During perimenopause, extensive changes are happening inside your body. Your hormone levels are changing, you’re potentially experiencing a range of symptoms from hot flashes to brain fog, you’re not sleeping as well and you’re experiencing stress on an emotional and physical level. All of these changes are manageable, but they do require some adjustments to your diet and lifestyle to ensure you’re looking after the evolving needs of your body to support optimal health.

It’s important to flag that each person experiences peri differently, so the dosages and necessity of most of the nutrients we cover below will be dependent on your individual symptoms, experience and nutrient needs. My Princess Peri Package is designed for this very purpose – it allows us to work together to define your personal needs and devise a dietary approach that most effectively manages your symptoms and addresses any nutrient deficiencies you may have. Check it out here.

Now, let’s dive into the key micronutrients to prioritise if you’re experiencing certain side effects or symptoms of peri. 

Decreased bone mineral density

This one does apply to everyone – regardless of your diet and individual experiences of peri. Unfortunately, as you age and particularly as you enter perimenopause, your production of oestrogen declines significantly. One of the main consequences of this is that your risk of developing osteoporosis (a condition where your bones weaken, and therefore break or fracture much more easily) increases. Oestrogen is the greatest regulator of your bone metabolism and strength (even in males!), so when your levels begin to drop, your bone mass begins to decrease too. Women lose an average of up to 10% of bone mass during the first five years after menopause (don’t panic, the rate of bone loss slows after this point).

To prevent the loss of bone mass and strength as your oestrogen continues to fall, you should focus on increasing your intake of the following micronutrients:

Heavier blood loss during menstruation

Heavy or prolonged periods, also known as menorrhagia, can result in greater blood loss during your period when it occurs. While not all women will experience this symptom of peri, if you do, it requires some nutritional adjustments to ensure your iron and energy levels aren’t compromised.

While some women will experience their periods suddenly stopping altogether in the lead up to menopause, others will notice irregular bleeding or other changes to their period – including increased blood loss in some instances. This is because, given your production of reproductive hormones including oestrogen and progesterone can vary so much between months during perimenopause, this can result in your oestrogen levels being higher than your progesterone some months. This creates a thicker uterine lining than normal, meaning your period will likely be heavier and longer as your body sheds this lining. If you’re unsure if your blood loss is particularly heavy or concerning, consider whether your period compromises your daily life – if your day-to-day activities are disrupted by heavy cramping, tiredness and fatigue, or having to change your sanitary products all the time, this can indicate your blood flow is heavier than it should be, and may put you at greater risk of anaemia.

This increase in blood loss can lead to iron deficiency anaemia, as your body’s iron stores will suffer as a result of your heavier menstruation over time. Anaemia may also occur due to changes in your digestive function and ability to absorb nutrients.Symptoms of iron deficiency anaemia include feeling tired constantly, weakness or dizziness, shortness of breath, and poor immune function, or even heart palpitations and pale skin.

To prevent anaemia and ensure your iron stores and energy levels are consistent and healthy, prioritise the following nutrients:

Common perimenopause symptoms

Perimenopause can come with a whole host of unwanted side effects, though each woman will experience these individually and uniquely, if at all. Some of the more common symptoms, including hot flashes, night sweats, and changes to cognitive function or mood can be managed and minimised by increasing your intake of omega-3 fatty acids. 

These symptoms are largely the result of reduced oestrogen levels, which leads to changes in thermoregulation (or your body’s ability to regulate its temperature) and your production of neurotransmitters – especially serotonin, which plays a significant role in happiness and mood. Luckily, evidence shows that omega-3s, on their own and in conjunction with other interventions, can relieve or improve many of these symptoms.

Omega-3 supplementation and dietary intake has been shown to reduce both the frequency and severity of night sweats in perimenopausal women, as well as ease psychological and depressive symptoms of peri. Omega-3s have also been proven to reduce the number of hot flashes experienced by perimenopausal women, from an average of 2.8 per day to 1.6 – a reduction equivalent to what can be achieved using hormone therapy or antidepressants.

Women undergoing perimenopause and menopause are at a greater risk of cognitive impairment and emotional problems, including anxiety and depression. However, these fatty acids are effective in treating any mental health problems linked to menopause, with proven beneficial effects for emotional and cognitive function during menopause.

