Perimenopause, the years leading up to menopause, can feel like a rollercoaster ride for many women in their 40s (although it can start earlier or later). Fluctuating hormone levels, primarily estrogen and progesterone, cause a cascade of symptoms that can disrupt your sleep, mood, and overall well-being. 

Hot flashes, night sweats,  irregular periods, and brain fog are just a few of the unwelcome guests that might show up at your perimenopause party.

But fear not! Perimenopause and menopause are natural parts of life, and there are natural ways to manage these changes.

Perimenopause vs. Menopause: A Tale of Two Transitions

Perimenopause and menopause are both natural stages in a woman's life, but they represent distinct phases with unique hormonal changes and impacts. Understanding the differences can help you navigate these transitions with greater ease.

Perimenopause

Think of perimenopause as the dress rehearsal for menopause. It's a transitional period leading up to menopause that can last anywhere from a few years to over a decade, often starting in a woman's 30s or 40s. During this time, the ovaries begin to gradually slow down egg production, leading to fluctuations in estrogen levels. These hormonal fluctuations are responsible for the hallmark symptoms of perimenopause, which can include:

Irregular Periods 

Periods may become shorter, longer, heavier, or lighter than usual, or they may skip months altogether. This is due to the unpredictable nature of ovulation during this time.

Hot Flashes

These sudden surges of warmth and sweating are a common complaint during perimenopause. They can be accompanied by flushing of the skin, chills, and night sweats, causing significant discomfort and disrupting sleep patterns.

Sleep Disturbances

Hot flashes and hormonal changes can disrupt sleep patterns, leading to insomnia, fatigue, and daytime sleepiness. This lack of quality sleep can further exacerbate other symptoms.

Mood Swings

Fluctuations in estrogen can impact mood, causing irritability, anxiety, depression, or difficulty managing emotions. You might experience increased tearfulness, feeling overwhelmed, or a general sense of low mood.

Vaginal Dryness

As estrogen levels decline, vaginal tissues can become thinner and less lubricated, leading to discomfort during intercourse and increased risk of urinary tract infections. This can also affect sexual desire and intimacy.

Decreased Libido

Reduced estrogen levels can also lead to a decline in sex drive. You might experience a decrease in sexual interest or find sexual activity less pleasurable.

Brain Fog

Some women experience difficulty concentrating, forgetfulness, and mental fogginess during perimenopause. This can affect memory, focus, and cognitive function.

Other Symptoms 

Headaches, joint and muscle aches, changes in appetite, weight gain, heart palpitations, and hair loss are also possible symptoms experienced by some women during perimenopause.

 

Menopause

Menopause, on the other hand, is a definitive point in time. It's diagnosed after a woman has not had a menstrual period for a full twelve months. This signifies that ovulation has ceased and she is no longer able to become pregnant naturally. Menopause typically occurs in the late 40s or early 50s, but the age can vary depending on individual factors.

Since estrogen levels are significantly lower at this stage, many of the symptoms experienced during perimenopause may continue or even intensify. However, for some women, the symptoms may lessen or even disappear altogether. Here's a breakdown of the effects of menopause:

Reduced Fertility

Once menopause occurs, a woman is no longer able to become pregnant naturally.

Continued Symptoms

Hot flashes, night sweats, vaginal dryness, sleep disturbances, and mood swings may continue or worsen during menopause.

Increased Risk of Certain Health Conditions

Menopause can increase the risk of developing certain health conditions over time, such as osteoporosis, heart disease, and urinary incontinence. However, maintaining a healthy lifestyle with regular exercise and a balanced diet can help mitigate these risks.

Emotional Impact

The hormonal changes of menopause can also have an emotional impact. Some women may experience feelings of loss, grief, or anxiety about aging. However, menopause is also a time of opportunity for a new chapter in life.

Here are 7 natural solutions to  help you navigate perimenopause and menopause:

1. Embrace a Healthy Lifestyle

Balanced Diet

Incorporating a variety of nutrient-rich foods into your diet is essential during perimenopause. Focus on consuming plenty of fruits, vegetables, whole grains, lean proteins, and healthy fats. These foods provide essential vitamins, minerals, and antioxidants to support overall health and hormone balance. 

The NHS guidelines on healthy eating offer valuable recommendations for creating a balanced meal plan tailored to your needs. (NHS, 2022)

Regular Exercise 

Engaging in physical activity is crucial for managing perimenopause symptoms and supporting overall well-being. Aim for at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise each week, along with muscle-strengthening activities on two or more days per week. Exercise not only helps regulate mood and improve sleep quality but also strengthens bones and muscles, reducing the risk of osteoporosis. Explore various activities such as walking, swimming, cycling, yoga, or Pilates to find what works best for you. 

