Menopause is a normal part of ageing, but the hormonal changes that occur during this transition can influence many aspects of health, including nutrition needs, appetite, bone health and metabolism.
You may have heard terms like premenopause, perimenopause, menopause and postmenopause, but what do they mean, and how can the hormonal changes during this time affect your health and nutrition?
While the foundations of healthy eating remain important throughout adulthood, the menopausal transition can be a time when certain health priorities, including muscle, bone, heart, metabolic and digestive health, deserve more attention.
First, what do all these terms mean?
Premenopause
Premenopause refers to the reproductive years before the menopause transition begins. It describes the time from when periods begin until perimenopause starts.
Perimenopause
Perimenopause is the transition leading up to menopause. It can begin several years before the final menstrual period, often in the 40s, although it can begin earlier or later.
During this time, hormone levels fluctuate, periods may become irregular and symptoms can begin. It usually lasts around 4–6 years, although it can range from 2–10 years (1, 2).
Menopause
Here’s the bit that surprises many people: menopause is a point in time, rather than a stage that lasts several years.
Menopause refers to your final menstrual period. It is confirmed retrospectively after you have gone 12 consecutive months without a period, when there is no other medical reason for the change.
It most commonly occurs between 45 and 55 years, with an average age of around 51 (1, 2).
Postmenopause
Postmenopause begins after menopause and continues for the rest of your life. Although some symptoms improve, others can continue for years. This is also an important time to pay attention to longer-term health, including bone and cardiovascular health.
What happens to your hormones?
The hormonal changes of menopause begin during perimenopause, when the ovaries gradually change how they produce reproductive hormones. Oestrogen and progesterone levels can fluctuate considerably before settling at lower levels after menopause.
These hormones have important roles throughout the body, which helps explain why the menopause transition can affect much more than your menstrual cycle (1, 2).
Oestrogen
Oestrogen plays a role in several areas of health, including:
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- Regulating the menstrual cycle and reproductive function
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- Maintaining bone strength
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- Supporting brain function
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- Maintaining bladder and vaginal health
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- Cardiovascular health
As oestrogen levels change, some people experience hot flushes, night sweats, sleep disturbances, mood changes and changes in their menstrual cycle.
Progesterone
Progesterone helps regulate the menstrual cycle and prepares the lining of the uterus for a possible pregnancy. During perimenopause, ovulation becomes less regular, meaning progesterone production can become more variable. After menopause, ovarian progesterone production falls.
What changes might you notice?
The menopausal transition can affect people differently. Some experience few symptoms, while others find that changes significantly affect their daily life.
Common changes include:
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- Menstrual cycle: Periods may become more or less frequent, and bleeding patterns may change.
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- Hot flushes and night sweats: These can occur during the day or night and may affect sleep and quality of life.
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- Sleep and energy: Hormonal changes and night sweats can make it harder to fall asleep, stay asleep or wake feeling rested.
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- Mood and concentration: Some people experience changes in mood, anxiety, irritability, concentration or memory.
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- Changes in body and health: Changes in body composition, muscle mass, bone health and cardiovascular health can occur around this stage of life.
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- Vaginal and urinary symptoms: Lower oestrogen levels can contribute to vaginal dryness, discomfort during sex and urinary symptoms.
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- Digestive symptoms: Some people notice changes in bowel habits, bloating or other digestive symptoms (3).
Not every change experienced during midlife is caused by menopause. Ageing, stress, lifestyle and other health conditions can also contribute.
If you experience new, persistent or concerning symptoms, speak with your GP. Some symptoms associated with menopause can overlap with other health conditions, and your doctor can help determine whether further investigation is needed.
So, does your diet need to change?
There is no need to completely overhaul your diet when you enter perimenopause or menopause. The foundations of a balanced diet remain important throughout adulthood, but this can be a useful time to consider whether you are meeting your nutritional needs and supporting your longer-term health.
Here are six practical areas to focus on.
