Written by
Louise W Lu, PhD, MPH, BMLS
Reviewed by
Michelle Ordner, Registered Nurse
"I’m not eating more, but I’m gaining weight. I feel tired, moody, and nothing seems to work anymore. What’s going on?"
If this sounds familiar, you're not broken. You're likely entering perimenopause — a natural but often confusing life phase where your body undergoes profound internal changes.
In perimenopause, hormones like estrogen and progesterone don't simply decline. They fluctuate unpredictably. These fluctuations impact how your body metabolizes sugar, stores fat, manages stress, regulates sleep, stabilizes mood, maintains muscle mass, and repairs cells. For a deep dive into these symptoms, check out our previous blogs: [Guide to Perimenopause: Your Body Is Changing — And It’s Smarter Than You Think] and [10 Signs You Might Be in Perimenopause (and What to Do About It)].
At this pivotal time, what you eat, how you move, and how you recover can either support your new rhythm — or work against it.
Forget quick fixes and exhausting diets. This guide is designed to help you work with your body’s new rhythm—not against it—combining the latest science with practical wisdom, so you can feel strong, clear-minded, and confident again.
Jump to Sections:
- Why is Nutrition Crucial During Perimenopause?
- Support Estrogen & Progesterone Metabolism
- Reduce Chronic Inflammation
- Maintain Muscle & Bone Strength
- Balance Blood Sugar & Insulin Sensitivity
- Support Brain & Mood Neurotransmitters
Why is Nutrition Crucial During Perimenopause?
Does this sound like you? You’re eating exactly like you always have, yet the weight keeps sneaking up. Meals you used to enjoy now leave you feeling exhausted, hungry shortly after, or even a little irritable.
Here’s what’s really happening: During perimenopause, estrogen and progesterone aren’t just fading away—they’re taking you on a hormonal rollercoaster. These unpredictable ups and downs mean your body processes sugars and fats differently, causing sharper blood sugar spikes after meals, increased belly fat storage, and a noticeable decline in muscle tone. Suddenly, foods your body managed effortlessly a decade ago become tricky.
What science says: Research has found that women entering perimenopause experience larger spikes and dips in blood sugar levels after meals, leading to energy crashes, increased hunger, and a higher long-term risk of metabolic issues like diabetes or heart disease. But here’s the good news: small dietary shifts can smooth out these spikes and support your metabolism.
Your game plan: By simply adding protein and fiber-rich veggies to each meal, incorporating healthy fats, and cutting down on sugars and processed carbs, you can ease these metabolic changes. The right nutrition helps you regain balance, boost energy, and start feeling like your best self again.
Support Estrogen & Progesterone Metabolism
Common Complaints:
Swollen breasts, mood swings, bloating, anxiety before your period, irregular cycles — even though your period hasn't stopped yet.
Why It Happens:
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During perimenopause, estrogen and progesterone levels don’t just decrease—they swing up and down unpredictably.
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Your liver and gut, responsible for breaking down excess hormones, might struggle to keep pace.
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This can lead to estrogen dominance, meaning your body holds onto excess estrogen, causing symptoms like breast tenderness, mood shifts, and bloating.
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If your body struggles with estrogen clearance over time, it could increase your risk of issues like fibroids, thickened uterine lining, or even hormone-related cancers.
Scientific Insight:
Research shows that poor estrogen metabolism is linked not just to symptoms, but also to increased risks of fibroids, endometrial thickening, and even hormone-sensitive cancers. Efficient estrogen detoxification becomes crucial.
What You Can Eat to Help:
- Eat 5+ servings of colourful vegetables daily to boost liver detox enzymes (especially sulfur-rich foods like onions, garlic, broccoli). Colourful polyphenols (e.g., from beets, berries, leafy greens) up-regulate liver Phase I and Phase II detox enzymes like CYP1A2 and GST, critical for processing excess estrogen in liver.
- Include cruciferous vegetables: Broccoli, cauliflower, cabbage, kale (at least 3 times a week). These veggies contain special compounds that help convert estrogen into safer forms.
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Add high-fibre foods (chia seeds, oats, brown rice) at breakfast to to help remove used-up hormones through your digestive system.
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Enjoy 1 serving/day of fermented foods (miso, yogurt, kimchi) to enhance gut health, reducing reabsorption of hormones.
