Managing Perimenopause Naturally

by Kelly Trotter

Perimenopause, often referred to as the “menopause transition,” is a significant phase in a woman’s life that marks the period leading up to menopause. This transition can last anywhere from 2 to 12 years, and during this time, a woman’s body undergoes various hormonal changes that can result in a range of symptoms. While this journey can be challenging, there are natural ways to manage perimenopausal symptoms effectively, promoting a smoother transition into the next phase of life. In this blog, we’ll explore the power of nutrition, lifestyle modifications, and herbal remedies to help you navigate perimenopause gracefully.

Understanding Perimenopause

Before diving into natural management strategies, it’s essential to grasp what perimenopause is and how it differs from menopause itself. Menopause and perimenopause are not the same thing. 

Menopause is a time of low oestrogen. Perimenopause is a time of ‘oestrogen on a roller-coaster’ where you can, at times, have more oestrogen than ever before. 

We often see perimenopause and menopause being spoken about as the same thing, but as our hormones are vastly different in these two stages, – it’s vital we get our definition correct. 

Perimenopause is the transitional phase – the two to twelve years before menopause and is when you’re most likely to experience symptoms.  Permimenopause is most likely to start in your 40s, but some may notice it as early as your late 30’s.[1]

Menopause is the life phase that begins 12 months after your last period and is when many symptoms start to settle down.[1]

The duration of perimenopause can vary widely among individuals. Some may experience it for just a couple of years, while others may endure it for a decade or more. Regardless of the timeline, managing perimenopausal symptoms naturally is possible and can greatly improve your quality of life.[1]

Common Perimenopausal Symptoms

Perimenopause can bring about an array of symptoms, and each woman’s experience is unique. [1] According to Professor Jerilynn Prior, a midlife woman with regular cycles is likely to be in perimenopause if she has any three of the following:

  • Hot flushes and night sweats, especially premenstrually.
  • New onset heavy and / or longer flow
  • Shorter menstrual cycles (less than 25 days)
  • Insomnia or mid sleep waking
  • Increased menstrual cramps
  • New or increased migraine headaches
  • New or increased premenstrual mood swings
  • Weight gain without changes in exercise or eating 
  • New sore, swollen or lumpy breasts 


Now, let’s explore natural ways to manage these perimenopausal symptoms.

The Power of Nutrition

Nutrients play a pivotal role in managing perimenopause naturally.

The goal is to focus on a diet rich in whole foods, including vegetables, fruits, whole grains, proteins and healthy fats. To support hormones, particularly oestrogen and insulin, it is best to avoid sugar, processed foods and alcohol.

The Nutrients to Know


Magnesium serves as a potent stress alleviator and is a preferred supplement for perimenopausal individuals. It plays a crucial role in regulating the hypothalamic-pituitary-adrenal axis (HPA axis), the primary system responsible for our stress response. Additionally, magnesium contributes to promoting better sleep and reducing hot flushes. Note that the dose and form matters. Consult one of our Naturopaths for tailored advice.

Vitamin B6

Vitamin B6 aids in managing mood symptoms during perimenopause and addressing premenstrual symptoms. It facilitates in the healthy metabolism of oestrogen and enhances the production of Gamma-aminobutyric acid (GABA) for overall well-being [1-3]


Taurine, an amino acid, has a calming influence on the brain and helps stabilize the HPA axis, demonstrating a tranquilizing effect similar to the neurotransmitter GABA. Since taurine is exclusively found in animal products, individuals following a plant-based diet may be susceptible to taurine deficiency. It is also important to know that oestrogen depletion can lead to reduced taurine levels, making it necessary for women to ensure adequate intake, particularly in comparison to men. [1-3]

The Herbal Medicines to Know


Withania somnifera, known as Withania or Ashwagandha, is an herbal remedy that assists in regulating the body’s stress response by stabilise the HPA axis. Additionally, ashwagandha possesses direct anti-anxiety properties and promotes better sleep. [1-5]

Black Cohosh

Cimicifuga racemosa, known as Black Cohosh, is an herb traditionally used to help manage the vasomotor symptoms of perimenopause – namely, hot flushes. The Spanish Menopause Society concludes that Black cohosh is an effective and safe treatment option for the relief of menopausal vasomotor symptoms. [6]


Ziziphus is a herbal non-addictive sedative traditionally prescribed to improve sleep quality, with fewer complications compared to chemical and hormone drugs for the treatment of sleep disorders. [7] Remember, it is crucial to consult with one of our Naturopaths before starting any herbal medicine to ensure the safety profile is met and that your individual needs are best taken care of. 