The NHS provides comprehensive guidance on physical activity recommendations for adults. (NHS, 2022)

Stress-Reducing Techniques

Chronic stress can exacerbate perimenopause symptoms such as hot flashes, mood swings, and sleep disturbances. Incorporating stress-reducing techniques into your daily routine can help mitigate these effects. Practices such as mindfulness meditation, deep breathing exercises, progressive muscle relaxation, and tai chi can promote relaxation and reduce stress levels. Additionally, engaging in enjoyable activities, spending time in nature, and maintaining social connections can contribute to overall emotional well-being. 

Explore resources from reputable sources such as the NHS or mindfulness-based stress reduction programs to learn and implement stress management strategies effectively. (NHS, 2022)

2. Beat the Heat with Cooling Strategies

Dress Appropriately

Dressing in lightweight, breathable fabrics such as cotton or linen can help manage the discomfort of hot flashes. Layering clothing allows you to adjust your attire quickly in response to temperature changes. Opt for loose-fitting garments that facilitate air circulation and minimise sweating. Additionally, wearing moisture-wicking fabrics can help keep you dry and comfortable during hot flashes. 

The NHS offers practical advice on managing hot flushes and night sweats, including tips on clothing choices. (NHS, 2022)

Maintain a Cool Bedroom Environment

Creating a cool and comfortable sleeping environment is essential for promoting restful sleep during perimenopause. Keep your bedroom well-ventilated and maintain a consistent room temperature conducive to sleep. Consider using a fan, air conditioner, or portable air cooler to regulate the temperature and improve air circulation. Additionally, investing in breathable, moisture-wicking bedding and sleepwear can help minimise discomfort from night sweats. 

Explore resources from organizations such as The Sleep Council for tips on optimizing your bedroom environment for better sleep quality. (The Sleep Council, n.d.)

Stay Hydrated

Adequate hydration is essential for overall health and well-being, particularly during perimenopause when hot flashes and night sweats can lead to increased fluid loss. Aim to drink plenty of water throughout the day to maintain hydration levels and support optimal bodily functions. Carry a reusable water bottle with you to ensure easy access to water wherever you go. Limit consumption of caffeinated beverages and alcohol, as they can contribute to dehydration and exacerbate perimenopause symptoms. 

The NHS provides guidance on maintaining hydration and offers tips for staying hydrated throughout the day. (NHS, 2022)

3. Explore the Power of Plants

Incorporate Phytoestrogen-Rich Foods 

Phytoestrogens are plant compounds that mimic the effects of estrogen in the body and may help alleviate some perimenopause symptoms. Incorporating phytoestrogen-rich foods into your diet can provide natural relief. 

Examples include soy products (tofu, tempeh, soy milk), flaxseeds, sesame seeds, legumes (beans, lentils, chickpeas), whole grains, and certain fruits and vegetables (such as berries, apples, carrots, and broccoli). These foods not only offer phytoestrogens but also provide essential nutrients, fiber, and antioxidants to support overall health. 

Explore resources from reputable sources like the Mayo Clinic for information on phytoestrogen-rich foods and their potential benefits. (Mayo Clinic, 2021)

Try Alternative Plants

In addition to commonly known phytoestrogen-rich foods, several alternative herbal remedies are believed to alleviate menopausal symptoms. Evening primrose oil, derived from the seeds of the evening primrose plant, is often used to relieve hot flashes, mood swings, and vaginal dryness. 

 

Dong Quai

Also known as female ginseng, has a long history of use in traditional Chinese medicine for women's health concerns, including menopause symptoms. While scientific evidence supporting the efficacy of these herbal remedies is limited, some women find them helpful in managing perimenopause symptoms. 

The National Institute on Aging offers information on complementary health practices during menopause, including herbal remedies. (National Institute on Aging, 2021)

4. Discover the Magic of Functional Mushrooms

Reishi Mushroom (Ganoderma lucidum)

Menopause brings a wave of changes, and disrupted sleep patterns are often a major challenge. Fragmented sleep can lead to fatigue, irritability, and difficulty concentrating, impacting daily life. This is where Reishi mushrooms, traditionally revered in Eastern medicine for their adaptogenic properties,  may offer support.

Adaptogens are considered to help the body adapt to stress, and research suggests Reishi may improve sleep quality and duration during perimenopause. While the exact mechanisms are still being investigated, some theories point to Reishi's potential to:

Modulate the nervous system: Reishi's bioactive compounds may interact with the nervous system, promoting relaxation and reducing anxiety, which can contribute to better sleep.

