Perimenopause—the years leading up to menopause—brings hormonal changes that can cause hot flashes, mood swings, sleep problems, and weight shifts. A new review in The American Journal of Medicine looks at different ways to manage these symptoms using a combination of approaches. The research suggests that eating more plant-based foods, doing yoga and strength training, taking certain supplements, and sometimes using hormone therapy can all help. The key is finding what works best for each person by combining lifestyle changes, nutrition, supplements, and medical treatments with the help of a healthcare provider.

The Quick Take

  • What they studied: Different ways to help people feel better during perimenopause, including diet changes, exercise, supplements, and medical treatments
  • Who participated: This is a review article that looked at many different studies and research about perimenopause management—not a single study with participants
  • Key finding: A combination of approaches works better than any single treatment. Plant-based eating, exercise, mind-body practices, and targeted supplements can reduce hot flashes and improve mood and sleep when combined with personalized medical care
  • What it means for you: If you’re experiencing perimenopause symptoms, you have many options to try. Working with your doctor to create a personalized plan that combines lifestyle changes with other treatments may help you feel significantly better

The Research Details

This is a review article, which means researchers looked at many different studies and research findings about perimenopause to summarize what we know. Instead of doing one new experiment, the authors gathered information from existing research on nutrition, exercise, supplements, and medical treatments to see what actually helps people manage symptoms during this life transition.

The review examined several categories of approaches: what you eat (especially plant-based foods and foods with natural plant compounds), physical activities (like yoga and weight training), supplements (like magnesium and vitamin D), and hormone therapy. The researchers looked at the quality of evidence for each approach to understand which ones have the strongest scientific support.

This type of review is valuable because it brings together information from many different studies, giving us a bigger picture of what works rather than relying on just one study.

Perimenopause affects millions of people and can significantly impact daily life with symptoms like hot flashes, sleep problems, and mood changes. By reviewing all available research, doctors and patients can make better decisions about treatment options. This approach is important because perimenopause is different for everyone, so having multiple evidence-based options allows for personalized care rather than a one-size-fits-all approach.

This review was published in The American Journal of Medicine, a respected medical journal. As a review article, it synthesizes information from many studies rather than presenting new experimental data. The strength of this type of research depends on the quality of studies reviewed and how carefully they were selected. Readers should note that while the review identifies promising approaches, individual studies within it may have varying levels of scientific rigor.

What the Results Show

The research suggests that eating more plant-based foods—especially those containing natural compounds called phytoestrogens (found in soy, flaxseed, and legumes)—may help reduce hot flashes and night sweats. These dietary changes also appear to support heart and bone health during this transition.

Exercise and mind-body practices like yoga and resistance training showed significant benefits for both physical and mental health. These activities helped improve mood, reduce anxiety, and enhance overall well-being during perimenopause.

Certain supplements showed promise for specific symptoms. Magnesium and other minerals may improve sleep quality, while some botanical supplements appeared helpful for mood and sexual function. Calcium, vitamin D, magnesium, and vitamin K2 all support bone health, which becomes increasingly important during this time.

Hormone therapy remains the most effective treatment for severe hot flashes and vaginal symptoms, though it’s not right for everyone. The key finding is that combining multiple approaches—diet, exercise, supplements, and when appropriate, medical treatment—works better than relying on any single strategy.

The review found that sleep disturbances respond well to a combination of lifestyle changes and targeted supplements. Mood changes and anxiety can be improved through regular exercise and mind-body practices like yoga. Sexual function and vaginal health may benefit from specific supplements and, in some cases, localized hormone treatments. Metabolic changes (like weight gain and changes in how the body processes food) can be addressed through strength training and plant-forward eating patterns.

This review builds on decades of research about menopause management. It confirms that hormone therapy is effective for severe symptoms while also validating what many people have discovered: that lifestyle approaches can be powerful tools. The emphasis on combining multiple approaches represents a shift from older thinking that relied primarily on hormone therapy alone. The review also highlights growing scientific support for plant-based compounds and mind-body practices that were previously considered alternative medicine.

As a review article, this research doesn’t provide new experimental data—it summarizes existing studies, which may vary in quality and size. Some supplements mentioned have stronger evidence than others, and what works varies significantly from person to person. The review doesn’t provide specific dosing recommendations for supplements, and individual responses to treatments can differ based on genetics, overall health, and other factors. Additionally, some areas need more research to fully understand effectiveness and safety.

The Bottom Line

If you’re experiencing perimenopause symptoms, consider: (1) Increasing plant-based foods in your diet, especially those with phytoestrogens—this has moderate evidence of benefit; (2) Starting or maintaining regular exercise, including both cardio and strength training—strong evidence supports this; (3) Discussing supplements like magnesium or vitamin D with your doctor—moderate evidence for specific symptoms; (4) Trying mind-body practices like yoga—good evidence for mood and sleep; (5) Talking with your healthcare provider about hormone therapy if symptoms are severe—strongest evidence for hot flashes. Work with your doctor to create a personalized plan based on your specific symptoms and health history.

Anyone experiencing perimenopause symptoms should find this helpful, particularly those who prefer to start with lifestyle approaches before considering medical treatments, or those who want to combine multiple strategies. People with a history of certain cancers or blood clots should discuss hormone therapy carefully with their doctor. Those with specific health conditions should check with their healthcare provider before starting new supplements or exercise programs.

Diet and exercise changes typically show benefits within 4-8 weeks, though some people notice improvements sooner. Sleep and mood improvements from supplements may take 2-4 weeks. Hot flash reduction from dietary changes or supplements usually takes 6-12 weeks. Bone health improvements develop over months to years. Hormone therapy often provides relief from hot flashes within days to weeks. Individual timelines vary significantly.

Want to Apply This Research?

  • Track daily symptoms (hot flashes, sleep quality, mood, energy level) on a 1-10 scale along with what you ate, exercise completed, and supplements taken. This helps identify which combinations work best for your body over 4-week periods.
  • Start with one change: either add one plant-based meal daily, commit to 20 minutes of movement (walking, yoga, or strength training) three times weekly, or add one targeted supplement after discussing with your doctor. Once that becomes routine, add another change.
  • Use the app to create a simple symptom log with weekly check-ins. Every 4 weeks, review which approaches correlated with your best symptom days. Adjust your combination of diet, exercise, and supplements based on patterns you notice. Share this data with your healthcare provider at appointments to guide treatment decisions.

This review summarizes research about perimenopause management but is not a substitute for personalized medical advice. Perimenopause symptoms and appropriate treatments vary significantly between individuals. Before starting any new supplement, exercise program, or considering hormone therapy, consult with your healthcare provider. Some supplements can interact with medications or may not be appropriate for certain health conditions. This information is for educational purposes and should be discussed with your doctor to determine what’s right for your specific situation.