What Helps With Perimenopause: 10 Effective Strategies
By Vanessa Gatelein, Menopause Yoga Health Coach
As our bodies transition towards menopause, some women will experience a range of perimenopause symptoms that can be truly frustrating and resemble a burnout state. As a Health Coach, I have worked with women for the past 13 years, helping them to not only sort out their nutrition, but get their lifestyle right. I want to help you know what helps with perimenopause, really.
When I turned 48 things started to shift in my body and my mind. My usual go-to tricks no longer worked and I ended up with what felt like a nervous breakdown, then gaining 6 kilos while exercising every day and "eating well." When I finally figured out without the help of a doctor, that my mental and physical state had a lot to do with perimenopause, I got angry and knew I needed to make a change.
I'm here to share my personal insights from lifestyle changes, alternative medicine, to medical interventions that I've experienced. There are many ways to look at what helps with perimenopause and menopausal symptoms, so grab a hot drink and tuck into this article.
Understanding Perimenopause
Perimenopause is the time leading up to menopause, typically starting in your 40s, but can sometimes show up earlier. And it's important to note, that some women will have a medically induced perimenopause/menopause from treatments like radiation or going through a hysterectomy.
During perimenopause, our ovaries produce less and less estrogen. As estrogen decreases, our adrenal glands and visceral fat start to create its own version of estrogen. This shift in hormone levels can create so many different mental and physical symptoms in your body, that you almost cannot believe it.
Compare these two lists. One was created by women for women about what symptoms have come up during perimenopause, menopause and beyond. Then look at what doctors label as perimenopause or menopausal symptoms. CRAZY - RIGHT? Estrogen is in EVERY cell of a woman's body and when it starts to get reduced, it will have an impact all over your body.
Common Symptoms of Perimenopause - The Doctor's List
Here is the list of what a doctor will note as symptoms of perimenopause. It's not the same as what women will report.
Irregular periods
Hot flashes and night sweats
Mood swings
Sleep disturbances
Vaginal dryness
Changes in libido
Weight gain
Fatigue
Common Symptoms of Perimenopause - The Women's List
Here is the real deal from the mouths of women going through the change.
Physical Changes
Heart palpitations – Feeling like your heart is racing or pounding.
Trouble sleeping – Finding it hard to stay asleep.
Low energy – Feeling constantly tired or like you can’t quite recharge.
Dizziness or lightheadedness – Occasional feelings of being off-balance or faint.
Headaches – More frequent or intense headaches than before.
Tinnitus – A constant ringing or buzzing in your ears.
Dry mouth and eyes – A feeling of dryness or irritation in your mouth or eyes.
Sore gums – Sensitivity or discomfort in your gums.
Muscle and joint aches – Soreness or stiffness in your muscles and joints.
Breathing issues – Feeling winded or struggling to catch your breath.
Frequent bathroom trips – More trips to the bathroom or having the urge to go all the time.
Vaginal dryness or soreness – Discomfort or dryness in the vaginal area.
Increased vaginal infections – Frequent yeast infections or UTI's.
Dry or itchy skin – Skin that feels dry, itchy, or irritated.
Thinning hair – Noticeable hair thinning or more hair shedding than usual.
Crawling skin feeling – When it feels like a bug is crawling on your skin, but nothing is there.
Psychological Changes
Low mood – Sadness or feeling down more often.
Anxiety – Feeling anxious even in situations that usually wouldn’t bother you.
Feeling tense – It feels like you cannot relax your body or mind.
Memory issues – Struggling to remember names or blanking out on facts.
Panic attacks – Suddenly feeling very scared.
Concentration problems – Not able to stay focused or get distracted easily.
Loss of interest – Not feeling motivated or engaged in activities that used to excite you.
Feeling down or depressed – A deeper, ongoing sense of unhappiness. :-(
Tears or crying spells – Feeling like you’re on the verge of tears for no clear reason.
Irritability – Feeling more easily frustrated or short-tempered than usual.
Mood swings – Sudden, unpredictable shifts in mood.
Low confidence – Feeling unsure of yourself, even though you've done that thing before.
Brain fog – Feeling mentally cloudy or having trouble thinking clearly.
Loss of libido – A decrease in interest in sex or a change in arousal.
