Are you in your 40s? You are now entering a crucial stage in a woman’s reproductive cycle: perimenopause. This is a period of transition from a woman’s reproductive years to menopause—a season of change that usually begins four years before the total cessation of a woman’s menstrual periods but could also begin as early as eight to 10 years before menopause.

During this period, the body undergoes significant changes due to hormonal imbalances, thus causing a myriad of emotions that may render a woman anxious or, worse, fearful.

A woman may begin to experience mood swings, anxiety, and even depression. There are also sleep disturbances brought about by night sweats and hot flashes, as well as palpitations, unexplained weight gain, especially in the belly area, irregular menses, and very heavy menstrual flow that could last longer than the usual number of days.

The interval between menstrual periods can also become as short as 21 days. Headaches and other aches and pains are also commonly experienced. Furthermore, as the production of the hormone estrogen declines, a woman’s risk of developing cardiovascular disease, type 2 diabetes, cancer, insulin resistance, and osteoporosis is higher.

Decreased metabolism occurs, which alters a woman’s efficiency in burning calories and fat. These changes favor visceral or abdominal fat deposition. Visceral fat causes low-grade systemic inflammation in the body, which increases damage to the heart and blood vessels, as well as targets other cells and organs in the body.

Decreased estrogen production also impacts a woman’s appetite. Estrogen helps suppress cravings. Therefore, a woman may experience food cravings during perimenopause. Left unmanaged, this could lead to weight gain and increased body fat, especially visceral fat. We all know the health implications of having excess weight.

In 2023, Hungarian Dietetic Association Secretary General Aliz Erdelyi and colleagues conducted a review on the importance of nutrition during menopause and perimenopause.

“Menopause is associated with an increased prevalence of obesity, metabolic syndrome, cardiovascular diseases, and osteoporosis. These diseases and unfavorable laboratory values, which are characteristic of this period in women, can be significantly improved by eliminating and reducing dietary risk factors,” their study states. “Changing dietary habits during perimenopause is most effectively achieved through nutrition counseling and intervention. To reduce the risk factors of all these diseases, and in the case of an already existing disease, dietary therapy led by a dietitian should be an integral part of the treatment.”

Moreover, Aliz and her colleagues emphasized that lifestyle modification greatly influences the strength, frequency, and tolerability of symptoms brought about by the hormonal changes during perimenopause and menopause.

Here are some tips on what to do to manage symptoms of perimenopause:

Soy in the form of edamame, soybeans, tofu, freeze-dried soy, and soymilk contains plant hormones, or phytoestrogens, known as isoflavones. It’s a myth that soy causes breast cancer. On the contrary, soy prevents cancer. It also alleviates symptoms of perimenopause, such as hot flashes and night sweats. Soy provides complete protein that is equal to the protein contained in animal products but without the pro-inflammatory side effects.

Therefore, soy will not cause an increase in uric acid levels. In fact, it is meat consumption, excess fat, and sugar intake that not only increase uric acid production but also prevent its proper excretion. Soy has omega-3s, which help with heart and immune health.

Consuming unhealthy fats and refined sugars from processed and ultra-processed foods worsens symptoms of perimenopause and menopause. They contribute to weight and fat gain, as well as increase the risk of developing chronic diseases.

Eating vegetables at every meal and having fruits for a snack or dessert will help quell inflammation in the body that is related to symptoms and disease conditions. Aim to eat at least one and a half to three cups of cooked vegetables (double the amount for raw leafy vegetables) and about two to three servings of fresh fruits daily. You can also consume fruits and vegetables in the form of smoothies without added sugars. For convenience, some may opt to consume freeze-dried fruits and vegetables if the availability of fresh produce is a challenge.

Exercising and being physically active throughout the day is not an option. It must be scheduled and formed into a habit. Exercise is medicine. It helps build muscle mass to prevent slow metabolism, thus helping burn more fat.

Being physically active aids in the production of the mood-stabilizing hormone serotonin, which is also a precursor for the sleep hormone melatonin. Aim to have at least two and a half hours of moderate-intensity exercise per week and twice a week of strength training. You can also incorporate 10 to 15 minutes of walking two to three times a day. Stand up as much as you can. Pace even when talking on the phone. You can lift stuff, but be mindful of observing proper posture.

Anxiety, palpitations, and other symptoms worsen when we forget to breathe properly. Before anxiety hits you, mindfully practice deep breathing upon waking up, before going to bed, in between work, and anytime when you feel tired or when negative emotions start to creep in.

A full inhale and full exhale done a few times will definitely help manage your symptoms. Other relaxation techniques include prayer and meditation, guided imagery, coloring and painting, basking in nature, taking walks, listening to classical music and worship songs, yoga, tai chi, singing, and more.

Have a bedtime routine at least an hour before your sleeping time. Take a warm bath, wear comfortable sleepwear, ensure a cool room temperature, avoid gadgets, and avoid fighting sleepiness. Wear a sleep mask or earplugs if light and noise prevent you from getting good-quality sleep. Lastly, pray and meditate as you do deep breathing right before snoozing.

Perimenopause can be a better life journey for a woman who is willing and able to adopt positive lifestyle changes. Choose to be positively better during perimenopause.