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Franco Rubartelli

The Foods You Should Include In Your Diet If You’re Perimenopausal

From calcium-rich dairy to kimchi, experts share the foods you should be eating more of as you enter perimenopause.

Vogue Adria

March 2, 2024

Identified as the transitional time before entering the menopause, the perimenopause marks the ending of a woman’s reproductive years and is usually first characterised by an irregular menstrual cycle. Although often ignored or undiagnosed – and easily confused with a slew of other health conditions faced by middle-aged women – the perimenopause, just like the menopause itself, can bring huge changes and challenges. With symptoms ranging from (but not limited to) hot flushes and disturbed sleep to mood swings, it can be a tumultuous time.

One way to offset the impact of some of these changes is through diet. If adopted early enough, the right tweaks will not only help to ease immediate symptoms, but could also help make your transition through to menopause less traumatic. “It’s more about a shift in your whole [way of] eating, because what [you might have] gotten away with in the past, you can’t really get away with during the perimenopause and menopause,” says Dr Naomi Potter, founder of Menopause Care and the author of Menopausing. “[That means avoiding] the hyper-palatable, high fat, high sugar, high salt foods that, if you are not feeling so great, you tend to reach for. It’s about shifting away from things that are quick and easy.”

Stimulants like caffeine and alcohol should also be avoided where possible, as they can exacerbate or even trigger hot flushes, and steer clear of anything too spicy that might cause inflammation in the body. “Diet is key [and] the thing to remember is that our bodies are not… in compartments, it is all connected,” says skin and wellness expert, Marie Reynolds.

Vogue asked the experts to share their advice on what women should be eating more of while experiencing perimenopause.

Getty: d3sign

Stick to healthy whole foods

It goes without saying that your basic diet needs to be healthy, fresh and balanced if you’re facing the perimenopause. That means eating plenty of fresh fruit and vegetables, wholegrains, healthy fats, good quality protein and fibre. By keeping the foundations of your daily diet strong, you’re setting yourself up to better handle the changing hormones that can impact your physical and mental health. “If you go for foods that are complex and unrefined, then they are normally more nutrient rich, so they’ve got the micronutrients and macronutrients,” says Dr Potter. “They are not insulin surges, so they don’t give you that quick sugar rush that then leads to the sugar and insulin low.” Fuelling yourself with lots of satiating protein and slow-release carbohydrates, like lean meat, fish, oats and sweet potatoes, is a good way to maintain a level blood sugar balance. That’s key if you are looking to reduce the sugar cravings and lack of energy associated with perimenopause.

Harness plant power

Declining levels of oestrogen are a hallmark of the menopause, and it often starts during the perimenopausal years. A critical female sex hormone that’s responsible for menstruation, bone health, puberty and pregnancy, when it begins to tail off the impact can be significant. Although not a like-for-like replacement for that which is being lost, plant oestrogens or phytoestrogens should be included in abundance in your diet, because they bind to the body’s oestrogen receptors in a similar way to hormonal oestrogen.

One of the richest sources of lignans, a potent phytoestrogen, is flaxseed, which can easily be sprinkled into smoothies, soups or on top of cereal and yoghurt. Sesame seeds and pumpkin seeds are small but mighty sources to have on hand, while cruciferous vegetables like broccoli and kale are excellent ways to enrich your diet. Rich in isoflavones, another phytoestrogen, soy (think tempeh, tofu and edamame) should appear on your shopping list too. As well as helping compensate for declining oestrogen, phytoestrogens also contain antioxidants which help fight cell damage linked to chronic diseases.

Feed your gut

The all-important gut can also be affected by fluctuating levels of oestrogen. “A specific group of bacteria in the gut is involved in processing and circulating oestrogen within the body,” says Lorraine Perretta, head of nutrition at Advanced Nutrition Programme. When those levels change, the gut bacteria becomes altered, which can lead to a host of issues including changes in skin health, brain function and sleep patterns.

Because the gut is so prone to being thrown off kilter with these hormonal changes, it’s important to encourage a healthy and diverse gut microbiome. “I would recommend eating plenty of gut-friendly fermented foods, in particular kimchi and tempeh,” adds Perretta, “ Anything with live cultures, such as live yoghurt, sauerkraut and miso can help to support the gut, in turn helping to support your skin and wellbeing.” If you struggle to include enough in your diet, a supplement can help. Advanced Nutrition Programme’s Skin Youth Biome is a good place to start.

Greens for better bone health

Another side effect of falling oestrogen levels is a reduction in bone density and mass, both of which can lead to conditions like osteoporosis – experts believe that women lose as much as 10 per cent of their bone mass in the first five years after menopause. “Vitamin D and calcium are particularly important. Bones can start to thin with the decline in oestrogen, and ensuring that vitamin D levels are high enough is important,” says Dr Potter. To reduce your risk make sure you have enough calcium, magnesium and vitamins D and K in your diet, all of which are fundamental to good bone health. Dairy is an obvious choice but dark leafy greens like kale and cabbage contain beneficial amounts of magnesium and vitamin K. Eating plenty of magnesium-rich foods can also help ward off irregular sleep patterns that many women experience.

To maintain the stores that you’ve worked so hard to build up, avoid eating foods that contain too much phosphorus. Found mainly in processed food and red meat, phosphorus is a mineral that causes the body to pull calcium out of your bones, making them weaker. Go one step further and support your healthy eating habits with some weight-bearing resistance training, which has been shown to support bone health and improve muscle strength.

Healthy fats to stay happy

Mood swings, depression and increased irritability are all part of many women’s perimenopausal experience. To maintain mental equilibrium, try and include plenty of healthy fats in your diet. Remember the acronym SMASH: that’s salmon, mackerel, anchovies, sardines and herring. High in vitamin D as well as iodine and selenium which support healthy thyroid function, these fish are also rich in anti-inflammatory omega-3s. According to experts, diets that are higher in omega-3 have been linked to a lower likelihood of depression and anxiety, while healthy fats can also help improve brain function – essential if you suffer from menopausal fogginess and forgetfulness. If oily fish isn’t on the menu for you, try upping your intake of avocados, eggs, chia seeds and olive oil instead.

Increasing your intake of healthy fats won’t only benefit your mood. “The menopause will also cause the drying of mucus membranes, which means everything dries up,” says Reynolds. As well as lubricating your joints and helping to prevent vaginal dryness (another unwelcome symptom of perimenopause), eating lots of healthy fats like omegas and glucosamine (found naturally in the shells of lobster and crab) helps strengthen your skin’s natural barrier, keeping it hydrated and preventing moisture loss.