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9 best gentle interventions for perimenopause

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If you’re experiencing perimenopause, you may wonder whether natural interventions exist that could help your symptoms. We provide nine natural strategies for perimenopause.
Perimenopause can be a challenging period in your life, leading to a whole host of symptoms and changes. 

Estimated to affect around 13 million women in the UK at any given time,1 perimenopausal symptoms can sometimes begin more than a decade before your periods stop, causing an array of feelings ranging from confusion to concern.2

While your doctor can recommend hormone replacement therapy (HRT) or non-hormone solutions to help combat these symptoms, perimenopause doesn’t typically require treatment unless its symptoms are causing you particular discomfort or distress. 

Therefore, you might be wondering if any interventions can help make a difference. In this article, we discuss exactly that, including nine evidence-backed strategies that could make managing your symptoms a lot easier.

What is perimenopause? 

Perimenopause describes the transitional stage before menopause. It’s the time when your menstrual cycles gradually become more irregular before stopping altogether, spelling the end of your reproductive years.3

Every woman experiences perimenopause differently and at varying ages. Perimenopause typically takes place between the ages of 45 and 56 years, lasting up to seven years.2,4 However, the transition to menopause can take up to 14 years for some people and even start in your 30s.

During perimenopause, you may notice several symptoms that affect your physical and mental health. These symptoms arise from the subtle (and not-so-subtle) changes that take place in your body, such as hormonal changes.

Together, the hormones oestrogen and progesterone are responsible for ovulation and menstruation.5,6 In preparation for menopause, your oestrogen levels begin to decrease, causing a hormonal imbalance. These fluctuations then lead to several changes: your menstrual cycles shorten or lengthen, your ovaries produce fewer eggs, and menopausal-related symptoms, such as hot flushes, vaginal dryness and difficulty sleeping, begin.

When your periods stop for 12 consecutive months, this signals the end of perimenopause, meaning that you’ve officially reached menopause.4

Symptoms of perimenopause

Throughout perimenopause, you may experience various symptoms. Some of the most common include:7,8
  • irregular periods
  • hot flushes 
  • mood changes
  • vaginal and bladder issues
  • decreased libido
  • night sweats
However, there are a whole host of other symptoms you may experience. So take a look at our dedicated guide to the signs and symptoms of perimenopause to learn more. 

We also recommend seeking medical advice if you find that your symptoms get in the way of performing everyday activities, you have any concerns about your menstrual cycle or think that you might be experiencing menopausal symptoms earlier than expected.9

Tips for gentle perimenopause management 

Perimenopause is a natural process that most women will experience at some point. While it's not a medical condition that requires treatment, it can cause various physical and emotional symptoms.

By working with your GP, they’ll be able to review your symptoms and create a treatment plan that lessens the impact on your daily activities.

However, in addition to medical treatment, interventions, such as exercising, eating well and taking care of your mental wellbeing, can also relieve some of the symptoms of perimenopause.

Here are nine more things that may help manage your perimenopause symptoms:

1. Regular exercise

Fitting in aerobic exercise a few times each week may help with specific symptoms of perimenopause, such as sleeping difficulties and depression.10 Trying yoga may also improve your sleep and mood during perimenopause.11 

Fancy a dip in chilly waters? While this may sound unappealing, there’s some evidence to suggest that cold water swimming could help with symptoms of perimenopause. 

A survey conducted by University College London (UCL) found that among 785 women going through menopause, cold water swimming significantly improved symptoms like anxiety, mood swings, low mood, and hot flushes.12

2. Add strength training to your workouts 

The hormonal changes that take place during perimenopause can affect bone density as your oestrogen levels drop7 – and that’s where strength training comes in. 

While it may be common knowledge that this kind of exercise builds muscles, multiple studies show that strength training or resistance exercise can also be important for maintaining musculoskeletal health — especially as we age.13

3. Meditation 

Meditation is well known for having various positive impacts on our health, whether it’s reducing stress levels, decreasing anxiety, improving attention, or increasing compassion.14–17 The list goes on. But did you know meditation might also help with perimenopause symptoms? 

Small studies indicate that meditation may improve the vasomotor symptoms of perimenopause, such as hot flushes, and improve your ability to cope with and alleviate other menopause-related symptoms.18,19 

4. Aromatherapy massage

According to some small studies, combining the invigorating scents of essential oils with relaxing massage may relieve some of the psychological symptoms of perimenopause.20,21 

Furthermore, novel research shows combining a therapeutic massage with music may improve sleep and quality of life in women going through menopause.22

5. Wear natural fabrics 

The clothes we wear can also impact our health – especially during perimenopause. 