1. Build balanced meals
Aim to include a combination of protein, carbohydrate, vegetables or fruit and healthy fats across your meals.
You do not need to make every meal perfect. Regularly including a variety of nutritious foods can help you meet your nutritional needs and support energy, fullness and overall health (4).
2. Prioritise protein
Include a source of protein at each main meal, such as:
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- Eggs
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- Greek yoghurt and milk
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- Fish, chicken, or lean meat
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- Tofu or tempeh
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- Beans and lentils
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- Nuts and seeds
As we age, maintaining muscle becomes increasingly important. Adequate protein, alongside regular resistance exercise, can help support muscle health (5).
For more information, read our Muscles & Menopause article.
3. Look after your bones
Bone health becomes increasingly important around and after menopause. Include calcium-rich foods regularly, such as dairy foods or calcium-fortified alternatives.
In Australia, women aged 51 and over are recommended to aim for 1,300 mg of calcium per day (6).
Vitamin D also plays an important role in bone health, so consider your dietary intake and opportunities for safe sun exposure.
4. Eat plenty of fibre-rich plant foods
Aim for a variety of vegetables, fruit, wholegrains, legumes, nuts and seeds. These foods provide fibre as well as a range of vitamins, minerals and other beneficial plant compounds.
If you are not currently eating much fibre, increase your intake gradually and make sure you are drinking enough fluid.
5. Choose heart-healthy fats more often
Include sources of unsaturated fats such as olive oil, avocado, nuts, seeds and oily fish.
At the same time, consider limiting foods high in saturated fat, such as fatty meats, butter and cream.
6. Consider the bigger picture
You do not need to cut out carbohydrates, avoid dairy, follow a restrictive diet or buy expensive supplements to support your health during menopause. A varied, balanced eating pattern, regular meals and adequate hydration are a great place to start.
What if you’re already eating well?
If you already have a balanced diet, you may not need to make major changes simply because you have entered perimenopause or menopause.
Instead, consider whether your current eating habits meet your individual needs, including protein, calcium and fibre, and whether symptoms are affecting your appetite or eating habits.
Your needs will vary depending on your health, lifestyle and goals. A dietitian can help you identify whether any adjustments or additional support may be beneficial.
Menopause nutrition does not need to be complicated
There is no single way to eat during menopause, and your individual needs will depend on your health, lifestyle and symptoms.
The foundations remain simple: eat a variety of nutritious foods, include enough protein and fibre, look after your bones and heart, stay hydrated and pay attention to how you are feeling.
If you’re unsure whether you’re meeting your nutritional needs or would like personalised advice, a dietitian can help you work out what works best for you.
Explore our Menopause Nutrition Series
Over the coming months, we’ll explore weight and body composition, digestion, bone health, blood sugar and insulin resistance, heart health, and how nutrition can support health and wellbeing during menopause.
References
- Australian Government Department of Health, Disability and Ageing. (n.d.). Everyone experiences perimenopause and menopause differently. https://www.health.gov.au/perimenopause
- Jean Hailes for Women’s Health. (n.d.). Menopause: Symptoms, causes and management. https://www.jeanhailes.org.au/health-topics/menopause/
- Shaw, N., Abbott, R., & Pettinger, C. (2025). The volume and characteristics of research on gastrointestinal symptoms in ‘natural’ peri- and postmenopause: A scoping review. Women’s Health, 21. https://pmc.ncbi.nlm.nih.gov/articles/PMC12575958/
- Australian Government, Eat for Health. (n.d.). Australian Dietary Guidelines 1–5. https://www.eatforhealth.gov.au/guidelines/australian-dietary-guidelines-1-5
- Kirk, B., et al. (2023). Consensus guidelines for sarcopenia prevention, diagnosis and management in Australia and New Zealand. Journal of Cachexia, Sarcopenia and Muscle. https://pubmed.ncbi.nlm.nih.gov/36349684/
- Australian Government, Eat for Health. (n.d.). Calcium: Nutrient Reference Values. https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/calcium
