The average person who experiences menstruation will spend about 3,000 days menstruating over the course of 40 years. Forty. Years. That’s a sh*t load of maxi pads. But when our bodies begin the transition towards menopause — known as perimenopause — new challenges await. The good news is that getting proper nutrition can lessen the impact.

I checked in with a health and hormone expert to find out exactly what nutrition our bodies need during perimenopause. And, aside from massive amounts of protein, the diet we should be following is actually pretty straightforward.

Why is proper nutrition during perimenopause so important?

“Proper nutrition during perimenopause is crucial as it helps manage hormonal fluctuations and their associated symptoms. Blood sugar regulation and adequate protein are the keys to minimizing perimenopause symptoms like hot flashes, brain fog, mood swings, weight gain, and fatigue,” says Dr. Christine Maren, an American Board of Family Medicine-certified physician and Institute for Functional Medicine certified practitioner.

While it’s normal for hormones to fluctuate during perimenopause, estrogen levels tend to decline relatively slowly at the onset of perimenopause before taking a full-on nose dive as we approach menopause. And because our bodies rely heavily on estrogen to manage insulin sensitivity, blood sugar levels can spike without the proper diet.

Maren says that these spikes can trigger stress responses and further disrupt our already out-of-whack hormones, but that stable blood sugar can help people in perimenopause maintain consistent energy levels and reduce mood swings.

What foods are essential during this transition?

Proper protein and fiber intake help with everything from regulating blood sugar to supporting gut microbes to maintaining bone and muscle mass, making them essential elements of a perimenopausal diet.

“Maintaining muscle mass during perimenopause is critical. High-quality, lean animal protein — think eggs, chicken, turkey, grass-fed beef, or bison — helps prevent age-related muscle loss, called sarcopenia, which is an outcome of declining hormones. Many women question why they’re losing muscle mass. We lose muscle because we lose estrogen,” explains Maren. “Protein also helps with blood sugar regulation. When blood sugar is out of range, it can lead to fatigue, insulin resistance, weight gain, disrupted sleep, and hot flashes.”

Because many of her patients are multitaskers (aka moms like us), she recommends a protein-rich breakfast to help with satiety throughout the day as well as with physical and mental functions: “Protein supports cognitive function, hormonal function, immune function, cellular health, neurotransmitters, detoxification, muscle building and recovery, and so much more.”

Fiber, complex carbohydrates, and healthy fats are all just as important, so Maren says it’s important to focus on consuming non-starchy vegetables, fresh whole fruits, and balanced amounts of foods containing omega-3 fatty acids, like avocados, nuts, seeds, and fish.

What about foods for women following a vegetarian or vegan diet?

While most complete protein foods are animal-derived, getting the proper amount of protein through a plant-based diet is still possible. For those following a vegan diet, Maren advises consuming minimally processed organic soy products like tofu and tempeh, in addition to high-quality protein powders that are typically formulated with a blend of hemp or pea proteins. She recommends that vegetarians incorporate low-fat organic Greek yogurt and low-fat organic cottage cheese into their diets.

Are there any foods or beverages you should avoid during perimenopause?

Sorry in advance to those of us who enjoy a glass of wine, but perimenopause is going to require a steep step back in alcohol consumption, as well as a reduced intake of refined carbs and sugars, caffeine, and ultra-processed foods. Before you cue the tears, know that cutting back means fewer hot flashes and mood swings, along with better sleep. These sacrifices also have positive health impacts.

“Refined carbs and sugars spike blood sugar [and can] ultimately lead to insulin resistance and weight gain,” says Maren. “[Alcohol] is associated with an increased risk of breast cancer … and women who are more sensitive to caffeine tend to have worsening hot flashes and anxiety following excessive caffeine intake, especially when consumed on an empty stomach. Finally, highly processed foods contain chemicals that can actually hijack satiety signals. They may also contain endocrine disruptors.”

What supplements should you incorporate into your diet during perimenopause?

Maren notes that, yes, supplements can be used to fill in nutritional gaps and support overall health during perimenopause. “I frequently recommend vitamins D3/K2, magnesium, methylated B complex, fish oil, zinc, collagen, and creatine,” she says, adding, “However, when it comes to choosing perimenopause supplements, there isn’t a one-size-fits-all solution.”

Because she also acknowledges that everyone’s journey through this transition is unique, she advises that each individual work with a medical professional to create a personalized supplement plan, while reminding that quality matters as much as personalization: “Look for products from reputable manufacturers that use third-party testing to verify both their ingredients and finished products.

What about natural or plant-based alternatives to traditional HRT?

“In my opinion, the most effective, safest, and best option for hormone replacement [therapy] is bioidentical/body-identical estradiol and micronized progesterone +/- testosterone,” says Maren. “However, if these are not available or suitable options, some people explore natural alternatives. The most studied plant-based options include phytoestrogens (from soy and flaxseed), black cohosh, and evening primrose oil. While these botanicals may offer mild hormone-supportive effects, they’re less effective than bioidentical hormones.”