Is Fasting Right For Me? How to Choose the Right Kind of Fast in Midlife

Is Fasting Right For Me? How to Choose the Right Kind of Fast in Midlife

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This article was first published on

The Midst – The gateway drug for the modern

midlife experience.

From Time Restricted Feeding to the 5:2 Diet, fasting is big news right now.

Fans of fasting say it aids weight loss, supports cognitive function, and boosts energy levels — but is it safe and effective when we’re juggling hormones, menopause, careers, family life, and other major midlife shifts?

Let’s explore the potential benefits and pitfalls of different types of fasting and answer the burning question – is fasting right for me?


What is fasting?

Fasting is simply the practice of not eating food (and occasionally no drinks either) for a set amount of time. Fasts have been practiced in cultures all over the world for thousands of years for religious, ethical, and health reasons. The famous Greek physician Hippocrates recommended therapeutic fasting as far back as the 5th century BCE, and many medical systems rooted in traditional wisdom still incorporate fasting as part of treatment plans today.


What are the pros and cons of fasting?

Good cellular housekeeping

Modern-day science has been catching up with traditional wisdom around fasting to investigate exactly what happens in the body when we abstain from food for long periods.

One of the key discoveries is the way fasting acts like a switch for a process called autophagy – a form of cellular housekeeping. When switched on, autophagy allows cells to clear out misshapen proteins, deal with damaged bits of DNA, and remove harmful toxins. In this way, autophagy helps keep our cells functioning efficiently and may be associated with healthful aging.

Fat-burning and Weight Loss

Fasting for more than 12 hours pushes your body to start using substances called ketones for fuel, rather than glucose. Ketones are produced when fats are broken down. A study of obese women following a 16:8 fasting protocol (a 16-hour fast followed by an 8-hour eating window) for 3 months showed this was effective for reducing weight, Body Mass Index, waist circumference, and cardiovascular risk, even when food intake was not closely monitored.

Better blood sugar balance and insulin sensitivity

Hormone changes during perimenopause and menopause can affect how well our cells respond to insulin, the hormone that carries sugars out of the bloodstream into cells. If we become insulin resistant, we end up with higher amounts of glucose in our blood which then gets stored as fat.

Fasting for 14 hours overnight and eating within a 10-hour eating window is effective at improving insulin sensitivity and blood glucose levels within 12 weeks.

Reducing inflammation

Chronic inflammation is a major factor in nearly all chronic health conditions including arthritis, obesity, auto-immune conditions, and heart disease. Inflammation levels in the body are measured by tracking levels of certain biomarkers like C-reactive protein (CRP). A meta-analysis of human studies investigating the effects of fasting found that fasting can significantly lower CRP levels, particularly in overweight and obese individuals.

Boost brain health

There isn’t a huge amount of research in this area done on humans, but animal studies show promising effects of fasting for cognitive function and possible prevention of neurodegenerative diseases like Alzheimer’s.


Possible side effects of fasting

Fasting certainly isn’t suitable for everyone, and we each have our capacity for managing fasts based on our health and what kind of lifestyle we live.

If we are under a lot of stress then fasting can make this worse as it adds additional physical stress. Equally, if we are handling stress well and don’t have any underlying health conditions, fasting can be a useful tool to use for weight balance, brain health, and healthy aging.

If you are new to fasting, start slowly and build up gradually – don’t jump straight in with a 14-hour fast! And if you start to experience unpleasant side effects, ease back on the length and frequency of your fasts.

Possible side effects of fasting include:

  • Hunger – this is the obvious one!
  • Feeling dizzy or light-headed
  • Bloating
  • Constipation
  • Fatigue and low energy
  • Irritability and low mood
  • Dehydration
  • Insomnia
  • Bad breath

The risk of side effects can be minimized by staying hydrated with water and herbal teas and resting as much as possible during your fast.


5 Types of Fasting and How to Choose The Right One!

There are lots of different ways to approach fasting, depending on how often you want to do it and what kind of lifestyle you have. The benefits of fasting will be even greater if you can make healthful food choices on non-fast days, and always be mindful of how you are feeling day-to-day. If your menstrual cycle is giving you cramps and low energy, don’t fast that day. If menopausal insomnia is driving you nuts, don’t do anything longer than a 12-hour overnight fast. Always adapt the fasts to suit you and not the other way around.