Lifestyle Modifications

Lifestyle modifications can have a significant impact on perimenopausal symptoms.

Reduce or eliminate alcohol

Consuming alcohol disrupts the proper metabolism of oestrogen, posing a concern, especially when oestrogen levels are already elevated to double their previous levels. Additionally, alcohol diminishes progesterone levels and hinders its calming effects in the brain. It is also well known that alcohol affects sleep, increases intensity of hot flushes, and increases inflammation within the body. [1-2, 8]

Regular Exercise

Engage in regular physical activity. This might look like daily walking,  strength training, body movements such as squats and lunges, or pilates. Exercise can help with mood regulation and weight management, particularly as insulin resistance is often a concern in this demographic. [1, 9]

Prioritise Yourself

Practice stress-reduction techniques such as meditation, deep breathing exercises, or mindfulness to combat mood swings and promote better sleep. [2,9] This may be a time where you may need to re-evaluate how much you prioritise your own health and happiness and seek help when needed.

Adequate Sleep

Prioritise getting enough sleep. Create a relaxing bedtime routine and establish a consistent sleep schedule to address insomnia. [9] 

Stay Cool

To manage hot flushes, wear layered clothing that can be easily removed, use fans, and keep your living space cool.

Social Support

Share your experiences with friends and family. Connecting with others who are going through similar changes can be reassuring and provide emotional support.[2,4]

Perimenopause is a natural phase in a woman’s life, and while it can be challenging, there are effective ways to manage its symptoms naturally. Through proper nutrition, lifestyle modifications, and guidance from healthcare professionals, you can navigate this transition with grace and minimise discomfort.

Remember that each woman’s experience of perimenopause is unique, so it’s essential to listen to your body and seek personalised guidance from our team when needed. With the right approach, you can embrace this new phase of life with confidence and vitality.

[1] Briden,. L. (2018). Period Repair Manual. Pan Macmillan Australia. 

[2] Walsh., G.S. et al.  The comparative effect of exercise interventions on balance in perimenopausal and early postmenopausal women: A systematic review and network meta-analysis of randomised, controlled trials. Maturitas, 2023. PMID: 37343343

[3] Grigolon., R.B. et al. Effects of nutritional interventions on the severity of depressive and anxiety symptoms of women in the menopausal transition and menopause: a systematic review, meta-analysis, and meta-regression.Menopause, 2023. PMID: 36576445

[4] Lopresti, A.L., et al. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine, 2019. PMID: 31517876.

[5] Gopal, S., et al. Effect of an ashwagandha (Withania Somnifera) root extract on climacteric symptoms in women during perimenopause: A randomized, double-blind, placebo-controlled study. The Journal of Obstetrics and Gynecology Research, 2021. PMID: 34553463.

[6] Castelo-Branco, C., et al. Black cohosh efficacy and safety for menopausal symptoms. The Spanish Menopause Society statement. Gynecological Endocrinology, 2022. PMID: 35403534.

[7] Mahmoudi, R., et al. Investigation the effect of jujube seed capsule on sleep quality of postmenopausal women: A double-blind randomized clinical trial. Biomedicine, 2020. PMID: 33854934.

[8] Inkelis, S., et al. Sleep and Alcohol Use in Women. Alcohol Research, 2020. PMID: 32685340.

[9] Willi., K. et al. Symptoms assessed in studies on perimenopausal depression: A narrative revie. Sex Reprod Healthc, 2020. PMID: 33010665

by Kelly Trotter

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