Natural ways to manage symptoms during perimenopause

Perimenopause, the transitional phase leading up to menopause, often brings hormonal fluctuations that can trigger a range of symptoms, including hot flushes, mood swings, sleep disturbances, and weight changes. 

While hormone replacement therapy (HRT) is a common treatment, many women are increasingly seeking natural ways to manage perimenopause symptoms. In this article, we'll explore how to manage perimenopause naturally - like tweaking your diet, lifestyle, and stress levels - plus some herbal remedies to help ease symptoms and support overall wellbeing.

Nutrition: Enjoy hormone-balancing foods

A balanced diet plays a key role in managing perimenopause symptoms. It can help to regulate hormones, manage inflammation, and keep energy levels stable. Focus on nutrient-rich foods such as:

• Phytoestrogen-rich foods: Foods like soy, flaxseeds, and legumes contain plant-based estrogens that may help balance hormones during perimenopause.
• Healthy fats: Omega-3 fatty acids found in oily fish, walnuts, and chia seeds support both heart and brain health, which is crucial during perimenopause.
• Calcium and vitamin D: Perimenopause can lead to a decrease in bone density, making calcium and vitamin D essential for bone health. Include dairy, leafy greens, oily fish like sardines and exposure to sunlight. Opting for almond, oat, or soy milk? Just make sure to check the label for calcium. 
• Magnesium: Known for its calming effects, magnesium can help with sleep and mood regulation. Foods like leafy greens, nuts, and seeds are good sources.
• Limit processed sugars and refined carbs: These can contribute to insulin spikes, leading to hormonal imbalances and worsening symptoms like hot flushes and mood swings.

Lifestyle: Adopt healthy habits for better mood & wellbeing

Managing perimenopause effectively also involves making lifestyle changes. This includes regular physical activity and healthy habits that can help  ease many common symptoms.

• Regular exercise: Particularly strength training and aerobic activities, can help manage weight, reduce the severity of hot flushes, and improve mood. Aim for at least 30 minutes of moderate exercise most days of the week.
• Good sleep hygiene: Quality sleep can be challenging during perimenopause due to hormonal changes. Create a relaxing bedtime routine, avoid caffeine and heavy meals late in the evening, and make your sleep environment comfortable and dark.
• Weight management: Hormonal changes can lead to weight gain, especially around the abdomen. Eating a balanced diet and exercising regularly can help maintain a healthy weight and ease symptoms like hot flushes.

Mind: Keep your stress levels in check 

Managing mental wellbeing is crucial when dealing with perimenopause. Hormonal shifts can bring on mood swings, anxiety, and irritability. Here are some strategies to help manage stress and promote emotional wellbeing:

• Mindfulness and meditation: Studies have shown that mindfulness practices can help to reduce stress, improve mood, and alleviate anxiety. Incorporating daily meditation or breathing exercises can significantly benefit mental wellbeing during perimenopause.
• Yoga: It isn’t just for flexibility - it’s great at easing perimenopause symptoms like hot flushes, sleep problems, and stress. It can also support relaxation, and encourage deep breathing, which can all help to manage mild anxiety and improve sleep quality.
• Social support: Connecting with others who are going through similar experiences can provide emotional relief and a sense of community. Consider joining a support group or talking to a trusted friend or healthcare professional.

Are herbal supplements effective?

Herbal supplements can offer a range of benefits during perimenopause and menopause. Always check with your healthcare professional to ensure they are safe and right for you. 

Some herbal supplements to consider:

• Black cohosh: Research suggests that black cohosh may help reduce the frequency and severity of hot flushes and improve mood. But the evidence is mixed, and it may cause side effects in some individuals. Always consult a healthcare professional before starting a new supplement.
• Red clover: Rich in phytoestrogens, red clover is thought to help balance hormones and relieve hot flushes. But more research is needed to confirm its effectiveness.
• Evening primrose oil: Known for its potential to alleviate breast pain and reduce mood swings, it may also help with hot flushes and irritability, though evidence is limited.
• Ashwagandha: An adaptogenic herb, ashwagandha may help balance hormonal fluctuations, manage stress and improve sleep quality during perimenopause. Early studies suggest it can reduce cortisol levels, helping to balance the stress response.
• Shatavari: An Ayurvedic herb traditionally used to support healthy sexual function in both men and women. Research has shown that it may help boost libido in menopausal women 

The bottom line

Managing perimenopause naturally is possible with the right combination of good nutrition, healthy lifestyle habits, stress management, and herbal supplements. If you're unsure, consulting a healthcare professional or multiple experts can give you the guidance and support you need.

Related reads:

• What is perimenopause, and am I going through it?
• The best foods for women during perimenopause and menopause
• Navigating mental health during perimenopause

Reviewed by the Healthylife health experts February 2025.