Did you know that suicide is most common in women especially during the ages of 45 to 54 years old?
(Mendez-Bustos et al., 2013). This is exactly the same time that hormones start to shift and we start to feel less great, a bit more angry and depressed.
So if you're having a lot more sadness lately and feeling depressed more often, PLEASE KNOW THAT IT IS NOT YOU. Go and visit your doctor or pharmacist and take your mental health seriously. There are treatments that work.
Vasomotor Symptoms
This refers to how your body regulates temperature.
Hot flushes – Sudden waves of heat that can leave you feeling sweaty and flushed. Also can feel like a sudden sunburn in the face, which can feel embarrassing.
Night sweats – Waking up at night, because you're drenched in sweat. And then suddenly getting cold.
From woman to woman, both in intensity and duration of these symptoms will be different. Some women don't even notice, while other women are significantly impacted and cannot function. I know of women who quit their high level position, because they felt so exhausted and lost so much confidence in themselves because they just couldn't think straight.
Lifestyle Changes: A Foundation for Perimenopausal Health
These changes address immediate concerns and at the same time support overall health and wellness.
1. Nutrition: Fueling Your Body Right
What exactly is a balanced diet and can nutrition help me during perimenopause? Isn't a healthy diet good enough? It's all about focus!
ADD IN nutrient-dense options:
Lots of PROTEIN (1.6g per kilo of body weight, so a 64 kilo woman should eat 102.4g of protein.)
Lots of healthy FATS (like those found in avocados and fatty fish).
A bit of complex CARBS like fruit, vegetables and whole grains.
Women need lots of protein in order to maintain and build muscle mass. It also supports healthy bone development and maintains healthy skin.
Women need healthy fats for hormones and brain function. The brain is over 60% fat and it needs fat to function. No low fat diets please!!
Women need complex carbs for mood and energy. Carbs are a loaded topic 🙂 so I encourage you to eat your carbs in the form of a vegetable as much as possible. I personally feel better without bread, pasta and rice, but I truly enjoy sourdough bread, cheese and wine and add it into my diet some weekends when I really, really want it. Because balance and food enjoyment are also key to feeling well!
SAMPLE FOOD LIST for PERIMENOPAUSE.
| Protein | Fats | Carbs |
|---|---|---|
| Lamb Beef Salmon Eggs Beans & Pulses |
Avocado Fatty fish (e.g. sardines.) Butter Coconut Chia seeds |
Green peas Asparagus Artichoke Sweet potato Quinoa |
LET GO of foods that trigger perimenopausal symptoms, like these foods:
Caffeinated beverages like coffee, tea, and cola
Alcohol of any kind
Spicy foods
Liquid oils
Sugar and high glycemic foods
Eating dinner after 6 in the evening
Why these foods?
Some women find these foods trigger hot flashes, mood swings or disrupt their sleep at night. Try keeping a food diary to understand how these foods and drinks can impact how you feel.
2. Exercise: Stop overexercising!!
Doing regular exercise is not just about preventing weight gain during the menopausal transition. Regular physical activity is a POWERFUL tool for managing perimenopause symptoms including maintaining bone density. A 2023 review suggests exercise, including yoga, can improve sleep quality during perimenopause.
What is regular physical activity?
Add in 15 to 30 minutes of gentle exercise most days of the week.
PLEASE avoid strenuous and endurance training during perimenopause. Your body will see this as a stressor, and will then make stress hormones instead of making estrogen hormones.
Exercise can prevent weight gain as you build muscle mass, support bone health, improve your mood, and increase energy levels – all important during perimenopause.
Exercise Ideas for Perimenopause
Walking outdoors :-)))
Swimming
Cycling
Strength training :-)))
Gentle yoga :-)))
Pilates
DO NOT do these exercise during Perimenopause
Long distance jogging or running
HIIT workouts
Zone 2 workouts
SpinCycle etc.
Workouts that having you doing cardio for an hour
Exercise that make you feel stressed
Keeping exercise focused on building muscle and maintaining calm will support your body during the transition. Stressful activities will stop your body from producing estrogen and will have it creating stress hormones instead. It can only do one thing at a time.
