Why “Just Eat Better” Isn’t Helpful During Perimenopause

Name: Why “Just Eat Better” Isn’t Helpful During Perimenopause
Creator: Rachael Orpen
Published: 2026-08-22T03:52:33-04:00

The short answer: In perimenopause, being told to “just eat better” rarely helps, because it skips the part that matters: understanding what your body actually needs and building a strong nutritional foundation around it. Hormones at this stage fluctuate like a rollercoaster rather than declining in a straight line, and not every new symptom is hormonal, so there is no single perfect diet to reach for. The foundations are simple and repeatable: eat regularly rather than skipping meals, aim for adequate protein at each meal, don’t overlook fibre, include healthy fats, and add a wide variety of plant foods. Food comes first and supplements second, chosen for a genuine individual need rather than because they are popular online. Pair this with resistance training to protect muscle and bone. Progress over perfection: small changes repeated consistently are what compound over time.

Perimenopause can be a particularly confusing time to navigate your health. You may be eating the same way you always have, exercising regularly and generally looking after yourself, yet suddenly your sleep, energy, mood, appetite, body composition or menstrual cycle feels different.

Perimenopause most commonly begins in the 40s, but it can start earlier, sometimes as early as the mid-30s. It typically lasts around four years, although the transition can range from approximately two to eight years and varies considerably between women. One of the most important things I want women to understand is that perimenopause isn’t simply a gradual decline in oestrogen.

Your hormones are more rollercoaster than downward slope

During perimenopause, ovarian function becomes increasingly unpredictable. Oestradiol levels can fluctuate considerably rather than declining in a smooth, linear fashion, while progesterone production can become less consistent as ovulation becomes less reliable. Eventually, ovarian hormone production declines more substantially, but getting there is not necessarily a smooth process.

This hormonal variability helps explain why symptoms can feel as though they come and go. You may have several weeks where you feel relatively well, followed by a period where your sleep, mood, energy or appetite suddenly changes.

There is also much more to perimenopause than hot flushes and night sweats. Women may experience changes in menstrual patterns, sleep, mood, cognition, energy, headaches, joint and muscle symptoms, libido, vaginal and urinary health and body composition. Not everyone experiences vasomotor symptoms such as hot flushes, and the combination and severity of symptoms varies considerably between women.

This is important because it is tempting to attribute every new symptom to changing hormones. As a nutritional therapist, I want to look at the bigger picture. Fatigue, for example, may have multiple contributors, including poor sleep, inadequate energy intake, iron or B12 deficiency, thyroid dysfunction or stress. Changes in weight and body composition can also have several contributing factors.

Perimenopause may be part of the picture, but it should not automatically be assumed to be the whole picture.

That is why I don’t believe the answer to perimenopause is simply to “eat better”. It is about understanding what your body needs and building a strong nutritional foundation around it.

Don’t skip breakfast

During perimenopause, fluctuations in oestrogen can affect insulin sensitivity and glucose metabolism, making the composition of meals increasingly relevant to metabolic health.

For women already experiencing poor sleep, fatigue or increased stress, starting the morning with coffee and going several hours without food can contribute to greater fluctuations in energy, appetite and blood glucose levels.

This is a pattern I sometimes see in practice: a woman skips breakfast, becomes increasingly hungry or experiences strong cravings later in the day, eats more in the evening and then feels she needs to compensate by skipping breakfast the following morning. The cycle can reinforce irregular eating and make it harder to recognise and respond to hunger and fullness cues. Establishing a consistent meal pattern can be a useful starting point for improving dietary habits and supporting more stable energy and appetite.

Breakfast does not need to be complicated. For busy or on-the-go mornings, prepping overnight oats or batch-cooking egg muffins can make eating well much easier. If getting enough protein from food is difficult, adding protein powder to porridge or a smoothie can also be a practical option.

I also encourage a mindset of addition rather than subtraction. Adding Greek yoghurt or protein powder to porridge increases its protein content; nuts, seeds or nut butter provide fat and micronutrients; and berries or other fruit add fibre and a range of polyphenols. These additions can improve the overall nutritional composition of a meal while making it more satisfying and supporting a healthy metabolic response.

Protein, fibre and blood glucose: focus on balance

“Blood sugar balancing” has become a major topic online, but this should not translate into fear of carbohydrates. A rise in blood glucose after eating carbohydrate is a normal physiological response. The more useful question is how the composition of the overall meal influences digestion, absorption, satiety and the subsequent metabolic response.