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Prioritise plant diversity: research suggests 30+ different plants per week improves gut-liver-hormone pathways.
Supplements to give you a boost:
- Active B6, B12, and Methylfolate: These vitamins fuel methylation, a key process in liver-based estrogen detox. Deficiencies can slow clearance and exacerbate mood symptoms.
- Magnesium + Zinc: Magnesium calms the nervous system and eases PMS; zinc is vital for progesterone production and helps liver enzymes function properly.
- D-Mannose + Probiotics (LGG, Bifidobacterium lactis): Help maintain a healthy gut microbiome to support estrogen metabolism and reduce reabsorption of used hormones.
- DIM (Diindolylmethane) or I3C (Indole-3-Carbinol): Plant compounds from cruciferous vegetables that help convert estrogen into less active forms. Useful for breast tenderness and estrogen-related bloating.
- Milk Thistle + NAC (N-Acetyl Cysteine): These antioxidants enhance liver Phase II detoxification and glutathione production, protecting against hormone-related oxidative stress.
- Deer Placenta Extract: Rich in HO-1 (heme oxygenase-1), it helps reduce oxidative stress triggered by hormone swings. Rather than supplying hormones, it supports your body’s own hormone-producing environment and ovarian microcirculation.
- Chaste Tree Berry (Vitex agnus-castus): Naturally supports healthy progesterone levels and estrogen balance, making it especially helpful for breast tenderness, PMS-like mood swings, anxiety, and irregular menstrual cycles common during perimenopause.
Reduce Chronic Inflammation
What You Might Notice:
Waking up feeling sore and stiff? Puffy face? Itchy skin? Achy joints that seem to have “aged overnight”? You’re not imagining it.
Why It’s Happening:
Estrogen naturally keeps inflammation in check. As estrogen levels drop, your immune system becomes more trigger-happy. Small inflammatory sparks can snowball into muscle pain, headaches, skin flare-ups, or plain old fatigue.
Scientific Insight:
Chronic low-grade inflammation during perimenopause doesn’t just make you feel lousy — over time, it’s linked to joint degeneration, cardiovascular disease, and faster biological aging. Supporting your body’s anti-inflammatory defenses now is one of the smartest moves you can make for long-term vitality.
What You Can Eat to Help:
- Pile your plate with antioxidant-rich foods like leafy greens, berries, carrots, purple cabbage, and sweet potatoes. Colourful plants are packed with flavonoids and carotenoids, natural inflammation-fighters.
- Eat fatty fish 2–3 times a week (think salmon, sardines, mackerel). Natural omega-3s help calm inflammatory pathways, protect your joints, and lift your mood.
- Cook with turmeric, ginger, and cinnamon daily. These spices work at the molecular level to block inflammatory messengers like NF-kB.
- Slash ultra-processed foods (like cookies, chips, and fast food) and swap in real whole foods. Processed foods stoke inflammation by damaging your gut barrier and feeding “bad” bacteria.
- Use cold-pressed olive or flaxseed oil instead of refined vegetable oils. Good fats balance your body’s omega-6 to omega-3 ratio and keep inflammation in check.
Supplements to Give You a Boost:
- Ultra-Pure Fish Oil (EPA:DHA = 5:1, >95% purity): High-EPA fish oil is a powerhouse for cooling down inflammatory processes, easing joint discomfort, and supporting breast and heart health during hormone swings.
- Turmeric Extract (Curcumin): Targets NF-kB and COX-2 — two major “inflammation switches” — helping soothe aches, skin irritation, and hormone-related puffiness.
- Astaxanthin: A potent antioxidant that stabilizes cell membranes and protects your skin, eyes, and joints from oxidative damage.
- Vitamin D3: Critical for immune balance. Low D3 levels are linked to more pain, worse mood swings, and even higher inflammation markers.
- Rosemary Extract (Rosmarinus officinalis): Natural rosmarinic acid fights oxidative stress, cools inflammation, and even supports memory and cognitive clarity.
- PQQ (Pyrroloquinoline Quinone): PQQ (Pyrroloquinoline Quinone): Promotes mitochondrial health, reduces oxidative damage, and supports tissue recovery from low-grade inflammation.