3. Stress Management: Find Your Calm
Stress 100% worsens perimenopausal symptoms. It's time to add in stress-reduction techniques regularly into your daily routine. This is non-negotiable as "Menorage" can sneak up on you and you'll need to know what to do with that anger.
Meditation
Deep breathing exercises
Mindfulness practices
Spending time in nature
Creative hobbies such as painting, collaging, scrapbooking or knitting
These practices can improve sleep, mood, and overall well-being, which is important for managing mental health.
Natural Remedies: Embracing Nature's Power
Not every woman is interested in taking medicine or hormone replacement therapy. It could be interesting to see if herbal remedies and/or nutritional supplements can ease the symptoms like hot flashes and vaginal dryness.
4. Herbal Remedies
While these herbs show promise, always consult your doctor or pharmacist before starting any new supplement. Even certain teas when taken in combination can create some trouble for you!
| Herb | Potential Benefits | Research Findings |
|---|---|---|
| Black Cohosh | May reduce hot flashes and night sweats | A 2013 review indicated positive effects on vasomotor symptoms like hot flashes. |
| Ginseng | May improve sleep quality and mood | A 2019 study linked ginseng glycoproteins with better sleep |
| Red Clover | Potential relief from hot flashes | Research has mixed results. |
| Valerian Root | Help create calm, reduce hot flush/flashes and supports sleep | Research is promising for hot flashes and sleep. |
5. Essential Nutrients
Normally we can get all that we need nutrition-wise from our diet. But certain nutrients could really support your body during perimenopause. Remember to check with your doctor or pharmacists for any contraindications.
Calcium: Essential for bone health.
Vitamin D: Supports bone density and our mood.
Omega-3 fatty acids: Awesome for your mood AND brain, eye and heart health.
B-complex vitamins: Support energy levels, your brain and your nervous system.
Magnesium: Eases sleep, muscle tension, and a good mood! (No wonder we crave chocolate.)
6. Support your Microbiome
Our microbiome takes up more space in our body than our own cells do! They are bacteria that support our digestion, mental health, and reduce the amount of not-so-great bacteria that exists in the body. Introducing prebiotics and probiotics.
You can either eat to support your microbiome or take supplements.
Here’s a simple list of prebiotic and probiotic foods to support your gut microbiome:
| Prebiotic Foods (Feed the good bacteria) | Probiotic Foods (Contain live beneficial bacteria) |
|---|---|
| Garlic | Yogurt (with live cultures) |
| Onions | Kefir |
| Leeks | Sauerkraut (unpasteurized) |
| Asparagus | Kimchi |
| Bananas (slightly green) | Miso |
| Apples (with skin) | Tempeh |
| Oats | Kombucha |
| Flaxseeds | Fermented pickles (in brine, not vinegar) |
| Chicory root | Natto (fermented soybeans) |
| Jerusalem artichoke | Cottage cheese (with active cultures) |
Some medical and herbal remedies I have explored.
Medical Interventions: When You "Just" Need Relief
While some women fly through perimenopause, others really suffer and that's where medicine can make a real difference in a woman's life.
7. Hormone Replacement Therapy:
Hormone replacement therapy (HRT) is effective for perimenopausal symptoms, especially hot flashes, night sweats and trouble sleeping. However, HRT has risks and isn’t ideal for everyone. For those women who have a family history of breast cancer, too much estrogen may create tumours, and this is why doctors often hesitate to prescribe HRT. Decisions about HRT should be made with a healthcare provider, weighing potential benefits and risks.
Types of HRT
Estrogen Therapy HRT – For women who have had a hysterectomy or prefer it.
Combined HRT (Estrogen + Progesterone) – For many different reasons like hot flashes, sleep, balance and symptom relief.
Body-Identical HRT – Uses regulated, bioidentical hormones (e.g., micronized progesterone and estradiol) that are chemically identical to those made by your body.
Local (Vaginal) Estrogen Therapy HRT – Low-dose estrogen that comes in creams, rings, or tablets that you place directly on or inside your vagina. The direct application helps vaginal dryness, vaginal skin discomfort, or urinary symptoms like UTI's by strengthening the tissues.
Non-Oral HRT – Patches, gels, creams, or sprays for those who prefer to avoid taking pills.
