What is Perimenopause?

Perimenopause is the transition leading up to a woman’s final period (menopause) and can begin as early as ten years before menopause. During this time, ovarian follicular activity declines, leading to fluctuations in hormone levels, particularly oestrogen, follicle-stimulating hormone (FSH), and progesterone. Testosterone levels also gradually decrease over time.

Hormonal Changes and Common Symptoms

As oestrogen declines, women may experience:

Hot flushes
Night sweats
Irregular periods
Mood swings
Sleep disturbances
Brain fog
Vaginal dryness

Progesterone levels also decrease, which can contribute to:

Heavier or lighter periods
Increased anxiety or irritability

A gradual decline in testosterone may impact:

Energy levels
Muscle growth and maintenance
Libido

Research References: PMID: 29027807, PMID: 27622993

What is Menopause?

Menopause marks the end of a woman’s reproductive years and occurs when the ovaries produce so little oestrogen that they stop releasing eggs and periods cease. A woman is officially in menopause when she has gone twelve consecutive months without a period.

How Menopause Affects Health

The decline in oestrogen levels can impact:

Bone health – Increased risk of osteoporosis
Cardiovascular health – Higher risk of heart disease
Gut health – Changes in microbiome diversity
Metabolism – Alterations in body composition and insulin sensitivity

To support these changes, key nutrients can play a role in promoting overall health and reducing the risk of chronic disease.

Research Reference: PMID: 38617417

Key Nutrients for Menopause

Calcium for Bone Health

Oestrogen plays a vital role in maintaining bone mineral density, and its reduction during menopause can accelerate bone loss, increasing the risk of osteoporosis.

Women over 50 or those post-menopause require 1,300 mg of calcium daily—about a 30% increase from earlier adult requirements.

Calcium-Rich Foods

Dairy: Milk, yoghurt, cheese (1 cup of milk = 300 mg of calcium)
Non-dairy sources: Tofu, almonds, tahini, dark leafy greens (e.g., kale, bok choy)
Fortified plant-based alternatives: Almond milk, soy milk

Spreading calcium intake across the day improves absorption.

Vitamin D for Calcium Absorption

Vitamin D is essential for calcium absorption. Getting enough Vitamin D is key for bone health.

Sources of Vitamin D

Safe sun exposure (15–20 minutes per day, depending on skin type and location)
Food sources: Fatty fish (salmon, sardines, mackerel), UV-exposed mushrooms, fortified foods (dairy, cereals)

If sun exposure is limited, a vitamin D supplement may be beneficial based on blood test results.

Protein for Muscle Growth

Oestrogen and testosterone declines contribute to muscle loss over time. Protein plays a key role in maintaining muscle mass and supporting bone health, especially when combined with strength training.

The exact amount per day varies depending on individual activity levels, body composition and goals.

Protein-Rich Foods

Lean meats: Chicken, turkey, fish, red meat
Plant-based proteins: Tofu, tempeh, lentils, chickpeas, quinoa
Dairy: Greek yoghurt, cottage cheese
Nuts and seeds: Almonds, pumpkin seeds, chia seeds

Distributing protein intake across meals enhances muscle protein synthesis.

Healthy Fats for Heart and Brain Health

To support cardiovascular health, aim to predominantly include unsaturated fats.

Sources of Healthy Fats

Monounsaturated fats: Extra virgin olive oil, avocado, nuts (almonds, cashews)
Polyunsaturated fats (Omega-3s): Fatty fish, walnuts, hemp seeds, chia seeds

Including at least two servings of oily fish per week is beneficial for omega-3 intake.

Fibre and Polyphenols for Gut Health

Oestrogen decline is linked to reduced gut microbiome diversity in some women, affecting gut health and overall health. Fibre and polyphenols (antioxidant compounds) support gut microbiome diversity and help to reduce inflammation.

Sources of Fibre and Polyphenols

Wholegrains: Oats, quinoa, wholegrain bread
Fruits & vegetables: Berries, citrus, spinach, broccoli
Legumes: Lentils, chickpeas, beans
Nuts & seeds: Almonds, sunflower seeds, flaxseeds
Herbs & spices: Turmeric, cinnamon, rosemary
Beverages: Tea, coffee, extra virgin olive oil

Eating a variety of plant-based foods across the week promotes gut health.

Final Thoughts

Although perimenopause and menopause come with significant changes, they also provide an opportunity to reassess lifestyle habits and prioritise long-term health.

Key Takeaways

Support bone health with calcium and vitamin D
Maintain muscle mass with protein and resistance training
Protect heart health by prioritising unsaturated fats
Optimise gut health with fibre and polyphenols

Looking for Support?

If you are navigating perimenopause or menopause, you are not alone. Nutrition, lifestyle adjustments, and medical support (such as hormone replacement therapy or other treatments) can all play a role in improving quality of life.

For personalised guidance, consider speaking with a dietitian specialising in menopause nutrition to develop a tailored approach that meets your unique needs.

Key Nutrients for Menopause: Supporting Your Health Through the Transition