When it comes to my perimenopausal clients, I don’t like to focus on weight loss.

However, for my clients it’s often a welcomed side effect of addressing hormone imbalances, calming the nervous system, and regulating the body’s processes.

I believe there are far more important things to worry about than weight loss when it comes to our health and frankly, our lives.

As Glennon Doyle famously said,  “Your body is not your masterpiece — your life is.”

However, around age forty, the 10-15 year period of perimenopause begins. 

What is perimenopause? Perimenopause is the 10-15 year period, usually beginning around the age of forty when menstrual periods become irregular as menopause approaches.

Perimenopausal women can have difficulty with weight loss and it can affect their health and their lives. Fortunately, I have 7 strategies for perimenopause weight loss that can help improve overall health for 40-55-year-old women.

I prefer to focus on supporting my client’s heart, hormone, bone, and brain health. As well as their mental focus, energy, enthusiasm, sex drive, strength, power, and joy.  Often when we focus on these things, perimenopause weight loss is a welcome side effect.

In fact, in the last session of our Healthy Perimenopause to Menopause Transition Program, one of the women lost 12 pounds in 6 weeks. To her the weight loss was not her goal, it was just a side effect of regaining her morning energy, having decreased pain, and suffering from fewer autoimmune disease symptoms.

All benefits of having balanced hormones.

Best of all she felt hopeful and back in control of her health and her energy after feeling like she was sleepwalking through her life for years.

Weight is just one small factor when women decide to improve their health.

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Strategies to Balance Your Hormones for Optimal Health and Weight Management

What To Do To Optimize Perimenopausal Health and Get The Side Effect of Perimenopausal Weight Loss?

Recognize that weight loss is a warning signal for a deeper hormonal imbalance.

When women gain abdominal weight, that is a specific sign that their blood sugar balance and insulin levels are off, and that their estrogen levels are decreasing (Davis, et al., 2012).

The increased abdominal fat gain in people in their 40s and 50s is associated with an increased risk of cardiovascular and metabolic diseases. Associated diseases include type 2 diabetes, heart attacks, strokes, reduction in health-related quality of life, and reduced sexual function.

Implementing lifestyle strategies that optimize estrogen levels, improve insulin sensitivity, and stabilize blood sugar are key to abdominal fat loss in perimenopause.

perimenopausal woman of color doing yoga in a park

How to Optimize Estrogen Levels in Perimenopause

1. Exercise Less and Less Intensely

This might sound counterintuitive… exercise less to lose weight?

People with elevated stress hormones such as cortisol or epinephrine can worsen these hormone imbalances by overexercising and exercising too intensely.

When stress hormone levels are dysregulated, sex hormone levels (including estrogen) drop.

Thus, I strongly recommend continuing to exercise as there are a myriad of benefits. But, focus on walking or moderate intensity cardio for about 150 minutes per week (outdoors is ideal.) Then, add 2-5 bouts of strength training per week.

Use heavy weights with support from a skilled professional, but don’t over do the weight lifting intensity. And, balance all exercise with joy by choosing exercise you like, and recovery, such as adding a few sessions per week of Yin Yoga, Tai Chi, or leisurely hikes.

2. Balance stress with mindfulness, meditation, prayer, or spending time in nature

Restorative activities are essential to balance the stressors of modern life.

In a randomized controlled trial, mindfulness meditation was associated with a significantly greater anxiety reduction measured by the Clinical Global Impression of Severity and Improvement and the Beck Anxiety Inventory (Hoge, et al., 2013).

3. Reduce stress by reducing stressors, interactions with stressful people, delegation, and speaking up about work stress

In my health coaching practice, my clients are overburdened with the expectations of daily life. Heavy work hours, responsibilities, work-life balance challenges, relationship stress, and hesitation with delegating responsibilities all contributed to burnout.

In the 2017 Women in the Workplace Study, researchers found that on average, 54% of women do all or most of the household work compared to 22% of men. This gap worsens when couples have children.

Partnered women with children are 5.5 times more likely to do a majority of the housework compared to male partners. This disparity continues even when women are primary breadwinners (McKinsey & Company & LeanIn, Women in the Workplace, 2017).

Advocating for your partner to take on more household chores could save your health, especially through the perimenopausal and menopausal years.

4. Take Maca

Research indicates that adding maca to your smoothies or supplement regimen has been shown to improve estrogen levels, balance hormones, and reduce perimenopausal symptoms, specifically related to low estrogen, (Lee et al., 2011 & Meissner, et al., 2006).

My personal favorite maca product was created by a gynecologist, Dr. Anna Cabeca, Mighty Maca Plus.

Estrogen is not the only hormone to consider. Because all of the hormones interact with each other, understanding the balance between them is key.

Stress, thyroid, and reproductive hormones all play important roles in perimenopause and menopause weight loss, pelvic pain, chronic pain, insomnia, fertility issues, hot flashes, fatigue, and more.

