Perimenopause & Menopause: What Can Help?

Perimenopause and menopause are natural stages of life, but the hormonal changes that occur can affect many aspects of physical and mental health. While every woman’s experience is different, research shows that healthy lifestyle habits can significantly improve symptoms, preserve long-term health, and reduce the risk of osteoporosis and cardiovascular disease.

Common Symptoms That May Worsen

As estrogen and progesterone levels fluctuate and eventually decline, women may experience:

• Hot flashes and night sweats
• Sleep disturbances and fatigue
• Mood changes, anxiety, or irritability
• Brain fog, difficulty concentrating, and memory lapses
• Weight gain, particularly around the abdomen
• Loss of muscle mass and strength
• Joint aches and stiffness
• Reduced exercise recovery
• Decreased bone density and increased fracture risk
• Vaginal dryness and discomfort
• Reduced libido

Not every woman experiences all of these symptoms, and their severity varies widely.

Diet: Build the Foundation

Nutrition plays an important role in supporting overall health during menopause.

Research supports:

• Adequate protein: Aim for approximately 1.2–1.6 g/kg of body weight per day to help preserve muscle mass and strength.
• Mediterranean-style eating: Emphasize vegetables, fruit, legumes, whole grains, nuts, olive oil, and fish. This eating pattern is associated with better heart health, healthier body weight, and lower inflammation.
• Calcium-rich foods: Dairy products, fortified plant beverages, tofu, and leafy greens help maintain bone health.
• Vitamin D: Necessary for calcium absorption and muscle function. Many adults require supplementation if dietary intake or sun exposure is inadequate.
• High-fibre foods: Whole grains, beans, fruits, and vegetables support digestive health, cholesterol levels, blood sugar control, and the gut microbiome.

Exercise: The Most Powerful Intervention

Regular exercise is one of the most effective ways to reduce many of the physical effects of menopause.

Resistance Training (Highest Level of Evidence)

Perform strength training 2–3 times per week, targeting all major muscle groups.

Research shows it can:

• Preserve and build muscle mass
• Improve strength and balance
• Support bone density
• Reduce abdominal fat
• Improve insulin sensitivity
• Enhance mood and quality of life

Aerobic Exercise

Aim for at least 150 minutes of moderate-intensity activity per week, such as brisk walking, cycling, swimming, or jogging.

Benefits include:

• Improved cardiovascular health
• Better energy levels
• Improved sleep
• Reduced stress and anxiety
• Weight management

Supplements with the Strongest Evidence

While supplements should complement (not replace) a healthy diet and exercise program, several have good scientific support.

Creatine Monohydrate

Research suggests creatine, particularly when combined with resistance training, can help:

• Improve muscle strength and lean muscle mass
• Enhance exercise performance
• Support healthy aging and physical function

Vitamin D

Supports bone and muscle health, particularly in individuals with low vitamin D levels or limited sun exposure.

Calcium

If dietary intake is insufficient, supplementation may help meet daily calcium requirements needed for bone health.

Protein Powder

A convenient option for women who struggle to meet daily protein needs through food alone.

Omega-3 Fatty Acids

May support cardiovascular health and may provide modest benefits for mood, although evidence for improving menopausal symptoms such as hot flashes remains inconsistent.

Key Takeaway

The strongest evidence for improving health during menopause is surprisingly simple:

• Eat a protein-rich Mediterranean-style diet.
• Strength train 2–3 times per week.
• Stay physically active with regular aerobic exercise.
• Ensure adequate calcium and vitamin D intake.
• Consider creatine monohydrate if participating in resistance training.

These lifestyle strategies are supported by high-quality research and can help preserve muscle, strengthen bones, support heart health, improve energy, and maintain quality of life throughout the menopause transition.