Perimenopause? Dietitians Share First Steps

Perimenopause is a natural phase of life that marks the transition toward menopause, typically beginning in a woman’s 40s, although it can start earlier for some. During this time, hormonal changes can bring about a range of physical and emotional symptoms that might feel overwhelming or confusing (or even surprising). If you’ve recently found out you’re in perimenopause, you’re not alone—this stage is something most women will go through at some point in their lives.

Here registered dietitians will help guide you through the initial steps of managing perimenopause. Their expert advice will offer practical, approachable tips to support your health and well-being during this transitional time. From understanding how your body’s needs are changing to small adjustments that can empower you, here’s what you need to know to feel your best.

1. Don’t panic.

Elizabeth Ward, a registered dietitian and co-author of The Menopause Diet Plan, advises that people should not panic if they find out they are entering the perimenopausal transition. “There are a lot of good conversations happening about perimenopause, but also a lot of negativity,” she says. “It’s important to remember that everyone’s perimenopause experience is unique.” Ward suggests that instead of spending time worrying about entering this phase of life, people should “use this time to make a plan for how to proceed to the next stage of life to minimize any potential symptoms and to support overall physical and mental health.” 

2. Educate yourself about perimenopause.

Take the time to learn about the changes your body is going through. Understanding the symptoms, hormonal shifts and potential effects on your physical and emotional health can help you feel more in control during this transition. There are many resources available, including books, credible online articles, and support groups, that can provide valuable insights. Being informed allows you to approach this stage of life with confidence and clarity, enabling you to make decisions that align with your needs and long-term health goals. Most importantly, make time to talk to your healthcare team for individualized advice (more on this below). 

3. Consult a health care professional.

Schedule an appointment with your doctor or a specialist in women’s health as soon as you learn you are in perimenopause. They can provide thorough guidance about what to expect, recommend necessary tests, and discuss treatment or lifestyle adjustments tailored to your individual circumstances. This proactive step ensures you have a trusted source of medical advice while navigating the complexities of perimenopause, helping you manage symptoms effectively and maintain your overall well-being.

4. Prioritize strength training.

“During perimenopause, hormonal shifts can affect muscle health, and we know that without intervention, our muscle mass steadily decreases with age,” says Johannah Katz, MA, RD, LDN, an Orlando-based registered dietitian. “This not only impacts metabolism and body composition but also increases the risk of falls and fractures later in life.”

Strength training is essential because it may help improve strength, physical activity, bone density, and hormonal and metabolic levels. Data published in BMC Women’s Health showed that resistance training resulted in an increase in fat-free mass among women who were at least 40 years old and not yet postmenopausal.

5. Resist the urge to buy menopause supplements.

While it may be tempting to turn to supplements that promise quick relief during perimenopause, it’s important to approach them with caution. Many supplements lack comprehensive scientific evidence to back their claims, and their effectiveness can vary widely from person to person. “Some of these approaches are downright dangerous, difficult to maintain, and expensive,” says Ward. 

That’s not to say that all perimenopause-focused supplements should be avoided. But they may not be necessary. Instead of relying on expensive over-the-counter products, focus on maintaining a balanced diet rich in essential nutrients, staying active, and consulting your healthcare provider for personalized advice. This approach not only saves you money but also ensures that you are prioritizing methods that are proven to support your well-being during this natural transition. And always talk to your doctor before trying anything new. 

Other Tips for Navigating Perimenopause

There’s no one “right” way to navigate perimenopause; it’s all about making healthy lifestyle choices that work for you. Here are some habits to consider when entering this new phase: 

• Prioritize Nutrition: A balanced diet rich in fruits, vegetables, lean protein, and healthy fats may help manage hormonal shifts and support overall health. Eating a balanced diet may be particularly helpful in reducing the risk of cardiovascular disease and osteoporosis—two conditions that post-menopausal women tend to be at a greater risk for.
• Stay Physically Active: Regular exercise, including cardio, strength training, and flexibility-focused activities like yoga, may help manage weight, improve mood, and reduce the risk of conditions associated with hormonal changes, such as osteoporosis and heart disease.
• Practice Stress Management: Techniques like meditation, deep breathing, or mindfulness exercises may help mitigate the emotional challenges that often accompany hormonal fluctuations. Consider setting aside time each day for relaxation.
• Get Adequate Sleep: Prioritize creating a restful sleep environment and maintain a consistent sleep schedule. Limit caffeine and screen time before bed to improve the quality of your sleep, which may be disrupted due to hormonal changes.
• Focus on Bone Health: Hormonal changes can significantly impact bone density, increasing the risk of osteoporosis. To support bone health, ensure an adequate intake of calcium-rich foods such as dairy products, leafy greens, and fortified alternatives. Additionally, vitamin D is essential for calcium absorption, so consider adding vitamin D-rich foods, spending time in sunlight, or taking supplements if needed. Weight-bearing exercises, such as walking, jogging, or resistance training, are also vital for maintaining strong bones and preventing bone loss.

The Bottom Line

Entering perimenopause can feel overwhelming, but taking proactive steps can make this transition smoother and more manageable. By taking the right steps, you can approach this stage of life with confidence. Remember, every person’s experience is unique, and it’s OK to seek help and support when needed. Staying connected with healthcare professionals and loved ones can provide additional reassurance as you navigate this new chapter. You’ve got this—positive changes and new beginnings await!