Testosterone Therapy – Sometimes prescribed alongside HRT to help with libido, brain fog, and energy.
8. Non-Hormonal Medications
For women who cannot or choose not to use hormone therapy, other options exist.
Vaginal Lubricants: There are creams and lotions without hormones, that also support the dryness and the feeling that the skin is thinning on the vulva. Also, I 100% recommend vaginal lubricants when making love, because the pulling and pushing can make small tears in the skin and can be quite painful.
Low-dose antidepressants: Can help with mood swings and hot flashes and can be a life-saver when depression is coming more often than usual.
Gabapentin: Initially an anti-seizure medication, it's been found effective for hot flashes.
Clonidine: A blood pressure medication that may reduce hot flashes.
Birth control: Could also be interesting, depending on what symptoms and concerns you may have.
Mind-Body Practices: Holistic Approaches to Perimenopausal Well-being
The mind-body connection is powerful and can be helpful for managing perimenopause symptoms. Holistic approaches can offer relief and improve quality of life for menopausal women, but you have to give it time to work AND be consistent with your practice :-)
9. Yoga: More Than Just Stretching
Yoga combines physical postures, breathing techniques, and meditation and a regular practice can ease perimenopause. A 2024 review highlighted yoga’s positive impact on sleep during perimenopause.
Symptoms such as hot flushes, sleep deprivation and weight gain are common, AND can impact your quality of life by making you miserable.
How can Yoga help during perimenopause?
I am certified to teach Menopause Yoga. It includes a yoga practice that supports women's health and where they are during the transition and beyond. And if you are curious about what Menopause Yoga looks like. Click here to see some of the poses.
Here are 10 ways yoga helps with perimenopause.
Reduces Stress & Anxiety: Perimenopause can bring mood swings, anxiety, and overwhelm. Yoga activates the parasympathetic nervous system (the “rest and digest” mode), helping to calm your mind, lower cortisol levels, and promote relaxation.
Supports Hormonal Balance: Gentle yoga and specific poses stimulate the endocrine system, supporting glands like the thyroid and adrenal glands, which play a role in hormone regulation.
Improves Sleep: If you’re struggling with night sweats or insomnia, restorative yoga and breathwork can help regulate your nervous system, making it easier to fall and stay asleep.
Boosts Energy & Fights Fatigue: Feeling drained? A well-sequenced yoga practice can improve circulation, boost oxygen levels, and help you feel more energized without overstimulating your body.
Eases Joint & Muscle Pain: As estrogen levels drop, joints can feel stiffer and muscles may ache. Yoga increases flexibility, improves mobility, and helps reduce inflammation-related discomfort.
Helps with Hot Flashes: Certain cooling breathing techniques (like Sitali breath) and gentle yoga poses can help regulate body temperature and make hot flashes feel less intense.
Supports Weight Management: Perimenopause can make weight management more challenging. A mix of strength-building yoga and mindfulness can help regulate metabolism and reduce emotional eating. This counts as your regular exercise.
Improves Pelvic Floor & Core Strength: Yoga strengthens the pelvic floor and core, which can help with bladder control, reduce back pain, and improve posture.
Helps Create Strong Muscle and Bones: By using your own body weight in targeted yoga poses, you can encourage your bones to strengthen themselves, stopping bone loss. And you will notice that your muscles will become stronger, supporting a healthy metabolism and improving your overall health.
Encourages Self-Compassion & Body Connection: Perimenopause is a time of change, and yoga offers a space to reconnect with your body, build self-awareness, and cultivate a positive mindset about this transition.
10. Acupuncture: Ancient Wisdom for Modern Symptoms
Acupuncture, from traditional Chinese medicine, is an alternative to hormone therapy and is an excellent way to manage perimenopausal symptoms when you are not getting the results you wanted from your doctor. While more research is needed, acupuncture may help with:
Hot flashes.
Sleeping better.
Mood swings.
I used acupuncture through the beginning of my pregnancy. And I know that is not menopause, but I personally find that acupuncture supports the body in finding its own balance. I have found acupuncture helpful in healing my frozen shoulder and with my emotional mood swings through the start of my perimenopause. My favorite local acupuncturist in Basel is Howard Austin.
