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Perimenopause Signs & How to Prepare

By Jill Levy

July 20, 2024

Many women lead demanding (and, often, stressful) lives, but they want to feel good and look good at every age and life stage — including during peri-menopause, menopause and after.

Women officially reach menopause when they have not had a period for 12 consecutive months. The road to menopause, however, is typically preceded by pre-menopause and perimenopause. This is a natural, normal progression. 

Perimenopause, which occurs “around” and leading up to menopause, is also known as the “menopausal transition.” It commonly occurs during a woman’s 40s and is a gradual process that involves hormonal changes.

In order to continue to feel well during this life stage, it’s important for women to take care of themselves “holistically,” meaning their bodies, minds and emotional health (such as their capacity to deal with stress). In this article, learn what perimenopause is, the signs that it’s beginning to occur, plus insights on how to help navigate this natural stage of life.

What Is Perimenopause?

Perimenopause is a transitional stage that occurs before menopause, marking the natural decline in reproductive hormone production in women, including in estrogen and progesterone. It typically begins several years before menopause.

In short, menopause occurs as a natural, normal biological process when women’s menses cease to occur. Generally speaking, for most women, the signs of menopause typically occur between the ages of 40 and 58 — with an average age of 51 or 52, according to some sources. However, every woman is different.

Some women can be in perimenopause for years or even up to a decade or more. Women may become aware of some changes taking place in their bodies leading up to menopause, which can include lighter or less regular periods, and changes in body weight or body composition, among other signs.  Some women may have no awareness of these changes at first.

Signs of Perimenopause

What are the most common normal signs of perimenopause? Perimenopause symptoms can vary widely among women (again, these are all considering normal during the perimenopausal transition to menopause). Common signs and symptoms include:

• Irregular periods: Menstrual cycles may become shorter or longer, with unpredictable timing. Some women may experience heavier or lighter periods.

• Hot flashes and night sweats: Sudden feelings of intense heat, often accompanied by flushing of the face and sweating, can occur during the day or at night, leading to disrupted sleep patterns.

• Sleep disturbances: Many women experience difficulties with falling asleep or staying asleep, often due to night sweats, hormonal fluctuations or overall anxiousness.

• Mindset changes: Hormonal fluctuations can affect one’s mindset, too. Some women may experience occasional  irritability, anxiousness or other changes. .

• Vaginal dryness and discomfort: Declining estrogen levels can naturally lead to vaginal dryness, itching or discomfort for some women. 

• Changes in libido: Some women may experience decreased libido or changes in sexual function that are common during this life stage.

• Changes in energy levels: Hormonal changes, sleep disturbances and other changes can impact energy levels. 

• Changes in hair quality: As estrogen levels normally decline during menopause, the hair growth cycle can become impacted, sometimes even leading to shorter and thinner hair strands.

• Changes in the gut: Research indicates that menopause yields lower gut microbiome diversity and an actual shift towards greater similarity to the male gut microbiome.

How to Prepare — Perimenopause Dietary and Lifestyle Tips

Women in their 40s and beyond should aim to eat well, exercise regularly, and supplement with hormonal balance, bone strength and heart health in mind.

Below are suggestions for how to prepare for the perimenopausal period of life — using dietary and lifestyle strategies.

As always, however, you should consult your healthcare professional prior to beginning any new dietary or lifestyle regimen, including as you go through perimenopause and transition to menopause or postmenopause. 

Diet

Middle-aged women should prioritize a perimenopause diet rich in protein, antioxidants, omega-3s, calcium and vitamin D.

According to some statistics, up to 70 percent of women ages 51–70, and as high as 90 percent of women over 70, don’t get enough vitamin D, meaning it’s essential not to skimp on vitamin D-packed foods. Digestion may also need to be supported during perimenopause; however, eating foods rich in probiotics, enzymes and fiber can usually help keep things on track.

General foods to include in your diet during the perimenopause to menopause transition include:

• All types of fresh vegetables and fruits, such as leafy greens and berries 

• Wild-caught fish, such as salmon and tuna

• Nuts and seeds, such as chia, flax, walnuts and almonds (they’re also high in calcium and healthy fats)

• Fermented soy products, such as organic tofu or tempeh

• Healthy fats, such as olive oil, avocado, nuts and seeds

• Quality proteins, including poultry, fish, eggs, legumes and organic dairy products

• Probiotic foods, including yogurt, kefir, sauerkraut and kimchi

Lifestyle Changes

Women (of all ages) should get regular exercise, including a mix of resistance training and endurance exercises, to stay at a healthy weight and support their overall health. It’s especially helpful for women to continue exercising through the menopause transition since it can help promote heart health, bone health and hormonal health.