Combining carbohydrate with protein, fibre and fat slows gastric emptying and the absorption of glucose compared with eating a carbohydrate-rich food in isolation. Fibre also supports gastrointestinal health and contributes to satiety, while adequate protein helps preserve lean tissue and supports appetite regulation.

This is why I encourage women to think about the whole meal rather than individual foods. Oats, potatoes, wholegrains, beans, lentils and fruit are all nutritious sources of carbohydrate. The aim is not to eliminate them, but to combine them with adequate protein, fibre, healthy fats and a variety of plant foods.

And while everyone seems to be talking about protein at the moment, I don’t want fibre to be forgotten. Adequate fibre supports bowel function, the gut microbiome, cardiometabolic health and blood glucose regulation. It is found in vegetables, fruit, wholegrains, legumes, nuts and seeds, so eating a diverse diet naturally helps increase fibre intake.

Don’t be afraid of healthy fats

Dietary fat plays an important role in overall health, and the type of fat we eat matters. Monounsaturated and polyunsaturated fats are important sources of essential fatty acids and are involved in cell membranes, hormone production and cardiovascular health. This becomes particularly relevant during perimenopause, when changing oestrogen levels are associated with changes in cardiovascular risk factors and lipid metabolism.

Omega-3 fatty acids, particularly EPA and DHA from oily fish, have important roles in cardiovascular health and lipid metabolism, making them a useful part of a diet designed to support healthy cardiometabolic ageing.

A perimenopausal client of mine who was nervous about increasing her intake of healthy fats had spent years associating foods such as olive oil, nuts and seeds with weight gain. After we increased her intake of unsaturated fats as part of a more balanced diet, she reported improved energy and satiety alongside improvements in some of the symptoms she had been experiencing.

One person’s experience is not evidence that increasing dietary fat will improve symptoms for everyone, but it illustrates an important principle: nutrition is not about subtraction. Adding nutrient-dense foods can improve the overall quality and composition of a diet and, in some cases, make meals more satisfying and metabolically supportive.

Eat the rainbow

Eat the rainbow is familiar, simple advice, but it should not be underestimated. The different colours found naturally in plant foods reflect different groups of polyphenols and other phytochemicals, which have different biological properties.

Variety is also important for the gut microbiome. Different types of dietary fibre and plant compounds provide fuel for different groups of gut bacteria, helping to support a diverse microbial community. This is particularly relevant during perimenopause because the relationship between the gut microbiome and sex hormones is bidirectional: hormonal fluctuations can influence the composition and activity of the microbiome, while gut bacteria are involved in the metabolism and recycling of oestrogens. Emerging research suggests that greater microbial diversity may be associated with healthier oestrogen regulation and lower inflammatory activity.

Phytoestrogens are naturally occurring compounds found in foods including soy, chickpeas, lentils, flaxseeds and kidney beans. These compounds have the ability to bind to oestrogen receptors and may have a beneficial effect on perimenopausal symptoms. Including a variety of these foods provides phytoestrogens alongside fibre, protein, vitamins, minerals and other phytochemicals, making them a useful part of a varied perimenopausal diet.

Food first, supplements second

The range of supplements marketed towards perimenopause can also feel overwhelming, with products promising support for everything from “hormone balance” and energy to sleep, weight management and bloating.

Supplements absolutely have a place, particularly where there is a confirmed deficiency, increased requirement or specific nutritional need. However, they need to be tailored to the individual rather than chosen simply because a particular product is popular online or because someone with similar symptoms is taking it.

A well-chosen supplement should complement the foundations of the diet rather than distract from them. It is much more useful to identify what an individual actually needs through testing than to spend money on a broad supplement regime based on generic perimenopause advice.

I often think of nutrition like building a house. Food, sleep, movement and the fundamentals of a healthy lifestyle are the foundations. Supplements can be useful additions, but they are not the foundations themselves.

Don’t forget your muscles

Nutrition is only one part of healthy ageing. Resistance or strength training is arguably one of the most valuable forms of exercise to prioritise during midlife because maintaining muscle mass and strength supports physical function, metabolic health and independence as we age. NICE specifically recommends maintaining muscle mass and strength through physical activity during perimenopause and menopause.

Bone health is another reason nutrition and resistance exercise become particularly important during midlife. Declining oestrogen is associated with accelerated bone loss, making adequate calcium, vitamin D and protein important alongside weight-bearing and resistance exercise. Calcium-rich foods include dairy products, tofu and leafy greens, while vitamin D can be obtained from oily fish, eggs and fortified foods, with supplementation considered in the winter months or where intake or vitamin D status is inadequate.