Here’s our easy guide to different types of fasting.


Time Restricted Eating / Time Restricted Feeding

What is it? This is the most common type of fasting and involves eating regular meals within a specific time window. Versions include:

12:12 – fast overnight for 12 hours then eat meals within a 12-hour window.

14:10 – fast for 14 hours, eat meals within a 10-hour window.

16:8 – fast for 16 hours, eat meals within an 8-hour window.

Who is it good for? If you’re new to fasting a 12:12 fast is the easiest one to start with and can gradually be adapted to suit the longer fasting times. Because you are asleep for the majority of the fast and eating normal meals in the eating window, this type of fast is good for people who want all the benefits of fasting with simple, no-fuss fasting protocols.


Circadian Fasting

What is it? Circadian fasting involves aligning your meals with your natural 24-hour internal body clock. Typically, this means eating larger meals earlier in the day, and fasting during the evening and overnight when digestion is less active.

Who is it good for? People who are in tune with their daily rhythms and can adapt meals to suit the fast.


Alternate Day Fasting

What is it? Rather than fasting every day for a set amount of time, Alternate Day Fasting involves alternating between eating normally for one day and then reducing food intake to around 500 calories or abstaining from food completely on the next.

Who is it good for? People who have the discipline to stick to the protocol! It can be harder to fit in with social occasions or a busy work diary than Time-Restricted Feeding and may be too extreme for people who have busy and demanding lifestyles.


The 5:2 Diet

What is it? The 5:2 diet allows you to eat normally for 5 days a week and then fast or have a small meal of around 500 calories on 2 other days.

Who is it good for? People who want more flexibility than the Alternate Day Fasting.


Who shouldn’t fast?

Most healthy adults can safely practice a simple 12-hour overnight fast without any difficulties so long as they are eating normally during the day. However, longer fasts and intermittent fasts are not recommended for:

  • Diabetics and those at risk of hypoglycemia
  • Children and teenagers
  • Frail older adults
  • People recovering from illness or exhaustion
  • People with thyroid conditions, chronic kidney disease, heart disease, chronic fatigue syndrome, or immunodeficiency
  • During pregnancy and breastfeeding
  • Anyone with or at risk of an eating disorder or binge eating
  • Those who are underweight or at risk of becoming underweight
  • People taking medications that require consistent and regular food intake

Managed carefully, fasting can be safe and effective but if you have any doubts about whether fasting is suitable for you, speak to your healthcare provider about it first.


How Do I Know if I’m Perimenopausal?

How Do I Know if I’m Perimenopausal?

Picture of a group of women talking about whether they are perimenopausal or not. This is the header image for the article on The Midst entitled How Do I Know if I'm Perimenopausal?

This article was first published on

The Midst – The gateway drug for the modern

midlife experience.

How Do I Know If I’m Perimenopausal?

Most of us grow up aware that menopause will happen at some point in midlife, but how many of us know about perimenopause and when that begins? With so many different symptoms and no clear timeline to follow, a lot of women are asking the question: How do I know if I’m perimenopausal?


What is perimenopause?

There are 3 main stages to the natural menopause journey: perimenopause, menopause, and post-menopause. Perimenopause covers the months and years leading up to menopause when your hormones are fluctuating and causing all kinds of physical and mental symptoms.

On average, women move into perimenopause in their late 30s / early-mid 40s.  However, with premature menopause and Primary Ovarian Insufficiency fertility levels decline, and the menstrual cycle stops before the age of 40.

There are ethnic differences in how women experience perimenopause and menopause. Research shows that Black, Latina, and Asian women may begin perimenopause earlier than white women and may have a longer transition phase.

Periods continue during perimenopause, although it might not be a regular cycle and it may be longer, shorter, lighter, or heavier than before. And if your menopause journey is surgically or medically induced, you may not experience the perimenopause phase at all – you may jump straight to menopause.

Menopause is that point in time when your periods have stopped. The average age for women to reach menopause in the US is 51, though women of color often experience it earlier than this.

