What to eat in perimenopause to thrive (not just survive)

Perimenopause is a time of change, and it can last anywhere from 4 to 6 years for most women. Thriving during perimenopause isn’t just about managing symptoms—it’s about setting yourself up for long term health. Hormonal shifts may impact energy, mood, metabolism, and bone health, but the right nutrition can make a world of difference. Here’s how.

How diet can impact perimenopause

A well balanced diet can be a powerful tool in supporting your body during perimenopause. Eating the right foods can help to support energy and mood, maintain bone and muscle health, and contribute to heart health. 

Prioritising protein, fibre, and healthy fats can keep blood sugar steady, while fruits and vegetables provide essential vitamins and minerals as well as antioxidants. Certain plant foods that contain phytoestrogens (a type of compound found in plants) may also contribute toward balancing oestrogen, such as soybeans and sesame seeds.

Protein: why it’s important and best sources

As oestrogen declines, muscle and bone mass naturally decrease, making protein essential. It helps to support muscle repair, metabolism, satiety, and bone health. It's key to focus on getting enough protein in every meal (aim for 30 grams) and try to add some high-protein snacks throughout the day. 

Good sources of protein include:

• Lean meats like chicken and turkey
• Fish such as salmon and sardines
• Eggs
• Legumes like lentils and chickpeas
• Greek yoghurt & cottage cheese
• Tofu & tempeh
• A protein powder supplement can be a quick and convenient protein snack

Fibre: why it’s important and best sources

Fibre is crucial for digestion, blood sugar balance, and heart health. In pre-menopausal women, oestrogen has a protective effect for heart health, specifically on cholesterol levels. Research shows us that consuming enough fibre long term reduces the risk of heart disease by lowering blood cholesterol and blood pressure. Aim for 25 grams per fibre per day.

Good sources of fibre include:

• Vegetables and legumes
• Fruits
• Wholegrains like quinoa, oats, and brown rice
• Nuts and seeds such as chia seeds, flaxseeds, almonds
• Legumes such as beans and lentils

Calcium and vitamin D: why it’s important and best sources

Oestrogen is a key player in maintaining bone mineral density and calcium absorption. As this key hormone declines, the risk of osteoporosis (low bone density) increases. Calcium helps to form and maintain strong bones and vitamin D enhances calcium absorption.

Good sources of calcium include:

• Dairy products like milk, cheese and yoghurt.
• Plant milks that are fortified in calcium.
• Plant-based options like tofu, cooked soybeans, sesame seeds and bok choy.

Where to get vitamin D:

• Sunshine is the best source. For most people, spending a few minutes outdoors most days of the week can maintain levels. If sun exposure is a concern or not possible, chat to your healthcare professional about a vitamin D supplement.
• Fatty fish like salmon and mackerel, egg yolks and even mushrooms (if you put them out in the sun for a little tan time).

Additional nutrient goals for perimenopause

• Add a serve of healthy fats like nuts, seeds, avocado or olive oil can help to balance blood sugar and provide essential fats.
• Incorporate plant foods with phytoestrogens may have an oestrogen balancing effect. There are two major types of phytoestrogens, isoflavones from soy (tempeh, tofu and soy products), and lignans from flaxseeds.
• Magnesium-rich foods may also further support bone health and also support mood,    so boost your intake of nuts, seeds, dark chocolate, and green leafy vegetables.

Balancing blood sugar

Changes to oestrogen and progesterone may also affect blood sugar and therefore energy levels and cravings. Here’s how to build a balanced plate at each meal  to keep blood sugar stable:

• Eat protein with every meal (aim for 30g).
• Choose complex carbohydrates (wholegrains, legumes) over refined ones (like white bread)
• Add healthy fats to meals for satiety
• Avoid skipping meals, as this can cause blood sugar dips and energy crashes

Be mindful of certain foods during perimenopause

Some women find that certain foods and drinks may trigger or worsen symptoms of perimenopause. Common triggers include alcohol, caffeine, spicy foods and smoking.

Other lifestyle factors that impact perimenopause

Beyond food, lifestyle plays a major role in symptom management:

• Strength training and movement helps maintain muscle and bone mass as well as supporting metabolism
• Maintaining good sleep hygiene and aiming for 7-9 hours of quality sleep can support mood and energy

The bottom line

Perimenopause is a time of change, but small, intentional shifts in your diet can make a big difference. By building balanced meals and supporting your body with nutrients like fibre, protein, calcium and vitamin D, you can thrive—not just survive—through this transition.

Related reads:

• Menopause - the facts women need to know
• Natural remedies for perimenopause and menopause
• How to manage symptoms of perimenopause and menopause

Reviewed by the Healthylife health experts February 2025.