Perimenopause lasts for several years, bringing with it a mix of changes: hot flashes, brain fog, mood swings, trouble sleeping, and weight shifts. Can we do a better job of supporting women’s health through perimenopause? Yes, a holistic approach can support women’s health during this transformation. Let’s empower women with evidence-backed tips for nutrition, exercise, stress-relief, and gut health. This article explores emerging research on healthy lifestyle approaches that can impact perimenopause.
What is Perimenopause
Perimenopause is the transitional phase leading up to menopause, often beginning in a woman’s 40s or earlier. During this stage, estrogen levels can become unpredictable, sometimes spiking higher than usual, and other times dipping lower. Fluctuations in estrogen impact a variety of physical and emotional aspects of women’s health.
Why Estrogen Matters
Estrogen is far more than a reproductive hormone – it plays a key role throughout the body.
When estrogen levels shift, it can affect mood, energy, cognition, knee pain, and sleep. As such, it’s important to find ways to support women’s health with evidence-based, holistic lifestyle habits that support hormonal balance during perimenopause.
What to Eat During Perimenopause
What you eat has a direct impact on your health, and can influence some symptoms experienced during perimenopause. Your hormones, joints, and even estrogen levels can be impacted by your food choices.
During perimenopause, declining estrogen and progesterone affect how your body uses energy and stores fat. Nutrition can help buffer some of these undesirable metabolic changes.
Insulin is best known for its role in your body’s ability to uptake sugar, but it also has a major relationship with estrogen. Estrogen helps enhance the delivery of insulin to muscles. The unpredictable estrogen levels experienced in perimenopause can lead to insulin resistance. As such, women can experience an increase in abdominal fat during perimenopause.
Chronic low-grade inflammation is associated with perimenopause. The impact affects many parts of the body, from vaginal dryness to joint pain. Researchers have noted the increase in knee pain in perimenopausal women with osteoarthritis.
An exciting area of research highlights the connection between the gut microbiome and estrogen metabolism, often referred to as the estrogen–gut axis. Certain gut bacteria can produce an enzyme called β-glucuronidase, which can actually “unpack” estrogen that your liver has prepared to excrete. When this happens, estrogen gets reabsorbed into the bloodstream.
If β-glucuronidase activity is too high (often due to an imbalanced microbiome, or dysbiosis), it can lead to higher circulating estrogen levels and potentially worsen symptoms like bloating, breast tenderness, and mood swings. On the other hand, too little estrogen activity can also cause challenges, such as hot flashes, sleep disturbances, and bone loss.
The key is balance, and supporting gut health is important. To nourish your gut microbiota, include fiber-rich whole foods in your diet. If supplements are needed, there are high-quality, clinically researched probiotics in capsules, powders, and chewable tablets.
Exercise in Perimenopause: Can It Help?
Exercise is an effective ways to support women’s health during perimenopause. Physical activity can boost mood and energy, but it also helps regulate weight and improve sleep. In addition, exercise is linked with a reduced risk of cardiovascular disease and can help in osteoporosis, which are two health concerns that increase as estrogen declines.
Types of Exercise That Help in Perimenopause
The key is consistency. Aim for a mix of movement most days of the week, even if it’s just a brisk walk combined with a few bodyweight exercises.
For more tips, explore our Holistic Guide to Strength Training for Women Over 40.
Stress Reduction: Supporting Women’s Health Through Perimenopause
Stress has a powerful influence on hormones. Elevated cortisol (a stress hormone) can worsen perimenopausal symptoms by disrupting sleep, increasing hot flashes, and making it harder to maintain balanced blood sugar and weight. Learning to manage stress is a cornerstone of holistic care in perimenopause. Here are some practical lifestyle habits that may be helpful to perimenopausal women who are experiencing higher levels of stress:
A Holistic Approach to Improving Women’s Health Through Perimenopause
Perimenopause can be challenging, but it can offer a motivating opportunity to start new habits that support women’s health.
Small, steady changes build up over time. Start with one lifestyle habit that you can accomplish. Then, add more to help support your body. Women’s health matters – especially during perimenopause. It’s possible to build resilience and feel empowered despite the unpredictability of perimenopause.
Supporting Women’s Health Together
At the Canadian School of Natural Nutrition (CSNN), we believe that transitions like perimenopause can be navigated with confidence when women are equipped with knowledge, nourishing foods, and supportive practices.
If this holistic approach inspires you, consider exploring CSNN’s Natural Nutrition Program or one of our workshops to deepen your understanding of how food, hormones, and lifestyle all work together.
References
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Detrimental Changes in Health during Menopause: The Role of Physical Activity. Int J Sports Med. 2023 Jun;44(6):389-396.
https://pubmed.ncbi.nlm.nih.gov/36807278/
Gut microbial beta-glucuronidase: a vital regulator in female estrogen metabolism. Gut Microbes. 2023 Jan-Dec;15(1):2236749.
https://pubmed.ncbi.nlm.nih.gov/37559394/
Estrogen and Metabolism: Navigating Hormonal Transitions from Perimenopause to Postmenopause. J Midlife Health. 2025 Jul-Sep;16(3):247-256.
The Mechanism by Which Estrogen Level Affects Knee Osteoarthritis Pain in Perimenopause and Non-Pharmacological Measures. Int J Mol Sci. 2025 Mar 7;26(6):2391.
https://pubmed.ncbi.nlm.nih.gov/40141035/
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