Balance hormones: Menopause disrupts hormone production, and Reishi may help regulate the hypothalamic-pituitary-adrenal (HPA) axis, potentially influencing sleep-wake cycles.

Reduce inflammation: Chronic inflammation is linked to sleep disturbances, and Reishi's anti-inflammatory properties may play a role in promoting better sleep.

It's important to remember that research on Reishi for menopause is ongoing, and more studies are needed to fully understand its effectiveness. However, the potential benefits for sleep and overall well-being during this transition make Reishi an interesting option for some women.

Read more on the benefits of Reishi mushrooms here

 

Cordyceps (Cordyceps militaris) 

Perimenopause can zap your energy levels, making even simple tasks feel overwhelming. If fatigue is a major concern, Cordyceps mushrooms, a traditional Chinese medicinal fungus, might be worth exploring. Cordyceps are known as adaptogens, meaning they may help the body adapt to stress, both physical and emotional. During perimenopause, fluctuating hormones can create a stress response in the body. Research suggests Cordyceps may be beneficial for:

Combating fatigue: Cordyceps contain compounds like cordycepin and adenosine that may influence energy production at the cellular level. Studies suggest it could improve exercise performance and reduce fatigue, potentially helping with perimenopause-related tiredness.

Supporting physical activity: Low energy can make exercise a struggle, hindering overall well-being. Cordyceps' potential to improve stamina and reduce fatigue might encourage women to stay active during perimenopause, which is crucial for maintaining bone health and managing weight.

Improving sleep quality: While directly linked to sleep is less researched, some studies suggest Cordyceps may promote relaxation and potentially improve sleep quality. Better sleep can indirectly contribute to increased energy levels.

It's important to note that research on Cordyceps for perimenopause is still emerging, and more studies are needed to definitively confirm its effectiveness.

Read more on the benefits of Cordyceps mushrooms here

Lion's mane mushroom (Hericium erinaceus) 

The fog rolls in – memory lapses, difficulty concentrating – these are common complaints during perimenopause as hormonal fluctuations can impact cognitive function.  Lion's Mane mushroom, revered for its potential to enhance cognitive health, might be a natural ally during this transition.

Lion's Mane contains unique compounds called hericenones and erinacines that have been shown to stimulate the production of Nerve Growth Factor (NGF). NGF plays a crucial role in the growth, maintenance, and repair of nerve cells, potentially influencing cognitive function.  Here's how Lion's Mane might be helpful:

Improving memory and focus: Research suggests Lion's Mane may improve cognitive function, memory, and concentration. This could be particularly beneficial for women experiencing brain fog or forgetfulness during perimenopause.

Supporting mood: Fluctuations in estrogen can also impact mood. Some studies suggest Lion's Mane may help regulate mood and potentially alleviate symptoms of anxiety and depression, which can sometimes accompany perimenopause.

Promoting overall brain health: Lion's Mane's potential to support nerve growth factor production might contribute to overall brain health and cognitive function by combating brain fog in the long run.

While research on Lion's Mane for perimenopause is promising, it's still ongoing. More studies are needed to definitively confirm its effectiveness. 

To learn more about the benefits of Lion’s Mane for Brain Fog read our article here

To learn more about the best mushrooms for menopause click the link here

 

5. Supplements for Support (with a Doctor's Guidance)

Black Cohosh 

Black cohosh (Actaea racemosa) is a perennial herb native to North America with a long and respected history in traditional Native American medicine. Today, it's one of the most popular natural supplements sought after by women experiencing the physical and emotional challenges of perimenopause and menopause. Here's a closer look at the potential benefits Black Cohosh offers for relieving some of these common symptoms:

Alleviating Hot Flashes and Night Sweats: Hot flashes and night sweats are some of the most bothersome symptoms associated with menopause. Black cohosh's potential influence on thermoregulation,  the body's process of regulating temperature, might be key here. Research suggests Black Cohosh may help reduce the frequency and intensity of hot flashes, offering some relief from these uncomfortable episodes.

Improving Sleep Quality: Disrupted sleep patterns are another common complaint during perimenopause and menopause. Black cohosh's potential interaction with neurotransmitters involved in sleep regulation might contribute to better sleep quality. Some studies have shown improvement in sleep duration and a reduction in sleep disturbances for women taking Black Cohosh.

Easing Mood Swings and Anxiety: The hormonal fluctuations of perimenopause and menopause can wreak havoc on mood, leading to irritability, anxiety, and even depression. Black cohosh's possible influence on mood-regulating neurotransmitters might offer some relief.  A study published in National Institutes of Health (.gov) showed promise for Black Cohosh in reducing symptoms of anxiety in menopausal women.

