Perimenopause is the transition period leading up to menopause, defined as the absence of a menstrual cycle for 12 consecutive months. Perimenopause begins in the early to mid-40s and can last between two and 10 years. During this time, many hormone changes occur, specifically fluctuations in estrogen and progesterone. These hormonal shifts result in symptoms such as hot flashes, heavy, irregular or shortened cycles, mood changes or anxiety, sleep disturbances, changes in bone density, blood sugar dysregulation and weight gain.

Nutrition and lifestyle choices have been shown to help balance hormones during this period. Adding specific nutrients can help relieve symptoms and support this natural stage of life. Foods rich in protein, fiber, phytoestrogens, calcium and healthy fats can play an important role in helping you thrive. Here are some foods worth including in your diet.

Nutrient-dense flaxseeds, also known as linseeds, are rich in healthy omega-3 fats, fiber, vitamin B6, magnesium and zinc. They also contain lignans, which are a plant compound that mimic estrogen, and have antioxidant and anti-inflammatory properties. Supplementing your diet with 10 grams (1.5 tablespoons) of ground flaxseed has been shown to reduce symptoms associated with perimenopause due to the lignans and fiber content of flaxseeds. Add ground flaxseeds to cereals, yogurt, baked goods, oatmeal and smoothies.

Soy foods contain a plant compound called soy isoflavone, a plant estrogen that mimics the body’s own estrogen and which has been shown to reduce perimenopause symptoms such as hot flashes and night sweats. Soy foods include edamame, soybeans and products made with soy such as tofu, tempeh and miso. Soy foods also contain protein, which help balance blood sugars. You can add tofu to stir-fries, enjoy edamame for a snack and sip miso soup or sundubu-jjigae.

Fatty fish such as salmon, sardines and mackerel are rich in omega-3 fats, which help with heart health and reducing inflammation in the body. This is especially important for people in the perimenopause stage since they are at a greater risk for cardiovascular disease. Omega-3s also support mood and brain health during this transition. Fish is also rich in vitamin D which supports bone health. Aim for two servings of fatty fish each week or supplement with a fish oil or algae-based supplement to obtain the recommended amount of EPA and DHA omega-3 fats. You can make fish tacos, fish patties or grill and add fish to salads for an easy weeknight dinner.

Yogurt is rich in calcium and vitamin D, two essential nutrients important for bone health. People in perimenopause are at increased risk for bone loss due to the decline in estrogen, so it is important to focus on nutrient-dense foods that support bone health. Yogurt also contains probiotics, which provide healthy bacteria to your gut and improves digestion and estrogen metabolism. Enjoy yogurt for breakfast, in smoothies or in baked goods.

Nuts and seeds, such as almonds, walnuts and pumpkin seeds, provide minerals like magnesium, selenium and zinc, as well as being a source of protein and omega-3 healthy fats. They support hormone balance, mood, heart health and reduce inflammation. They’re also a source of fiber, which supports the gut microbiome and blood sugars. Sprinkle nuts and seeds onto salads, in granola or oatmeal, or enjoy in a trail mix.

Leafy greens, such as spinach, kale and Swiss chard, are a source of fiber and minerals magnesium, calcium and vitamin K, which support bone density. Magnesium also supports sleep and relaxation, helping to alleviate sleep disturbances that occur during this phase. In addition, cruciferous vegetables like kale have compounds called glucosinolates that support estrogen metabolism and hormone balance. Add leafy greens to salads, smoothies, soups or stews.

Meats such as chicken, turkey, beef or lamb are important during perimenopause as they are a source of complete protein needed to maintain muscle mass. They are also rich in heme iron and B12 which support energy, blood circulation and mood. Protein also helps balance blood sugars and improves insulin resistance, which people are at increased risk for during this stage. Choose organic, grass-fed meat when possible for increased nutrition.