The Power of Community and Support
I know that I was embarrassed about the vaginal symptoms I was having. And my original gynaecologist didn't give me any support, so I felt I was doomed to have a raw and achy vagina. After spending time with other women my age and older, perimenopause stopped feeling so isolating and I was able to get the help I needed from another gynaecologist in town with the help of a vaginal estrogen cream.
Women need women.
Just by being in the presence of other women feels incredibly supportive and healing.
Support Groups: Sharing and Learning
I am looking to create a perimenopause support group, both in person and online, in order to offer a community during perimenopause.
My goal is to create a safe space to share experiences. Because during this time, we need:
Tips and strategies from other women who understand what we are going through.
Emotional support and acknowledgment.
Information about new research and treatment options to ease symptoms and understand what helps with perimenopause.
Open Communication with Partners and Family
Because perimenopause can impact you quite strongly, it will impact your relationships. Being able to openly communicate with partners and family may be difficult. They may not understand what you feel (because sometimes we don't even understand what we are feeling!!)
Here's what you can do.
Educate yourself on what is happening in your own body and mind.
Then... educate them about perimenopause.
Discuss how symptoms affect you.
Explore how they can help you with simple tasks every day. KEEP IT SIMPLE.
Find compassion with yourself and others.
FAQs about what helps with perimenopause
What helps with perimenopause?
My top three tips:
Get educated on what's happening in your body and mind. (Menopause Reading List.)
Start shifting your habits immediately towards self-care. Even if it feels selfish. Do it!
Connect with other women going through the same thing. It will keep you sane.
Why do I feel so ill with perimenopause?
Perimenopause is a TOTAL body change. There is estrogen in every cell of a woman's body. Feeling unwell during perimenopause is common due to fluctuating hormones. You may feel flashes of nausea, extreme fatigue, headaches, mood swings and low libido. Your immune system may also be taking a hit, so it is so important to take really good care of yourself at this time.
What vitamins are best for perimenopause?
Add in KEY vitamins: Vitamin D, B vitamins (B6 and B12), Vitamin E, calcium, and Omega-3 fatty acids. Magnesium is a lifesaver regarding sleep, relaxing tense muscles and balancing your mood. Check with your doctor before starting new supplements if you already take medication. Vitamin and mineral supplements can really help in transitioning through perimenopause, especially if you haven't been taking care of yourself the past few years.
How do I balance my hormones during perimenopause?
Balancing hormones involves gentle exercise, a diet rich in protein and healthy fats, stress management, and getting enough sleep. Hormone replacement therapy, supervised by your doctor, may be a good option. Let go of certain overly warming foods and drinks like caffeine in order to manage menopause hot flashes and trouble sleeping.
Why do I feel so bad during perimenopause?
Because estrogen is found in every cell of a woman's body, when estrogen starts to decline, we feel it throughout our entire body and mind. This change not only impacts our period, but impacts our skin, hair, bones, muscles, brain cells, heart, eyes and vaginal health. Even though this is considered a normal part of life, it can be devastating, especially if you have been stressed in the years leading up to perimenopause.
Stress will block your body from making enough estrogen, and your body will make stress hormones instead. This makes symptoms like mood swings, fatigue, hot flashes, sleep problems, night sweats, and weight gain even worse.
Along with the emotional impact, perimenopause can feel overwhelming and poorly timed. We may be parenting children and supporting aging parents at the same time. We may be at the peak of our career. And then suddenly, we are thrown off by these physical, mental and emotional symptoms that just don't seem to make any sense.
Conclusion
Perimenopause can be surprising, but taking the time to learn what is happening and how to best take care of yourself is truly what helps with perimenopause. From lifestyle changes and natural remedies to medical interventions and mind-body practices, you've got options!
To bring a positive spin to the menopause, you can even EMBRACE this transition as a time for your own growth and self-development. With the support of other women, the right doctor or gynecologist and "feel-good" tools, perimenopause can be a time of empowerment and renewed focus on health and well-being.
This is Vanessa, signing off as the Menopause Yoga Health Coach!
I wish you an amazing journey and would love to support you should you want a guide by your side.
Ready to get started?
If you want work with me and create a new healthy and balanced lifestyle then click below to…
