How can you rebalance your hormones during perimenopause?

Rebalancing your hormones during perimenopause—and more specifically during the premenopausal phase—requires a holistic approach that combines nutrition, stress management, and natural support. By stabilizing fluctuations in estrogen and progesterone, you can reduce debilitating symptoms. This guide explores practical strategies for restoring hormonal balance during your perimenopause.

Understanding Hormonal Imbalances During Perimenopause

Perimenopause is not merely a hormonal imbalance, but also a period of upheaval in the body’s overall balance. Perimenopause is the period that begins before the onset of menopause. This period is accompanied by hormonal changes that are primarily linked to ovarian aging. Communication between the brain (the pituitary gland) and the ovaries also becomes less fluid.

When we talk about perimenopause, we automatically think of falling estrogen levels. However, estrogen isn’t the first hormone to decline. In reality, the imbalance often begins with progesterone. As a reminder, progesterone is produced by the corpus luteum, a structure that forms from the follicle (after the egg is released). If ovulation is of poorer quality, so is the corpus luteum, and its ability to secrete enough progesterone is reduced.

Furthermore, this drop in progesterone often leads to a condition known as“estrogen dominance.” In other words, even if estrogen levels remain constant or decrease slightly, they are still too high relative to progesterone. This imbalance can cause certain symptoms that appear before menstruation (during the premenstrual phase). These symptoms may include breast tenderness or pain, water retention, fatigue, sleep disturbances, digestive discomfort, irritability, or emotional instability. Periods (or menstruation) may also become heavier and be accompanied by more severe pain than usual.

Thus, at the onset of perimenopause, a hormonal imbalance characterized by a relative deficiency of progesterone often develops first.

Understanding this mechanism is the first step toward no longer being a passive victim, but rather becoming an active agent of change.

Adjusting your lifestyle to restore hormonal balance during perimenopause

A healthy lifestyle is the foundation of your hormonal balance. Here are the three fundamental pillars:

1. Hormonal nutrition

To help your liver metabolize and eliminate excess estrogen, focus on cruciferous vegetables. Cruciferous vegetables such as broccoli, black radish, and cabbage are particularly rich in sulfur-containing compounds involved in liver detoxification. Also consider increasing your fiber intake, particularly soluble fiber, to ensure optimal bowel elimination, thereby preventing eliminated hormones from recirculating into the bloodstream in excessive amounts. Soluble fiber is found particularly in oatmeal, legumes (beans, chickpeas, lentils), fruits like apples (rich in pectin), chia seeds (to be soaked), …

Tip: When broccoli is raw, it contains an enzyme (myrosinase) that converts some of its compounds into molecules that are beneficial to the body (such as sulforaphane). Cooking largely destroys this enzyme, and even though cooked broccoli remains nutritious and easier to digest, it loses some of its optimal protective effect. It is therefore advisable to mix a little raw broccoli (grated, for example) into your plate with cooked broccoli.

A balanced intake of fatty acids, including sufficient amounts of omega-3 fatty acids—particularly EPA and DHA, which are found in fatty fish (such as sardines, mackerel, trout, etc.)—provides overall support for the balance of the female cycle.

2. Insulin Regulation

Insulin is the "master" hormone. If its levels are unstable due to a diet that’s too high in sugar, it can disrupt progesterone production and increase abdominal fat storage. Choose foods with a low glycemic index that are high in fiber (such as whole-grain cereals, legumes, sweet potatoes, etc.) and protein-rich breakfasts to promote good blood sugar balance. A protein-rich breakfast helps prevent morning energy slumps and promotes energy, focus, and well-being.

3. Sleep and the circadian rhythm

Lack of sleep is a source of stress for the body and can disrupt the secretion of cortisol (known as the “stress hormone”). Chronic stress, combined with high cortisol levels, can disrupt ovulation and affect progesterone production. Going to bed before 11 p.m., avoiding screens (blue light) in the evening, and adopting a relaxing bedtime routine (reading, meditation, herbal teas, etc.) can help optimize your ability to fall asleep and improve sleep quality. It’s also important to get exposure to natural light first thing in the morning, as this helps synchronize your biological clock (circadian rhythms).

