What to Eat During Perimenopause and Menopause: A No-Nonsense Guide: Hormones, Menopause Weight Gain, and Eating Well

15 June

Eating well during perimenopause and menopause doesn't mean giving up everything you enjoy. It means understanding how your hormones have changed what your body needs — and adjusting accordingly. Here's what actually matters.

I've always eaten well. Lots of vegetables, good food, nothing extreme. I was never someone who counted macros or tracked anything.

But I also grew up Italian, which meant breakfast was often a cornetto and a cappuccino, or something sweet with very little protein. Carbs on their own, first thing in the morning. My body handled it fine, or so I thought, for decades.

Then perimenopause arrived, and things started to shift. The same meals that had served me well weren't working the same way. Energy dipped. Cravings changed. And when I started learning about insulin sensitivity and what oestrogen actually does for glucose regulation, a lot of it suddenly made sense, including why menopause weight gain is so common even when nothing about your diet has changed.

This post is about what to eat during perimenopause and menopause — not as a diet, not as a list of restrictions, but as an understanding of what your body actually needs right now and why.

Why nutrition needs to change during perimenopause and menopause

This isn't about your willpower or your habits getting worse. It's about your hormonal environment changing — and what you eat needing to reflect that.

Oestrogen influences how your body processes food, stores fat, manages blood sugar, and supports gut health. As it fluctuates in perimenopause and declines in menopause, the nutritional approach that worked in your 30s may simply stop delivering the same results.

A few things shift:

Insulin sensitivity often decreases — which is one of the key drivers of menopause weight gain, and means carbohydrates affect you differently
Muscle mass becomes harder to maintain without adequate protein
Gut health changes, affecting digestion, mood, and inflammation
The liver works harder to process oestrogen, making nutrient quality more important

None of this means starting from scratch. It means making targeted adjustments to something that was probably already pretty good.

The insulin sensitivity piece

This is probably the most important thing to understand about nutrition during this transition — and the one most often left out of the conversation.

Oestrogen plays a direct role in regulating insulin sensitivity: how effectively your cells take up glucose from the bloodstream. When oestrogen declines, many women find that their insulin response becomes less efficient.

What that looks like in practice:

Foods that never used to be an issue may now cause a sharper blood sugar spike
Energy dips more noticeably after meals
Cravings — particularly for carbohydrates and sugar — can intensify
Excess glucose gets stored as fat more readily, particularly around the abdomen and one of the reasons menopause weight gain tends to show up differently than it did before

This is why many women describe carbohydrates 'affecting them differently now.' The insulin response has genuinely changed. It's not in your head.

The solution isn't to cut carbohydrates out — it's to understand how to eat them in a way that supports steadier blood sugar. More on that below.

If abdominal weight gain is also part of the picture, the post on perimenopause and menopause weight gain goes deeper on the hormonal mechanisms behind it.

Protein: why you probably need more than you think

Protein is the nutritional foundation of this transition. Most women aren't getting enough of it — and the gap matters more now than it used to.

Here's why protein becomes more important during perimenopause and menopause:

Muscle is harder to maintain as oestrogen declines, and adequate protein is essential for preserving it
Protein is more satiating than carbohydrates or fat — it keeps you fuller for longer
It has a stabilising effect on blood sugar when eaten alongside carbohydrates
It has a higher thermic effect, meaning your body uses more energy to digest it

A reasonable target is around 1.2–1.6g of protein per kilogram of body weight per day, spread across meals rather than loaded into one. You don't need to weigh everything, but it's worth knowing whether your current intake is in that range.

Practical sources:

Eggs (one of the most complete protein sources available, and quick to cook)
Greek yoghurt — also useful as a pre-bedtime snack to stabilise overnight blood sugar
Chicken, fish, lean meat
Legumes — lentils, chickpeas, beans (also excellent for fibre)
Tofu and tempeh
Cottage cheese

If breakfast is your weakest protein meal — as it was for me — that's a good place to start. Swapping a pastry for eggs, or adding Greek yoghurt to whatever you're already eating, tends to have a noticeable effect on energy and hunger through the morning.

Fibre: the underrated essential

Fibre doesn't get the attention it deserves in menopause nutrition conversations. It should.

