Foundational habits can make a difference. Start small.
Food and drink choices
The impact of certain foods. Use your body as your guide. Take notice of how you feel after eating certain foods. This can change as we age. Which foods make you feel clearheaded versus foggy? Which foods bring on a nap 45 minutes later? Which keep you up at night?
Pay attention to hydration. Headaches and constipation can be the result of not enough water. For those that get UTIs, regular water intake can help prevent them. It turns out the requirement to drink 8 glass a day isn’t true as Dr. Jen Gunter explains in this Ted talk, “Why you don’t need 8 glasses of water a day,” from May of 2021. Some contexts (e.g. hot weather, exercise, hot flashes) might increase your intake needs.
Alcohol. It’s worth testing the impact of reducing or eliminating alcohol. Here are two reasons to consider. First, alcohol has been shown to increase estrogen levels. And second, alcohol interferes with getting good sleep.
Caffeine. Again, self-test here. While there are benefits of caffeine, in those experiencing increased anxiety, caffeine can exacerbate anxious feelings.
When I really stick to “clean” eating (and drinking – i.e. no alcohol!), my perimenopause symptoms are sooooo much better. I can’t believe what a MAJOR impact food has!WLB Community Member
I once did a 21-day elimination cleanse — I gave up gluten, sugar, dairy, caffeine, and alcohol for 7 days and then over 14 days added them back one by one. After three days without sugar, I noticed a big difference. I have not continued to eliminate these things, but the awareness of the impact of food, particularly sugar, has stuck with me.
Sleep
Assess your sleep. If you are waking up at night, you are in good company but probably frustrated and tired. Making an effort to consider the causes of your poor sleep and trying to fix your newly “disrupted” sleep is worth it as research links poor sleep to poor long-term health — seven of the top 15 causes of death in the US, including cardiovascular disease, blood cancers, stroke, accidents, diabetes, sepsis, and hypertension, have been linked to shortened sleep duration. Sleep also has a bi-directional relationship with mental health. Sleep apnea was found in 20% of the female participants in the Study of Women’s Health Across the Nation (SWAN), and contributes to dementia risk in older adults, with women appearing particularly vulnerable. Sleep is a foundational pillar of long-term physical and mental health and worth working on if yours isn’t great.
Find remedies. There are numerous remedies worth trying. Two things we’ve learned; it’s easy to get anxious about your sleep which only begets even less sleep and it’s easy to poo-poo sleep hygiene but it is important and it works. Even if you’ve thought a sleep mask was somewhere you’d never go, give it a try to get a bit more early-morning sleep if you sleep in a bright room. Schedule your sleep into your life like you do your meals, exercise, and social activities.
Stress Management
Assemble stress management tools. Midlife is a time of stress. It’s inevitable. Responsibilities from our many roles as caregivers, employers/employees, partners, community members each can bring stress. The changes associated with perimenopause are also inevitable. Research documents that increased stress makes perimenopause symptoms worse. If you don’t already have stress manage practices to turn to, it’s worth exploring some options. There are many options.
Breathwork. Breathwork is inexpensive and can be done anywhere. See the sidebar for apps we like – many are free. Waking. Yoga. Many studies show the benefit of mindfulness for menopause symptoms. We’ve created a WLB page on mindfulness which you’ll find in a deeper dive below.
BREATHWORK RESOURCES
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A 3-minute breathing practice to reduce anxiety (Ricke Breden, Insight Timer)
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Alternate nostril breathing: this yogic technique helps quiet the mind and ease racing thoughts. (Cleveland Clinic)
Movement & Strength
For perimenopause symptoms, the benefit of exercise for anxiety, sleep, mood, energy are well-supported by research. While many studies have been done on the relationship between exercise and hot flashes, there doesn’t seem to be clear supporting evidence.
For long term health, the shift from being sedentary to modestly active yields the largest drop in risk to your health. If you’re already getting some structured exercise, adding “exercise snacks” on top can still help — particularly by counteracting the harms of sitting for long stretches. Someone who does a 30-minute workout but then sits for 10 hours still benefits from breaking that sitting up with a few minutes of movement every hour. This extra activity sometimes called “exercise snacks” improves cardiovascular and metabolic function (blood pressure, insulin sensitivity, inflammation) and is linked to lower all-cause mortality. Resistance training (i.e. strength training, lifting weights) adds an additional benefit on top of aerobic activity, lowering all-cause, cardiovascular, and cancer mortality. And resistance training also supports your bone health.
When you think about exercise consider what activities you can imagine doing for many years to come. Maybe it’s something new. Also consider when in your day you can fit it in.
I stopped eating before 8 pm (no easy feat!) and try to be in bed by 9:30-10pm (even if I am not sleeping). I now take walks after dinner and this has helped with my symptoms.WLB Community Member
TELL US: WHAT HAS WORKED FOR YOU?
Dive deeper
A study on types of breathwork found sighing had real benefits
REFERENCES
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7. Kaoutar Ennour-Idrissi, Elizabeth Maunsell and Caroline Diorio. Effect of physical activity on sex hormones in women: a systematic review and meta-analysis of randomized controlled trials. Breast Cancer Research 2015. 17:139
8. Mayo Clinic article on exercise during perimenopause.
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10. Marcelo C. Garcia; Elisa H. Kozasa; Sergio Tufik; Luiz Eugênio A. M. Mello; Helena Hachul. The effects of mindfulness and relaxation training for insomnia (MRTI) on postmenopausal women: a pilot study. Menopause. 25(9):992–1003, SEP 2018. DOI: 11.1097/GME.0000000000001118.PMID: 29787483. Issn Print: 1072-3714. Publication Date: 2018/09/01
11. Gordon JL, Halleran M, Beshai S, Eisenlohr-Moul TA, Frederick J, Campbell TS. Endocrine and psychosocial moderators of mindfulness-based stress reduction for the prevention of perimenopausal depressive symptoms: A randomized controlled trial. Psychoneuroendocrinology. 2021 Aug;130:105277. doi: 10.1016/j.psyneuen.2021.105277. Epub 2021 May 19. PMID: 34058560.
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14. Bhasin MK, Dusek JA, Chang BH, Joseph MG, Denninger JW, et al. (2017) Relaxation Response Induces Temporal Transcriptome Changes in Energy Metabolism, Insulin Secretion and Inflammatory Pathways. PLOS ONE 12(2): e0172873.