How to survive perimenopause — diet tips, supplements, HRT and skincare

Ever since Davina McCall’s Channel 4 documentary Sex, Myths And The Menopause aired back in May, menopause has been a hot topic.

The show got widespread praise for detailing the stigma associated with menopause and breaking the taboos around it.

Davina was just 44 when she started to experience hot flushes, depression and mental fog and the TV presenter (now 53) uses hormone replacement therapy (HRT) to manage her symptoms. But Davina is not alone.

According to healthcare charity Nuffield Health, some 13 million women in the UK are experiencing perimenopause and menopause.

And yet, despite reporting common symptoms associated with it, almost half of the women questioned failed to recognise this is what it could be.

Due to a lack of knowledge, women are being incorrectly diagnosed as depressed and given anti-depressants.

Menopause is a natural part of ageing and this is when a woman stops having periods altogether. The average age for a woman in the UK to reach menopause is 51. However, periods usually start to become less frequent and symptoms can begin to appear months and even years before this as oestrogen levels decline.

This is classed as perimenopause and according to two authors of new book, The Perimenopause Solution, there’s a real lack of understanding when it comes to this stage.

In fact, millions of women in their thirties and forties go through it without even realising they are perimenopausal. Imagine how much easier it would be if you knew what to expect and were armed with solutions to deal with it.

Co-authors Dr Shahzadi Harper, a women’s wellbeing doctor, and Emma Bardwell, a nutritionist and member of the British Menopause Society, say more than one billion women worldwide will be post-menopausal by 2025. There is a real need for advice.

‘Because perimenopause is still shrouded in secrecy and shame, there’s an unprecedented number of myths being peddled,’ says Emma.

‘Most people use menopause as an umbrella term for the time in a woman’s life that encompasses perimenopause, menopause and postmenopause. But perimenopause is the most important stage to get to grips with because that’s when the majority of symptoms occur.’

There are more than 34 officially recognised symptoms of menopause. The most common and openly talked about are hot flushes, night sweats, irritability, moodiness and weight gain. Other symptoms include brittle nails, disrupted sleep, hair loss, gum soreness, headaches and joint pain.

There is no one size fits all when it comes to symptoms and, as we all have the odd bad night’s sleep or a fluctuating period, how do we know when it’s actually perimenopause?

‘If you’re a woman over 45, you’ve got symptoms and you’re not feeling yourself then we’d say you’re in perimenopause,’ says Dr Shahzadi.

‘If you’re under 45 and feeling this way then it’s probably perimenopause and now is the time to ask your doctor for some blood tests. A lot of women and, frankly, some doctors, think that because they still have their periods, they can’t be perimenopausal. But they could be.

‘The average age for menopause (when you actually have your last period) is 51, but three out of four women experience some symptoms four to ten years before that, and 75 per cent of women will experience perimenopausal symptoms that diminish their quality of life.’

According to the authors, navigating perimenopause can be challenging, but if you have the tools to cope, the symptoms are manageable.

‘We are both advocates of HRT,’ says Emma. ‘It’s the gold standard treatment for many perimenopause symptoms. However, the starting point for us is to take a holistic view. In the early stages, symptoms can be managed by lifestyle approaches. That’s why The British Heart Foundation advocates attention to your diet to reduce the risk of heart disease — the biggest killer in women over 50.

‘One of the most important things you can do for anxiety and mood is balance blood sugar levels. Try to get protein in every meal and reduce highly processed foods.

‘Up to seven in ten women in the UK could be deficient in magnesium. That can impact sleep and a whole range of perimenopause symptoms. High-stress states can deplete magnesium, so look at where you’re getting your intake. This is why working women in busy cities have more symptoms compared with women who don’t work and live in the countryside.’

If you’re not already doing it, exercise regularly.

‘For lots of women, exercise is the first thing to fall by the wayside when they’re tired or feeling low,’ says Dr Shahzadi. ‘But regular movement helps alleviate stiffness, fatigue, concentration issues, poor sleep and irritability. Studies have shown strength training can lessen the likelihood of having hot flushes, too.’

It may be hard to talk about, but perimenopause might be a chance to make some lifestyle changes. ‘Coming to the end of your reproductive life can feel like bereavement,’ adds Dr Shahzadi.

‘But now we’re living until the age of 90, this is the time to ensure the second half of our lives is primed for health and happiness. Women shouldn’t be stigmatised for it.’

What to eat and what to avoid…

‘There’s plenty of evidence to show that eating certain foods during the perimenopause can help support your mind and body,’ says Lola Biggs, dietician at natural supplement brand Together Health. ‘Here are a few suggestions to get you started…’

Hot flushes: ‘Avoid alcohol, spicy foods, coffee and chocolate, which are believed to trigger flushes due to the impact they have on the blood vessels — the increased dilation brings a rush of blood and with it heat.

‘Instead, include soya milk, tofu and edamame beans, which mimic the effect of oestrogen in the body and can help cut down the number and severity of hot flushes.’

Weight gain: ‘This is quite common during the menopause. It can be due to the metabolism naturally slowing down and an increase in sedentary living. Watch the amount of refined sugar and saturated fats in your diet and reduce processed foods (white bread, pasta, biscuits) as they aren’t nutritionally balanced.

‘Eating complex carbohydrates such as wholemeal pasta, rice and whole grains help the body to balance blood sugar levels and keep you fuller for longer.’

Anxiety and irritability: ‘Protein foods which contain the amino acid tryptophan are key as this helps manufacture the neurotransmitter serotonin. Serotonin helps moods and having enough may help control appetite and sleep.

‘Eat foods like oats, legumes (chickpeas, beans, lentils which are full of vitamin B6, magnesium and antioxidants), turkey and cottage cheese. Try an antioxidant green tea, which contains L-Theanine and has been linked to feeling calm.

‘Brain fog is often reported by women and ashwagandha root can have a positive impact on our brain’s ability to process things.’

Tiredness: ‘It’s tempting to reach for sugary treats to boost energy, but the sharp rise in blood glucose levels may be followed by a sharp dip, making you feel wiped out.

‘Instead, eat three balanced meals, rich in whole foods and healthy fats, and a handful of nuts or an energising beetroot juice to boost natural energy levels. Avoid caffeine after 2pm and alcohol as these can cause sleep problems.’

Products to ease menopause symptoms

Suvi Labs Botanicals + Collagen

Combines seven natural ingredients to manage the emotional and physical challenges of perimenopause.

Buy it for £39 (60 capsules) from Suvi Labs

Together Health Menopause Multi

Contains high levels of vitamin B1, B6, B12, biotin and vitamin D3, along with ashwagandha and sage.

Buy it for £18.99 (60 capsules) from Together Health

RAI x M&S Hot Flush Cool Fix Serum

Hot and bothered? This serum comes in a rollerball and instantly cools hot, flushed skin. It also boosts collagen and hydration.

Buy it for £28 (60ml) from M&S

Health & Her Perimenopause Mind+

Created for mood and mind support during the early stages of perimenopause.

Buy it for £17.99 from Health & Her

Menopause Faace Mask

Packed with collagen-boosting, hydrating and anti-inflammatory ingredients like rose water and more.

Buy it for £29 (100ml) from Faace

The Perimenopause Solution is out now, £14.99, at Waterstones

This article contains affiliate links. We may earn a small commission on purchases made through one of these links but this never influences our experts’ opinions. Products are tested and reviewed independently of commercial initiatives.

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