Supporting Vaginal Health: Declining estrogen levels can contribute to vaginal dryness and discomfort during sex. While research is ongoing, some studies suggest Black Cohosh may offer some improvement in vaginal lubrication.

The National Center for Complementary and Integrative Health provides information on black cohosh and its potential benefits for menopause symptom management. (National Center for Complementary and Integrative Health, 2021)

 

Red Clover

Red clover (Trifolium pratense) is a flowering plant native to Europe, Asia, and Africa.  For centuries, it's been used in traditional medicine, and today, it's a popular natural supplement for women experiencing the hormonal shifts of perimenopause and menopause. Let's delve deeper into the science behind Red clover and explore its potential benefits for alleviating some common menopausal symptoms.

The Isoflavone Advantage: Mimicking Estrogen's Effects

Red clover's potential to ease menopausal discomfort hinges on its unique composition – it's rich in isoflavones. These plant-based compounds possess a weak estrogen-like activity, offering a glimmer of hope for women experiencing symptoms linked to declining estrogen levels during menopause.

Here's how Red clover's isoflavones might translate to relief:

Combating Hot Flashes and Night Sweats: Hot flashes and night sweats are a hallmark of menopause, disrupting sleep and causing significant discomfort. Studies suggest that Red clover isoflavones may help alleviate these symptoms. They might work by modulating the hypothalamus, a key brain region involved in thermoregulation, the body's process of regulating temperature. 

By influencing this system, Red clover isoflavones may help reduce the frequency and intensity of hot flashes, offering some respite.

Supporting Vaginal Health: Declining estrogen levels can lead to vaginal dryness and discomfort during intimacy. Research suggests that Red clover isoflavones might offer some improvement in vaginal health. Some studies indicate that these compounds may help maintain vaginal lubrication and elasticity, potentially improving sexual function during menopause.

The NHS provides information on alternative treatments for menopause symptoms, including red clover and its potential role in managing hot flashes and vaginal dryness. (NHS, 2022)

 

Consider Vitamin D

Vitamin D, often called the "sunshine vitamin," plays a vital role in our overall health and well-being. However, its importance becomes even more crucial during perimenopause, a time when hormonal changes can significantly impact bone health. Here's how adequate vitamin D intake can be a powerful ally for women transitioning into menopause:

Building Strong Bones: Vitamin D's primary function is to regulate calcium absorption from the gut. Calcium is the building block of strong bones, and during perimenopause, declining estrogen levels can lead to bone loss. Vitamin D ensures that the calcium we consume is efficiently absorbed and utilized by the body, promoting bone mineralization and reducing the risk of osteoporosis and fractures, a common concern for women after menopause.

Beyond Bones: Additional Benefits of Vitamin D

While bone health is a primary concern, vitamin D offers a wider range of benefits during perimenopause:

Immune Support: Vitamin D plays a vital role in regulating the immune system, potentially helping the body fight off infections and illnesses, which can be more frequent during hormonal fluctuations.

Muscle Strength: Adequate vitamin D levels are linked to improved muscle strength and function, which can be beneficial for maintaining mobility and preventing falls, a significant risk factor for older adults.

Mood Regulation: Studies suggest that vitamin D deficiency might be linked to mood swings and depression, both of which can be experienced during perimenopause. Maintaining optimal vitamin D levels may contribute to emotional well-being.

The National Osteoporosis Foundation offers information on vitamin D supplementation and its role in supporting bone health during perimenopause. (National Osteoporosis Foundation, n.d.)

6. Prioritise Quality Sleep

Establish a Bedtime Routine

Creating a relaxing bedtime routine can help signal to your body that it's time to wind down and prepare for sleep. Incorporate activities such as taking a warm bath, practising relaxation techniques (such as deep breathing or progressive muscle relaxation), reading a book, or listening to calming music into your nightly routine. 

Consistency is key, so aim to go to bed and wake up at the same time each day to regulate your body's internal clock and improve sleep quality. 

Explore resources from organizations such as the National Sleep Foundation for tips on establishing a bedtime routine and optimizing your sleep environment. (National Sleep Foundation, n.d.)

Limit Screen Time

Exposure to blue light emitted by electronic devices such as smartphones, tablets, computers, and televisions can disrupt your body's natural sleep-wake cycle and inhibit the production of melatonin, a hormone that regulates sleep. To promote better sleep quality, limit screen time in the evening, especially within the hour before bedtime.

