Navigating Perimenopause Naturally
Perimenopause means “around menopause” and refers to the time that the female body begins making the natural transition to menopause, which marks the end of the reproductive years. Perimenopause is also called the menopausal transition.
Perimenopause begins around the average age of 45, with some women experiencing symptoms starting at mid to late 30’s and others not experiencing symptoms until the age of 50. Perimenopause can be considered the bridge between the fertile years and menopause. It is characterized by a marked decline in estrogen, which leads to progressive amenorrhea, or irregular menstrual cycles until menses has ceased entirely.
Most women start to experience hot flashes, alterations in sleep, depression, increased anxiety, vaginal dryness, sleep disturbances, dyspareunia, and other mood disturbances.1
After the period of perimenopause, women will transition into menopause, which is characterized by the permanent cessation of the menstrual cycle after experiencing amenorrhea for 12 months. Women will experience similar symptoms during menopause as they did during perimenopause. As estrogen levels continue to decline through menopause, they will eventually stabilize at significantly lower amounts than the fertile or perimenopausal period. Dependent on the individual, some women will experience symptoms of menopause for many years, while others might experience minimal or no symptoms.2
In addition to the wide range of hormonal fluctuations and symptoms women might experience during perimenopause and menopause, they are also at an increased risk of osteoporosis, cardiovascular disease, and some cancers. Taking proactive measures and strategies to prevent these conditions, concerns, and risks through nutritional and physical means can set women up for long-term health and wellness.
Whole Food Nutrient-Rich Diet
Diet plays an important role in the onset and symptoms of perimenopause and menopause. Studies have found that women who consumed higher quantities of vegetables had lower vasomotor abnormalities contributing to fewer menopausal symptoms, improved quality of life, and better cognition. In contrast, those consuming a diet rich in refined and ultra-processed foods experienced more severe menopausal symptoms, sexual dysfunction, worsened memory, and had worse self-rated health scores.3
Additionally, studies support whole food diets rich in Vitamins D, C, and B complex, Calcium, and higher protein intake in reducing the risk of osteoporosis, cardiovascular disease, insulin resistance, and osteoporosis development.4
A whole food-based diet would be one characterized by an abundance of vegetables, fruits, lean protein, unrefined fats, whole grains, and healthy fluid intake.
Nutrients to Support Hormones
Magnesium is a mineral supporting and acting as a co-enzyme for over 300 processes within the body. The key function of magnesium is to support bone health, sleep, energy production, insulin sensitivity and mood. For perimenopausal and menopausal women, adequate magnesium intake helps protect against osteoporosis as magnesium helps integrate and absorb calcium into the bones. Magnesium has relaxation properties, and has been shown to help support and achieve restful sleep.
It also supports mood, reducing anxiety and depression. Magnesium may also reduce the frequency and severity of hot flashes, however more research is needed to confirm. .5 Some foods rich in magnesium include dark chocolate, leafy greens, buckwheat, Swiss chard, beans, and bananas.
Calcium – As women entering perimenopause and menopause are at a higher risk of osteoporosis, an emphasis on calcium is needed. It is recommended that perimenopausal women consume 1,000 mg of calcium, and menopausal women should consume 1,200 mg. These levels have been shown to prevent bone loss and reduce the risk of fractures.6 Foods high in calcium include dairy products, bone meal, collard greens, and kale.
Vitamin D – Adequate Vitamin D consumption is vital for proper calcium absorption. It is recommended to consume at least 600 IUs of Vitamin D per day, alongside the calcium intake for peri- and menopausal women. Not only does Vitamin D help enhance the absorption of calcium, but it is also important for supporting hormone balance, improving mood, and reducing fatigue. Additionally, Vitamin D has been shown to enhance the growth of vaginal epithelial cells and alleviating genitourinary tract problems, as well as regulating the immune response.7 Foods high in vitamin d include fish, dairy products, and eggs.
Omega-3 Fatty Acids provide vital nutrients, like EPA, DHA, and DPA. These compounds, and the anti-inflammatory nature of omega-3’s have been shown to help peri- and menopausal women. Whole Omega-3’s play an important role in general human health, they have been shown to reduce hot flashes, night sweats, and improve mood. Additionally, omega-3’s support healthy hair, skin, and nails, which are often impacted during menopause, and support musculoskeletal health.8 Foods high in omega-3s include fish, nuts, seeds, and eggs.