Menopause means ‘end of periods’ and is defined as that day on the calendar when you haven’t had a period for 12 months (or 2 years if you’re under 40). At this point you can say you’ve done it; you’ve gone through menopause!

The post-menopause phase is everything after this point – i.e., the rest of your life after your menstrual cycle has stopped. You may find a few symptoms lingering on, but these should settle down as your body adjusts to producing much lower levels of sex hormones.


What are the symptoms of perimenopause?

According to the Menopause Invisibility report by Gen-M, there are at least 48 different symptoms associated with perimenopause and menopause. There are the common ones that you’ve probably heard about, like hot flashes, anxiety, night sweats, weight gain, and brain fog, but there are plenty that are less well-known, including:

  • Altered sense of smell and taste
  • Acid reflux and bloating
  • Vulvovaginal dryness and pain
  • Itchy ears
  • Burning mouth and tongue
  • Dizziness
  • Cold flushes
  • Thinning hair
  • Pins and needles in your hands, feet, arms, or legs
  • Insomnia
  • Palpitations

If you’re in your late 30s or early-mid 40s and you’re starting to notice some of these symptoms – whether your periods are changing or not – you could be in perimenopause.

The reason for such a crazy range of symptoms is because estrogen and progesterone act in lots of areas of the body. From bones and nerves to the heart and digestive tract, our sex hormones do way more than just run the menstrual cycle.

Take the brain for example. A lot of women notice increasing anxiety and difficulty sleeping in their late 30s / early 40s. Their monthly cycle is the same and menopause may be ten or twenty years away yet, so they don’t make the link between these symptoms and their hormones.

But the brain is one of the first places to be affected by changing estrogen and progesterone levels. Progesterone has a calming effect on the nervous system and estrogen influences our sleep/wake cycle. So, when these hormones start to fluctuate during perimenopause, we can experience difficulty sleeping, mood swings, and frequent anxiety.


Can perimenopause symptoms be something else?

There is a crossover between some perimenopause symptoms and other health conditions. It’s always worth speaking to your healthcare provider if you are concerned about what’s going on, especially if you have a family history of health issues.

Health conditions to consider include:

  • Thyroid function can be affected by perimenopause and may cause similar symptoms. Weight gain, constipation, low energy, and brain fog are all signs of low thyroid function (underactive thyroid) while anxiety, racing thoughts, weight loss, diarrhea, and palpitations are classic signs of overactive thyroid.


  • Pregnancy! It may be the last thing on your mind at this point in life, but until you’ve reached menopause there is still a chance you can fall pregnant.


  • Over-exercising: a high-intensity training regime can cause periods to stop.


  • Sleep apnoea: night time waking can be due to hormone changes but can also be caused by sleep apnoea, a serious sleep condition. Left unchecked, sleep apnea can increase the risk of Type II Diabetes, heart disease, and high blood pressure.


  • Depression: mood swings and low mood are common during perimenopause but if symptoms persist or get worse, speak to your healthcare provider about support.


  • Arthritis: joint pains are common in midlife, but persistent pain and swelling may be a sign of osteoarthritis or rheumatoid arthritis.


  • Cancers: persistent fatigue, night sweats, and itchy skin can be signs of lymphoma, a type of cancer.


How can I manage perimenopause symptoms?

Diet and lifestyle changes are a great place to start. Food and drink, movement, relaxation, and sleep all provide the foundations for a healthy well-being and can go a long way toward easing perimenopause symptoms.

And, if you then decide to try Hormone Replacement Therapy (HRT) or herbal alternatives for hormone balance, your body will be in a better place to respond to them.

Try these five top tips for managing perimenopause symptoms:

  1. Minimise caffeine: this can be hard to stomach when you rely on a coffee fix, but caffeine is a major trigger for symptoms of anxiety, gastrointestinal problems, insomnia, and fatigue. Tolerance to caffeine can change over time and you may not be able to handle it as well as you used to. Try gradually replacing coffee, tea, and caffeinated sports drinks with water and herbal alternatives and see what a difference it makes.


