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Perimenopause; can diet and lifestyle help?

It's that life stage that creeps up on you and just when you're in the thick of work stress and bringing up kids, symptoms appear with a bang; tiredness, anxiety, changes in menstrual cycle, dry skin and hair, sort joints, weight gain, brain fog and feeling hot, hot, hot....and not in a sexy way!

So can diet and lifestyle help?

Well, it certainly can for some people and is worth a try.

Here are my top 3 ideas:

Increase phytoestrogens;

Changing 10% of your diet to include phytoestrogens can help to reduce hot flashes. A review of relevant research (1) states that, while results have been inconsistent, a 2012 meta-analysis concludes that ingestion of soy isoflavones (average 54 mg; aglycone equivalents) for 6 weeks to 12 months significantly reduced the frequency of hot flashes by 20.6% and severity by 26.2% (2). 

The three isoflavones genistein, daidzein and glycitein account for approximately 50%, 40% and 10%, respectively, of the total isoflavone content of soybeans. Isoflavone supplements providing more than 18.8 mg of genistein (the average for all studies) were more than twice as potent at reducing hot flash frequency than lower genistein supplements. Each gram of soy protein in soybeans and traditional soyfoods is associated with approximately 3.5 mg of isoflavones. So, one serving of a traditional soyfood, such as 100 g of tofu or 250 ml soymilk, typically provides about 25 mg isoflavones (1). Eating in fermented form, such as miso, natto or tempeh, is the more traditional way of consuming soy in Asian countries. It is also important to always look for non GMO.  

Other sources of phytoestrogens include chickpeas, lentils and flaxseed. Having a balance between the various sources is important, so mixing and matching is a good idea: how about miso soup with hummus on wholewheat pitta for lunch, or lentil dhal with dinner and ground flaxseed on your porridge. (3). Why not try my recipe for Miso and Bean Soup and incorporate a range of phytoestrogens in one bowl!

Boost essential fats

Found in nuts, seeds, oily fish and eggs, essential fats, such as Omega 3, help your hormones to work more effectively and can really help with dry skin, vaginal dryness, painful joints and high cholesterol (3). A 2018 review also found that Omega 3 supplementation helped to reduce night sweats (4). 

Food sources, such as salmon, trout, mackerel, sardines and herrings contain the active and potent omega 3's called EPA and DHA. These can get to work straight away. Vegetarian sources includes ground flaxseed, chai seeds, pumpkin seeds and walnuts, as well as algae based supplements. Aim to incorporate at least one source into your diet per day, with oily fish 2-3 per week. My recipe for Smoked Mackerel Pate is an easy way to incorporate oily fish into your lunchtime routine. 

Reduce stress

The production of stress hormones can interfer with the production and use of oestrogen and progesterone, which can make perimenopausal symptoms worse (3). Managing sources of stress can actually be a bit more wide ranging and trickier than it seems. Sources include:


Actually feeling stressed, whether in work, with the kids, in traffic. Trying to find mechanisms to help you cope with day to day stresses is very important, whether it's deep belly breathing, or mindfulness, or yoga or getting outdoors for 30 minutes per day. 

Blood sugar rollercoaster; eating refined carbohyrates and sugary foods can cause swings in blood sugar, leading to the production of stress hormones. Aim to reduce sugar and refined carbohydrates, include good fats and/or protein at meal times, as well as a small amount of wholegrain carbohydrates, and increasing berries and vegetables. 

Reduced sleep; your sleep hormone, melatonin, acts in tandem with cortisol to manage your circadian rhythm. Dysfunction on one can disrupt the production of the other, leading to disrupted sleep and possibly insomnia, which impacts on hormone production around the body. To maximise your sleep, aim to switch off electronic devices at least one hour before bed time, try to get exposure to day light at some stage during the morning, avoid stimulants such as caffeine, nicotine and alcohol, especially in the afternoon (5). 


This is not a complete list of all the things to try to reduce symptoms of perimenopause, but it's a good place to start. For a more indepth discussion on your symptoms and how nutritional therapy can help, why not book a one to one consultation where we'll come up with a plan tailored to you. Click on the foodhugs clinic tab for more information. 

1. Messina M. Soy and Health Update: Evaluation of the Clinical and Epidemiologic Literature. Nutrients [Internet]. 2016 [cited 9 January 2020];8(12):754. Available from:

2.Taku K, Melby M, Kronenberg F, Kurzer M, Messina M. Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity. Menopause: The Journal of The North American Menopause Society [Internet]. 2012 [cited 9 January 2020];19(7):776-790. Available from:

3. Glenville, Marilyn. Natural Solutions to Menopause. London; Pan Macmillan. 2011.

4. Mohammady M, Janani L, Jahanfar S, Mousavi M. Effect of omega-3 supplements on vasomotor symptoms in menopausal women: A systematic review and meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology [Internet]. 2018 [cited 9 January 2020];228:295-302. Available from:

5. Chatterjee, Rangan. The stress solution; 4 steps to a calmer, happier, healthier you. London; Penguin Life. 2018.

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