Open Thread #8: Perimenopause
Plus, a sneak peek of my Center for BrainHealth talk
Hello, everyone! I am writing to you from my kitchen in Jackson with my dog Orzo draped over my feet. He’s having some health challenges and so I am keeping a close eye on him. I can’t lie, it’s been nice to have him as my constant companion as I write your newsletter and do other work. In fact, Orzo was by my side in his big fluffy bed as I zoomed into the Center for BrainHealth’s women’s conference on Wednesday. (Scroll down below the Open Thread to see some of the slides.) Pease send Orzo some healing vibes!
This month we have been delving into the brain health issues before, during, and after perimenopause—the neuroendocrine transition phase in the years leading up to menopause. As we’ve come to learn, the brain goes through meaningful changes in structure and function during this time. And, these changes have an impact on cognitive health decades later.
If you answered my survey in the last post, thank you! It sounds like it’s time for an Open Thread to get everyone’s questions answered.
If you want to catch up on the mini-series first, check out these posts:
Previously on BHK, we’ve covered a lot related to this topic since women’s health and brain health are intimately linked:
How Perimenopause Affects Metabolism
The Surprising Link Between Hot Flashes and Alzheimer’s
A Recap of Pivotal Studies About HRT and Women’s Brain Health
A Q & A with Dr. Lisa Mosconi about her book The Menopause Brain
Questions about perimenopause? Now I’d love to hear from you:
What are the questions you have about perimenopause and the particular challenges it poses?
What are the questions you have about hormone replacement therapy, which includes estrogen and sometimes progesterone and testosterone?
Are there other topics in perimenopause you’d like to see covered here on BHK?
And for those of you who are post-menopausal, what do you wish you’d known then so you can share with younger friends and daughters?
Please share!
It was such an honor to share the latest science on What To Eat During Perimenopause with the Center For BrainHealth’s Empowering Women Through Brain Health conference earlier this week.
Here are some highlights from my slide deck:
Brains age better on a Mediterranean-style diet. In fact, according to a series of MRI’s by Dr. Lisa Mosconi assessing brain volume in more than 50 brains, Medi-eaters have twice the brain volume as those who follow a Standard American Diet.
When I created the Brain Health Kitchen Food Pyramid for my book, I took into account all the studies to date pertaining to dietary pattern and cognitive health. I recommend more sesrvings of plants than in the Medi and MIND guidelines, take into account data on the benefits of flavonoid-rich foods, and include fermented food based on the importance of cultivating a healthy gut microbiome. Another big difference: I demoted alcohol from being a brain health food to one to limit or avoid.
Eating a Mediterranean-style diet doesn’t always mean eating the exact foods of Mediterranean countries. Many Traditional Heritage Dietary Patterns provide a template of brain-healthy food groups and are devoid of ultra-processed foods. They just aren’t as well studied to prove they are brain-protective. Sometimes finding the best brain-healthy way of eating—for you—means tapping into the food that makes the most sense from a cultural point of view.
When women approach perimenopause, nutrition and health goals shift as their hormones start to fluctuate widely. I’ve written extensively here on BHK about the importance of eating more plants, meeting protein and calcium needs, cutting back on alcohol, limiting ultra-processed foods, and other factors that have heightened importance during perimenopause, if you want to start making some shifts in those areas.
Perimenopausal women have been told for years that certain foods and supplements are the answer to managing symptoms. But here’s the truth: the only way of eating that has been shown to significantly reduce perimenopausal symptoms (like hot flashes and brain fog) is the Mediterranean diet. Here are my recommendations for adjusting MEDI to fit a perimenopausal woman’s increased needs (such as protein and calcium) while dialing back on foods that make symptoms worse (like caffeine and alcohol).
That’s all for today. Paying subscribers—look for an announcement this weekend about a special offer to join me at a brain health retreat this spring. If you’d like to view my presentation at the Center for BrainHealth, please head to their website where the recording will be available soon.
Thank you for being a part of the BHK community! And if you know someone who may be entering perimenopause and would love to learn more, please do share! Have the best weekend, friends.
Love,
Annie
Founding Members: Our next Cooking Class and Kitchen Chat will be on Sunday, March 23, 2025 in the late afternoon. Everyone is welcome—upgrade to Founding Member here to get 4 cooking classes/year.
Brain Health Consultations: If you’d like to meet with me one-on-one, I have a limited number of spots available for consultations. Book a spot here.
Brain Health Retreats Update:
Brain Health, Food, and Fun in Puglia, Italy in April, 2025: SOLD OUT. Join the waitlist by contacting info@viarosaitaly.com.
Sardinia, Italy in May, 2025: SOLD OUT. Join the waitlist by calling 877-298-9677.
Sardinia, Italy in October 2025: Announcing dates soon. Get on the list by calling 877-298-9677.
Brain Health + Fitness in Costa Rica February 5 to 10, 2026: We are already half full. Learn more and reserve your spot here.
I have a GYN appointment this month and I am thinking of asking about HRT. I am in perimenopause and don't have any symptoms that are horrible - I would say mild, but I have gained some weight and working on that. Does HRT address the weight gain issue? I suppose as I transition to menopause my symptoms may increase so HRT now may be the right path.
I am 50 and had my menopause 5 years ago. Is it too late to start HRT?