• Menopause
• Nutrition

Perimenopause Diet: Foods to Eat or Avoid

Medically reviewed and edited by Kerri Louati, MS, RD, LD, CDE

Published: August 11, 2025
Updated: November 20, 2025
4 mins

Perimenopause is the transitional phase leading up to menopause when hormone levels begin to fluctuate unpredictably. These shifts can contribute to symptoms such as irregular periods, hot flashes, night sweats, sleep disturbances, mood changes, increased anxiety, difficulty concentrating, and changes in weight or body composition. 

Blood sugar instability, increased inflammation, and shifts in estrogen metabolism can also become more pronounced during this time. Because of these underlying physiological changes, certain foods may help reduce symptom intensity while others may exacerbate it.

Foods to Add to a Perimenopause Diet

Choosing a diet built around whole, nutrient-dense foods – and making sure you’re getting enough protein – can genuinely help your body handle the ups and downs of perimenopause. Focusing on minimally processed foods gives your blood sugar more stability, supports a healthier gut, and helps your body process hormones more efficiently. 

Making protein a priority also becomes increasingly important, since it helps preserve muscle, supports your metabolism, and keeps you feeling satisfied. And when you fill your plate with fiber-rich plant foods, you’re supporting digestion and healthy estrogen balance at the same time.

Together, these simple nutrition choices can help you feel more steady, energized, and grounded as you move through this transitional stage.

Ground flaxseeds

Ground flaxseeds are one of the most studied foods for perimenopausal support. They contain lignans, which gently modulate estrogen activity and support estrogen detoxification. Research shows that daily flaxseed consumption can reduce the frequency and severity of hot flashes and improve hormonal balance. 

A randomized controlled trial found that flaxseed significantly decreased hot flash scores compared with placebo. Flaxseeds also provide fiber and plant-based omega-3s that help balance blood sugar and support gut health, both essential during hormonal transitions.

Eggs

Eggs provide high quality protein along with choline, vitamin D, B12, and essential fats that support energy, cognition, and metabolic health. Choline plays an important role in keeping the liver working well. It supports the processes your body uses to break down and clear hormones, which becomes especially helpful during menopause.

Research suggests that most adult women don’t meet the recommended “adequate intake” for choline, making eggs an efficient way to increase intake. Eggs also help maintain steady blood sugar levels due to their balanced protein and fat content, which can reduce mood fluctuations, cravings, and energy dips that many women experience during perimenopause. Their nutrient density and satiating profile also make them supportive for weight management during this transition.

Wild salmon

Wild salmon delivers omega-3 fatty acids that help reduce inflammation, support heart health, and stabilize mood during perimenopause. Studies show omega-3 supplementation can reduce psychological symptoms and may also improve hot flash severity. 

A systematic review found that omega-3s were effective for reducing depressive symptoms in perimenopausal and menopausal women. Salmon is also rich in vitamin D, which supports bone density and immune function as estrogen levels decline.

Broccoli

Broccoli is especially supportive during perimenopause because it contains key compounds found in brassica vegetables that influence how the body metabolizes estrogen. These compounds – including glucosinolates that convert to sulforaphane and indole-3-carbinol – help shift estrogen toward more protective metabolites. A study published in the Journal of Nutrition found that increased intake of brassica vegetables such as broccoli changed the ratio of estrogen metabolites in a favorable direction, supporting healthier estrogen detoxification and balance. Broccoli also contains fiber and antioxidants that support gut health, liver function, and metabolic stability, all of which play central roles in managing perimenopausal symptoms.

Blueberries

Blueberries are loaded with antioxidants, especially anthocyanins, which help counteract oxidative stress that increases during the hormonal transition. They support cognitive function, memory, and mood, which are areas many women notice shifting in perimenopause. Their low-glycemic nature also helps maintain steady blood sugar levels, minimizing energy crashes and cravings.

Sauerkraut

Sauerkraut is a naturally fermented food rich in probiotics that nourish the gut microbiome. A balanced microbiome supports the estrobolome, the group of bacteria responsible for metabolizing estrogen. Research has found how fermented foods improve microbial diversity, reduce inflammation, and support digestive function, all of which help regulate hormonal symptoms. Supporting gut health is essential during perimenopause, as estrogen fluctuations can affect digestion, mood, and immune resilience.

Yogurt 

Yogurt is a nutrient-dense food that supports gut health, hormone balance, and body composition during perimenopause. Its probiotics help nourish the gut microbiome, which plays a key role in estrogen metabolism and inflammation regulation. But yogurt also offers benefits that are uniquely relevant to women during the menopausal transition. 

One study found that women who consumed yogurt more frequently experienced significantly less weight gain and had a lower risk of developing obesity over 12 years compared with women who consumed little or no yogurt. This may be due to yogurt’s combination of high-quality protein, probiotics, and calcium, all of which support metabolism, appetite regulation, and blood sugar stability. Choosing yogurt with live active cultures and no added sugars offers the most benefit.

Foods to Avoid During Perimenopause

Certain foods can worsen common perimenopausal symptoms such as hot flashes, sleep disturbances, blood sugar swings, weight gain, and mood fluctuations. Limiting the following food groups may help regulate hormones, support stable energy, and reduce inflammation during the transition to menopause.

Caffeine

Caffeine can be a double edged sword during perimenopause and menopause. For some women it boosts alertness and mood, but for others it can worsen hot flashes, night sweats, anxiety, heart palpitations, and sleep disruption. 

