It’s a topic talked about regularly and ever more openly. From celebrities and talk show hosts to books and podcasts, the conversation on how to navigate menopause continues to grow—because, frankly, there’s a lot to discuss.

For one, it’s a multi-layer process consisting of fluctuating hormonal changes that can impact women in several ways.

“Perimenopause refers to the symptoms experienced in the transition to menopause, which is the last menstrual period,” explains Dr. Gloria Bachmann, professor of obstetrics, gynecology, and medicine at the Rutgers University Robert Wood Johnson Medical School in New Brunswick. She explains that, because of decreasing egg cells, the ovaries stop producing the same levels of estrogen and progesterone needed for ovulation.

The decrease in hormones contributes to many changes in the body that typically begin in the mid-40s—and are not the same for everyone.

As your body prepares for menopause, a healthy lifestyle can offer surprising support.

“The duration of perimenopause symptoms are so individualized; some women carry on with symptoms into their 60s,” says Bachmann.

Bachman advises women to plan ahead and learn what to expect well before changes set in, and to not be afraid to ask questions.

“People are often reluctant to talk about it because they think it’s a sign of aging—but in reality, it’s a sign of changing,” she says. “Your body is always fluctuating, and it’s important to listen.”

Your Lifestyle Can Shape your Menopause

While every woman’s experience is different, certain lifestyle choices can have an impact.

“People with obesity tend to get worse vasomotor symptoms (such as hot flashes and night sweats) earlier, longer, and more severe,” says Dr. Jeff Levine, professor and director of reproductive and gender health programs at Robert Wood Johnson Medical School and member of the Master Educators’ Guild. He adds that smokers tend to reach menopause earlier and experience symptoms that are more severe.

Levine says stimulants like caffeine or alcohol can sometimes worsen hot flashes, and fluctuating hormones can cause additional effects.

“Changing hormonal levels can cause sleep and emotional disturbances like irritability and depression, and make it harder to deal with stress,” he says. “Not getting adequate sleep can exacerbate perimenopausal symptoms … and taking ‘me time’ is important for maintaining mental health.”

A Proper Diet Can Help the Transition

Other products of shifting hormones are changes to appetite and dietary needs, with cravings and food intolerances being common.

“A decrease in estrogen has an effect on other hormones like leptin and ghrelin, which regulate our body’s natural appetite levels,” says Velta Soucie, Registered Dietitian for The Center for Nutrition and Diabetes Management at Hunterdon Health in Flemington. “This can have a two-fold effect because people often turn to sugary, high-carb foods for comfort, which can trigger mood swings.”

She suggests mood-stabilizing techniques such as listening to music, spending time with your pet, or working on a hobby.

With changing hormone levels, the metabolism may decrease significantly, and the body may require a decrease of “up to 250–300 calories per day,” says Soucie. “If a menopausal woman continues to eat the same way she always has, it may contribute to additional weight gain.”

Another product of decreased estrogen is a decrease in bone density, which raises one’s risk for osteoporosis. Soucie advises consuming foods containing vitamin D (like oily fish and egg yolks) and calcium (milk, yogurt, almond milk, and calcium-fortified foods) to improve bone mineral density and help prevent osteoporosis.

Muscle mass decreases as well. “To help fight this battle, it is best to eat adequate amounts of heart-healthy proteins like fish, seafood, chicken, eggs, beans, and nuts,” says Soucie, adding to aim for 20–25 grams of high-quality protein at each main meal.

The enjoyment of certain foods is another subject of change.

“Decreased levels of estradiol and progesterone lead to decreased diversity in the gut microbiome,” says Soucie. “This may weaken the gut barrier, which increases gut permeability—meaning more microbial products can enter the bloodstream, triggering inflammation and digestive changes.”

Soucie advises adding fiber to your diet to avoid GI issues (whole grains, seeds, beans, fruits and vegetables); probiotics (yogurt, sauerkraut, and fermented foods); prebiotics (onions, garlic, bananas, and oats), and omega-3 fatty acids (salmon, sardines, other fish, flax seeds, and walnuts).

Handling the Hormones

With hormones being so disruptive, some opt for hormone replacement therapy, while others take a more natural approach. “Phytoestrogens are compounds found in plants that structurally resemble estrogen and can bind to the body’s estrogen receptors, creating a mild estrogen-like effect,” says Dr. Jessica Schneider, MD, OB/GYN at Hunterdon Obstetrics and Gynecology in Phillipsburg.

“For women who have low estrogen levels, this effect can have the potential to alleviate symptoms when consumed in adequate quantities,” says Schneider, noting that the same diet might not have the same benefits for women with high estrogen.

These compounds can be found in foods like soybeans, chickpeas, flaxseeds, peanuts, barley, berries, and green or black tea.

“For women who have high estrogen levels, consuming too many phytoestrogens can have an anti-estrogenic effect because they can block naturally occurring estrogen from binding to the receptors,” she says, adding it’s best to talk to a registered dietitian before making changes to your diet.

How to responsibly satisfy menopause cravings:

• The first three to four bites of any food are the most satisfying. Research shows that satisfaction doesn’t increase the more you eat, so aim for small portions to satisfy a craving.
• Stay well hydrated, eat regularly, and choose whole foods.
• Eat more protein and high-fiber foods, as well as those that are naturally sweet such as fruits, fruit cups, honey covered nuts, dried fruits, and yogurts.
• When craving salty and sweet foods, opt for healthier alternatives like fruits, dark chocolate, nuts, seeds, and pickles.

—Tips from Dr. Jessica Schneider, MD, OB/GYN at Hunterdon Obstetrics and Gynecology in Phillipsburg

— High-fiber foods —
whole grains, seeds, beans, fruits and vegetables

— Probiotic foods —
yogurt, sauerkraut, and fermented foods

— Prebiotics —
onions, garlic, bananas, and oats

— Omega-3 fatty acids —
salmon, sardines, flax seeds, and walnuts

— Heart-healthy proteins —
fish, seafood, chicken, eggs, beans, and nuts

— Foods rich in vitamin D —
oily fish and eggs

— Calcium —
milk, yogurt, almond milk, and calcium-fortified foods

— Foods with phytoestrogen —
soybeans, chickpeas, flaxseeds, peanuts, barley, berries, and green or black tea

While change can be difficult, it is also inevitable—all you can do is allow and embrace it. Having the tools, guidance, and encouragement to do so can help make it a little easier.