Perimenopause is a fantastic opportunity to improve your health. It can also be a challenging time of life. Many of the symptoms of perimenopausal hormonal fluctuations can hinder health change. This is why working with an expert who can guide and support you through these changes is helpful. A dietitian can help relieve perimenopause symptoms and improve your nutrition and overall health. Research suggests that people who follow a health-promoting eating pattern and have good metabolic health entering the perimenopause transition experience fewer symptoms overall.
Before we get into specific reasons why working with a dietitian can be beneficial, let’s start by defining perimenopause.
What is perimenopause?
Perimenopause is the time leading up to menopause when hormonal fluctuations begin. It can last anywhere from 4 to 10 years and ends with menopause. Menopause is the 12-month anniversary of when you stop getting your period. You may have heard of some of the symptoms of the menopause transition, like hot flashes, mood swings (hello meno-rage), and brain fog. Fatigue, digestive issues, and weight changes are other shared experiences of perimenopause. Navigating these changes with the support of a dietitian during perimenopause can be helpful.
While all these symptoms don’t sound that great, you don’t have to put up with feeling like crap every day. Discussing the changes that occur during perimenopause is becoming less taboo than it once was.
Stress management, good sleep hygiene, and regular movement support your physical and mental health during perimenopause. With any life stage, good nutrition is one of the pillars of good health. Learning to listen to and nourish your body will help you thrive during perimenopause.
Here are 5 reasons to work with a dietitian during perimenopause
1 | Learn how to reduce perimenopause fatigue
Fatigue during perimenopause is no joke. And there are a variety of reasons why it can happen. A few of them are related to nutrition.
RULE OUT IRON DEFICIENCY
Menstrual cycle changes are a common cause of fatigue. During perimenopause, periods can become heavy, more frequent or both. This contributes to increased blood loss and iron depletion. In some cases, iron deficiency occurs, and when not corrected, anemia is the result.
Signs and symptoms of iron deficiency include trouble concentrating, fatigue, a pale appearance, having cold hands and feet, dizziness, and shortness of breath. Some people will experience worsening restless leg syndrome with low iron. If you have noticed any of these symptoms, it’s a good idea to see your healthcare provider to assess your iron levels. If iron levels are low, they need to be corrected with an iron supplement.
IMPROVE YOUR SLEEP
Lack of good quality sleep is another reason you may experience fatigue during perimenopause. Low iron levels, hormone changes, stress, alcohol, and other life factors (hello, tiny humans waking up at all hours of the night) can all negatively affect sleep quality. Poor sleep often leads to overcompensating with caffeine (further disrupting sleep) and endless sugar cravings. The hormones that promote hunger increase when we have poor sleep. This means chronic sleep deprivation will leave you feeling more hungry than usual and craving foods that give you a quick burst of energy.
When I work with clients, we find out if iron is an issue, and we also work on sleep hygiene as part of our overall plan because of its impact on appetite, energy levels, and metabolism. If hot flashes are the main reason for poor sleep, then finding out if they are due to perimenopause or other health conditions is the first step. Once that is determined, then an appropriate treatment option can used. The Menopause Society does not recommend soy and isoflavone supplements to treat hot flashes. However, some research links the intake of certain foods with reduced vasomotor symptoms for some people. Recommended treatment options include menopause hormone therapy, non-hormone medications, or cognitive behavioural therapy.
ADJUST YOUR EATING
Having a plan for those rough mornings when sleep just didn’t happen is essential – it’s just not realistic to expect a great night of sleep every night, even if you correct the issues causing poor sleep. Turning to complex carbohydrates (think whole grains, vegetables and fruit) balanced with protein or fats helps keep energy levels more stable, especially on mornings when sleep is illusive.
There are many other reasons for fatigue besides low iron and poor sleep, but these are common during perimenopause, and I see them often in my practice. Hydration, other nutrient deficiencies, overall eating pattern and meal balance can also play a role. In my experience, undernourishment and a chaotic, unbalanced eating pattern significantly contribute to feeling fatigued and having low energy.
2 | Improve your digestion during perimenopause
Although the link between digestion and perimenopause is not well understood, I see a lot of clients with increased bloating and heartburn. Progesterone levels decline as perimenopause progresses, and it is thought that this can play a role in digestive changes. Progesterone slows gastric motility, or how fast food moves through your digestive system. When it takes longer for food to move through the digestive tract, fibre will spend a longer time being fermented by bacteria, producing more bloating. Many clients notice this is more pronounced before they expect their period. We work together to adjust their eating pattern to help reduce overall bloating and have a plan for this duration of their cycle.
