Perimenopause diet: What to eat (and avoid) to support your hormones

There's a particular kind of frustration that comes with doing everything right and still not feeling quite right. If you've noticed your body responding differently to food lately — weight settling around your middle, energy levels becoming unpredictable, or cravings intensifying — you're not imagining it.

These shifts often mark the start of perimenopause, when your hormones begin to fluctuate and change how your body processes nutrients and stores energy. While you can't control the timing, supporting your body through nutrition and lifestyle changes can help you feel more balanced and energised.

There's no one-size-fits-all perimenopause diet, but understanding how certain foods interact with your hormones can make this chapter feel a lot more manageable.

How your body changes during perimenopause

Perimenopause typically begins in your 40s, though some women notice menopause symptoms earlier. This transition is marked by the time that oestrogen and progesterone — the hormones that regulate your menstrual cycle — start to rise and fall unpredictably [1].

These hormonal changes can influence nearly every system in your body, from metabolic health and bone health to mood, sleep, and even how you store fat.

Common changes include:

• Weight gain, especially around the abdomen
• Hot flushes and night sweats
• Mood swings and irritability
• Sleep disturbances
• Vaginal dryness
• Shifts in body composition, with loss of muscle mass
• Altered cholesterol levels and blood pressure

While these changes are all normal menopausal symptoms, what you eat can help your body adapt more smoothly.

Why diet matters as hormones fluctuate

The hormone oestrogen helps regulate metabolism, appetite, and blood sugar [2]. When oestrogen levels are balanced, it maintains your cells' sensitivity to insulin — the hormone that allows cells to take up glucose from your bloodstream to use for energy [3].

As oestrogen levels decline during perimenopause, your cells gradually become less responsive to insulin. This means glucose doesn't move quite so efficiently from your bloodstream into your cells, causing your pancreas to produce more insulin to compensate [3]. Over time, this creates insulin resistance — a cycle where you have both high blood sugar and high insulin levels.

High insulin levels prevent stored fat from being broken down for energy, making it easier to gain weight around your midsection [4]. This abdominal fat then releases fatty acids that further interfere with insulin function [3].

Declining oestrogen can also affect bone density and increase cardiovascular risk. During perimenopause, basal metabolism can decrease by up to 250 to 300 calories per day because of those changing hormone levels, which means you won't need as many calories as you once did [5].

The goal of altering your diet during perimenopause isn't to restrict eating or cut out entire food groups — it's more about fuelling your body in a way that aligns with its changing needs. A balanced diet rich in calcium, vitamin D, and healthy fats can help support bone and heart health while easing fatigue, bloating, and hot flushes [6].

Can you improve perimenopause symptoms through diet?

Research shows that making gradual improvements to your diet can reduce symptoms associated with perimenopause [7].

A nutritious and balanced eating pattern during perimenopause may:

• Stabilise energy levels and reduce mood swings
• Support weight management and metabolic health
• Improve sleep quality
• Balance hormones
• Reduce inflammation
• Reduce the frequency or intensity of hot flushes and night sweats
• Support bone and heart health [5]

A Mediterranean diet, for example — eating foods rich in plants, whole grains, olive oil, lean meats, and low-fat dairy products — has been linked to better cardiovascular health. It's also been shown to improve mood and overall well-being [8].

How nutrition affects mood, sleep, and weight

Your diet influences more than just physical symptoms — it can impact how you feel emotionally, too.

Mood: Low oestrogen can affect serotonin levels, the 'feel-good' hormone. B vitamins help your body produce serotonin, making them extremely important for preventing cognitive dysfunction and mood changes during perimenopause [5]. Including foods rich in omega-3 fatty acids, B vitamins, and protein supports brain health and emotional balance [9].

Sleep: Spicy foods, caffeine, and alcohol consumption can worsen night sweats and insomnia [10]. Cutting back can go a long way to improving sleep quality.

Weight: With a slower metabolism, you may need to adjust your energy intake — but eating too little can work against you, slowing your metabolism even more and leaving you without the energy or nutrients you need. During perimenopause, there's less room for nutrient-poor foods because, while your body needs less energy overall, you still need to meet your daily nutrient needs [5]. Prioritise protein intake and dietary fibre to keep you feeling full and support muscle mass.

If maintaining or losing weight feels harder than it used to, remember that it's not about your willpower (or lack thereof) — it's all to do with your changing biology.

For women seeking more structured support, Juniper's Weight Reset Program offers access to health coaching and guidance from dietitians to help you make sustainable, empowering changes tailored to your body's needs. Whether you're considering hormone replacement therapy or focusing on lifestyle changes, nutrition plays a key role in managing perimenopause symptoms.

The importance of a healthy diet during perimenopause and menopause

A healthy diet supports every aspect of midlife health — from bone strength to heart function to long-term disease prevention.

The right nutrition can help reduce the risk of developing cardiovascular issues, insulin resistance, other serious illnesses, and osteoporosis. It also supports bone density, improves cholesterol levels, and helps maintain muscle mass with adequate protein intake.

Think of nutrition as a tool for resilience — helping your body stay strong and steady as hormones shift.

What is the best diet for perimenopausal women?

There's no single best diet for perimenopausal and menopausal women, but evidence suggests certain eating patterns are particularly beneficial.