And what about sleep?

Sleep can become particularly vulnerable during perimenopause. Hormonal fluctuations, vasomotor symptoms, mood changes and other physical symptoms can all contribute to disrupted sleep. Melatonin, which helps regulate the sleep-wake cycle, also declines with age, with changes in melatonin secretion observed around the menopausal years.

Poor sleep can then have a knock-on effect on appetite, energy, mood, concentration and motivation to exercise, creating a frustrating cycle.

Rather than looking for a single “cortisol-balancing” food or supplement, I prefer to consider the whole picture: adequate nutrition, regular meals, appropriate caffeine intake, exposure to daylight, daytime movement and a consistent sleep routine. Persistent or significant sleep problems also deserve appropriate medical assessment rather than simply adding another supplement.

Progress over perfection

The most important thing I want women to take away from all of this is that you do not need to completely overhaul your lifestyle.

Start with the fundamentals. Aim for adequate protein at each meal, make sure fibre is not being overlooked, and increase the variety of plant foods on your plate. Include sources of healthy fats, eat regularly, and prioritise resistance training alongside other forms of movement.

Progress over perfection is a principle I return to constantly with clients. A single nutritious meal will not transform your health, just as one less nutritious meal will not undo it. But small changes repeated consistently can become habits, and those habits can compound over months and years.

And it isn’t only what we eat that matters. How we eat can also influence digestion and our relationship with food. Taking time to eat, chewing thoroughly and paying attention to hunger and fullness can support the digestive process and help create more sustainable eating habits.

There is no single “perimenopause diet” that works for every woman. Individual symptoms, dietary intake, lifestyle, medical history and nutritional requirements all need to be considered. This is where personalised nutrition and, where appropriate, tailored supplementation can be particularly valuable; helping to identify where changes are likely to provide the greatest benefit, rather than simply following generic advice or spending money on supplements that may not be relevant to you.

Good nutrition during perimenopause is not about doing everything perfectly. It is about understanding what matters, making realistic changes and consistently giving your body the nutritional support it needs.

About the author

Rachael Orpen is a registered Nutritional Therapist passionate about helping women understand nutrition and make realistic, sustainable changes to support their health. She takes an evidence-based, individualised approach to nutrition, with a particular interest in women’s health, including perimenopause and menopause. Find her at orpennutrition.com and on Instagram @ronutrition_.

Frequently Asked Questions

Does “just eating better” actually fix perimenopause symptoms?

Not on its own. There is no single perimenopause diet that works for every woman. It is less about eating “better” in a vague sense and more about understanding what your body needs and building a strong nutritional foundation: eating regularly, and getting enough protein, fibre, healthy fats and a variety of plant foods.

Should I skip breakfast or wait to eat in the morning?

A consistent meal pattern tends to help. Starting the day on only coffee and going several hours without food can lead to bigger swings in energy, appetite and blood glucose, then overeating in the evening and skipping breakfast again. Breakfast can be simple, such as overnight oats or batch-cooked egg muffins.

Do I need to cut carbs to balance my blood sugar?

No. A rise in blood glucose after eating carbohydrate is a normal physiological response, and “blood sugar balancing” should not become a fear of carbs. Combining carbohydrate with protein, fibre and fat slows glucose absorption. Oats, potatoes, wholegrains, beans, lentils and fruit are all nutritious carbohydrate sources.

Will eating more healthy fats make me gain weight?

Not inherently. Nutrition is about addition, not subtraction. Monounsaturated and polyunsaturated fats matter for cell membranes, hormone production and cardiovascular health. One client who feared olive oil, nuts and seeds reported improved energy and satiety after increasing healthy fats as part of a balanced diet, though one person’s experience is not proof for everyone.

Are perimenopause supplements worth taking?

They have a place, particularly where there is a confirmed deficiency, increased requirement or specific need, but they should be tailored to you rather than chosen because a product is popular online. Food, sleep, movement and lifestyle are the foundations; supplements are additions, best identified through testing rather than a broad regime.

What kind of exercise matters most in perimenopause?

Resistance or strength training is arguably the most valuable form to prioritise, because maintaining muscle mass and strength supports physical function, metabolic health and independence as you age. NICE specifically recommends maintaining muscle through physical activity, and it also supports bone health alongside adequate calcium, vitamin D and protein.