Lifestyle Medicine Needs To Be the Foundation of Perimenopause Care

In perimenopause hormones fluctuate, cycles become less predictable and symptoms like hot flushes, sleep disturbance, brain fog, and mood shifts can appear seemingly overnight. For many women, it brings uncertainty-“Is it just stress?” “Am I too young for menopause?” “What can I actually do about this?”

The thing I want all women in this stage of life to know is that while perimenopause is an inevitable life stage, you’re not powerless in how you experience it. In fact, our daily choices hold the key to how well we feel and cope.

Lifestyle medicine is an evidence-based approach that uses everyday behaviours - nutrition, physical activity, sleep, stress management, social connection, and avoidance of harmful substances- to prevent, treat, and even reverse chronic disease. When applied during perimenopause, these foundations not only help manage symptoms more effectively, but also set women up for better long-term health in post-menopause and beyond.

As a dietitian, I have always believed that nutrition is essential to functioning at our best. The way we fuel our bodies shapes everything - from our energy levels to our ability to cope with stress, from our hormonal balance to our long-term health outcomes.

Now, as I have learned more and more about lifestyle medicine and as a lecturer in the Lifestyle Medicine qualification at James Cook University, my passion has grown beyond nutrition alone. While I’ve always known that sleep, movement, stress management, and social connection matter, I can now clearly see the impact of these working together with nutrition to improve women’s health.

For women in perimenopause, this is not just about easing hot flushes or sleeping better (though managing these things is a priority), it’s about setting yourself up as the strongest possible  version to tackle the next decades of life. 

That’s why, when we established the Midlife Women’s Clinic, we knew that lifestyle medicine had to be at the heart of how we support women in perimenopause.

Lifestyle plays a significant role in symptom management

Hormonal fluctuations during perimenopause affect every system in the body-from the brain to the bones. Lifestyle habits are powerful levers that can reduce the severity of symptoms and restore a sense of balance.

   •   Nutrition: A whole-food, protein-rich diet with omega 3 and phytoestrogen-containing plants (like soy, flaxseeds, and legumes) can stabilise blood sugar, reduce inflammation, hot flushes, support muscle mass, bone strength and brain function.

   •   Movement: Regular activity improves mood, energy, and sleep, while resistance training protects against the natural decline in muscle mass, and therefore metabolic rate.

   •   Stress management: Calming the nervous system through mindfulness, breathwork, or simply building pauses into the day reduces anxiety, sleep disruption, and irritability.

Medical treatments, including hormone therapy, can be life-changing for some women. But they work best on top of a strong foundation of lifestyle. For example, MHT can protect bone density, but without exercise and adequate nutrition, its benefits are limited.

Now is the time for future-proofing health

Perimenopause is also a critical window to proactively address long-term health. The changes happening beneath the surface are unseen but significant:

   •   Bone health: Oestrogen decline accelerates bone loss. Weight-bearing exercise, resistance training, vitamin D and calcium-rich foods protect bone density.

   •   Heart health: Cardiovascular risk increases after menopause. Nutrition patterns like the Mediterranean diet, along with movement and not smoking, are protective.

   •   Metabolism: Hormonal shifts affect insulin sensitivity and fat distribution. Balanced meals, quality sleep, and regular exercise support metabolic health.

Addressing these areas in perimenopause means entering post-menopause with a reduced risk of chronic disease, and a greater potential to stay strong, independent and vibrant for as long as possible 

The Big Picture: Preparing for Life Beyond Perimenopause

Women in Australia spend, on average, one-third of their lives in post-menopause. The lifestyle choices made during perimenopause don’t just influence how you feel today; they shape your risk of osteoporosis, heart disease, cognitive decline, and other chronic conditions in the future.

This is why I believe so strongly in embedding lifestyle medicine into care for women at this life stage - it really is a no-brainer.