How To Have a Better Perimenopause Part 1

October is Menopause Awareness Month (and yesterday was World Menopause Day!), so let’s spend some time talking about this important phase of life and the lesser recognised one before it, perimenopause. 

Menopause is the day when we haven’t had a period for 12 months.

What we’re commonly calling menopause now, is actually post-menopause.

Did you know that you could spend more years without a period than with one? This is one of the reasons that I believe so strongly that we must move away from the wholly negative messaging that we’re seeing around this topic, focused on severe symptoms and ‘menopause as an estrogen deficiency’ (spoiler alert: it’s not). Of course there will be symptoms that we experience as we transition into this new phase of life, but they aren’t inevitable and won’t last for the rest of your life. 

What you do in your menstruating years will set you up for a better perimenopause and menopause.

Since many of you are still menstruating and cycling regularly, let’s spend some time diving into perimenopause. 

Perimenopause, which can start as early as your late 30s, but most typically starts in our early to mid 40s, and can last around ten years. This time of life is best described as a sequence of events that happens gradually.

Remember, you’re not a passive participant in these events. There’s a lot you can do through nutrition, supplements, exercise and lifestyle changes that can affect how you feel, both physically and mentally during this time. 

The perimenopausal sequence of events can be best described like this:

  1. Regular menstrual cycles can start shortening by a day or two. 
  2. Menstrual cycles gradually change, becoming more irregular and / or shorter. 
  3. There is a longer space between periods and when they come, they can be shorter and lighter or heavier. 
  4. Finally, the menopause arrives when you haven’t had a period for 12 months. 

During this time, you’ll ovulate less frequently as fewer follicles are available to grow into mature eggs. It’s really important to note that it’s still possible to get pregnant. It’s not about the number of follicles, but the quality of those follicles when they turn into mature eggs. As an aside, this is why it’s important not to get obsessed with your AMH number if you are trying to get pregnant, but instead, focus on what you can do to improve the quality of your eggs through nutrition, supplementation and stress management. I cover this extensively in chapters 5 and 6 of my book You Can Have a Better Period

Here are some ways you can support yourself nutritionally if you’re in your perimenopausal years:

Add foods that support the liver

During perimenopause, estrogen levels can fluctuate dramatically because not only do you gradually produce less of it, but you also have less progesterone, which counterbalances estrogen. We can’t stop this process, but we can make sure that we’re adding in foods that help the liver and the gut metabolise, or breakdown estrogen so it can be removed from our body through our stools and urine. Here are some foods that you can add into your meals that are really helpful for what we call estrogen detoxification, or the way our liver breaks down estrogen that our body has already used:

  • Add cruciferous vegetables like broccoli, kale, cabbage, kohlrabi, brussels sprouts, bok choy, radish and wasabi.
  • Eat one medium raw carrot each day. Carrots are in the apiaceae family (this also includes parsley, dill, celery and fennel) and contain caffeic acid, which supports estrogen detoxification in the liver.
  • Cook with alliums like onions, garlic, leeks, scallions, shallots, and chives.
  • Add turmeric to your smoothies or fresh juices.

Add foods that help manage the stress response

Anxiety can be one of the earliest symptoms of perimenopause. You can feel fine one moment and then the next, you get hit by a wave of full body anxiety to which you can’t necessarily attribute a cause. To give yourself some extra protection if this happens, you can add foods with specific nutrients into your meals that help manage the stress response. Remember, when we’re stressed, the body uses these nutrients faster so make sure to keep topping them up!

  • Magnesium: pumpkin seeds, green, leafy vegetables, sunflower seeds, cashews, pistachios
  • Vitamin B6: avocado, spinach, wild salmon, organic chicken, sweet potatoes
  • Vitamin C: berries, broccoli, kale, red and yellow peppers, citrus, tropical fruits

Add more high quality protein and fat to your meals to manage your blood sugar levels.

As we move into our late 30s and 40s, we can have more responsibilities and obligations in our lives, which mean that we need to make sure we have enough energy to make it to the end of each day without crashing. Very often, I see perimenopausal women relying on coffee and sugar to prop up their energy levels, which can in the long term, make them feel even more frazzled.

When you add enough high quality protein and fats into each meal, you feel full after each meal, you have more energy and there’s less need to reach for something sweet or drink another coffee to keep you going.

  • High quality protein: Organic / free-range beef, lamb, chicken, dairy and eggs, game, seafood, beans, lentils, fermented tofu and tempeh
  • High quality fats: Nuts, seeds, full-fat, organic dairy, free-range eggs, olive oil, avocado (whole or oil), coconut (oil, cream or milk), butter and ghee

Have you noticed the effects of what you eat on managing perimenopause symptoms? In my next post, I’ll talk about lifestyle factors that can help us have a better perimenopause.

Le’Nise Brothers is a yoga teacher and registered nutritionist, mBANT, mCNHC, specialising in women’s health, hormones and the menstrual cycle. She is also the host of the Period Story Podcast, which aims to break taboos around menstrual health and hormones. 

Le’Nise has helped hundreds of women improve their menstrual and hormone health through her private practice and group programmes, talks and workshops for the likes of Stylist, Channel 4, Boden, Ebay and TikTok and her Instagram page. Le’Nise works primarily with women who feel like they’re being ruled by their sugar cravings, mood swings and hormonal acne & bloating. They want to get to grips with heavy, missing, irregular & painful periods, fibroids, PMS, PCOS, endometriosis, post-natal depletion and perimenopause. 

Her first book You Can Have A Better Period was released in March 2022. 

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