The perimenopause diet, explained by a dietitian.

With age and falling estrogen, the body loses muscle more easily and rebuilds it less efficiently. Muscle is metabolically protective — it supports strength, blood-sugar handling and metabolic rate — so protecting it becomes a priority.

Practically, that means including a source of protein at each meal rather than back-loading it all at dinner. Paired with strength training, adequate protein is one of the most protective things you can do in this stage.

Because insulin sensitivity often dips in perimenopause, blood-sugar swings can show up as afternoon energy crashes, evening cravings and disrupted sleep. Steadying blood sugar tends to steady all three.

The lever isn't cutting carbs — it's balancing them. Pairing fiber-rich carbohydrates with protein and healthy fat slows the rise and fall, which is far more sustainable than restriction.

Fiber does double duty in perimenopause: it supports blood-sugar balance and satiety, and it helps the body metabolize hormones and protects heart health. Most people benefit from gradually getting more, from plants of all kinds.

A few nutrients deserve extra attention as estrogen declines — calcium and vitamin D for bone health, omega-3s for heart and brain, and magnesium for sleep and mood. Food first, with any supplements guided by your physician based on your labs.

Nutrition won't erase perimenopause, but it can take the edge off several symptoms — steadier energy and mood from balanced blood sugar, better sleep from steadier nights, and less of the afternoon crash-and-crave cycle.

It also lays the groundwork for the years ahead: bone density, heart health and metabolic health all become more important as estrogen's protective effects fade.

This is a stage where generic advice falls short — your symptoms, labs, history and life all shape what actually helps. A dietitian personalizes the approach and adjusts it as the transition evolves.

It's also weight-inclusive work: the focus is energy, labs, sleep, strength and how you feel — not the scale. And it works best coordinated with your physician, especially if hormone therapy is part of your care.