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The top 3 lifestyle tweaks to prevent and support perimenopause madness

Perimenopause Part 4 –

If you have read part 1 and 2 of this series, you should by now have a fairly good understanding of the underlying imbalances that can contribute to perimenopause chaos, and why they matter. If you have missed them, catch up on them here (part 1), and here (part 2).

But it would be all doom and gloom if we left it at that, and that is definitely not what Functional Medicine stands for.

Within Functional Medicine, we aim to empower you to take your health into your own hands, by uncovering and then addressing those underlying imbalances, and bring them back to balance. You can think of it much like a cogwheel that has started to get rusty and build up sludge, and slowly runs less efficiently. That’s what happens when all the different factors accumulate over the past decades.

Part 3 (read here if you missed it) elaborated on what to eat to nourish your body and support your hormones through this time, and when not to eat (aka how to use fasting for hormone optimisation).

In today’s post, I am going to walk you through the other 3 top lifestyle tweaks you can start right away to clean out the cogwheel and turn your perimenopausal years from chaos to a win.

3) Stress Reduction

You may recall from part 1 how our stress messenger chemicals cortisol and noradrenaline can contribute to hot flashes, abdominal weight gain, low progesterone and other perimenopausal havoc, especially if they are elevated at the wrong time of the day.

One of the maybe most important steps in optimising not only perimenopause, but overall long term health span, is to learn how to manage stress, rest and include play into one’s life.

If you feel wired in the afternoon, are racing from task to next, have trouble sleeping, your cortisol and noradrenaline are likely running high too late in the day.

Simple strategies to reset your stress response

  • Breathwork: also called ‘paced breathing’ in research, has been shown to shift our nervous system away from the fight-or-flight (cortisol and noradrenaline) mode, over to the rest-and-digest mode, helping with hot flashes and to lower stress biology.
  • Mindfulness meditation: You don’t have to sit there for 30 minutes, as this may just add more to the feeling of ‘limited time in the day’. Just a few moments of becoming aware of your breath, your thoughts, what it is you are doing right now, can shift you over to the rest-and-digest state and improve cortisol and adrenaline response.
  • Getting a massage, stretching, foam rolling, saunas have all been shown to be a great support, as are reading, spending time in nature, etc
  • An often overlooked factor is oxytocin. Oxytocin is a messenger chemical that gets released when we hug, touch, especially during an orgasm, but also just feeling connected. Oxytocin opposes cortisol, making it one of the most powerful tools in your kit. Make time for your loved ones, friends, family, partner, pets, and your perimenopause symptoms will thank you for it.
  • If you have unresolved trauma which keeps you stuck in the fight-or-flight loop, ruminating and being stressed out day in day out, it may be a good idea to work with a therapist to resolve these issues. Oftentimes without this, all the other efforts may be without success.

4) Exercise and movement

Tweak No. 4 of the top 5 to support & prevent perimenopausal symptoms, is movement.

Most of you know that exercise is important, but why really is it in particular also important to support the perimenopausal transition?

  • Exercise balances cortisol, and helps burn up excess amounts.
  • It produces endorphins which counter noradrenaline and cortisol, making you happier and more relaxed
  • It supports testosterone production, which is great for libido, muscle tone, energy levels, that zest in life.
  • Exercise directly stimulates muscle tone plus lowers bone density loss, preventing osteoporosis and frailty.
  • One of maybe the biggest health promoting benefits is its insulin sensitizing effect. You may recall from earlier blog posts how insulin resistance (the opposite of insulin sensitivity) contributes to hot flashes, cardiovascular damage, abdominal fat accumulation and more.

But wait, as with most things, it is the dose that makes the cure or poison. Same goes for exercise. If you do high intensity exercise day in, day out, you may be pumping out too much cortisol, and stressing your body out even more. Research shows that when exercising at higher intensity for up to 45 minutes, it helps the body clear excess cortisol. When done for longer in one setting, or not allowing for rest days in between, it does the opposite!

For best perimenopause and long term health effects, you may want to include

  • 3x/ week: high intensity exercise (up to 45 minutes) of anything you enjoy, such as a high intensity Barre workout/ power yoga/ pilates/ spinning/ fast running etc.
  • The other days of the week, plan in ‘daily movement’: a gentle run, a power walk, a gentle yoga/ pilates/ Barre session, golf, gentle tennis, skiing, some stretching and breathwork to round it up.

5) Sleep & Circadian rhythm living

Last, but definitely not least, comes sleep, and with it circadian rhythm living.

You may live according to the saying ‘I can sleep when I am dead’, but you may want to reconsider this, if living your optimum live is of importance to you.

Research over the past decades shows that getting adequate amounts, and most importantly, good quality sleep such as deep and REM sleep, are crucial for many processes in the body, and to no surprise, also to support and prevent perimenopausal symptoms.

If you are lacking sleep, your entire biology the next day functions differently.

  • Your body is less insulin sensitive, making you store more abdominal fat, even if eating the same amount and type of food, and contributing to hot flashes
  • You’re more prone to cravings, in particular highly palatable foods, high in the dangerous fat and sugar combination
  • Your body is more inflamed, especially a type called IL6
  • You produce less cortisol first thing in the morning, and more later in the day, tampering with your circadian rhythm, and subsequent sleep the next night
  • Your brain can’t clear out debris that has accumulated during the day, which over the short term can lead to brain fog, irritability and memory trouble, but long term can contribute to the development of more permanent damage such as Alzheimer’s.
  • Same goes for the rest of the body, we need rest to heal, reset, clear out debris.

You are aware that you should be getting 7-9 hrs of sleep, but you toss and turn, or wake up in the middle of the night and then have trouble getting back to sleep?

Some basic steps you can try to help you get a better night sleep include:

  • Keep your blood sugar stable during the day, so you avoid a drop at night which will wake you up or keep you awake
  • Support your daily cortisol (stress) and circadian rhythm response, to allow for it to drop enough at night to get a good sleep. This includes limiting coffee or other stimulants to the morning, even very high intensity exercise may best not be done right before bed, unless you are highly trained and used to it.
  • Avoid eating too late, or drinking alcohol. Both can interrupt sleep
  • Make sure your bedroom is entirely blacked out and cool enough. Both light and being too hot have been shown to disrupt sleep
  • Most have heard by now that it is important to avoid blue light from screens too late in the day, and have a soothing bedtime routine.
  • While a herbal sleepy tea can be a good idea, drinking too much too close to bed just calls for night time loo runs.
  • Other night time tools can be magnesium, phosphatidylserine, ashwagandha, or if these fail, melatonin.

If you have tried these, but are still having trouble sleeping, you may want to work with an experienced Functional Medicine practitioner to help you find and address what deeper triggers may be at cause for you individually. These can include low progesterone/ GABA/ serotonin/ vitamin D, heavy metals and food intolerances, candida albicans, and more.  

I hope you now feel empowered to take on this stage of your life with ease, and turn it into a win.

As always, comment below if you have questions, or if you found any of this particularly helpful. I’d love to hear from you!

Stay tuned for one last post in this perimenopause series, where I will shed light on HRT – hormone replacement therapy, what to watch out for, risks, benefits, and some herbal and nutritional supplements to consider to help you along the way!

Xx In Health, Mirthe

Picture of Mirthe


It is my goal to empower you to become the CEO of your health trajectory, preventing and optimising with precision and science backed strategies to live your best life & thrive.

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It is my goal to empower you to become the CEO of your health trajectory, preventing and optimising with precision and science backed strategies to live your best life & thrive.

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