Omega-3s also benefit heart health and help to maintain cognitive function in ageing adults. They act via different mechanisms to support neuron function, reduce inflammation and cell death, and even prevent diseases such as Alzheimer’s. The protective impacts of omega-3s on brain health can greatly help to reduce the cognitive and emotional symptoms of perimenopause.

Poor sleep

Another unwanted symptom of peri is poor sleep quality – whether that looks like having difficulty falling or staying asleep, or you find yourself waking throughout the night or early in the morning. Inadequate sleep has many flow-on effects for your general physical and mental health and wellbeing, so it’s something to address where possible. Consider incorporating the following micronutrients to assist with sleep quality:

Anxiety or mental health complications.

Many women also experience changes to their mood, cognitive function or mental wellbeing during menopause, attributed to the changing levels of hormones and neurotransmitters, as well as the psychological distress that the physical and mental symptoms of peri can cause for some people.

Adaptogens may be able to help manage these symptoms of peri. Adaptogens are herbs, roots, mushrooms or other plant substances which support your body’s response to stress. These supplements are available as capsules, teas and powders, and have been reported to help keep your body balanced and healthy when your stress response is activated by any kind of physical, emotional or hormonal stressor.

As you can imagine, peri acts as a significant stress on your body – physically, emotionally and hormonally. So any supplement or compound that helps to mitigate or relieve the effects of this stress, and allow your body to repair and restore balance, is likely to help reduce some of the unwanted symptoms that come with perimenopause. While most adaptogens have different effects and uses, a couple which have been suggested to help with perimenopause and its associated symptoms include:

Muscle loss and weakness

With insufficient production of oestrogen comes an increase in inflammation and oxidative stress in your body, all of which can contribute to your body being less able to build lean muscle mass and strength during resistance training during perimenopause. Additionally, women gradually lose muscle mass as you age, which can seriously increase your risk of falls, injury, weight gain and bone weaknesses. Naturally this is something you want to combat – and it’s possible to do so with dietary or supplemental interventions.

  • Creatine. Creatine supplementation has been proven to counteract some of the menopause-related decrease in muscle, bone and general strength. By helping to reduce inflammation and oxidative stress, and prevent bone turnover or breakdown, creatine supports bone formation and strength and results in improvements to your muscle strength and exercise capacity too. When used alongside resistance training, creatine has an even greater positive impact on bone mineral density and body composition. Not only this, but creatine has also been found to improve mood and brain function. Given these are some of the more concerning consequences of perimenopause, creatine’s ability to reduce and prevent the associated health decline makes it a great nutrient to consider prioritising in your diet, or supplementing with under the guidance of a health professional.

What foods should you prioritise to get more of these beneficial nutrients?

      • Calcium: seeds, dairy products, canned salmon, beans and lentils, leafy greens.
      • Vitamin D: oily fish, egg yolk, liver, red meat, some fortified cereals and milks, mushrooms (after exposure to the sun).
      • Magnesium: leafy greens, nuts and seeds, whole grains, dark chocolate, beans.
      • Iron: red meat, eggs, spinach and leafy greens, fortified breads or cereals, chicken, beans.
      • Vitamin C: citrus fruits, strawberries, broccoli, Brussels sprouts.
      • Omega-3 fatty acids: fatty fish (salmon, sardines, mackerel), extra virgin olive oil, nuts and seeds.
      • Melatonin: eggs, fish, nuts, some mushrooms, cereals, legumes and seeds.
      • Creatine: meat, poultry, fish (note: plant foods do not contain creatine).

    As you can see, there are some common threads in the list. Foods like leafy greens, nuts and seeds contain an abundance of different micronutrients which can help alleviate symptoms of peri, and are all easy to add to your diet. Other nutrients, like creatine, are more difficult to get from dietary sources if you follow a plant-based diet. Some of the nutrients we discussed, like adaptogens or tart cherry concentrate, are nutritional supplements to only be taken under the guidance of a health professional. Making small tweaks to your dietary choices can be a really powerful and simple way of reducing your peri symptoms – so start incorporating some of these nutrient-dense whole foods, and experience the benefits they offer for yourself.

    My Princess Peri Package is designed with you in mind. Approaching your diet and lifestyle in a tailored, personalised way to ensure the dietary strategies and interventions I provide are directly tailored to you and your individual needs means you’ll get the most effective, powerful tools to improve and reduce your symptoms and unique experience of perimenopause. Don’t suffer in silence – get the relief you deserve. Find out more here.