What really helps, according to the research
We collected the research and guidelines on the approaches that most often help in perimenopause: from strength training to hormone therapy. Each one comes with its source, so you can check it and talk it through with your own doctor.
This is collected research and things that helped us and the women in our community, and it is in no way medical advice or a substitute for seeing a doctor. Every body is different, and every decision about therapy, supplements or training should be made together with your own doctor.
Body, food and medicine
Strength training
As oestrogen falls, muscle and bone density are lost. Strength (resistance) training is one of the best documented tools for slowing that down.
Creatine (monohydrate)
It is not “just for bodybuilders”. In peri and postmenopausal women it is increasingly studied for muscle, strength and possible support for cognition.
Magnesium (bisglycinate)
A form of magnesium that is well absorbed and less likely to upset your stomach. It comes up most often for sleep and mild anxiety.
Hormone therapy (MHT/HRT)
For many women the most effective option for hot flushes and genitourinary symptoms. The decision is always individual, with the advice and support of a doctor.
Food
There is no “magic” diet for perimenopause, but a few simple eating habits really can make this time easier.
Talking, and working on yourself
Perimenopause is not only a physical change, it can shake your mood, your sleep, your confidence and your sense of identity. There is no single “correct” school of psychotherapy; what matters more is finding support, and a person, with whom you feel safe and heard.
Psychotherapy
Talking to a professional can make this period much easier, and it is not, and should not be, a “last resort”. It is a foundation of taking care of yourself.
Somatic (body) therapy
When stress and tension “settle into the body”: into the shoulders, the jaw, the breath, the stomach, unexplained aches, sometimes the easiest and most effective place to start is the body itself.
Gestalt therapy
It invites you to be here, in the present moment, to feel what is happening now instead of only analysing the past.
Coaching
When you are not in crisis but you want support to find your footing, at work and in life, coaching can be a useful ally.
The somatic and gestalt approaches are also practised by Iva Jerković, whom we recommend (see below). If you are dealing with depression, anxiety or trauma, please seek help, it is the foundation of your wellbeing.
Practical tips for work and life
These tips are really, really simple, and they can do a lot, at least while symptoms are mild.
Write decisions and thoughts down straight away, and group the hard tasks into the part of the day when you are sharpest, your best part of the day. Ideally use pen and paper rather than a computer.
Layers of clothing (where possible), water always within reach, a small fan on your desk, a spot near a window, all of these can help. Fight for your place in the office.
Plan demanding tasks inside your “energy window” where you can, and make micro-breaks normal, because they reset you. Put them in your calendar.
Try to keep the same routine, a cooler room than before, fewer screens and less caffeine in the evening. Caffeine even in the early afternoon can disturb the quality of your sleep. Choose decaf.
Ask clearly and concretely for what you need: flexible hours and/or place of work, a quiet space, more frequent breaks. Whatever makes sense for you, just be specific.
Saying “no” is self-care. Most of us are used to enduring and pushing through. Now the body will not allow it, or allows it at the cost of our health. Psychotherapy can help a great deal with setting boundaries.
You did not imagine it — you need proper support
Perimenopause is not proven with a questionnaire, that is only there to raise your own awareness; a doctor confirms it. See a doctor if:
- Your symptoms seriously disrupt your sleep, your work or your relationships. Disrupted sleep is an important symptom too.
- You have very heavy, very irregular or painful bleeding, or changes in the length and duration of your cycle.
- You feel persistent mood changes, sadness or anxiety, which can come suddenly and with no visible reason.
- You want to talk about treatment (including hormone therapy) and your options.
- A list of your symptoms and how long they have lasted. If you can, note the intensity and frequency too. For an endocrinologist that is very valuable information.
- Notes about your cycle (length, how heavy, how irregular).
- How the symptoms affect your day and your work.
- Write down the questions you want to ask in advance, because once we are at the doctor we tend to forget all sorts of things.
Our self-check quiz can serve as a reminder for that conversation.
Experts we recommend
Experts we trust from the community's own experience. This is not a paid recommendation, because this is not a business, only the names we would give a friend.
Doc. Dr Ljiljana Marina
Endocrinologist with almost 20 years of experience in women's reproductive health, certified in gynaecological endocrinology; she works particularly on menopause and premature ovarian insufficiency. Co-author of the first large study on menopause in the workplace in Serbia. Biography →
Dr Mina Hagen
PhD in psychology and assistant professor at FMK; she works on reproductive health and the influence of sex hormones on mental wellbeing. Co-author of the first large study on menopause in the workplace in Serbia. Biography →
Dr Antoan Stefan Šojat
Endocrinologist focused on reproductive endocrinology; co-author of the first European guideline on hormone therapy in menopause and a member of the Executive Committee of the European Society of Endocrinology (ESE).
Dr Biljana Živaljević
Gynaecologist and obstetrician (primarius) with almost 30 years of experience; in her Belgrade practice she follows and advises women through peri and menopause. Biography →
Iva Jerković
Somatic Experiencing practitioner, gestalt therapist and counsellor: working with stress, anxiety and the body. ivajerkovic.hr
Do you know a doctor who helped you? Share it with us in the group.
If you feel very unwell, have thoughts of harming yourself or are in crisis, contact a doctor or call emergency services. In Serbia you can reach Centar Srce (support in crisis situations, centarsrce.org). You are not alone!
The best help is being understood
What no piece of advice can do, a community of women who understand you without explanation can.