Perimenopause represents a profound transition spanning several years before menopause. During this time, women experience hormonal fluctuations, neurological rewiring, cardiovascular changes, and shifts in gut health. These changes can feel destabilising, but instead of pushing through on autopilot and repeating old lifestyle patterns, this phase offers a unique opportunity to pause, review, and regroup. By slowing down and taking a complete inventory of lifestyle habits, relationships, and self-care across four key health pillars —food and substances, exercise, sleep, and stress management/social connections—women can support their bodies and minds during this transition, laying the foundation for lasting well-being.

The Power of the Pause

Pausing can feel counterintuitive in a world that moves fast, where responsibilities seem never-ending and to-do lists multiply. However, perimenopause invites us to stop and truly listen to our bodies. To pause is not just a symbol. It is a critical action. During this time, we become aware of the subtle (or not-so-subtle) changes—mood swings, hot flashes, and shifts in energy—and acknowledge what no longer serves us. Slowing down and creating reflection space allows us to understand better our needs, a crucial first step in navigating perimenopause with intention. Without pausing, we miss the chance to listen and respond to the body's signals effectively.

Review: Taking Inventory Across Four Health Pillars

After pausing, the next step is to review our lifestyle habits. This process helps us identify areas where small, intentional changes can significantly impact our well-being.

1. Food and Substances

Nutrition plays a pivotal role in managing the hormonal changes that occur during perimenopause. Much of our hormone regulation is influenced by the microbiota ( microbes in our gut), which is shaped by what we eat. Since each person’s microbiota is unique and constantly changing, our dietary choices should be intentional. Consider these points when reviewing your eating habits:

• Balancing hormones through food: Incorporating phytoestrogens, like flaxseeds, soy, and lentils, may help balance fluctuating hormones. Avoiding processed foods, excess sugar, and alcohol can reduce unnecessary stress on the body.

• Anti-inflammatory choices: Eating foods rich in omega-3 fatty acids, such as fatty fish and walnuts, can help reduce inflammation and support brain health. Including at least 30 grams of fibre a day nourishes healthy gut microbes, which in turn help stabilise hormones, reduce inflammation, and ease symptoms. Eating a variety of plants and seeds is essential for healthy microbiota. Making our gut microbes healthy and happy is critical during perimenopause.

• Hydration: Drinking plenty of water helps manage hot flashes and supports overall energy levels.

• Listening to your body: There is no one-size-fits-all diet. Each woman should experiment to find the food combinations that benefit her most. Slowing down helps us better listen to our bodies while adjusting our diets accordingly, fostering a deeper connection to our unique needs.

2. Exercise

Exercise during perimenopause is about more than just maintaining physical fitness—it is crucial for mental clarity, emotional balance, healthy weight and vitality. However, the type and intensity of exercise that worked in earlier years may need to be adjusted to better suit this stage of life. Key considerations include:

• Strength training: As muscle mass declines with age, weight-bearing exercises can counteract this, helping to maintain strength and bone density.

• Gentle movement: Activities like Yoga, Pilates, and Tai Chi are easier on the joints while improving flexibility and balance and reducing stress.

• Moderate aerobic exercise: Walking, cycling, or swimming offer cardiovascular benefits while being gentle on the body.

• Consistency over intensity: Rather than pushing the body to its limits, focus on sustainable routines that support energy levels and reduce stress. Adding joy to your exercise routine is vital to staying consistent and committed.

By tailoring exercise habits to your current needs, you can remain connected to your body while alleviating some perimenopausal symptoms, such as fatigue and mood swings. Again, slowing and listening to how the body responds to your exercise regimen is vital. Pivoting and adjusting while experimenting with different exercise combinations can be fun. Your body is your sounding board; you must pay attention and listen to their response.

3. Sleep

Sleep disturbances are common during perimenopause, with night sweats, insomnia, and frequent waking among the everyday challenges. However, quality sleep is essential for cognitive function, emotional regulation, weight management and overall health. Reflecting on your sleep habits might involve:

• Sleep hygiene: Establish a consistent bedtime routine, reduce screen time before bed, and create a dark, quiet, and cool environment for sleeping. Avoid heavy meals and strenuous exercise late in the day, and expose yourself to natural light in the morning to help regulate your sleep-wake cycle.

• Natural sleep aids: A warm, non-caffeinated, non-alcoholic drink, an evening bath or shower, and supplements like magnesium may help some women relax and prepare for sleep.

• Cognitive-behavioural strategies: Mindfulness, meditation, and deep-breathing techniques can help quiet the mind and prepare the body for restorative rest.

By making small adjustments to sleep routines, women can improve the quality of their rest and restore energy during this transitional time.

4. Stress Management and Social Connections

Perimenopause often brings heightened stress, making effective stress management essential for emotional and physical health. Equally important is nurturing positive social connections, which provide emotional support and foster a sense of belonging and purpose. Reflecting on this pillar involves:

• Mindfulness and meditation: Incorporating mindfulness, yoga, or deep breathing exercises into your routine can reduce stress and calm the mind.

• Journaling and self-reflection: Writing down your thoughts, emotions, and reflections can help you process changes in both body and mind, leading to greater self-awareness.

• Nurturing relationships: Staying connected with supportive friends, inspirational people, and loved ones is crucial during challenging times. Equally important is setting good boundaries with individuals who create friction or stress. Emotional self-awareness and assertive boundary-setting are essential skills for navigating this transition.

• Seeking solidarity: Sharing your experience with other women going through perimenopause can create a sense of community and mutual understanding, helping to alleviate feelings of isolation.

Women can enhance resilience and maintain emotional balance during this life phase by prioritising stress management and cultivating strong, supportive social bonds.

Regroup: Moving Forward with Intention

After pausing and reviewing lifestyle habits across these four health pillars, the next step is to regroup. This involves making intentional choices and crafting a plan for the future. The goal is not perfection but progress—tuning in to what feels right and making minor, sustainable adjustments that honour your evolving needs.

Regrouping may include working with a healthcare professional to adjust your nutrition, beginning a new fitness routine, committing to better sleep hygiene, or deepening your social connections. You might explore psychological support or work with a health coach to develop/increase emotional self-awareness and establish healthy boundaries. The key is to move forward with self-compassion and patience, embracing this transition with agency, confidence and grace.

Embracing the Pause-Review-Regroup Cycle

The beauty of the pause-review-regroup approach is it’s cyclical. Perimenopause and menopause are journeys with many phases and changes. By regularly pausing, reviewing, and regrouping, women can respond to their evolving needs with flexibility and compassion. This reflective process empowers women to embrace these transitions as opportunities for growth, self-care, and deeper self-understanding.

Perimenopause reminds us that slowing down, reflecting, and realigning our habits can be our most powerful actions in a world that constantly pushes us to keep rushing and comparing. By embracing this intentional approach, women can navigate this transition authentically and resiliently, making thoughtful choices that nurture their bodies, minds, and overall well-being.