Tip: Especially in winter—and even throughout the rest of the year—using photobiomodulation (infrared light), particularly in the morning upon waking, can help reset your circadian rhythms. Infrared light also helps reduce stress while supporting overall well-being. It has proven positive effects on immunity, energy levels, and inflammation.

4. Engaging in regular physical activity

Physical activity is a key component of maintaining overall good health. During perimenopause, this recommendation remains just as relevant. However, it is important to learn to listen to your body and adjust your workout routine according to the different phases of your cycle.

At the start of the menstrual cycle, right after your period, during the follicular phase, estrogen levels gradually rise. This period is often associated with a surge of energy, motivation, and drive. It’s a good time to engage in more dynamic and intense activities, such as running or more demanding sports. In short, it’s a phase that’s conducive to peak performance.

Conversely, after ovulation, during the luteal phase (the end of the cycle before menstruation), it is common to experience increased fatigue, heightened emotional sensitivity, or low mood, particularly when there is an imbalance in estrogen and progesterone levels. This period is better suited to gentler, restorative activities: walking, yoga, meditation, Pilates, or light strength training.

The key, then, is to adjust the intensity of your physical activity to the rhythm of your cycle, while paying attention to how you feel and what your body needs at that moment.

Natural Solutions for Hormonal Balance During Perimenopause

Nature offers powerful tools for smoothing out hormonal peaks and troughs. Many women are turning to natural solutions for a successful transition into perimenopause.

• Chaste tree (Vitex) is the go-to herb for supporting progesterone production and relieving premenstrual syndrome symptoms. It helps regulate the menstrual cycle and can be taken throughout the entire menstrual cycle.
• Magnesium is essential during perimenopause; it calms the nervous system and can help improve sleep and energy levels. It is a mineral essential for hormone production and regulates the conversion of vitamin D into its active form.
• Adaptogens (Ashwagandha, Maca): These plants help the body adapt to stress. Maca, in particular, is known for supporting libido and energy levels. Maca may help reduce hot flashes. Maca is best taken in the morning with breakfast. Ashwagandha is a plant with soothing and adaptogenic properties, known for its stress-regulating effects. It is most often taken in the evening to promote relaxation and prepare the body for sleep. However, depending on individual sensitivity and response, it can also be taken in the morning to energize the body.
• Evening primrose oil (or borage oil) is rich in omega-6 essential fatty acids such as GLA and DGLA, which have anti-inflammatory properties. Evening primrose oil or borage oil helps keep the skin supple and hydrated, and may reduce symptoms associated with premenstrual syndrome.
• B vitamins, such as vitamins B9, B12, and B6, support many key physiological processes, particularly in the production and elimination of hormones. Vitamins B9 and B12 are involved in an essential process called “methylation.” This methylation occurs throughout our cells, and the liver remains a key organ and a major metabolic hub where this process is highly active. Hepatic methylation plays a key role in the elimination of hormones such as estrogen and certain derivatives.

When should you see a specialist?

Although natural adjustments often work, you shouldn’t face physical or emotional distress alone. A consultation with a specialist or a gynecologist is recommended if:

1. Your periods are becoming irregular: heavy bleeding (menorrhagia) that can lead to severe anemia (iron deficiency)
2. The psychological impact is significant: if anxiety or episodes of depression are getting in the way of your social or professional life.
3. Insomnia becomes chronic: chronic sleep deprivation has a significant impact on your quality of life and makes your days difficult.

A complete blood workup—which may include measurements of FSH, LH, estradiol, and progesterone (measured at its peak, i.e., 7 days after ovulation), can help the practitioner determine whether treatment with bioidentical hormones (such as bioidentical progesterone) is necessary in addition to dietary adjustments and targeted supplementation.

A ferritin test may also be performed to detect any iron deficiency (which can be exacerbated by heavy menstrual bleeding).