Here's what fibre does during this transition:

Slows glucose absorption, which helps moderate the blood sugar spikes that become more pronounced when insulin sensitivity drops
Feeds the gut microbiome — a well-fed microbiome supports metabolism, inflammation levels, and even mood
Increases satiety, helping with the hunger dysregulation that often accompanies disrupted sleep
Supports regular digestion, which can become more sluggish during this transition

Two targets are worth knowing: aim for 30–40g of fibre per day, and aim for 30 different plant foods per week — not 30 portions, but 30 different types. It sounds ambitious, but it's more achievable than it seems when you count herbs, spices, nuts, seeds, and legumes alongside vegetables and fruit.

Fibre-rich foods worth prioritising:

Vegetables — the more variety the better
Legumes: lentils, chickpeas, black beans, edamame
Whole grains: oats, quinoa, brown rice, rye
Fruit — particularly berries, apples, and pears
Nuts and seeds — flaxseed is particularly useful, and has additional benefits discussed below

Fermented foods — kefir, live yoghurt, kimchi — deserve a mention of their own. They support gut bacteria directly, working alongside fibre to feed and diversify the microbiome.

Healthy fats and why they matter

Fat has had a difficult reputation for decades. During perimenopause and menopause, the right kinds of fat are genuinely useful — and not something to be avoided.

Healthy fats support:

Hormone production — sex hormones require fat to be synthesised
Cell membrane health — which affects how efficiently hormones communicate with cells
Satiety and blood sugar stability when eaten alongside carbohydrates
Brain health and cognitive function — particularly relevant given the brain fog many women experience
Absorption of fat-soluble vitamins (A, D, E, K), including vitamin D which is critical during this stage

Good sources to include regularly:

Oily fish — salmon, sardines, mackerel (also excellent sources of omega-3s, which support inflammation and joint health)
Extra virgin olive oil — one of the most well-researched fats for cardiovascular and metabolic health
Avocado
Nuts and seeds — particularly walnuts, almonds, chia seeds, and flaxseed
Eggs

A note on flaxseed specifically: it contains lignans, which are plant compounds that can have a mild oestrogen-like effect in the body. The evidence on phytoestrogens — plant oestrogens including soy isoflavones and lignans — is mixed, and the research is not yet definitive enough to make strong claims. What is clear is that flaxseed is an excellent source of fibre and healthy fat regardless, so it's worth including for those reasons alone.

What to do about carbohydrates

This isn't a low-carb post. Carbohydrates are not the enemy. But during perimenopause and menopause, how you eat them — and when — matters more than it used to.

The principles that help:

Choose whole food carbohydrates over refined or processed ones — oats over cornflakes, brown rice over white, whole grain bread over white.
Never eat carbohydrates alone — always pair them with protein, fat, or fibre to slow glucose release. Toast with eggs or nut butter. Rice with fish and vegetables.
If you exercise, try to eat carbohydrates around your workouts — before for energy, after for recovery. This is when your body is most primed to use them well.
Pay attention to portions at meals that are mostly carbohydrates — not to restrict, but to notice whether the amount you're eating matches how you feel afterwards.
Notice how your body responds — energy levels, hunger, and cravings two hours after a meal are useful signals. The breakfast that worked at 35 may not be working the same way now, and that's worth paying attention to.

You don't need to fear carbohydrates. You need to understand that your body is working with a different insulin response than it used to — and adjust from there.

This is something I know from the inside

I genuinely never thought about macros. I ate well by instinct — lots of vegetables, good olive oil, fruit, lean meats, pulses, fish. It was a healthy diet by any measure.

But breakfast? Often a cornetto. Or something sweet with nothing to balance it. I was Italian, that was just breakfast. And for years, it was fine.

It was only when I started learning about insulin sensitivity and what oestrogen actually does for glucose regulation that I understood why carbs on their own first thing in the morning might be contributing to the energy dip I'd been noticing by mid-morning.

I did track macros for a time — not obsessively, but enough to understand what I was actually eating. I'd recommend it if you're inclined to try. It's easier to make good decisions once you have a clearer picture of your baseline. Not necessary, but genuinely helpful.

I'm not someone who is ever going to meticulously track macros long-term. But I do now make sure there's protein and something substantial in my first meal. It makes a difference.

If your diet is already healthy but things feel slightly off — energy, cravings, weight — the adjustment may not be dramatic. It might just be a shift in how you're eating what you're already eating.