Use features such as night mode or blue light filters on your devices to reduce blue light exposure, or consider wearing blue light-blocking glasses. Instead of screen-based activities, engage in relaxing and screen-free activities such as reading a physical book, practising gentle stretching or yoga, or journaling before bed. 

Harvard Health Publishing provides information on the negative effects of blue light and practical tips for reducing screen time before bedtime. (Harvard Health Publishing, 2018)

7. Strengthen Your Pelvic Floor

Learn Proper Technique

Pelvic floor exercises, also known as Kegel exercises, are designed to strengthen the muscles of the pelvic floor and improve bladder control, particularly important during perimenopause when hormonal changes may affect pelvic floor function. To perform Kegel exercises correctly, identify the pelvic floor muscles by tightening the muscles you would use to stop the flow of urine or prevent passing gas. Once you've located these muscles, contract them for a count of three to five seconds, then relax for the same duration. 

Aim to perform 10 to 15 repetitions of Kegel exercises, three times per day, gradually increasing the duration and intensity as your pelvic floor muscles strengthen. Proper technique is essential to ensure the effectiveness of Kegel exercises and prevent injury, so consider consulting with a pelvic health physiotherapist or healthcare professional for guidance. 

Explore resources from organizations such as the NHS for information on performing Kegel exercises correctly and effectively. (NHS, 2022)

 

Alternative Exercises

In addition to traditional Kegel exercises, several alternative exercises can help strengthen the pelvic floor muscles and improve bladder control during perimenopause. 

Pilates, a low-impact exercise system that focuses on core strength, stability, and flexibility, often includes exercises that target the pelvic floor muscles. Incorporating Pilates exercises into your fitness routine can help improve pelvic floor function and reduce urinary incontinence symptoms. 

Similarly, yoga, a mind-body practice that combines physical postures, breath control, and meditation, includes poses and movements that engage and strengthen the pelvic floor muscles. Regular practice of yoga can enhance pelvic floor awareness, stability, and control, contributing to improved bladder function and pelvic health. Consider attending classes led by certified Pilates or yoga instructors who specialise in women's health or pelvic floor rehabilitation to ensure safe and effective exercise participation. 

Harvard Health Publishing offers information on the potential benefits of yoga and Pilates for pelvic floor health and urinary incontinence management. (Harvard Health Publishing, 2020)

By incorporating these natural solutions into your lifestyle and seeking guidance from healthcare professionals, you can effectively manage perimenopause symptoms and improve your overall well-being.

References

Guggenheim, A. G., Wright, K. M., & Zwickey, H. L. (2014). Immune modulation from five major mushrooms: Application to integrative oncology. Integrative Medicine: A Clinician's Journal, 13(1), 32–44.

Harvard Health Publishing. (2018). Blue light has a dark side. https://www.health.harvard.edu/staying-healthy/blue-light-has-a-dark-side 

Harvard Health Publishing. (2020). Yoga: Another way to prevent osteoporosis? https://www.health.harvard.edu/womens-health/yoga-another-way-to-prevent-osteoporosis 

Mayo Clinic. (2021). Menopause diet: 5 things you need to know. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menopause-diet/art-20047879 

National Center for Complementary and Integrative Health. (2021). Black cohosh. https://www.nccih.nih.gov/health/black-cohosh 

National Institute on Aging. (2021). Menopause and complementary health practices. https://www.nia.nih.gov/health/menopause-and-complementary-health-practices 

National Osteoporosis Foundation. (n.d.). What women need to know. https://www.nof.org/preventing-fractures/general-facts/what-women-need-to-know/ 

National Sleep Foundation. (n.d.). Sleep hygiene. https://www.sleepfoundation.org/sleep-hygiene 

NHS. (2022). Eat well. https://www.nhs.uk/live-well/eat-well/ 

NHS. (2022). Complementary and alternative medicine. https://www.nhs.uk/medicines/herbal-remedies-and-complementary-medicines/what-is-complementary-and-alternative-medicine/ 

The Sleep Council. (n.d.). Top tips for a good night's sleep. https://sleepcouncil.org.uk/top-tips-for-a-good-nights-sleep/ 

Weng, Y. T., Chang, W. T., Liu, T. Y., Chuang, H. L., & Wu, J. S. (2019). Immunomodulatory functions of extracts from the Chinese medicinal fungus Cordyceps cicadae. Journal of Ethnopharmacology, 235, 399–407. https://doi.org/10.1016/j.jep.2019.01.011

By incorporating these natural solutions into your daily routine and seeking guidance from healthcare professionals, you can effectively manage perimenopause symptoms and enhance your overall quality of life. Remember to listen to your body, be patient with yourself, and make adjustments as needed to find what works best for you during this transitional phase of life.