Perimenopause brings a cascade of hormonal changes that can trigger hot flashes, mood swings, sleep disruptions, weight gain, and bone density loss. For people with ADHD, this can be even worse: A 2025 study found that the women with ADHD experienced more severe perimenopause symptoms than those without.
While diet alone won’t eliminate these symptoms, there are some things that research suggests can reduce how severe your experience is: blood sugar balance, added sugar awareness, phytoestrogens, calcium, vitamin D, omega-3s, magnesium, and adequate hydration.
Balance your Blood Sugar
One of the most impactful dietary changes for perimenopause involves stabilizing blood sugar levels. Estrogen and progesterone affect how your body uses insulin, so during this time of life it is especially important to focus on a balanced plate.
The easiest way to balance your blood sugar is through this formula:
As often as possible, combine protein with your carbs.
Protein and fat help slow digestion and prevent the large blood sugar spikes and crashes that can trigger both worsened perimenopause and ADHD symptoms. For example, a breakfast of full-fat Greek yogurt with blueberries and toast will serve your brain and body better than just toast and blueberries.
To take it a step further, add fiber to every meal. Fiber is in plants: seeds, nuts, beans, fruits, veggies, herbs, and grains. The more fiber we eat, the happier our bodies tend to be: they boost our immune system, help our brains, and even make our cardiovascular system work better… all of which worsen during perimenopause due to the reduction in estrogen.
Be mindful of added sugar
Added sugar is completely fine in moderation. However, as we go through perimenopause, our brains start to need more energy due to the reduction of hormones. This is why many women start to experience high sugar or starchy/bread-based carbohydrate cravings.
It is completely normal to experience this. However, the trick is to become mindful of it and ask yourself these questions:
- When was the last time I had a balanced meal? (protein + fiber + enough calories)
- When was the last time I drank water?
Oftentimes, these sugar or carbohydrate cravings come from a lack of energy in the brain. When we eat mostly carbohydrates, we get quick bursts of brain energy and then a crash of energy that makes us crave more carbohydrates.
When we eat plenty of protein, fiber, and water, it takes longer for us to get the energy to our brain, but then it sustains us for longer periods of time. Of course, feel free to consume sugar—it’s a great source of joy and quick energy when the brain fog really settles in! However, I just encourage you to consider having a cheesestick along with your handful of M&Ms so that the energy you get stays longer.
If you are looking for an exact number to watch for, try to eat 25g or less of added sugar a day. Added sugars are found in many places, such as peanut butter, baked goods, protein bars, fruit juices, jam, drinks, etc. I try to purchase 0-sugar products whenever possible because it adds up quickly! Excess sugar can exacerbate many symptoms of perimenopause, along with ADHD. Again, moderation is fine, but simply being aware of what you’re eating will make a difference.
Phytoestrogens
Phytoestrogens are plant compounds that weakly mimic estrogen in the body. As natural estrogen declines during perimenopause, these compounds may help fill the gap.
The best sources include soy products like tofu, tempeh, edamame, and miso. Flaxseeds are one of the most studied phytoestrogen for perimenopause: I like to get mine ground and add to pancake mix, smoothies, and oatmeal.
Calcium and Vitamin D
Estrogen plays a crucial role in maintaining bone density, so its decline during perimenopause accelerates bone loss. Not just that, but estrogen also affects how we absorb calcium and vitamin D. Take it a step further, and people with ADHD are more likely to be deficient in these two nutrients already, so it’s doubly important.
You can get enough calcium from eating plenty of dairy products, fortified plant milks (soy milk will hit your calcium, vitamin D, AND phytoestrogen needs!), dark leafy greens like spinach, sardines, and almonds. Protein helps us absorb calcium more effectively, along with vitamins B6 and D.
For vitamin D, you can find good sources in salmon, mackerel, and fortified milks. You can also discuss supplementation with your healthcare provider, especially if you live in a region that doesn’t get direct sunlight for multiple months of the year. To learn more about how to get more vitamin D, I have a whole podcast episode here that discusses the research!
Omega-3 Fatty Acids
Omega-3 fatty acids also have good research behind them for helping reduce perimenopause severity. There are multiple types of omega-3s, but the main ones are EPA/DHA and ALA. All of them are important for perimenopause. The EPA/DHA omega-3s help the brain, and the ALA omega-3s help the body.
EPA/DHA is typically only found in fatty fish like salmon, sardines, and anchovies. You can find it in algae in small amounts as well as supplements. However, most supplements are oxidized, meaning they are unhelpful to your brain. Most people are better off simply eating 8oz of salmon every other week.
ALA omega-3s ideally should be eaten every day. You can find them in many seeds and nuts, like flax, chia, hempseed, and walnuts. Your body can also convert ALA omega-3s into the EPA/DHA omega-3s, which is why eating these regularly is important.
Magnesium
Magnesium supports hundreds of bodily processes, including sleep quality, muscle relaxation, and mood regulation. Not just that, but magnesium plays a crucial role in regulating estrogen, potentially making the hormonal shifts feel less severe.
Most people with ADHD don’t eat enough magnesium, and it’s estimated that about 80% of the US population is deficient in magnesium. Rich sources include dark leafy greens, nuts and seeds (especially pumpkin seed), whole grains, legumes, and dark chocolate.
Hydration
Our bodies and brains contain so much water. When we’re dehydrated, they can’t work as well. Aim for 2L of water daily, and more if you’re highly active or experiencing heavy sweating. You can get water from many sources, like tea, sparkling water, and fruits like watermelon. If you struggle to get enough water, check out this article on how to drink more water if you have ADHD.
Make it easy
This all may seem complicated, but it’s easy if you use this formula:
- 3 meals a day
- Protein with every meal
- Plants with every meal
- Fish once a week
- Water
- Seeds and nuts for snacks
And of course, allow yourself to have joy. None of this really matters if it’s stressing you out. Additionally, dietary changes take time to show effects. Give any new eating pattern at least a month or two before deciding it’s not working. If you have ADHD, you might also benefit from a symptom tracker—it’s easy to forget what you were previously experiencing!
Not just that, but nutrition works best alongside other lifestyle factors. Regular exercise, stress management, adequate sleep, and social connection all influence how you experience perimenopause.
This article summarizes current research for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making treatment decisions.