When to consider a menopause coach for nutrition support

General nutrition advice is widely available. But knowing what applies to your specific situation — your symptoms, your lifestyle, what's actually going on — is a different thing.

It might be worth getting personalised support if:

You've been eating carefully and the weight gain isn't shifting the way it used to
You're not sure how to adjust your approach for where you are right now
Energy, cravings, or gut health are affecting your daily life and you don't know where to start
Nutrition is one piece of a bigger picture that includes sleep, stress, and weight

As a perimenopause and menopause coach, nutrition is one of the first things I look at with clients — because it connects directly to insulin sensitivity, energy, gut health, sleep, and mood. None of these things work in isolation.

What to do if this sounds like you

Start with protein and fibre — if you change nothing else, adding more of both to your current meals tends to have the most noticeable impact.
Look at your breakfast first — it's often where the biggest gap is, and it sets your blood sugar up for the rest of the day.
Pay attention rather than tracking — notice how you feel after different meals. Your body is giving you information. And if you do want to track, by all means do — it gives you a more precise picture and makes it easier to make decisions once you know what you usually eat.
Talk to your doctor if you're concerned about blood sugar or metabolic changes — these are worth investigating properly, not just managing through diet alone.
Consider personalised support if you're not getting the results you expect — at Fabulous in Midlife, I work with women in perimenopause and menopause to figure out what's actually going on and what will actually help.

Ready for more personalised support?

If your energy, weight, cravings, or gut health feel harder to manage than they used to, you can book a free consultation to explore working together.

Book your free consultation

Not ready for that yet? Join the Fabulous in Midlife mailing list for practical, no-nonsense guidance on perimenopause and menopause — delivered to your inbox, without the noise.

Frequently asked questions

Does what you eat affect menopause weight gain?

Yes, significantly — particularly through the insulin sensitivity pathway. As oestrogen declines, the body becomes less efficient at managing blood sugar, and excess glucose is stored as fat more readily, especially around the abdomen. Eating enough protein, pairing carbohydrates with protein and fat, and prioritising fibre all directly support better blood sugar regulation — which is one of the most effective nutritional approaches to managing menopause weight gain.

What should I eat during perimenopause and menopause?

The foundations are: adequate protein at every meal (especially breakfast), plenty of fibre from varied plant foods, healthy fats, and whole food carbohydrates eaten alongside protein and fat. The goal isn't restriction — it's understanding how your changing body processes food differently now.

Do I need to cut out carbohydrates during perimenopause?

No. But the way and when you eat carbohydrates matters more than it used to. Reduced insulin sensitivity means carbohydrates eaten alone are more likely to cause blood sugar spikes. Pairing them with protein, fat, and fibre makes a significant difference — and eating them around exercise is also a good strategy.

Why does protein matter more during menopause?

Oestrogen helps protect muscle mass. As it declines, muscle becomes harder to maintain — and adequate protein, together with resistance training, is essential for preserving it. Protein also supports blood sugar stability, satiety, and metabolism.

What are phytoestrogens and should I be eating them?

Phytoestrogens are plant compounds that have a mild oestrogen-like effect in the body. They're found in foods like soy, flaxseed, and certain legumes. The research on their effects during menopause is not yet definitive, and individual responses vary. Flaxseed and legumes are worth including regardless — they're excellent sources of fibre and healthy fat independent of any hormonal effect.

How does gut health connect to perimenopause and menopause?

Declining oestrogen directly affects gut bacteria. As the microbiome shifts, it can influence digestion, inflammation, mood, and even how oestrogen itself is processed. Prioritising fibre and fermented foods supports gut health during this transition.

Should I be taking supplements during perimenopause and menopause?

This post focuses on food rather than supplements. Vitamin D, magnesium, and omega-3s are commonly discussed in the context of menopause, but supplement needs vary depending on your individual situation, diet, and any medical factors. It's worth discussing with your GP or a registered dietitian.

About the author

Paola is a certified women's health and nutrition coach and breathwork practitioner at Fabulous in Midlife, helping women navigate perimenopause and menopause with practical, evidence-based support. Follow along on Instagram and Facebook @fabulousinmidlife or visit fabulousinmidlife.com.

Jayde Lee