In this month’s column, functional medicine dietitian, Alexandra Daccache, answers your health questions with evidence-based advice and compassionate wisdom.
Dear Alexandra,
I’m Lily, 49, and struggling with perimenopause symptoms that seem to be getting worse each month. I’ve just started taking progesterone, but I’m feeling constantly bloated, anxious, and tired. My skin is becoming dry and showing signs of aging that weren’t there before. I’m trying to stay positive, but some days are really hard. What nutrition changes could help me feel more like myself again?
— Lily
Alexandra’s Response:
Dear Lily,
Thank you for sharing your perimenopause journey with us. First and foremost, I want you to know that you’re not alone in these experiences. The symptoms you’re describing—bloating, anxiety, fatigue, and skin changes—are common during this transition, and there’s much we can do nutritionally to support your body through this time.
For skin health and energy support:
- Prioritize omega-3 fatty acids from wild-caught fish like salmon and sardines, which help maintain skin elasticity and reduce inflammation
- Increase vitamin C intake through bell peppers and berries to support collagen production
- Consider incorporating collagen-rich bone broth into your diet, which may help improve skin hydration and texture
- Significantly reduce sugar intake, as it contributes to inflammation that affects both gut health and skin appearance
For bloating relief:
- Remember, addressing bloating isn’t about eating less—it’s about eating right
- Introduce fermented foods like yogurt, kefir, and sauerkraut to support gut health
- Consider following a low-FODMAP diet (reducing certain class of carbohydrates that are more difficult for people to digest) temporarily if bloating persists
- Practice mindful eating—chew thoroughly and avoid multitasking during meals
For hormonal balance:
- Incorporate foods rich in phytoestrogens like flax seeds, soy products, and legumes, which may help ease the hormonal transition
- Ensure adequate protein intake (aim for 25-30g per meal) to maintain energy levels and support muscle mass
- Drink plenty of water—at least 8-10 glasses daily—to combat dry skin and support elimination
- Reduce processed foods, refined sugar, caffeine, and alcohol, all of which can exacerbate perimenopause symptoms
For better sleep and reduced anxiety:
- Establish a regular sleep routine with consistent bedtime and wake times
- Limit screen time at least one hour before bed
- Include magnesium-rich foods like dark leafy greens, nuts, and seeds in your evening meals to promote relaxation
- Practice stress-reducing techniques such as deep breathing, meditation, or gentle yoga
Start by making gradual changes rather than overhauling your entire diet at once. Monitor how your body responds and adjust accordingly. Everyone’s perimenopause journey is unique, and finding the right nutritional balance may take some experimentation.
Remember that nutrition is just one piece of the puzzle. Regular physical activity, stress management, and working with healthcare providers on hormonal support are equally important aspects of navigating this transition with grace.
I hope these suggestions help you find relief, Lily. Remember, this is a natural transition, not something to endure alone. I’m here to support you through this journey.
Do you have a nutrition question for Alexandra? Submit your questions in the comments section below, and your concern might be featured in our next issue of Timeless ME magazine.
Alexandra Daccache is a functional medicine dietitian and health expert, dedicated to transforming lives through a holistic, personalized approach to wellness.
📱 Instagram: @alexandradaccache