Progesterone also helps to protect against H. pylori, a bacteria that can cause gastroesophageal reflux disease (GERD). The main symptom of GERD is heartburn and diet adjustments are an important strategy for managing GERD.
Many with IBS (irritable bowel syndrome) will notice more flare-ups of symptoms due to hormonal fluctuations. This is an excellent time to reassess symptom management, including diet and stress management.
3 | Reduce the risk of developing heart disease during menopause
Working with a dietitian during perimenopause can help you get ahead of issues that may arise down the road. This is particularly true for heart disease. Menopause increases the risk of developing heart disease due to the decreased estrogen once the age of menopause is reached. It’s common to see LDL cholesterol and blood pressure increase during this time. Increased insulin resistance is also linked with perimenopause, so learning to adjust your eating pattern to manage blood sugar levels will help to protect your blood vessels and reduce the risk of diabetes.
Many eating patterns and foods can help reduce the risk of heart disease and diabetes and lower LDL cholesterol and blood pressure. Eating patterns rich in plant-based protein (no, you don’t need to become vegan), whole grains, nuts, seeds, fatty fish, fruits, vegetables and legumes are most beneficial here. When life gets busy (hello, 40s!), finding ways to fit these nourishing foods into our day can be challenging. That’s where working with a dietitian can benefit you – we can help you find practical strategies for adding foods to support your health.
5 | Reduce bone losses during menopause
Another menopause-related health change is bone loss and an increased risk for osteoporosis. Research suggests across the menopause transition, bone losses of 10-12% are expected (that’s about one T-score). The highest rates of bone loss happen at the time of menopause. The average annual loss is about 2%, beginning one to three years before menopause. This rate persists for five to ten years post-menopause.
Unfortunately, many don’t think about our bone health until we have a fracture or receive an osteopenia diagnosis. There aren’t any outward signs of low bone density or osteoporosis. You can learn more about risk factors and health screening for osteoporosis at this site.
The majority of our bone mass is built during childhood through early adulthood. By the time you reach the age of 30, you’ve got all the bone you are ever going to have. Adequate calcium, vitamin D, protein, magnesium, phosphorus, and vitamin K are all needed to maintain bone mass. In addition, reducing salt intake and avoiding excess alcohol intake can help us to reduce the risk of bone loss and osteoporosis. Prevention of osteoporosis is further supported with regular weight-bearing exercise to help keep bones strong. This includes activities like resistance training, walking, and running.
As with heart health, working with a dietitian can help you ensure you receive adequate nutrition to minimize bone loss during the menopause transition.
5 | Learn to stop dieting – once and for all
It’s estimated that more than 50% of women will diet throughout their lifetime, and many will spend over a decade dieting. These types of statistics are equally enraging and heartbreaking. Sadly, this is understandable given the pervasiveness of diet culture that we live in. Imagine what you could do with your time instead of dieting. The amount of mental energy that would be freed up.
If you’ve been a chronic dieter for most of your life, it might be worth asking yourself whether it’s truly serving you and your health. Consider the time, energy, and money you have spent chasing the latest fad diet. Are you really healthier for it?
Midlife is a great time to switch gears, focus on your overall health and fix your relationship with food. It’s not always an easy journey, but it’s worth it to experience the freedom from giving up dieting.
Finding a way of eating that helps you feel energized and supports your health – without restriction, is an excellent pursuit in perimenopause. It’s estimated that most women will spend 40% of their lives post-menopausal. Don’t you deserve to spend it doing things you love rather than dieting?
Invest in your health during perimenopause to support longevity and healthy aging
Many eating patterns can help reduce the risk of heart disease, diabetes and osteoporosis. A great reason to work with a dietitian during perimenopause is to help you get the most out of your eating pattern regarding disease prevention while also enjoying the foods you eat.
And if you’re already managing a health condition? Even more reason to work with a dietitian to optimize your health.
WANT TO LEARN MORE?
If you want to work with a dietitian who can help you relieve perimenopause symptoms, The Nourished Menopause Group Program might be a good fit.
