Nutrition During Perimenopause

In perimenopause, the “Rules” change. This is particularly true when it comes to nutrition. During perimenopause, hormone levels fluctuate in less predictable ways and it is often a frustrating time. Very often I hear my clients say, “What used to work for maintaining my weight and health just doesn’t seem to work anymore”.  

Estrogen and progesterone are the two big hormones we are all  (hopefully) familiar with by now. During perimenopause, estrogen levels begin to look like a rollercoaster track, and progesterone levels drops steadily. This can result in difficulty sleeping, mood swings/mood volatility, brain fog, difficulty staying focused, difficulty maintaining weight or easier to gain weight, and achy joints, to name some of the most common changes. But even this list isn’t complete as we also understand there are changes in cardiovascular risk factors such as cholesterol, and women can also experience changes in digestion and even inflammation.

In part because of the changing patterns of estrogen and progesterone, the stability of other hormones is impacted, namely insulin and cortisol. This means we are more “stress reactive” (a little stress goes a long way – we have stronger reactions to stress both physically and emotionally), and insulin resistance can start to develop (the early stages of prediabetes and diabetes, which also impacts the risks of cardiovascular disease).

Nutrition can be a powerful tool and ally during these dramatic changes. Meal timing, the amount of protein, the balance of protein and carbs, the amount of “carbs” are a few of the variables that can be helpful for maintaining a sense of steadiness and stability (physically and mentally). The type and amount of exercise and adequate sleep are also important for maintaining a steady course during the hormonal fluctuations of perimenopause.

Estrogen helps cortisol and insulin stay “balanced” – that is, estrogen helps the body use these other hormones efficiently, so a little signal goes a long way. As estrogen levels fluctuate and begin to decline, cortisol and insulin are less stable. Cortisol is our stress response and insulin helps keep our fueling levels stable and efficient. Too much cortisol (over time) makes it harder to lose weight in part because it keeps insulin levels elevated. Elevated insulin levels make it harder to lose weight because it makes it harder to use fat for fuel.

Eating to help balance blood sugars can help prevent or slow weight gain during the changing hormone landscape of perimenopause. This doesn’t mean “no carbs”, in fact, that approach is usually counterproductive. But (it does mean) a different focus on the amount and types of carbs, pairing with adequate portions of protein and meal timing can help keep your hormones balanced, or at least less reactive.

What does all of this mean for your plate, meaning, how does this information impact what you eat? Perhaps you’ve become aware of the popularization of “protein, protein, protein!” While adequate dietary protein helps, it can’t fix “everything”.

• Eat to maintain blood sugar balance. This helps keep the “stress hormones” balanced. This means eat breakfast(!), and make sure you have 20-25g of protein included in your meal. This also means eating regularly (one of the hardest things to do when your schedule is packed) – eat a mid-afternoon snack packed with protein.

  
  

• Exercise smarter, not harder. The temptation is to push more miles, or join the latest fitness gym based on monitoring metrics to make sure you’re in the optimal “zone”, but for a perimenopausal woman, that approach often backfires (yeah, weight gain!). Exercise smarter means just enough high intensity exercise to stimulate the right actions (muscle building) while keeping physiologic stress low (that means less running and more walking).

  
  

• Sleep is elusive for many women during perimenopause and can be it’s own dragon to slay. However, it’s still important to start with the basics of sleep hygiene. You know, make sure you disengage from electronics and blue lights and worldly-stimulate at least an hour before bed time. If this time of day is “Your Time”, then start to find ways to nourish yourself offline. And prioritize your bedtime like you did for your children when they were toddlers…

  
  

Perimenopause can feel like a journey no one asked to embark on. While changes in hormones are inevitable, feeling like your body has been “hijacked” doesn’t have to be.