  1. Nourish your gut: there’s a group of microbes in the gut called the estrobolome that processes deactivated estrogen. When the estrobolome is out of kilter, it produces too much of an enzyme that reactivates estrogen, sending it back into circulation. More estrogen might sound like a good thing but it’s not, and this recycled estrogen can worsen hormone imbalances. To keep your estrobolome in check, include fermented foods like sauerkraut, kimchi, natural yogurt, and kefir, and eat fiber-rich fruits, vegetables, and whole grains.


  1. Eat a rainbow of fruits and vegetables every day: the colorful compounds in fruits and vegetables help manage inflammation and hormone balance. Aim to include as many different colors as you can in each meal.


  1. Include plenty of good quality protein in every meal and snack: We start to lose more muscle mass after menopause, and this affects metabolism and bone health. Make space for at least ¼ plateful of protein-rich foods with each meal. Eggs, good-quality meat, fish, shellfish, beans, pulses, nuts, and seeds are all good sources. Collagen powder can help top up protein levels – vegetarians and vegans can use pea, hemp, or soy protein.


  1. Include phytoestrogen foods each day: chickpeas, tofu, tempeh, miso, alfalfa sprouts, and ground flaxseeds are all rich in plant-based estrogen compounds called phytoestrogens. These compounds help balance out fluctuating estrogen levels during perimenopause and can ease troublesome symptoms.


Perimenopause is a unique journey for each of us, and symptoms can change as we get nearer to menopause. Making diet and lifestyle changes is a good place to start, alongside finding a supportive healthcare practitioner to discuss any concerns.

Natural Nutrition for Perimenopause - What to eat to feel good and stay sane book cover by Sally Duffin Perimenopause Nutritionist

Discover even more nutrition and lifestyle tips for managing perimenopause and menopause in “Natural Nutrition for Perimenopause – What to eat to feel good and stay sane”.

Available on Amazon or direct from YPD Books, this friendly guidebook covers everything from what perimenopause is and how to spot the signs of change to essential nutrients, supplements, toxins, and lifestyle support.

“Reading this book has helped me understand how my diet and lifestyle can support my body through perimenopause.  And it’s written beautifully too.”   Amazon Reviewer

bones, skin, an

Perimenopause Support – A round up of the best articles

Perimenopause Support – A round up of the best articles

Concerned about perimenopause brain fog?

Anxiety levels rising?

Or maybe you’re experiencing uncomfortable vulvo-vaginal symptoms and need some self-care guidance.

I’ve got you covered.

Here’s a round-up of my most recent perimenopause support articles from around the web.  

Each one is packed with insights and top nutrition and lifestyle tips to help you manage your menopause, your way.

Perimenopausal Brain Fog: A Nutritionist’s Guide to Thinking Clearly

For many women, cognitive changes like brain fog and memory loss are some of the earliest signs of perimenopause. They creep in along with emotional changes like anxiety and mood swings, long before periods begin to stop. As a nutritionist, I’ve heard from women who fear they are losing their minds and are worried about early onset dementia, when in fact these shifts are all part of the menopausal transition…

Blog post: How can collagen help ease menopause symptoms?

Can Menopause Affect Mental Health?

Most people are aware of common menopause symptoms like hot flushes, mood swings, and insomnia. Less well known, however, are the effects menopause can have on mental health.

According to research by Nuffield Health, large numbers of women are struggling to cope with their mental health during menopause and perimenopause among their residing symptoms. Of the women surveyed experiencing symptoms:
– 47% feel depressed
– 37% are experiencing anxiety
– 18% have needed to take time off work because of their menopausal symptoms

How Eating Plant Foods Can Help Ease Symptoms of Perimenopause

During perimenopause, the hormones estrogen and progesterone begin to fluctuate, affecting every part of the body from bones, skin, and hair, to your muscle composition, your cholesterol levels, and even how your brain functions.  Many women turn to hormone replacement therapy (HRT) to gain relief, but HRT isn’t for everyone and ultimately it just delays the inevitable onset of menopause. Making diet and lifestyle changes, on the other hand, is something anyone can do, and there are several key plant foods that have been proven to help ease perimenopause symptoms.

eating plant foods can help ease perimenopause symptoms
menopausal vaginal health

The Menopausal Vagina: Everything You Wanted to Know But Were Afraid to Ask

Vaginal pain and dryness have to be the least talked about symptoms of perimenopause and menopause, yet an estimated 50-60% of women are affected. A lot of women don’t know how to talk about these symptoms because of upbringings that shroud anything to do with vaginas in an aura of shame and stigma. By the time menopause comes along, women can feel too embarrassed to seek help and suffer in silence.