Phytoestrogens are plant-derived estrogen-like compounds, or plant compounds with estrogen-like properties. They include isoflavones and lignans, which have a similar chemical structure to estradiol. Phytoestrogens can exert estrogenic or antiestrogenic effects, dependent on the physiological state of the body. In peri- and menopause, the body experiences depleting levels of estrogen. When the body has low estrogen levels, phytoestrogens can help exert an estrogenic effect.
In most cases, the main symptoms of menopause stem from the lack of estrogen, including hot flashes, mood swings, vaginal dryness, and the increased risk of osteoporosis. Incorporating phytoestrogens into the regime can help produce estrogenic signals, thereby reducing the severity of menopausal symptoms.9 Foods high in phytoestrogens include flax, cruciferous vegetables including kale, nuts, garlic, and alfalfa.
Resistance Training
One of the hallmarks of perimenopause and menopause is the decline of bone and muscle mass, often leading to osteoporosis. One strategy to combat the loss of muscle mass is performing in regular resistance training. As opposed to aerobic training, anaerobic training teaches the body to respond to an external force, or resistance, to build or maintain muscle.
For women in the menopausal state, resistance training has been shown to improve muscle mass, bone density, joint health, enhanced mood and clarity, improve sleep, and set women up for success in later years with improved balance. Additionally, as resistance training can help build and maintain muscle mass, it can regulate metabolism, leading to a more active, responsive metabolism, even into later life.
Healthy Sleep
Unfortunately, sleep is often impacted during menopause due to alterations in hormones. However, healthy sleep practices are paramount to a comfortable menopause transition. Some ways to combat sleep issues during menopause include reducing screen time, participating in a consistent sleep schedule, supplementing with magnesium, and opting for herbs like chamomile, lemon balm, valerian, and jujube, lavender, or passionflower to promote relaxation in the body.
Herbal Strategies
Herbal strategies and interventions can be a fantastic option to support those going through the menopause transition.
Wild Yam – Wild yam has been traditionally used to support menopause symptoms, muscle spasms, and can act as an antioxidant. It contains a compound called diosgenin, which is a precursor of gonadal hormones, indicating it can have estrogenic effects. The lack of estrogen in menopause results in menopausal symptoms, and supplementing with estrogenic compounds can reduce symptoms.11
Black Cohosh – Similarly to wild yam, black cohosh has estrogen-like effects to help reduce menopausal symptoms. In addition to the reduction of menopausal symptoms, like hot flashes and mood swings, black cohosh has serotonergic effects, which could impact mood and anxiety. Black cohosh also acts as an antioxidant, which could reduce the risk of developing cardiovascular disease.12
Ginseng – Ginseng has been used as a complementary therapy in menopause treatment for decades, specifically Korean Red Ginseng. Ginseng contains ginsenosides, which have estrogen-like effects, helping to alleviate menopause symptoms. In addition, studies have found ginseng to be a significant therapy for improving well-being and depression symptoms, compared with placebo, for those going through menopause transitions.13
Maca – Maca has commonly been thought of as a hormone balancing herb, it has balancing properties that can be beneficial for menopause. Studies have found maca can alleviate nervousness, mood disorders, and anxiety/depression in those going through menopause, as well as promoting normal sexual functioning.14
St. John’s Wort – St. John’s Wort is commonly used as a mood support formula, often assisting those with anxiety and depression. However, clinical studies have shown that St. John’s Wort can reduce psychological and vegetative symptoms of menopause, like hot flashes and mood swings, as well as promoting a sense of vitality.15
Key Takeaway
The female lifecycle is characterized by significant changes, often uprooting the current life phase and pushing them into another challenge. Utilizing herbal strategies, like Ginseng or Black Cohosh, alongside nutritional and lifestyle interventions can significantly reduce the symptoms that women experience during the menopausal transition and promote a better quality of life.
To learn more about black cohosh, check out our Black Cohosh Whole Plant Minutes with Mimi Hernandez video below:
Did you know WholisticMatters is powered by Standard Process? Learn more about Standard Process’ whole food-based nutrition philosophy.