Wearing more natural fabrics, such as bamboo, cotton and linen, can be helpful when experiencing hot flushes or sweating. These materials are often more breathable and naturally moisture-wicking — which helps sweat evaporate more quickly during a hot flush.

6. Take supplements for perimenopause 

Consider using licensed herbal products and food supplements to potentially combat your perimenopause symptoms. Some of the key ingredients to look out for in these products include:23 
For more information on how these supplements could help you, read our article on eight of the best perimenopause supplements.

However, it’s important to keep in mind that the science behind how these herbal products work and whether they’re actually effective is scarce and solid clinical evidence is lacking. Some small and emerging studies have found there to be potential benefits in some of these ingredients, but further research is needed.24,25,26

As always, if you’re considering taking any of these supplements, speak to your GP before trying them out. Some of these may interact with other medications or may not be suitable for you, which is why it’s important to check this with your doctor.

7. Stabilise your blood sugar levels

Hormonal changes during perimenopause may disrupt your blood sugar levels. This is because fluctuating levels of oestrogen and progesterone can cause blood glucose to spike and fall. 

Some research indicates a link between hot flushes and higher blood glucose levels.27

Therefore, eating a balanced diet with plenty of fruit and vegetables, maintaining a moderate body weight and getting regular exercise can all help with managing your blood glucose level effectively.28

8. Increase your veg intake 

Increasing your intake of fruit and vegetables, and limiting how many ultra-processed foods you eat, may help with some symptoms of perimenopause. 

For example, a large 2012 study found that women who eat more vegetables, fibre, fruit, and soy products experienced symptoms like hot flashes and night sweats (known as vasomotor symptoms) less frequently during perimenopause.29

9. Use a natural lubricant 

Vaginal dryness is common during all stages of the menopause. This can cause itching, discomfort during sex and the urge to urinate more than usual.30

Natural lubricants are available to ease the discomfort of vaginal dryness, with some of the best options being water-based. These water-based lubricants are also safe to use with any condoms and won’t damage them.

The final say 

During perimenopause, hormones start to fluctuate, causing irregular periods and several menopause-related symptoms, such as hot flushes, mood swings and difficulty sleeping.

However, several natural perimenopause interventions exist which might help reduce your symptoms. These include: 
  • performing regular exercise 
  • strength training 
  • meditating 
  • aromatherapy massage
  • wearing natural fabrics 
  • taking suitable food supplements 
  • managing your blood sugar level
  • eating a healthy diet
  • using a natural water-based lubricant
For further information on perimenopause, check out our menopause support hub. Here, you’ll be able to seek guidance from our menopause-trained advisors and qualified menopause nurses. 

The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any treatments or remedies.

