What to eat during perimenopause and menopause

As a woman, you may feel like you’ve tried it all—calorie counting, over-restricting, eliminating carbohydrates, increasing your exercise—but still struggle with weight gain and changes in body composition during perimenopause and menopause.

As estrogen levels decline during this transition, changes in metabolism, fat distribution, muscle mass, and bone health can occur. These changes may increase the risk of cardiovascular disease, insulin resistance, type 2 diabetes, bone loss, muscle loss, increased abdominal fat, sleep disturbances, and changes in cognitive, emotional, urinary, and digestive health.

The symptoms and changes associated with perimenopause and menopause can vary significantly from woman to woman. This information isn't meant to frighten you—it’s meant to help you better understand what may be happening in your body so you can feel more prepared to navigate these hormonal changes.

Understanding these changes is the first step toward supporting your health, strength, and well-being through this transition.

Focus on nutritious meals

There are several key nutrition priorities to focus on during perimenopause and menopause. Your main focus should be on protein, fiber, calcium-rich foods, vitamin D, and phytoestrogen-containing foods to help support muscle and bone health, digestion, and overall well-being.

Aim for more protein

Studies show that women should aim for 1-1.6 grams of protein per kilogram of body weight per day. You may benefit from the higher end of this range if you are more physically active or working to maintain or build muscle. Schedule a visit with your Registered Dietitian to see what protein range would be best for you to aim for each day.

If you have kidney disease, discuss your specific protein needs with your nephrologist, as they may differ.

Activate your digestion

Studies suggest aiming for 30–45 grams of fiber each day. If this seems out of reach, gradually increase your intake over time to help minimize bloating and gas.

Fiber can support satiety, regular bowel movements, cardiovascular health, metabolic health, and may improve depressive symptoms. Learn more about the benefits of a high-fiber diet here.

Consider phytoestrogen-rich foods

Some research suggests that regularly including phytoestrogen-rich foods may help support certain symptoms associated with perimenopause and menopause. Phytoestrogens are naturally occurring plant compounds that can interact with estrogen receptors in the body.

Consider regularly including:

• Soy foods: soybeans, edamame, tofu, tempeh, and soy milk
• Nuts and seeds: flaxseeds, sesame seeds, almonds, and sunflower seeds
• Beans and legumes: lentils, navy beans, kidney beans, and pinto beans
• Fruits: peaches, strawberries, raspberries, and prunes
• Mustard or cabbage family vegetables: broccoli, cabbage, cauliflower, Brussels sprouts, and collard greens

Support healthy bones

Calcium intake should increase to 1,200 mg per day for women experiencing perimenopause and menopause to support bone health and reduce the risk of fractures and osteoporosis.

What does 1 serving of calcium look like?

Examples include:

• 1 cup milk: ~300 mg calcium
• 1 cup calcium-fortified soy milk: ~300 mg
• 1 cup yogurt: ~200–400 mg, depending on the type
• 1½ ounces cheese: ~300 mg
• 3 ounces canned salmon or sardines with bones: ~200–300+ mg
• ½ cup calcium-set tofu: ~200–400 mg, depending on the brand
• 1 tablespoon chia seeds: ~75–80 mg
• 1 ounce almonds: ~75 mg

Because calcium absorption is limited at one time, it can be helpful to spread calcium-rich foods throughout the dayrather than trying to get all of your calcium in one meal.

If you are unable to meet your calcium needs through food, talk with your primary care provider before starting a supplement.

Note: A supplement may not be appropriate for everyone.

Vitamin D also plays an important role in calcium absorption and bone health. Your body can produce vitamin D through daily sun exposure, but the amount produced varies based on factors such as time of day, season, geographic location, skin pigmentation, age, and sunscreen use. Because of this variability, sun exposure alone may not provide enough vitamin D for everyone.

• If you are vitamin D deficient or unable to obtain adequate vitamin D through food and sun exposure, talk with your primary care provider about whether a vitamin D supplement is appropriate for you.
• Food sources of vitamin D include fatty fish, egg yolks, and fortified dairy or plant-based milks.

Drink lots of unsweetened fluids

Aim for approximately 11.5 cups (about 2.7 liters) of total fluids per day, primarily from water and other unsweetened beverages. Individual needs may vary based on activity level, climate, body size, and other factors.

Staying adequately hydrated may support overall health and is particularly important if you experience increased sweating from hot flashes. Adequate fluid intake may also help with vaginal dryness and reduce the risk of developing a urinary tract infection.

You don't need to overhaul your entire diet overnight.

Focus on consistently adding protein, fiber, calcium-rich foods, vitamin D sources, and phytoestrogen-rich foods to your meals. Small, sustainable changes can add up and help support your muscles, bones, heart, digestion, and overall health throughout perimenopause and menopause.

If you have questions about dietary supplements or menopausal hormone therapy (MHT), consider finding a healthcare provider who has experience caring for women during this stage of life. Not all providers have specialized training in menopause care, so finding someone knowledgeable and comfortable discussing your symptoms and treatment options can be helpful. You can find a menopause-trained provider through The Menopause Society’s Provider Directory.