We’re here to change that attitude. Let’s explore what happens to menopausal vulvas and vaginas (yes, there’s a difference!) and what steps you can take to get relief from painful discomfort…

Managing Midlife Anxiety

Most women are familiar with feelings of anxiety. Whether it’s a few pre-menstrual jitters, anxiety about work, or worrying about your child on their first day at school or college, we know what it’s like to experience that sense of panicky dread and uncertainty. But during midlife, a new kind of anxiety emerges. One with no particular rhyme or reason but enough power to make you think you’re losing your mind.

Katherine Tyack-Grant, from Yorkshire, UK, was in her early forties when she started to experience overwhelming anxiety…

Managing midlife anxiety
How Collagen Can Support Bone Health

How Pura Collagen Can Support Bone Health

Oestrogen plays a key role in bone health.  Once oestrogen levels drop post-menopause, the risk of bone fracture increases significantly. According to statistics from the Royal Osteoporosis Society, 1 in 2 women over the age of 50 will develop osteoporosis, with as many dying from fracture-related causes as from lung cancer.

Oestrogen influences bone health by regulating the activity of osteoblasts and osteoclasts. When oestrogen levels decline after the menopause, osteoclast cells start resorbing bone faster than osteoblasts can build it.  This leads to weak bones that are more prone to fracture.

Stress in the Menopause and How to Manage It

The way stress affects us can change during menopause. On top of the usual everyday demands of family, life, and work, our fluctuating hormones risk leaving us more exhausted and frazzled than ever. We may not be able to completely escape stress in the menopause, but there are tips and techniques we can use to manage it…

Stress in the menopause and how to manage it
Natural Nutrition for Perimenopause - What to eat to feel good and stay sane book cover by Sally Duffin Perimenopause Nutritionist

Enjoyed these articles?

You can discover even more nutrition and lifestyle tips for managing perimenopause and menopause in “Natural Nutrition for Perimenopause – What to eat to feel good and stay sane”.

Available on Amazon or direct from YPD Books, this friendly guidebook covers everything from what perimenopause is and how to spot the signs of change to essential nutrients, supplements, toxins, and lifestyle support.

“Reading this book has helped me understand how my diet and lifestyle can support my body through perimenopause.  And it’s written beautifully too.”   Amazon Reviewer

bones, skin, an

5 Clever Tips to Help Your Good Food Habits Grow!

5 Clever Tips to Help Your Good Food Habits Grow!

Starting a Nutrition Plan, giving up caffeine or sugar, or even just quitting chocolate for Lent requires changing your habits around food. 

You have to think about meals in advance and be prepared to say no to foods you previously relied upon.


It can take up to 6 weeks for new habits to become firmly established in your life so it’s useful to have a few tricks up your sleeve to help those habits get a hold.

Get organised

As school teachers like to remind us, “failure to prepare is preparing to fail!” Plan your meals for the week ahead and only buy in what you need to make them. 

Keep healthy snack options like nuts, seeds and dried fruit in your car and desk drawer, carry a re-usable water bottle and keep a couple of herbal teabags with you ready for any unplanned brews.

Only change 1 thing at a time

It’s tempting to try and completely overhaul your meals because you want to feel better – now!  But this can lead to confusion and overwhelm.  Choose 1 thing (what you have for breakfast or what you drink each day) and stick with it for 7 days.  Then add something else to the mix.  This gives you chance to get used to each small change and helps them develop into regular habits.


Deal with Food Pushers

There is always someone saying “go on, just have a couple of biscuits, it won’t kill you!” and they’re right, it probably won’t. 

But it will derail all your good work and keep you trapped in the unhelpful old habits. 

So how to respond to these people?

Simply say: “no thank you, if I eat that I won’t feel well”.  Food pushers are often envious of your willpower and motivation and secretly wish they had the drive to make powerful positive changes to their wellbeing too.

