Perimenopause is like puberty—only in reverse. As production of our main hormones—estrogen and progesterone—wind down, there can be a lot of hormonal upheaval and a lot of other changes too. Here’s how a personal trainer and dietitian coped when they were going through it.
Tips from a personal trainer
Amanda Thebe admits she used to be pretty dismissive when clients in their 40s complained of fatigue. She, herself, was in her 40s and strong, fit and thriving—until she wasn’t. Suddenly she was walloped by bouts of intense vertigo and vomiting that left her in bed for days with crippling fatigue and, eventually, depression. Years of tests and shruggy doctors left her feeling shattered, until finally an ob/gyn said, “I believe you. I know what’s going on.” Thebe was diagnosed with migraines (common in times of hormonal turbulence) and started taking an antidepressant. Three years later, she began hormone replacement therapy, and the clouds lifted. She started sharing her experiences, forming a Facebook group called Menopausing So Hard to let women tell their own stories, both frustrating and hopeful. “I was blindsided,” she says. “We have to have these conversations.” Here are her tips for what our bodies need during perimenopause.
1. Weights are key to preserve muscle
It’s normal to lose muscle mass as we age, so let’s pack it on. It helps with everything from improving cardiovascular and bone health to reducing the frequency of hot flashes. “Pick up a weight that challenges you, and do some squats and lift them overhead. If you can pick your kids up, you can pick up a kettlebell.”
2. Exercise every day
Yes, you do have the time. “I’m talking 10 minutes a day,” Thebe says. Look for a class at your local gym or on YouTube that uses words like “resistance” and “strength training,” or “functional movement” (to make sure your form is correct).
3. Stop being mean to yourself
“I can’t believe the way I hear women talk about themselves,” she says. “It’s horrible! Be kind, take care of yourself. Try yoga, start meditating and walk the dog. Do things you love and get support.”
Tips from a registered dietitian
Kristyn Hall sees a lot of forty-something women in her Calgary practice with the same complaints: “My clothes don’t fit, and I’m exhausted.” By our 40s and 50s, she says, a lot of us are decades-deep into patterns of disordered eating and dieting, bouncing between strict rules and complete anarchy. “Add in more stress and less sleep, a naturally slowing metabolism, plus the natural aches and pains that accompany aging, and you’ve got a body and mind that feel unfamiliar,” she says. “Bodies age. Let’s figure out how we can support that in wonderful ways.” Here’s her best advice.
1. Watch for triggers
A lot of the things we reach for in times of stress may be exacerbating perimenopausal symptoms. “Alcohol can worsen hot flashes, coffee can make you more jittery, and processed carbs can make you feel more sluggish,” Hall says.
2. Increase your fibre intake
Get lots of fibre (both soluble and insoluble) to help your gut feel great and to cut down on uncomfortable bloating. Probiotics are also beneficial for gut health.
3. Eat lots of nutrient-dense food
Help your body build crucial muscle mass by incorporating protein throughout your day instead of just packing it in at dinner. Look for foods high in phytonutrients, calcium, magnesium and vitamin D—critical nutrients our bodies need. For phytonutrients, look to flaxseeds, apples, beets and berries. To get calcium, go for dark greens like kale or bok choy, and for vitamin D, opt for fatty fish and cheese or supplement as needed (it’s really hard to get your vitamin D needs met with food alone).
4. Don’t look for a quick fix
Be cautious of the latest diet fads, like keto and intermittent fasting. “It’s still dieting,” Hall says. As for those clothes that don’t fit? “Throw them out.”
Originally posted in August 2019, updated August 2021.