Sources

  1. Harper, J., et al. An online survey of perimenopausal women to determine their attitudes and knowledge of the menopause. Women’s Health. 2022;18:174550572211068. https://doi.org/10.1177/17455057221106890.
  2. McCarthy, M., et al. The peri-menopause in a woman’s life: A systemic inflammatory phase that enables later neurodegenerative disease. Journal of Neuroinflammation. 2020;17(1). https://doi.org/10.1186/s12974-020-01998-9.
  3. Delamater, L., et al. Management of the perimenopause. Clinical Obstetrics and Gynecology. 2018;61(3):1. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082400.
  4. Peacock, K., et al. Menopause [Internet]. National Library of Medicine. StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507826.
  5. Delgado BJ, et al. Estrogen [Internet]. National Library of Medicine. StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538260.
  6. Cable, JK., et al. Physiology, progesterone [Internet]. National Library of Medicine. StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558960.
  7. Mayo Clinic. Perimenopause - Symptoms and causes [Internet]. [cited 2024 Feb 20]. Available from: https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666.
  8. Inayat, K.., et al. Symptoms of menopause in peri and postmenopausal women and their attitude towards them. Journal of Ayub Medical College Abbottabad. 2017;29(3):477–82. Available from: https://jamc.ayubmed.edu.pk/jamc/index.php/jamc/article/view/3448/1566.
  9. NHS. Early menopause [Internet]. [cited 2024 Feb 20]. Available from: https://www.nhs.uk/conditions/early-menopause.
  10. Sternfeld, B., et al. Efficacy of exercise for menopausal symptoms. Menopause. 2013;21(4):1. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3858421.
  11. Buchanan, DT., et al. Effects of yoga and aerobic exercise on actigraphic sleep parameters in menopausal women with hot flashes. Journal of Clinical Sleep Medicine. 2017;13(01):11–8. https://doi.org/10.5664/jcsm.6376.
  12. Pound, M., et al. How do women feel cold water swimming affects their menstrual and perimenopausal symptoms? Post Reproductive Health. 2024;20533691241227100. https://doi.org/10.1177/20533691241227100.
  13. Hong, AR., et al. Effects of resistance exercise on bone health. Endocrinology and Metabolism. 2018;33(4):435. https://doi.org/10.3803%2FEnM.2018.33.4.435.
  14. Goyal, M., et al. Meditation programs for psychological stress and well-being. JAMA Internal Medicine. 2014;174(3):357. https://doi.org/10.1001/jamainternmed.2013.13018.
  15. Orme-Johnson, DW., et al. Effects of the transcendental meditation technique on trait anxiety: A meta-analysis of randomized controlled trials. The Journal of Alternative and Complementary Medicine. 2014;20(5):330–41. https://doi.org/10.1089/acm.2013.0204.
  16. Norris, CJ., et al. Brief mindfulness meditation improves attention in novices: Evidence from ERPs and moderation by neuroticism. Frontiers in Human Neuroscience. 2018;12(315). https://doi.org/10.3389/fnhum.2018.00315.
  17. Galante, J., et al. Effect of kindness-based meditation on health and well-being: A systematic review and meta-analysis. Journal of Consulting and Clinical Psychology. 2014;82(6):1101–14. https://doi.org/10.1037/a0037249.
  18. Sung, MK., et al. 'A potential association of meditation with menopausal symptoms and blood chemistry in healthy women'. Medicine (Baltimore). 2020;99(36):e22048. doi: 10.1097/MD.0000000000022048.
  19. Winges Conflitti, B., et al. Reducing menopausal symptoms with mindfulness-based meditation. Holistic Nursing Practice. 2024;38(2):93–101. https://doi.org/10.1097/hnp.0000000000000633.
  20. Darsareh, F., et al. Effect of aromatherapy massage on menopausal symptoms. Menopause: The Journal of The North American Menopause Society. 2012;19(9):995–9. https://doi.org/10.1097/gme.0b013e318248ea16.
  21. Mehrnoush, V., et al. Efficacy of the complementary and alternative therapies for the management of psychological symptoms of menopause: A systematic review of randomized controlled trials. Journal of Menopausal Medicine. 2021;27(3):115. https://doi.org/10.6118/jmm.21022.
  22. Keskin Töre, F. The effects of therapeutic touch and music on sleep quality, menopausal symptoms, and quality of life in menopausal women. Menopause. 2023;30(12):1221–9. https://doi.org/10.1097/gme.0000000000002269.
  23. Johnson, A., et al. Complementary and alternative medicine for menopause. Journal of Evidence-Based Integrative Medicine. 2019;24(24):2515690X1982938. https://doi.org/10.1177/2515690X19829380.
  24. Lee, HW., et al. Ginseng for managing menopausal woman's health. Medicine (Baltimore). 2016;95(38):e4914. doi: 10.1097/MD.0000000000004914.
  25. Franco, O., et al. Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. JAMA. 2016;315(23):2554–63. doi: 10.1001/jama.2016.8012.
  26. Ghazanfarpour, M., et al. Red clover for treatment of hot flashes and menopausal symptoms: A systematic review and meta-analysis. J Obstet Gynaecol . 2016;36(3):301-11. doi: 10.3109/01443615.2015.1049249.
  27. Thurston, RC., et al. Vasomotor symptoms and insulin resistance in the study of women’s health across the nation. The Journal of Clinical Endocrinology & Metabolism. 2012;97(10):3487–94. https://doi.org/10.1210/jc.2012-1410.
  28. Galaviz, KI., et al. Lifestyle and the prevention of type 2 diabetes: A status report. American Journal of Lifestyle Medicine. 2019;12(1):4–20. https://doi.org/10.1177/1559827615619159.
  29. Kroenke, CH., et al. Effects of a dietary intervention and weight change on vasomotor symptoms in the Women’s Health Initiative. Menopause. 2012;19(9):980–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3428489.
  30. NHS. Vaginal dryness [Internet]. [cited 2024 Feb 20]. Available from: https://www.nhs.uk/conditions/vaginal-dryness.
 

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