How to Improve Insulin Sensitivity and Blood Sugar Balance in Perimenopause

5. Time Restricted Feeding and Intermittent Fasting.

  • Data trends indicate that eating meals at regular intervals, preferably earlier in the day, can help improve weight loss efforts and reduce health risks in perimenopausal women, (Hutchison, et al., 2017 & Nair & Khawale, 2016).
  • Research indicates there are potential health improvements to intermittent fasting. Some potential improvements include weight loss, reduced cancer risk, cancer treatment support, improved metabolic issues in PCOS, cardiovascular disease, and depression.
  • It’s especially important to stop eating earlier in the evening. Aim to stop eating by 6 or 7pm, and even earlier in the winter when it gets dark earlier.

6. Low carbohydrate nutrition.

  • Nutrition plans that emphasize a high intake of vegetables, fiber, healthy fats, and proteins have been shown to improve metabolic risk factors, including insulin resistance and blood sugar instability (Hu et al., 2012).

7. High-Intensity Interval Training. (HIIT)

  • Women who add HIIT training to their workout program show benefits of improved insulin sensitivity, fat loss, and improved growth hormone levels for building muscle (Boutcher, 2011).
  • I realize that earlier in this post,  I recommended decreasing the frequency and intensity of exercise. This recommendation is only for people who have balanced their stress hormones and built up their stress resilience.
  • Understanding hormone balance is key. The stress, thyroid and reproductive hormones all play important roles in perimenopausal symptoms.
  • Blood sugar regulation and stress hormone balance must be optimized in order to reduce symptoms of perimenopause and menopause. Healthy stress resilience is a prerequisite to increasing exercise intensity, especially during this time of significant hormonal transition.

Read More Perimenopause and Menopause Blogs

Solutions for Vulvovaginal Atrophy

Exercise and Hormones in Women Over 40

Managing Sleep Issues in Midlife Women



Boutcher, S. H. (2011). High-Intensity Intermittent Exercise and Fat Loss. Journal of Obesity, 2011, 868305. http://doi.org/10.1155/2011/868305

Davis SR, Castelo-Branco C, Chedraui P, Lumsden MA, Nappi RE, Shah D, Villaseca P. (2012) Understanding weight gain at menopause, Climacteric, 15(5), 419-29. doi: 10.3109/13697137.2012.707385.

Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J., … Simon, N. M. (2013). Randomized Controlled Trial of Mindfulness Meditation for Generalized Anxiety Disorder: Effects on Anxiety and Stress Reactivity. The Journal of Clinical Psychiatry, 74(8), 786–792. http://doi.org/10.4088/JCP.12m08083

Lee MS, Shin BC, Yang EJ, Lim HJ, Ernst E. (2011) Maca (Lepidium meyenii) for treatment of menopausal symptoms: A systematic review, Maturitas, 70(3), 227-33. doi: 10.1016/j.maturitas.2011.07.017.

Meissner, H. O., Mrozikiewicz, P., Bobkiewicz-Kozlowska, T., Mscisz, A., Kedzia, B., Lowicka, A., … Barchia, I. (2006). Hormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (I) Biochemical and Pharmacodynamic Study on Maca using Clinical Laboratory Model on Ovariectomized Rats. International Journal of Biomedical Science : IJBS, 2(3), 260–272.

Hutchison, A. T., Wittert, G. A., & Heilbronn, L. K. (2017). Matching Meals to Body Clocks—Impact on Weight and Glucose Metabolism. Nutrients, 9(3), 222. http://doi.org/10.3390/nu9030222

Hu, T., Mills, K. T., Yao, L., Demanelis, K., Eloustaz, M., Yancy, W. S., … Bazzano, L. A. (2012). Effects of Low-Carbohydrate Diets Versus Low-Fat Diets on Metabolic Risk Factors: A Meta-Analysis of Randomized Controlled Clinical Trials. American Journal of Epidemiology, 176(Suppl 7), S44–S54. https://doi.org/10.1093/aje/kws264

Nair, P. M. K., & Khawale, P. G. (2016). Role of therapeutic fasting in women’s health: An overview. Journal of Mid-Life Health, 7(2), 61–64. http://doi.org/10.4103/0976-7800.185325


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Dr. Jessica Drummond,


Dr. Jessica Drummond, DCN, CNS, PT, NBC-HWC, is the founder and CEO of The Integrative Women’s Health Institute, The Outsmart Endo Health Coaching Program, and the creator of the Women's Health Coach Certification.

She is passionate about caring for and empowering people who struggle with women’s and pelvic health concerns. She is equally passionate about educating and supporting clinicians and wellness professionals in confidently and safely using integrative tools to transform women’s and pelvic healthcare.

Dr. Drummond has two decades of clinical experience as a licensed physical therapist, licensed clinical nutritionist, and board certified health coach working with women with pelvic pain, including endometriosis, vulvodynia, and bladder pain syndrome. She brings a unique, conservative, and integrative approach to supporting women to overcome hormonal imbalances, and chronic pain conditions.

She is a sought after international speaker on topics such as integrative pelvic pain management, natural fertility options, optimal hormone health, menopause, and female athlete nutrition. Dr. Drummond was educated at the University of Virginia, Emory University, Duke Integrative Medicine, and Maryland University of Integrative Health.

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