earlier levels. The recommendations are for 1.2-1.6g protein per kg of body weight. Just a note here: a gram of protein is not a gram of meat / fish / egg etc (as a rough estimate divide by around 4.5, so 100g steak or fish might give around 22g protein, eggs give around 12-15g per egg.. there are some excellent conversion charts online).

Decrease carbohydrate intake: This is hard during perimenopause because of changes in blood sugar control and energy mechanisms that take place with decreases in oestrogen, but doing it will help decrease brain fog, improve sleep and help muscle and joint pains. It will also decrease the likelihood of weight gain. Do not even attempt to do this without increasing protein first as you will just feel hungry and sluggish and possibly sad. If you get carb cravings increase the protein a bit further and see if that helps.

Eat the rainbow: lots of good root veg of different colours - preferably with some of them fermented or pickled (such as kimchi, sauerkraut and pickled beetroot). This supports your gut at a time when the gut microbiome is going through nearly as many changes as your own hormones. It is seen that good gut support can radically improve mood and brain fog issues in some people. If most of your carbohydrate intake can come from this you will be doing very well.

Exercise: Weight bearing exercise and resistance / strength training - the recommendation is to lift heavy things with few repetitions. Walk plenty and lift weights (body weight can count eg planks, push-ups etc). Again you need to increase protein to get the best from this as we are trying to build (rather than lose) muscle mass - you need some of the protein you eat to be available to do this, and not all just tied up with general repairs.

Drink water: Water helps to release the energy in our cells for use, it keeps our brain functioning to its best and it allows our kidneys to flush out toxins from the system more efficiently. Staying well hydrated is key.

Coffee: Do not medicate brain-fog with coffee. This doesn't mean you can't drink coffee, in fact there is some evidence that 1-2 mugs a day can have some benefits around gut health and possibly cardiovascular health (still in debate).. but if you are very foggy then water is going to do you more good and get you through the day better.

Sleep: Sleep can become difficult in perimenopause - after brain-fog it is one of the most commonly reported early symptoms - often before sweats and flushes etc. If insomnia is a really major issue it may be worth seeing your GP to rule out other causes, however always make sure you are practising good "sleep hygiene" first as otherwise this is the first thing you will likely be told. If you know it is solely due to perimenopause, and particularly if you are getting muscle aches then magnesium supplements can be helpful. There are several different magnesium formulations on the market - for various reasons I usually advise magnesium glycinate / bisglycinate or a "magnesium complex" capsule.

Social connection: Spend time with friends - support each other whether it's going for a walk and a chat together, crying over a cup of tea because you've had a rubbish week, or just holding each other accountable for your food choices / bedtimes / exercise regimes or whatever you are struggling with. It has been shown over and over again that mood and energy levels can be radically improved with good social networks.

Get yourself a good perimenopause supplement. There are many out there and different ones seem to suit different people. However I am not talking about simple "50+ multivitamins".. instead we are looking at things that help boost our phyto-oestrogens and stabilise our blood sugar, cortisol etc. Some that I have seen good results with, in myself and my clients, are: Rheal Balance Tonic, Dr Vegan PeriMenoFriend, Happy Mammoth Hormone Harmony... but do have a look around - try the ones that stand out to you and ideally let me know of any others that you find really helpful.

If you are still struggling go and see your GP. Needing HRT is not a failure. For some people it is the absolute best remedy, for others it is a real health necessity (eg premature ovarian failure - ie early menopause). If you are not suitable for it (eg breast / ovarian cancer treatment etc) your doctor will still be able to discuss other options.

Finally I would always suggest for anyone finding things difficult to see a Menopause Specialist - there are several on Welvow. Some have a background in healthcare, others do not, but they all have amazing depth of knowledge and a fully holistic outlook on how to help. I hope that the one thing we have learned through the constant bombarding of information in the last few years is that none of us need to suffer in silence and what we are going through is really there.

If you feel you would like more help or information from me around your perimenopause or post menopause, particularly with diet, please do reach out for an appointment.

This article first appeared in the Welvow (formerly Seed) editorial archive.