Go off menu

Don’t be afraid to order off menu when eating out.  If you want to have grilled chicken, steamed vegetables and a baked potato but that exact combination is not on the menu, but chicken, side orders of veg and jacket potatoes are, ask if they can put it together for you.  If a dish comes with a creamy sauce and you’re dairy free, ask for no sauce.  Most restaurants are more than happy to help with reasonable requests like this.

Open sandwiches with colourful vegetables for good food habits.

Failsafe Meals

Keep a supply of frozen homemade soups, frozen vegetables and storecupboard staples like eggs, pesto, pasta, lentils, and tinned fish for when you’re too tired to cook anything complicated. 

You can soon put together a mackerel & pasta salad, soup and oatcakes or vegetable omelette to keep your energy levels up.

With a bit of forward planning and preparation you can help your new good food habits settle in and become part of your daily routine. And don’t worry if you have a bad day – this happens to us all, and it doesn’t mean your habits are broken completely. Just start again the next day. Positive change comes from repeated practise, so keep on keeping on and your habits will flourish.

Need more help? 

Click the link below to find out more about my 1-1 support plans tailored to your specific nutrition needs.

Perimenopause – Your Questions Answered

Perimenopause – Your Questions Answered


Perimenopause is a different experience for each of us, yet there are several common themes and questions.

Fortunately, nutrition and lifestyle medicine can be a big help at this time of transition.

From hot flushes and anxiety to low mood and vaginal dryness, making changes to what we eat and how we live can make a powerful difference during perimenopause.

This blog answers some common perimenopause questions, and you can find out more in my new book ‘Natural Nutrition for Perimenopause – What to eat to feel good and stay sane’ available from Amazon, YPD Books, Waterstones online, and Tullivers in York.


Natural Nutrition for Perimenopause - What to eat to feel good and stay sane book cover by Sally Duffin Perimenopause Nutritionist

Heavy Periods

Q. My periods are getting heavier and I’m starting to experience a lot more irritability and anxiety. I’ve just turned 41 – could this be perimenopause?

A. Yes. Some of the first signs of perimenopause are changes to moods, period frequency, and/or period flow. These can start happening in your mid to late 30s. However, many women don’t notice this if they’re taking the Pill or using hormonal implants.
Fluctuating oestrogen levels affect our brain just as much as the ovaries and womb lining. There are oestrogen receptors throughout the brain, and each area responds differently to changes in oestrogen levels. For example, if the amygdala doesn’t receive enough oestrogen we can feel more anxious and fearful. If the hypothalamus (our central temperature regulator) is affected we can experience hot flushes.

Try keeping track of your symptoms to see if they fit into any kind of monthly pattern. To help manage the anxiety. follow the tips below in the Q&A for Anxiety & Low Mood.

Heavy periods can increase your iron loss, so be mindful of regularly including iron-rich foods throughout your cycle:

– Haem iron (animal source) is the most bioavailable form for us to absorb and use, and is found in red meat, poultry, fish, and eggs.
– Non-haem iron is found in animal foods too, and also in vegetables – especially dark green leafy veg; pulses, dried fruits, nuts, wholegrains, and Blackstrap molasses. Combine vitamin C rich foods with non-haem iron sources to aid absorption.

Q. My periods are incredibly painful and heavy and I don’t want to take the Pill or have a coil fitted. Do I have to put up with this until after menopause?

A. Symptoms like this can be a sign of fibroids or endometriosis. Both conditions are influenced by oestrogen and hormone fluctuations. During the early stages of perimenopause we can be in a temporary state of oestrogen dominance. Because we stop ovulating every month, there’s very little progesterone produced to counter-balance oestrogen. Unfortunately it can take months, even years, for fibroids or endometriosis to be diagnosed as many doctors fail to recognise how serious the symptoms are. Ask for a referral to a gynaecologist who will be able to offer the right support and testing. It will also be helpful to get your iron levels checked to make sure the heavy periods aren’t depleting your iron stores.

Hot flushes

Q. Hot flushes are keeping me awake every night. I’m feeling exhausted all day, and having difficulty concentrating at work. What can I do?

