How to Manage Perimenopausal and Menopausal Symptoms
How to Manage Perimenopausal and Menopausal Symptoms
Author: Dr. Kim Celmer, Naturopathic Physician
Hormonal shifts can begin as early as a woman’s mid-30s, marking the transition toward perimenopause — the phase leading up to menopause. This phase typically includes a decline in fertility as well as changes to menstrual cycles and other symptoms relating to ovarian function. Perimenopause can last up to 10 or more years, and symptoms may come and go as the ovaries go through fluctuations in estrogen and progesterone production.
Common symptoms of perimenopause and menopause
Women can experience a wide range of symptoms due to hormonal fluctuations, including:
Irregular periods: Irregular, shorter, longer, heavier, or lighter
Hot flashes and night sweats: Sudden warmth and sweating, often disrupting sleep
Vaginal and urinary symptoms: Dryness, discomfort during intercourse, increased urgency, or incontinence
Physical changes: Weight gain (especially around the abdomen), bloating, joint pain, headaches, heart palpitations
Skin and hair changes: Dryness, thinning hair on the scalp, increased facial hair
Sleep disruptions: Insomnia, difficulty staying asleep
Cognitive and emotional symptoms: Mood swings, irritability, anxiety, depression, brain fog, memory lapses
Sexual and reproductive changes: Decreased libido, declining fertility
Managing symptoms through lifestyle choices
While hormonal changes are inevitable, adopting a proactive approach to health can help alleviate discomfort and support overall wellbeing.
1. Develop a healthy diet
A nutrient-dense diet can significantly impact how the body responds to perimenopause and menopause.¹ Look for foods including:
Calcium and vitamin D: To support bone health
Phytoestrogens: Plant-based compounds that mimic estrogen — found in soy, flaxseeds, and more
Omega-3 fatty acids: May help reduce inflammation and support mood — found in fatty fish, walnuts, chia seeds, hemp hearts, and flax
Limit caffeine, alcohol, and sugar: These can exacerbate hot flashes and mood swings
2. Exercise for strength and stability
Physical activity can help manage symptoms related to weight, stress, and sleep.
Aerobic exercise: Supports cardiovascular health and may reduce hot flashes²
Strength training: Helps maintain muscle mass and bone density
Yoga and pilates: Can improve joint flexibility, balance, and stress management
3. Use stress management techniques
Mindfulness practices can help mitigate the emotional ups and downs associated with hormonal changes. Try:
Meditation, breathing exercises, and journaling to alleviate anxiety and depression
Spending time in nature to promote a calm mood
4. Improve sleep hygiene for more restorative rest
Establish a consistent bedtime routine
Avoid heavy meals, alcohol, and screen time before bed
Create a cool, dark, and comfortable sleep environment
Supplements for perimenopause and menopause support
While diet and lifestyle adjustments are fundamental, certain natural supplements can provide additional support:
Black Cohosh: May reduce hot flashes and night sweats
Evening Primrose Oil: Thought to help with breast tenderness and mood swings
Maca Root: Can support energy and hormone balance
Ashwagandha: An adaptogen, which can aid stress management and adrenal health
Red Clover: Contains phytoestrogens that may help with hot flashes
The role of vitamin B6 in hormonal health
Vitamin B6 plays a crucial role in mood regulation and hormonal balance.³
Mood stability: Vitamin B6 is involved in serotonin and dopamine production, reducing mood swings
PMS symptoms: It’s thought to help with bloating, irritability, and breast tenderness
Energy levels: Vitamin B6 aids in red blood cell production and the metabolism of proteins, fats, and carbs — supporting sustained energy
Sleep quality: Contributes to melatonin production to regulate sleep-wake cycles.
Cognitive function: May help alleviate brain fog and memory lapses.
Benefits of DIM (Diindolylmethane) for hormonal health
DIM, a compound found in cruciferous vegetables (broccoli, kale, cabbage, and Brussels sprouts), is widely studied for its role in hormone metabolism and estrogen balance. It’s thought to:
Affect estrogen levels: May promote the breakdown of estrogen into beneficial metabolites (2-hydroxyestrone) rather than harmful ones (16-hydroxyestrone)⁴
Reduce symptoms of estrogen dominance: May help with bloating, breast tenderness, and irritability
By understanding the changes happening in your body and taking proactive steps through diet, exercise, stress management, and targeted supplementation, you can navigate perimenopause and menopause with confidence. Find what works best for you and seek professional guidance when needed.
Dr. Kim Celmer (ND) is a Naturopathic Physician and Owner of the Institute of Complementary Medicine. Dr. Celmer has spent over 25 years providing comprehensive care focusing on age management, hormone optimization, and general primary care that is both integrated and personalized. She is a member of the Institute for Natural Medicine.
Sources
1 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. Retrieved February 3, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC10780928/
2 Ruta Nonacs, MD PhD. (February 1, 2017). In Brief: Why Exercise Helps with Menopausal Hot Flashes. MGH Center for Women’s Mental Health. Retrieved February 3, 2025, from https://womensmentalhealth.org/posts/brief-exercise-helps-menopausal-hot-flashes/
3 Field, D. T., Cracknell, R. O., Eastwood, J. R., Scarfe, P., Williams, C. M., Zheng, Y., & Tavassoli, T. (2022). High-dose Vitamin B6 supplementation reduces anxiety and strengthens visual surround suppression. Human Psychopharmacology: Clinical and Experimental. Retrieved February 3, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC9787829/
4 Cynthia A. Thomson, Emily Ho, Meghan B. Strom. Chemopreventive properties of 3,3′-diindolylmethane in breast cancer: evidence from experimental and human studies. Nutrition Reviews. Retrieved February 3, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC5059820/
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