Perimenopause: Why quality, not quantity, is what matters when it comes to diet and exercise


Weight gain, hair loss, fatigue, hot flashes, brain fog, and so on are just a few symptoms women in perimenopause experience as they transition from having regular menstrual cycles to having none. Too often, these changes in their overall health, body, and mind are easily dismissed as just a “normal” part of aging. But considering perimenopause can last from 10-20 years, that’s a long time to experience such life-disrupting and challenging physical and cognitive changes.

These frustrating symptoms also often correspond to a time in most women’s lives, their late 30s and into their 40s, when they are managing an excessive amount of stress, which only compounds the myriad symptoms. Caring for ailing parents while still supporting children at home, working while managing the household and trying to juggle other commitments all leave women feeling depleted and exhausted, all while their ovaries are starting to shut down production of the critical hormones they need for vitality.

Diet and Exercise to help combat menopause.

A key to mitigating the effects of these symptoms is to create a diet and exercise plan that restores energy, reduces stress and provides a manageable approach to maintaining a wellness plan despite a busy life.

What if ‘trying everything’ hasn’t worked?

As a wellness coach, new clients often approach me when they have “tried everything” and still don’t feel themselves. In particular, women aged 40 to 60 are concerned that they barely eat, exercise daily, and still pack on pounds. Not surprisingly, they feel exhausted. The problem they face is believing that the same diet and exercise routine they did in their 20s and 30s will still work. It won’t. Doing more of the same and expecting better results leaves these women feeling hopeless. Instead, perimenopausal women must reframe their ideas of what eating healthy and exercising enough means.

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The first place to start is with nourishment. I prefer “nourish” to “diet” because it forces us to think more about food in the way it supports health, as opposed to just the calories we ingest. I see women during perimenopause eat less and less yet get worse results. For some women, the problem with cutting calories is twofold: 1) they are choosing foods that are low in calories but not nourishing nor filling and less likely to enhance their health, and 2) the lack of sufficient nourishment puts their metabolism into survival mode, so that they hoard calories, rather than burn off fat.

While it may appear counterintuitive, eating more food, especially nutrient-dense proteins, fats, and even carbohydrates, helps to increase metabolism and allows these women to burn fat for energy again.

The easiest path to better nourishment is to focus on protein. I rarely work with a woman who isn’t already doing a great job of eating her veggies, but protein is often lacking.

First, focus on eating a high-protein breakfast, such as eggs, yogurt or a protein shake. This helps give women energy first thing in the morning and stave off the sugar cravings later in the day. This approach is crucial if they exercise in the morning. Without protein, they burn sugar, or worse yet, muscle, for energy. Instead, they can tap into their fat stores. Lunch should also be a solid meal, not a snack or an afterthought. This meal should again have a good portion of protein, 4 to 6 ounces, with some fibrous veggies and drizzled with healthy fats like olive oil or avocado oil. By having this midday meal, women can avoid the afternoon snack attack that often thwarts their health efforts. Lastly, getting one more good portion of protein at dinner, combined with starches like potato or rice, will help stabilize blood sugar throughout the night and enhance their sleep quality.

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Ideally, I like to work women up to about one gram of protein per pound of ideal body weight. For example, shooting for a goal weight of 140 pounds would equate to 140 grams of protein per day. I know that sounds like a lot, but if they work their way up gradually by slowly increasing protein portions, this becomes second nature. Not only does all that protein crowd out empty calories like cookies and ice cream, but it also helps women put on and maintain muscle, keep hunger at bay, and maintain blood sugar. I recently had a client in her early 60s make this switch. By swapping her morning oatmeal for yogurt, afternoon snacks for chicken salad, and boosting her dinner protein, she’s lost more weight in her belly than she wanted. In fact, we had to increase her carb portions to ensure she didn’t lose any more weight. Now, that’s a good problem to have.

What’s the best way to exercise?

Once there’s enough protein in their diet, it’s time to focus on movement. When I work with clients, I consistently see a problematic approach to staving off the weight gain of perimenopause: over-exercising. In particular, they often overdo their cardiovascular exercise. In their 30s, two spin classes a week would keep them in shape. Now, they do it five times a week and have added hikes with friends, long bike rides, and swimming on Sundays. It’s too much! Instead of doubling down on what’s not working, it’s time for a change, and that change is weight lifting.

Those of us over 40 are old enough to remember that women were not really welcome in the weight room in the 80s and 90s. It was a rare woman with cut arms and visible muscles (thank goodness for Linda Hamilton!) It’s time to let go of those old stereotypes and get into the gym. In conjunction with weight training, all that additional protein helps perimenopausal women lay down a little muscle, feel stronger, and gain more energy. By incorporating weight training two to three times a week into an exercise regimen, the results can be stunning. Chronic cardio breaks muscle down instead of building it up. The key is to establish a day of rest in between those training sessions. Muscles need time to repair so the fruits of that labor can actually be seen. I could not believe the difference when I made this switch about three years ago. I have since gained more bone mass, boosted my energy, and almost have arms as good as old Linda.

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When it comes to diet and exercise during perimenopause, the key is to work smarter, not harder. Focus on quality instead of quantity when you eat. Avoid over exercising and incorporate more weight training.  And rest between more demanding workouts.

Don’t dismiss your symptoms as a function of age. This is not our grandmother’s change of life. We are more vibrant, and we deserve to maintain our vitality.

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