Nutrition through Peri- & Post-Menopause
Five Key Strategies to support the body through the peri-menopause and beyond.
Menopause and the years leading up to it (perimenopause) are times of significant hormonal and metabolic change. This transition is associated with an increased risk of insulin resistance, obesity, cardiovascular disease, and osteoporosis. Whilst this can feel overwhelming – and let’s be real, rather unfair – it’s also empowering to know that you can take steps to reduce your risk of these conditions and help to manage symptoms through your nutrition and lifestyle choices.
Let’s discuss five of the most important nutrition and lifestyle strategies.
1. Prioritise Muscle Health
Declining oestrogen levels can contribute to loss of lean muscle mass, leading to a reduced metabolic rate and other negative health effects. This impact on metabolism is one of the factors that can make weight gain more likely through these years.
In conjunction with resistance exercise, eating enough protein is important to help preserve muscle tissue.
Actionable Tips:
Incorporate strength training exercises 2-3 times a week to support muscle building.
Aim for 1.2 - 1.6 g protein per kg of body weight per day.
Try to distribute protein fairly evenly throughout the day by including protein-rich foods in each meal (think: meat, chicken, fish, Greek yoghurt, eggs, tofu, beans).
2. Support Bone Health with Key Nutrients
One of the lesser discussed roles of oestrogen is the regulatory role it plays on bone metabolism through promoting bone forming cells and suppressing bone resorption cells. Bone loss naturally occurs as we age but is further accelerated with the decline of oestrogen in late perimenopause and beyond.
Calcium and vitamin D are two of the most important nutrients to support bone density and help to prevent further bone loss.
Actionable Tips:
Calcium is best absorbed through food. Include calcium-rich foods (such as dairy products) through the diet, if possible. Speak with a nutritionist if you are concerned that you may not be getting enough calcium through food, for example if you avoid dairy.
Go for short walks in the sunshine to help support vitamin D levels, and consider supplementation through the winter months. It may be a good idea to test your vitamin D level to ensure that this is optimal.
3. Focus on Fibre-rich Carbohydrates
Hormonal and metabolic changes during the menopause transition can reduce insulin secretion (release) and sensitivity, making insulin resistance more likely.
Focusing more on fibre-rich carbohydrates, and less on low-fibre alternatives (“simple” or high-sugar carbohydrates) can help to support blood sugar regulation, reduce cravings and aid in weight management.
Actionable tips:
Include a variety of high-fibre foods: fruits, vegetables, whole grains, legumes, nuts, and seeds.
Aim for 25–30 grams of fibre per day.
Gradually increase fiber intake to avoid bloating and ensure adequate hydration.
Pair carbohydrates with protein and/or healthy fats (eg. apple slices with peanut butter).
4. Support Cardiovascular Health with Healthy Fats & Colour
Menopause is associated with increases in LDL cholesterol (the kind that can accumulate in arteries), triglycerides, and small decreases in HDL (“good”) cholesterol. These changes contribute to a higher cardiovascular risk.
Diets high in processed meats, deep fried foods and refined sugars are also associated with increased risk of heart disease. Whilst a Mediterranean-style diet is associated with reduced blood pressure, improved cholesterol levels and a lower risk of metabolic syndrome. This pattern of eating shows promise in supporting cardiovascular health throughout the menopausal transition, but may also help preserve lean mass and improve insulin sensitivity.
A key component of a Mediterranean Diet is including a variety of colourful fruits and vegetables (providing a range of nutrients and antioxidants), alongside foods rich in heart-healthy fats such as omega-3 fatty acids.
Actionable tips:
Include omega-3 rich foods like salmon, tuna, sardines, chia seeds, flaxseeds, and walnuts.
Use olive oil as primary cooking fat.
Include plenty of fruits & vegetables (variety of colours), whole grains, legumes, nuts and seeds.
Limit processed meats and sugary food or drinks.
5. Support Sleep (as much as possible)
Sleep disturbances are among the most frustrating concerns that I hear from clients. In The Menodoctor Survey NZ (2023), 80% of responders reported sleep problems - making this the most commonly reported symptom. Sleep quality often declines during perimenopause due to hormonal fluctuations, hot flushes, and stress.
Poor sleep can increase cravings, impact metabolism and blood sugar regulation the next day. Chronic poor sleep can further increase the risk of insulin resistance and weight gain over time. Supporting sleep, as best we can, is important for many aspects of health, but of particular importance throughout this time.
Actionable tips:
Avoid large, heavy meals within three hours of bedtime.
Reduce alcohol - although it may make you feel sleepy initially, alcohol disrupts sleep and can worsen night sweats.
Limit caffeine to the first half of the day.
Engage in regular daily exercise, as this has been shown to improve sleep and reduce stress.
Seeking Support?
The decline of hormone production from the ovaries not only impacts fertility, but also affects many other areas of health. Whilst it can feel overwhelming if you’re experiencing symptoms and it may feel like there’s a lot to focus on, I encourage you to break it down and work on small consistent changes over time.
If you’d like more guidance on how to align your nutrition and lifestyle to support your body through perimenopause and beyond, I’d love to help. Feel free to book in for a free discovery call here.
References:
Erdélyi, A., Pálfi, E., Tűű, L., Nas, K., Szűcs, Z., Török, M., Jakab, A., & Várbíró, S. (2023). The Importance of Nutrition in Menopause and Perimenopause-A Review. Nutrients, 16(1), 27. https://doi.org/10.3390/nu16010027
Faubion, S. S., Sood, R., Thielen, J. M., & Shuster, L. T. (2015). Caffeine and menopausal symptoms: what is the association?. Menopause (New York, N.Y.), 22(2), 155–158. https://doi.org/10.1097/GME.0000000000000301
Manaye, S., Cheran, K., Murthy, C., Bornemann, E. A., Kamma, H. K., Alabbas, M., Elashahab, M., Abid, N., & Arcia Franchini, A. P. (2023). The Role of High-intensity and High-impact Exercises in Improving Bone Health in Postmenopausal Women: A Systematic Review. Cureus, 15(2), e34644. https://doi.org/10.7759/cureus.34644
North American Menopause Society (2006). The role of calcium in peri- and postmenopausal women: 2006 position statement of the North American Menopause Society. Menopause (New York, N.Y.), 13(6), 862–880. https://doi.org/10.1097/01.gme.0000243566.25205.0b
Shihab, S., Islam, N., Kanani, D., Marks, L., & Vegunta, S. (2024). Alcohol use at midlife and in menopause: a narrative review. Maturitas, 189, 108092. https://doi.org/10.1016/j.maturitas.2024.108092
Silva, T. R., Oppermann, K., Reis, F. M., & Spritzer, P. M. (2021). Nutrition in Menopausal Women: A Narrative Review. Nutrients, 13(7), 2149. https://doi.org/10.3390/nu13072149
The Menodoctor Survey NZ, 2023
Troìa, L., Garassino, M., Volpicelli, A. I., Fornara, A., Libretti, A., Surico, D., & Remorgida, V. (2025). Sleep Disturbance and Perimenopause: A Narrative Review. Journal of clinical medicine, 14(5), 1479. https://doi.org/10.3390/jcm14051479
Disclaimer: this blog is intended for educational purposes only and does not replace individual health or medical advice. For more support please always seek the guidance of your relevant health practitioners.