A. Hot flushes are one of the most distressing perimenopausal symptoms. I can’t promise these tips will get rid of them completely but they can certainly reduce the severity and frequency:

– Minimise caffeine as much as possible. Avoid it altogether if you can! This means tea, coffee, energy drinks, and chocolate. And decaff versions too – sensitive people can react to the trace amounts of caffeine left in decaffeinated drinks.

– Keep your blood sugar levels balanced by eating within 2 hours of waking, replacing refined carbohydrates (white bread, white pasta, cakes, sweets, biscuits etc) with smaller portions of wholegrain versions, and only snacking if there’s a gap of more than 5hrs between meals.

– Try drinking sage tea or taking sage tablets or tincture. The A.Vogel ‘Menosan’ tablets and tincture are a licensed herbal remedy for managing hot flushes and sweats and can help with temperature regulation.

– Relax! Stress is a big trigger for hot flushes. We can’t always make stress go away but we can change how we respond to it. We can do this by building daily downtime into our schedules. This might mean going for a mindful walk, listening to music, following a guided meditation, doing crafts or creative writing, or simply soaking in a bath with essential oils. Mindful relaxation (as opposed to flopping in front of Netflix) is a great way to build our resilience to stress.

Anxiety & low mood

Q. Since starting perimenopause my moods have been really low. I feel anxious and depressed a lot of the time. I’m also really tired. Is this normal?

A. Mood swings and anxiety can be symptoms of perimenopause, but they can also be linked to other conditions. Have you had your thyroid checked? Depression and fatigue can be signs of an underactive thyroid. Many women start to experience thyroid issues around the time of menopause so it’s worth getting your thyroid hormome levels checked with your GP. Ask them to check your levels of TSH (thyroid stimulating hormone), T4 and T3 (thyroid hormones) and thyroid antibodies. The thyroid antibodies are important because an underactive thyroid may be due to auto-immunity.

If your thyroid is OK, look at ways to manage the anxiety and depression and low energy:

– Follow the blood sugar balancing tips (see previous Q&A) as poor blood sugar balance can worsen mood swings.

– Include at least 3 servings each day of foods rich in magnesium and B-vitamins such as avocado, sweet potato, nuts, seeds, dark green leafy vegetables, poultry, and eggs. These nutrients are vital for mood balance and energy levels.

– Make sure you’re getting enough sleep. Our brains need 7-9hrs each night, with at least 1 hr of that before midnight. Aim to be in bed by 10.30pm-11pm to give yourself the opportunity for a good rest.

– Include mindful relaxation time each day. Yoga, journalling, mediation, spending time outdoors in natural surroundings, and crafts are all known to be beneficial for managing depression and anxiety.

– Swap regular tea and coffee for herbal teas that soothe and support the nervous system. Lemon balm, chamomile, oat straw, valerian, and lavendar are good options.


Q. I’ve been told to eat phytoestrogens. What are they and where can I find them?

A. Phytoestrogens (phyto = plant) are naturally occurring substances found in fruits, vegetables, and grains. They have a similar effect to human oestrogen, but are hundreds and hundreds of times weaker. They’re not a hormone replacement therapy by any means.  Instead, they have a modulating effect on our fluctuating oestrogen levels and may help reduce hot flushes and offer protection to our bones.

There are 3 types of phytoestrogens. The top food sources include:

  • Isoflavones found mainly in soybeans (edamame) and fermented soy products like tofu and miso. You can also find them in chickpeas, aduki beans, kidney beans, and red clover. Red clover seeds can be sprouted – try sprouting them alongside mung beans and alfalfa seeds.
  • Lignans flax seed is by far the richest source, followed by sesame seeds, broccoli, and cashew nuts.
  • Coumestans found in mung bean sprouts and alfalfa sprouts.

Q. Is soy safe to eat? I’ve read so many conflicting things about it!

A. Soy foods certainly are a controversial subject! Unfortunately a lot of the research done on soy uses raw soy extract – not the natural wholefoods recommended for perimenopausal women. The soy foods suggested for perimenopause are the fermented soy products like tofu and miso, and whole cooked soy beans. These foods are part of the traditional diet in Far Eastern countries where women have far fewer menopausal issues. Having said that, no food is entirely suitable for everyone, and some people find soy difficult to digest. If you have any concerns about soy, give yourself peace of mind and enjoy other phytoestrogen foods instead.