Evidence-based eating patterns that support hormonal balance

Dietary approaches that tend to work best include:

Mediterranean diet: A varied diet that's high in fruits, vegetables, whole grains, legumes, and olive oil. This eating pattern is packed with anti-inflammatory and antioxidant-rich foods that help with weight management, blood sugar control, and cardiovascular health [5][8].

Plant-forward eating: Diets rich in soy, nuts, and seeds may help reduce hot flushes, thanks to plant compounds called phytoestrogens [11].

High-fibre diet: Fibre helps slow digestion, manage hunger, and support gut health [5]. Upping your dietary fibre intake can control blood sugar levels and boost metabolic health.

Daily protein intake: Try to get 1 to 1.2 grams of protein per kilogram of body weight per day — if you’re more active, you may need up to 1.6 grams daily [5]. Including lean meats, fish, eggs, and plant proteins helps preserve muscle mass and supports weight management.

What to eat during perimenopause

Focus on nutrient-dense foods that provide steady energy, support hormonal balance, and strengthen your bones and heart.

Nutrients and foods that may ease common symptoms

During perimenopause, what your body needs is changing and evolving. Focus on nourishing yourself with quality over quantity, as you still need to meet your daily nutrient requirements even though your body may need less energy overall [5].

Here's what to include on your plate:

Protein-rich foods: Aim for 20 to 30 grams of protein per meal [5], which helps you reach that daily target of 1 to 1.2 grams per kilogram of body weight. Include fish, lean meats, poultry, tofu, eggs, beans, and legumes.

Whole grains: Choose whole wheat bread, oats, brown rice, and quinoa for sustained energy and fibre [5].

Healthy fats: Omega-3 fatty acids help with inflammation, mood swings, and hot flashes [5]. Include oily fish like salmon and mackerel, avocado, olive oil, nuts, and seeds to boost your good fat intake.

Calcium and vitamin D: Essential for bone health [5]. Include low-fat dairy products or calcium-fortified plant milks and salmon.

Phytoestrogen-rich foods: Soy foods such as tempeh and edamame, flaxseeds, and legumes may help balance hormone levels and reduce hot flushes [5].

Fruits and vegetables: Eating a variety of colourful fruits and vegetables daily can help reduce perimenopause symptoms [5].

B vitamins: B6 and B12 support mood regulation and energy. Good sources include animal proteins, leafy greens, whole grains, and fortified foods [5].

Magnesium: This mineral supports metabolism, hormone balance, and may help reduce hot flushes and PMS [5]. You can find magnesium in spinach, avocados, bananas, black beans, and dark chocolate.

Vitamin E: May help reduce hot flashes [5]. Top sources include sunflower seeds, almonds, peanut butter, and spinach.

What to limit or avoid in your diet during perimenopause

You don't need to cut anything out completely, but moderation matters. Some foods can worsen symptoms:

• Refined carbohydrates and sugary snacks: Can spike blood sugar and trigger mood swings [5]
• Saturated and trans fats: May increase LDL cholesterol — also known as “bad” cholesterol — and cardiovascular risk [5]
• Excess salt: Can affect blood pressure [5]
• Alcohol: May worsen hot flashes and disrupt sleep [5]
• Caffeine and spicy foods: Can intensify night sweats and trigger hot flushes [10]

Simple, gradual dietary changes are more effective — and sustainable — than strict rules.

Combining exercise and nutrition for better results

Diet is one part of the puzzle — movement is the other. Regular exercise helps regulate hormone levels, supports weight loss, and protects bone and heart health [12].

Increasing your current exercise levels by even a small amount can improve your mood, sleep quality, weight management, and muscle function [5], especially when combined with a balanced diet.

Try a mix of:

• Resistance exercises to build muscle mass and support metabolism. Along with protein intake, you'll need strength training to sustain and improve lean body mass [5].
• Aerobic activity, like walking, swimming, or cycling, for heart health.
• Stretching or yoga to reduce stress and improve flexibility.

Even 10 to 15 minutes of daily movement can make a noticeable difference.

Other lifestyle tips to help with perimenopause symptoms

Beyond what's on your plate, a few lifestyle changes can make a real difference:

Sleep: Keep your bedroom cool and limit screens before bed. Have dinner at least 2 hours before bedtime, and spread fluid intake evenly throughout the day, rather than drinking a lot right before bed [5].

Stress: Mindfulness, breathing exercises, or gentle yoga can ease mood swings [5]. Lean on your support network when you're having a difficult day — sharing a laugh with your friends or a big hug with your partner is one of the best stress busters you'll find.

Quit smoking: It's nothing you wouldn't have heard before, but quitting smoking supports heart and bone health and reduces hot flushes [5] — amongst a myriad of other health benefits.

Hydration: Drink water regularly, especially if you're dealing with night sweats. As people age, risk factors for dehydration increase. Aim for about 2 litres (6 to 8 cups) daily [5]. Drinking enough water can help relieve hormonal symptoms like bloating, hot flashes, and headaches.

If you're feeling unsure about where to start, Juniper's Weight Reset Program can help you make tailored, evidence-based changes to your eating habits, exercise, and weight management — all under the guidance of health professionals who understand women's midlife health.

Perimenopause doesn't have to feel like guesswork. With expert advice and professional support, you can feel more like yourself again.

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