Maintain Muscle & Bone Strength
What You Might Notice:
Climbing stairs feels harder. Your back and knees complain after a long day. Your once-firm muscles start looking… softer. Even if you’re eating the same (or more), strength seems to vanish.
Why It’s Happening:
Estrogen is your secret weapon for maintaining muscle protein synthesis and bone mineral density. As levels decline in perimenopause, your body naturally shifts toward losing lean mass and bone strength.
→ This not only slows metabolism but also increases your risk of falls, fractures, and chronic aches.
Scientific Insight:
Research shows women can lose up to 8% of their muscle mass within 5 years of menopause. Bone loss can also accelerate by 2–3% per year if not proactively addressed. It’s not just about appearance — it’s about preserving your mobility, metabolism, and independence for decades to come.
What You Can Eat to Help:
- Aim for 20–30g of protein per meal. Include protein-rich foods like eggs, tofu, fish, Greek yogurt, tempeh, and cottage cheese to stimulate muscle repair.
- Snack smart with calcium-boosters. Almonds, sesame seeds, sardines (yes, with bones!) and fortified plant-based milks feed your bones the minerals they crave.
- Load up on leafy greens. Spinach, kale, and bok choy deliver calcium, magnesium, and vitamin K — key for strong bones.
- Add mushrooms and fermented soy foods. They’re rich in vitamin D2 and K2, helping calcium get into your bones (not your arteries).
- Ditch phosphorus-bombs like cola and processed meats. Excess phosphorus leaches calcium from bones and worsens mineral imbalances.
Supplements to Give You a Boost:
- Algae-Based Calcium + Vitamin D3 + K2: Gentle on digestion, high in bioavailability, and critical for steering calcium where it belongs — into your bones, not your arteries.
- HMB (Beta-Hydroxy Beta-Methylbutyrate): A natural muscle-preserving molecule that helps prevent muscle breakdown, especially when estrogen declines or workouts are irregular.
- Reduced CoQ10 (Kaneka Ubiquinol): Fuels mitochondrial energy production inside muscle cells, reducing fatigue and supporting endurance.
- Lycopene: A vibrant antioxidant (found in tomatoes and watermelon) that protects bone-building cells from oxidative stress and boosts bone formation signals.
- Boron: A trace mineral that supports calcium and magnesium metabolism, improves bone density, and may help regulate hormone levels.
- Maca Root Extract: A traditional adaptogen known for boosting stamina, balancing hormones naturally, and enhancing recovery after exercise. Maca may help improve energy levels, support lean muscle maintenance, and ease perimenopause fatigue without acting directly like estrogen.
Balance Blood Sugar & Insulin Sensitivity
What You Might Notice:
Sudden belly weight gain. Afternoon slumps where your body feels like it’s running on empty. Craving sugar or carbs late at night. Feeling foggy and sluggish after meals.
Why It’s Happening:
Estrogen isn’t just about reproduction — it fine-tunes how your body responds to insulin. When estrogen drops during perimenopause, your cells become less sensitive to insulin, meaning your body needs more of it to handle the same amount of sugar.
The result? More fat storage (especially around your midsection), blood sugar rollercoasters, and unstable energy.
Scientific Insight:
Research shows women experience larger post-meal blood sugar spikes as they age, even when eating the same foods they tolerated well in their 20s or 30s.
These spikes not only trigger cravings and crashes but also slowly raise the risk of metabolic issues like type 2 diabetes and heart disease if left unchecked.
What You Can Eat to Help:
- Combine protein, fiber, and healthy fats at every meal. This slows sugar absorption and smooths out your blood sugar curve.
- Prioritize low-GI carbs like quinoa, sweet potatoes, lentils, and buckwheat. They offer a slower, more stable energy release — no more carb comas!
- Snack smart: eat veggies or a protein bite before carbs. A handful of nuts, a boiled egg, or carrot sticks before a starchy meal can significantly reduce your blood sugar response.
- Experiment with morning time-restricted eating (like the KInD™ approach). Starting your day with a fat-adapted metabolism can improve insulin sensitivity over time. Consider time-restricted eating and morning intermittent keto cycles (like the KInD™ approach) to enhance fat metabolism.
Supplements to Give You a Boost:
- BHB Complex (Beta-Hydroxybutyrate): Provides clean, exogenous ketones to fuel your brain and body, helping curb morning cravings and improving fat metabolism.
