My Top 10 for Managing Perimenopause & Post Menopause

I’ve worked (nutritionally) with perimenopause and midlife women for the last 13 years. And through this, I have found some things that seem to provide (at least) some of the answers to these questions.

Choosing to eat anti-inflammatory, high fibre and plant-focused foods. With plenty of variety. This is similar to the Mediterranean style diet full of gorgeous vegetables, fresh fruit, herbs, spices, nuts, seeds, legumes/pulses/beans, whole grains, fermented foods, and extra virgin olive oil. all my recipes are centred around this principal, high in fibre and with plenty of nutrients. 

This does not mean you have to eat fully plant-based, instead having a big focus on plant foods which make up most of your meals. Whilst eating some dairy, eggs, seafood/fish is still really beneficial. Have a look at my blog post about this here. 

Eating plant foods that contain phytoestrogens will help whether or not you are on HRT.

Why is that? Because phytoestrogen-rich foods, for example tofu (eg Isoflavones) and flax seeds (eg lignans) have co-benefits. Things like added natural fibre and protein. And not forgetting … the anti-inflammatory effects.

In the body, phytoestrogens can act in a similar, but weaker effect, than both your own estrogen and HRT body-identical estrogen. This means that they can offer some of the benefits of estrogen. It's worth remembering, however, that they are much weaker (in these effects) than your own estrogen or HRT.

There are many plant foods containing phytoestrogens, my standouts are tofu/soy, chickpeas, ground flax/linseeds, chia seeds, raw almonds, and sprouts (as in sprouted seeds/beans eg alfalfa, broccoli sprouts).

Choosing foods and supplements which support areas of possible deficiency can be hugely beneficial.

We’re looking for whole-body benefits, so important for mental as well as physical health. Plus they can be obtained in the form of supplements as well as food sources. I specifically formulated a supplement drink called HeraRise for women's health. You can find it here. 

This fabulous mineral seems to help not just with bone health but also blood glucose balance, and neurological pathways eg think potential calming effects, and perhaps less headaches. Have a look at my blog post here for more details.

In my clinical experience, these B vitamins seem to help with energy, mental health and female hormone actions eg B6 helping to prevent tender breasts and reduce premenstrual symptoms.

B vitamins, except for B12, are found in many plant foods, so eat plenty! B12 is only found in dairy, eggs, seafood, chicken and other meats. 

Polyphenols are naturally occurring plant compounds that are good for the gut microbiota and have anti inflammatory effects in the body.

All plant food contains them, my standouts are: Turmeric and Quercetin - quercetin for example is found in apples and red onions.

Such an important vitamin and one that until recently was not appreciated as being so supportive beyond bone health. For example, it seems in post menopausal women Vitamin D may also be beneficial at reducing pro-inflammatory biomarkers (PMID: 29738417).

Seafood in general contains this beneficial anti inflammatory oil. Standouts sources are sardines, herring, salmon, sprats, mackerel, anchovies and mussels. Read my blog all about this here.

All movement is good in perimenopause and menopause! So choose exercise/fitness/movement that you enjoy and can do often. Since muscle mass begins decreasing in a woman’s thirties, then strength training/building is really important to consider in your choices of exercise.

Plus there is research that suggests yoga and pilates are also really beneficial too. I love the suggestions offered on social media by Claudia Brown, Rebekah Rotstein, Kate Oakley, Dinah Siman, Claire Phipps and Petra Coveney.

Why Cutting Back on Alcohol Can Make a Big Difference
Reducing or cutting out alcohol altogether can be one of the most impactful changes you make for your wellbeing—especially during perimenopause and menopause. That’s because alcohol can worsen both physical and mental symptoms. It disrupts the absorption of important micronutrients, interferes with hormone balance, and affects the quality of your sleep (more on that below).

Hydration and Energy:
Alcohol is also dehydrating, which can leave you feeling tired, foggy, irritable, or even hungrier than you actually are. Dehydration can mimic hunger, often leading to cravings for sugary foods. So before reaching for something sweet, try drinking a large glass of water and waiting several minutes—you might be surprised how often that helps.
If you’re looking for alternatives, there are now some brilliant non-alcoholic options on the market. And if you’re after something refreshing and a little bit different, check out my favourite alcohol-free cocktail—the Switchel— here over on my social media or YouTube channel here. 

What to Drink
The good news is that nearly any fluid (except alcohol) can contribute to hydration—including water-rich foods like fruits and vegetables. But for truly effective hydration, simple water and herbal teas are hard to beat. They’re gentle on the digestive system and easy for the body to absorb. Aim for around two litres of water, herbal teas or regular tea each day. The key is consistency—rather than drinking large amounts in one go, it’s better to sip steadily throughout the day to stay well hydrated.

Just so important. Aim to work out what’s stopping you waking up feeling refreshed & ready to take on the day! There’s blog post on my website about this here. 

Cognitive Behavioural Therapy is a great talk therapy to help manage symptoms, really good information is from Simona at The Menopause CBT Clinic.

I love this quote…

“Usually, we think of happiness as delight or joy or celebration...and yes, these are aspects...but happiness sustained is more than these elements. It is found in: Moments of meaning. Moments of learning. Moments of awe. Moments of connection, and Moments of acceptance and peace.” Maria Sirois, Psy.D.

And here’s an app that I think is helpful Evia App.

No explanation needed here 

HRT stands for Hormone Replacement Therapy, sometimes called Menopause Hormone Therapy (MHT).

This is really helpful for symptom relief during perimenopause and early post menopause.
Balance Menopause app has lots of free facts about perimenopause and menopause, as well as information about MHT / HRT.