Perimenopause preparedness: nourish your body through the transition

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Life is full of transitions, and just when you think you've mastered your routines — balancing work, family, social life and wellness — your hormones decide to shift gears. As the ovaries produce fewer eggs, estrogen and progesterone fluctuate unpredictably, setting off a cascade of changes that last an average of four to eight years before menopause. These hormonal shifts can sometimes bring hot flashes, mood swings, brain fog, sleep disturbances, intimacy discomfort, digestive issues, weight changes and joint pain — often leaving you wondering why your tried-and-true wellness strategies suddenly feel ineffective.

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Our moms may have kept quiet about perimenopause, but conversations about hormonal health have gained momentum, and today more information is at our fingertips than ever before. From bioidentical hormone therapy to adaptogens, personalized nutrition and medications, the options seem endless. But what truly works? How do you support your body through this transition in a way that aligns with your unique needs?

Read on for some basic background and tips to fuel your body for the fluctuations ahead so you feel empowered, energized and in control as you navigate this phase of life.

What’s Contributing to My Perimenopause Symptoms?

Hormonal fluctuations are the driving force behind perimenopause symptoms. In the early stages, estrogen and progesterone levels can swing dramatically and unpredictably, like a hormonal rollercoaster. As perimenopause progresses, there’s a more consistent decline in these hormones, leading to noticeable changes throughout the body. Think of it as puberty in reverse —the shift can throw off sleep, mood, metabolism and overall well-being.

The good news? Many of these changes can be managed through nutrition and lifestyle choices. Below are key areas of health impacted by perimenopause and strategies to support your body through the transition.

Insulin Resistance

Estrogen plays a vital role in insulin sensitivity, helping regulate blood sugar, metabolism and energy balance. As estrogen levels drop, many women experience increased insulin resistance which makes it harder to stabilize blood sugar levels. This can lead to fluctuating energy, mood swings, stubborn weight gain, higher LDL cholesterol, increased cravings and even joint discomfort. Supporting insulin sensitivity through balanced nutrition, movement and stress management can help minimize these effects.

Inflammation

Estrogen helps regulate the immune system and keeps pro-inflammatory cytokines in check. As levels decline, inflammation can spike, showing up as brain fog, skin irritation, joint pain, digestive distress and fatigue. In general, chronic inflammation can exacerbate most aging-related concerns. Incorporating anti-inflammatory foods, regular physical activity and quality sleep into your routine can make a big difference.

Gut Imbalances

Hormones influence gut health more than most people realize. Estrogen supports a healthy gut lining and microbiome, while progesterone helps relax the smooth muscles of the digestive tract to keep things moving. As these hormones fluctuate, you might notice some digestive discomfort, bloating and constipation. Supporting gut health with fiber-rich plant foods, hydration and mindful eating can make a big difference in digestive balance.

Decreased Stress Resilience

Estrogen protects neurotransmitters like serotonin and dopamine, while progesterone has natural calming effects, and oxytocin fosters connection and emotional well-being. As these hormones decline, stress can feel more overwhelming, and heightened cortisol sensitivity can amplify anxiety and emotional ups and downs. Sleep disturbances further compound the issue, making resilience harder to maintain. Prioritizing stress management techniques, restorative sleep, movement and social connection can help regulate emotional well-being during this transition.

   

Nailing Down Nutrition

A solid nutrition foundation is key to leveling out imbalances that emerge as hormone levels fluctuate and decline. The first step? Focus on eating patterns to enhance metabolic flexibility, stabilize blood sugar, support energy and mood, optimize gut health and reduce inflammation. Once these foundations are in place, working with a qualified health care provider can help fine-tune your approach with targeted supplements and/or medications for personalized support.

Foundational Foods and Eating Patterns

Prioritize whole, nutrient-dense foods including lots of plants (e.g., vegetables, nuts, seeds, herbs, spices, legumes, fruit, whole grains), and drink plenty of water.

  • Plan full, balanced meals that include:
  • Consider meal prep short-cuts to have healthy meals without the fuss and frustration.
  • Eat mindfully at the kitchen table or outside when the weather allows.
  • Give your body 12 hours (or more if/when appropriate) with no food or sweetened beverages between dinner and your next meal.

Limit or Eliminate

  • Snacking/grazing out of boredom or for a quick fix
  • Simple sugars/processed carbohydrates
  • Alcohol
  • Caffeine – strategic consumption is key
    • If you wake up anxious or stressed, avoid caffeine within the 1-2 hours of waking.
    • If you are sensitive to caffeine, avoid it on an empty stomach and after 12pm.

What’s Next?

Read Perimenopause power-up: beyond basic nutrition for a deeper dive into micronutrients, therapeutic foods and essential lifestyle strategies to optimize mid-life nutrition and maintain perimenopause poise.

 

Shredded Chili Tofu

Makes 2-3 servings
Recipe Adapted From: It Doesn't Taste Like Chicken
PRINT RECIPE

Ingredients
1 350g block extra-firm tofu
1 Tbsp avocado oil
1 Tbsp tamari or soy sauce
2 tsp chili powder
½ tsp smoked paprika
½ tsp garlic powder
¼ tsp cayenne pepper (optional)

Instructions

  1. Preheat your oven to 350°F (180°C). Line with parchment paper or lightly grease a large baking sheet.
  2. Drain off the excess water from the tofu and pat dry. (There is no need to press the tofu.)
  3. Use the large side of a cheese grater to grate the block of tofu into shreds. Set aside.
  4. Mix the oil, tamari/soy sauce, chili powder, smoked paprika, garlic powder and cayenne (if using) in a large bowl. Add the shredded tofu and use a spatula to gently toss to evenly coat the tofu in the seasonings.
  5. Spread the tofu evenly over the prepared pan. Bake for about 30 minutes, stirring the tofu halfway through, until the tofu is browned. For chewier shreds you will want to bake them a little longer, or for more tender shreds bake them a little less.
  6. Serve over a salad, in tacos or lettuce wraps, on a baked potato, or any other way you like.
  7. Shredded tofu will last for several days in an airtight container in the fridge.

Note: If you’d like the tofu to more closely resemble BBQ shredded chicken, heat up ¼ cup of your favorite BBQ sauce and ¼ cup water in a pan, and after the tofu is done baking, stir in the tofu. The tofu will absorb some of the liquid and soften to create a meaty texture.

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About Author

Jen Sohl-Marion, MPH, RDN, LDN

Manager of Nutrition and Healthy Living Programs

Jen is the Manager of Nutrition and Healthy Living Programs at SAS Institute in Cary, NC. She is a Registered Dietitian Nutritionist and an Integrative and Functional Nutrition Certified Practitioner. Outside of work, Jen enjoys hiking with her family, practicing yoga and spending quality time with her dogs.

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