- Chromium Picolinate: Enhances insulin receptor sensitivity, helping smooth out blood sugar fluctuations and tame sugar cravings.
- Cinnamon Extract (Cinnamaldehyde): Naturally mimics insulin’s action, slowing carb digestion and supporting balanced post-meal blood sugars.
- NMN (Nicotinamide Mononucleotide): Boosts NAD+ levels to support cellular energy, mitochondrial efficiency, and overall metabolic health — key for combating insulin resistance.
- Gymnema Sylvestre: A traditional herb known as the “sugar destroyer.” It helps stabilise blood sugar by improving insulin action and reducing sweet cravings — ideal for tackling perimenopausal belly fat and preventing afternoon energy crashes.
Support Brain & Mood Neurotransmitters
What You Might Notice:
Forgetfulness when you walk into a room. Mood swings that seem to come out of nowhere. Feeling “not like yourself.” Trouble falling asleep — or waking up at 3 AM and staring at the ceiling.
Why It’s Happening:
Estrogen isn’t just a “reproductive hormone” — it’s a major player in your brain.
It helps produce serotonin (your feel-good neurotransmitter) and GABA (your calming signal).
When estrogen levels fluctuate or fall, your brain’s chemical messengers get thrown off balance, leading to emotional ups and downs, sleep issues, and that classic perimenopause “brain fog.”
Scientific Insight:
Current research highlights that hormonal shifts during perimenopause are strongly associated with neurotransmitter disruptions, affecting mood, cognition, and sleep quality. Supporting these pathways can make a tangible difference in how you feel day-to-day.
What You Can Eat to Help:
- Eat tryptophan-rich foods like eggs, yogurt, bananas, pumpkin seeds, and turkey. Tryptophan is the raw material your body uses to build serotonin.
- Pair protein foods with complex carbs (like oats, quinoa, or brown rice). Carbs help tryptophan cross into your brain, boosting its calming effects.
- Prioritize magnesium- and omega-3-rich foods daily. Dark leafy greens, almonds, salmon, flaxseeds — all help buffer stress and support nervous system health.
- Skip evening sugar, caffeine, and heavy meals. They can overstimulate your brain when it needs to wind down for restful sleep.
Supplements to Give You a Boost:
- L-Tryptophan + 5-HTP: Natural building blocks for serotonin, helping to stabilize mood swings and improve sleep cycles.
- GABA + L-Theanine: Help your brain activate “calm mode,” reducing stress response and making it easier to fall and stay asleep.
- Magnesium (Glycinate or Citrate): Supports muscle and nervous system relaxation, critical for both deeper sleep and better mood regulation.
- Phosphatidylserine + CDP-Choline: Aid in brain cell membrane repair and improve mental clarity — great for tackling brain fog and focus issues.
- Ashwagandha (KSM-66® Withania somnifera): A clinically studied adaptogen that lowers cortisol levels, enhances resilience to stress, and supports better GABA activity — crucial for calming your mind and smoothing emotional swings during hormonal fluctuations.
- Rhodiola Rosea (Golden Root): An energy-balancing herb that boosts mental stamina, sharpens focus, and eases fatigue — perfect for beating that “midday brain meltdown” without relying on caffeine.
Explore More Articles in the Perimenopause Collection
More science-backed, self-compassionate guides to help you feel strong, clear, and energised through every phase:
- Guide to Perimenopause: Your Body Is Changing — And It’s Smarter Than You Think
- 10 Signs You Might Be in Perimenopause (and What to Do About It)
- What Can You Do in Perimenopause? A Complete Nutrition & Lifestyle Guide
- Key to Fat Loss in Peri-menopause - Aim the Belly Fat
- Three Rules for Thriving in Perimenopause: Eat Smarter, Move Better, Hydrate Wisely
Authors:
Michelle Ordner
Registered Nurse (RN)
Michelle's expertise spans healthcare, nutrition infusion, and menopausal care. She began her nursing career in New Zealand in 1991 and has since served 17 years in critical care across the USA. After returning to NZ, she trained in cosmetic medicine and stem cell therapy, and holds a UK certification in intravenous nutrition. Her work focuses on integrative care for menopausal health and wellness.