- Santoro, N. (2016). Perimenopause: From Research to Practice. Journal of Women’s Health, 25(4), 332-339. doi: 1089/jwh.2015.5556
- Peacock, K., Carlson, K., Ketvertis, K. M. (2023). StatPearls [Internet]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507826/
- Silva Noll, P. R., Noll, M., Zangirolami-Raimundo, J., Baracat, E. C., da Costa Louzada, M. L., Junior, J. M. S., Sorpreso, I. C. E. (2022). Life Habits of Postmenopausal Women: Assocation of Menopause Symptom Intensity and Food Consumption by Degree of Food Processing. Maturitas, 156, 1-11. https://doi.org/10.1016/j.maturitas.2021.10.015
- Erdelyi, A., Palfi, E., Tuu, L., Nas, K., Szucs, Z., Torok, M., Jakab, A., Varbiro, S. (2023). The Importance of Nutrition in Menopause and Perimenopause – A Review. Nutrients, 16(1), 27. doi: 3390/nu16010027
- Park, H., Qin, R., Smith, T. J., Atherton, P. J., Barton, D. L., Sturtz, K., Dakhil, S. R>, Anderson, D. M., Flynn, K., Puttabasavaiah, S., Le-Lindqwister, N. A., Padula, G. D., Loprinzi, C. L. (2015). NCCTG N10C2 (Alliance) – A Double-Blind, Placebo-Controlled Study of Magnesium Supplementation to Reduce Menopausal Hot Flashes. Menopause, 22(6), 627-632. doi: 1097/GME.0000000000000374
- North American Menopause Society. (2001). The Role of Calcium in Peri- and Postmenopausal Women: Consensus Opinion of The North American Menopause Society. Menopause, 8(2), 84-95. doi: 10.1097/00042192-200103000-00003.
- Mei, Z., Hu, H., Zou, Y., Li, D. (2023). The Role of Vitamin D in Menopausal Women’s Health. Frontiers in Physiology, 14, 1211896. doi: 3389/fphys.2023.1211896
- Iqbal, A. Z., Wu, S. K., Zailani, H., Chiu, W. C., Liu, W. C., Su, K. P., Lee, S. D. (2023). Effects of Omega-3 Polyunsaturated Fatty Acids Intake on Vasomotor Symptoms, Sleep Quality, Depression in Postmenopausal Women: A Systematic Review. Nutrients, 15(19), 4231. doi: 3390/nu15194231
- Chen, M. N., Lin, C. C., Liu, C. F. (2014). Efficacy of Phytoestrogens for Menopausal Symptoms: A Meta-Analysis and Systematic Review. Climacteric, 18(2), 260-269. doi: 3109/13697137.2014.966241
- Woods, N. F., Mitchell, E. S., Smith-DiJulio, K. (2009). Cortisol Levels during the Menopausal Transition and Early Postmenopause: Observations from the Seattle Midlife Women’s Health Study. Menopause, 16(4), 708-718. doi: 1097/gme.0b013e318198d6b2
- Komesaroff, P. A., Black, C. V., Cable, V., Sudhir, K. (2001). Effects of Wild Yam Extract on Menopausal Symptoms, Lipids and Sex Hormones in Healthy Menopausal Women. Climacteric, 4(2), 144-50. PMID: 11428178.
- Castelo-Branco, C., Navarro, C., Beltran, E., Losa, F., Camacho, M. (2022). Black Cohosh Efficacy and Safety for Menopausal Symptoms. The Spanish Menopause Society Statement. Gynecol Endocrinol, 38(5), 379-384. doi: 10.1080/09513590.2022.205659
- Kim, M. S., Lim, H. J., Yang, H. J., Lee, M. S., Shin, B. C., Ernst, E. (2013). Ginseng for Managing Menopause Symptoms: A Systematic Review of Randomized Clinical Trials. J Ginseng Res, 37(1), 30-36. doi: 5142/jgr.2013.37.30
- Meissner, H. O., Mscisz, A., Reich-Bilinska, H., Mrozikiewicz, P., Bobkiewicz-Kozlowska, T., Kedzia, B., Lowicka, A., Barchia, I. (2006). Hormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium Peruvianum Chacon): (III) Clinical Responses of Early-Postmenopausal Women to Maca in Double Blind, Randomized, Placebo-Controlled, Crossover Configuration, Outpatient Study. International Journal of Biomedical Science, 2(4), 375-294. PMID: 23675006
- Grube, B., Walper, A., Wheatley, D. (1999). John’s Wort Extract: Efficacy for Menopausal Symptoms of Psychological Origin. Adv Ther, 16(4), 177-86. PMID: 10623319