One study surveyed 1,806 women who presented with menopausal concerns and found that caffeine use was associated with significantly more bothersome vasomotor symptoms, even after adjusting for smoking and menopause status. For women already struggling with hot flashes, night sweats, or insomnia, it can be helpful to experiment with reducing total caffeine intake or avoiding it later in the day to see whether symptoms improve. 

Added sugars

Added sugars can contribute to blood sugar spikes and crashes, increased cravings, mood swings, and weight gain, all of which may feel more pronounced during perimenopause due to changes in insulin sensitivity and metabolism. High intake of added sugars is also linked to greater inflammation and an increased risk of cardiometabolic disease, which becomes more relevant as estrogen levels decline. 

A study published in JAMA Internal Medicine found that higher consumption of added sugars was associated with a significantly increased risk of cardiovascular mortality, even after adjusting for overall diet quality and lifestyle factors. Reducing added sugars in foods such as sweetened beverages, pastries, flavored yogurts, and packaged snacks can help promote more stable energy levels and support healthier metabolic function during the transition to menopause.

Alcohol

Alcohol can intensify hot flashes, worsen sleep quality, disrupt hormone metabolism, and contribute to weight gain. Women going through the transition to menopause are often more sensitive to alcohol’s effects because declining estrogen alters the way the body metabolizes it. 

Research from the Study of Women’s Health Across the Nation (SWAN) found that alcohol intake was associated with more frequent and severe vasomotor symptoms including hot flashes and night sweats. Excessive alcohol consumption is also linked to increased risks of breast cancer, partly due to its influence on estrogen metabolism and DNA damage.

Fried foods

Eating fried foods often can make inflammation worse, strain metabolic health, and raise the risk of conditions like heart disease and diabetes. These issues matter even more during perimenopause, when shifting hormones can change how your body uses energy, make it easier to store fat around the abdomen, and leave you more sensitive to blood sugar ups and downs.

A study of more than one hundred thousand women aged 50-79, higher intake of fried foods was associated with increased all cause and cardiovascular mortality. Choosing cooking methods such as baking, grilling, air frying, or sautéing may help support more stable energy levels, reduce inflammation, and protect long term cardiometabolic health during the menopausal transition.

Processed foods

Ultra processed foods often contain additives, refined oils, artificial sweeteners, and emulsifiers that can disrupt appetite regulation, promote overeating, and increase inflammation. These effects are especially important during perimenopause because hormonal changes can slow metabolism, alter insulin sensitivity, and increase the likelihood of weight gain. 

One study conducted by the National Institutes of Health demonstrated that participants consuming an ultra processed diet ate significantly more calories per day and gained weight compared to the same individuals eating minimally processed foods, even when the meals were matched for calories, macronutrients, sugar, sodium, and fiber. Limiting highly processed packaged foods and choosing whole food alternatives may help support more stable blood sugar, better energy levels, and improved weight regulation during the perimenopausal transition.

Other Lifestyle Habits to Consider During Perimenopause

Exercise and movement

Regular physical activity is one of the most effective ways to support both physical and emotional wellbeing during perimenopause. Strength training is especially important because declining estrogen levels can accelerate bone loss contributing to osteoporosis and reduce muscle mass. Lifting weights helps maintain bone density, supports metabolism, and improves body composition. Complementary activities such as yoga, Pilates, or mobility work can support flexibility, balance, and core strength. Even simple habits like walking daily can improve mood, reduce stress, and support cardiovascular health.

Sleep support

Sleep often becomes more disrupted during perimenopause due to hormonal fluctuations, night sweats, and changes in cortisol patterns. Prioritizing consistent sleep and wake times, creating a calming bedtime routine, and reducing screen exposure in the hour before bed can all support better sleep quality. Eating too late in the evening may also interfere with sleep, so aim to finish larger meals a few hours before bedtime.

Stress management

Stress tends to amplify perimenopausal symptoms including hot flashes, irritability, and sleep disturbances. Practices such as deep breathing, meditation, spending time in nature, mindfulness exercises, or gentle evening stretching can help regulate the nervous system. Even brief daily stress reduction practices can make a noticeable difference over time.

Eating habits 

Eating regular meals on a consistent schedule helps stabilize blood sugar and energy levels throughout the day. This becomes especially important during perimenopause, when blood sugar fluctuations may worsen mood swings, fatigue, and cravings. Even if weight loss is a goal, it is important not to skip meals, as this can increase appetite later in the day and contribute to overeating. Meal planning or prepping a few items in advance can make it easier to maintain nutrient dense eating patterns during busy weeks.

Where Can I Learn More About Menopausal Care?

Nutrition is a key component of managing your menopause. However, some menopausal symptoms may require additional treatment. The LifeMD Women’s Health Program offers compassionate, personalized care for women. 

A LifeMD provider can offer hormonal replacement therapy for those who qualify, to support common premenopausal symptoms like hormone imbalances, mood swings, trouble sleeping, and weight changes. LifeMD also offers nutrition support with their dietitian services.  

Make an appointment to take steps toward reaching your optimal health.

Kerri Louati, MS, RD, LD, CDE

Kerri Louati, MS, RD, LDN, CDE, is a registered dietitian and certified diabetes educator specializing in nutrition, integrative medicine, functional laboratory interpretations, and functional medicine. She is also the Director of Women's Health Clinical Operations at LifeMD. She previously served as the Director of Nutrition and Coaching with the telehealth platform Optimal Human Health MD.

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