Walking, stretching, climbing stairs, swimming, dancing and playing tennis are some exercises that may interest you if you’re 40+. Strength training, such as lifting weights or doing bodyweight exercises, will also help you maintain muscle and bone mass.

Other lifestyle habits to prioritize include getting enough sleep and managing stress, which can both impact hormones. Aim for 7 to 9 hours of sleep per night, as well as building stress-reducing activities into your day, such as yoga, meditation, journaling and reading.

Other tips for navigating perimenopause and menopause include:

• Sharing your experiences with trusted friends or support groups.

• Avoiding smoking and limit alcohol and caffeine intake, as they can worsen symptoms.

• Dressing in light layers and wearing natural fabrics that allow your skin to breathe. 

• Using a fan or open windows to regulate temperature. 

• Avoiding triggers like spicy foods, hot beverages and stressful situations that can exacerbate hot flashes.

• Establishing a relaxing bedtime routine and creating a comfortable sleep environment.

• Avoiding too much caffeine and electronics before bed.

• Using vaginal lubricants to help ease discomfort.

Supplements

Aside from eating well and exercising, other lifestyle tips  during perimenopause can include the use of certain supplements that support overall health. These can include:

1. Probiotics

Have you ever heard that “you are what you eat”? Well, in fact, you are what your body actually absorbs! If you do not absorb the nutrients in your food, then those nutrients aren’t fully working to nourish your cells, muscles, brain and entire body. 

Probiotics are “friendly” microbes that live in your gut and assist in healthy digestion and nutrient absorption. Eating probiotic-rich foods can help your gut produce more good bacteria, as can taking a quality probiotic supplement each day.

Regenerative Organic Certified® Menopause Support are powerful probiotics for women entering or experiencing menopause. These are a never-seen-before combination of prebiotics, postbiotics and 30 probiotic strains — plus herbs and mushrooms grown in nutrient-dense soil on our founder-owned ROC™ farms.

Or simply try Ancient Nutrition’s SBO Probiotics Women’s capsules for digestive support, healthy immune system support, and reduction of occasional constipation, gas and bloating.

2. Black Cohosh

Black cohosh is an herb and root that has been used to support women’s reproductive health for centuries. It naturally contains chemicals that can be beneficial to the body, including for hormonal support. Research indicates that black cohosh needs to be taken consistently for 3–6 months before seeing results, so consistency is important when using this herb. 

You’ll find Organic Fermented Black Cohosh in Ancient Nutrition’s Women’s Hormone Balance capsules, which support healthy energy, help reduce fatigue and effects of stress, and promote a positive mindset and reproductive health.

3. Reishi Mushroom

Eastern thought points out that the body needs to maintain its “equilibrium” against stressors and more, especially during challenging times of life that involve significant changes. Beneficial mushrooms help the body maintain its equilibrium or balance. Generally speaking, some of the beneficial compounds in “functional mushrooms” include polysaccharides and polysaccharide peptides, beta glucans, glycoproteins and triterpenes.

Reishi, known scientifically as Ganoderma lucidum and popularly as “the king of herbs” or “10,000-year mushroom,” has been a go-to for thousands of years in the Asian region for promoting bodily balance.

Reishi is also generally considered an adaptogen and body tonic, helping the body to “adapt” its responses to stressors to help support the health of the whole body. It’s also used as a tonic that may help to “tone” and energize systems in the body, including a healthy immune system. Additionally, reishi features certain antioxidants, such as triterpenes, that can help fight free radicals, thereby helping to promote overall health.

For help maintaining overall balance, consider taking Ancient Nutrition’s Multi Mushroom Daily Immune Defense tablets.

4. Vitamin D3

Vitamin D is essential for proper absorption and metabolism of calcium, phosphorus and other nutrients. Older people make less vitamin D than younger people do when exposed to sunlight, but some people avoid being out in the sun altogether — meaning they aren’t making vitamin D.

D3 is the preferred form to take in supplement form. Supplementing with vitamin D3, such as Ancient Nutrition’s Vitamin D formula, can help to support bone health, healthy immune system function and one’s overall outlook, too. You can also consider taking a high-quality multivitamin to cover your nutritional bases, including for vitamin D, which can be difficult to get from foods alone.

Note: If you are experiencing significant or bothersome perimenopause symptoms, then consult with a healthcare professional for support. They can help evaluate your symptoms, provide appropriate management options and discuss potential treatments, if necessary.