Unlock the Hidden Triggers Sabotaging Your Perimenopause—#7 Will Shock You!

So, you’ve suddenly found yourself navigating the swirling storm of perimenopause—bummer, right? But guess what? You’re definitely far from flying solo. Every year, nearly 2 million women in the U.S. step into this wild hormonal ride that kicks off before menopause officially pays a visit. It’s that confusing in-between spot where estrogen and progesterone start playing tricks on your body, throwing hot flashes, mood swings, and wonky periods into the mix. Now, here’s a little food for thought: just like those pesky period cramps that sneakier sodium and grease seem to aggravate (we’ve all been there, eyeing those fries!), your lifestyle choices can seriously turn up the volume on perimenopause symptoms. Lucky for us, Health & Her has done the heavy lifting, revealing the top triggers that can worsen those frustrating symptoms—and trust me, knowing these can tip the scales back in your favor. Ready to uncap the mystery and reclaim some control? Let’s dive in. LEARN MORE

If you’ve recently entered perimenopause, know you are not alone. Nearly 2 million women begin perimenopause in the U.S. each year—the transition phase before menopause when hormone levels begin to fluctuate, often causing symptoms like hot flashes, mood changes and irregular periods.

Like most developmental stages women experience throughout their lifetime, symptoms can sometimes be worsened by lifestyle choices. Think of your period, for example. If you experience cramps, you may find that although you often crave indulgent savory foods like french fries while on your period, the sodium and grease actually worsen your cramps. The symptoms women experience during perimenopause can also be worsened by lifestyle choices, or “triggers.” Thanks to new research from women’s hormonal health brand Health & Her, we now know what the biggest perimenopause symptom triggers are.

What exactly is perimenopause?

Before we dive into the triggers for perimenopause symptoms, let’s first understand what perimenopause is.

“Perimenopause is the transitional phase from a woman’s reproductive years to menopause,” says Brynna Connor, MD, Healthcare Ambassador at NorthWestPharmacy.com. “It’s marked by a period in which hormone production—particularly estrogen and progesterone—begins to fluctuate and gradually declines.” Perimenopause usually begins in a woman’s 40s, most commonly between ages 40 and 44, but it can start as early as the mid-30s or as late as the mid-50s in some cases.

If you haven’t experienced perimenopause yet, you likely have questions about what symptoms to expect.

Dr. Connor says the most common symptoms are:

• Vasomotor symptoms, meaning the hot flashes and night sweats
• Hormonal changes
• Mood and cognitive changes
• Joint pain
• Muscle aches 
• Disrupted sleep 
• Hair loss 
• Dry and/or thin skin
• Increased risk of urinary tract infections
• Decreased libido

However, this list is not exhaustive of all the symptoms someone may experience when entering perimenopause.

“Much like the age at which they enter perimenopause, the symptoms can vary greatly from person to person, caused by individual hormone fluctuations, genetic predisposition, and someone’s overall health and lifestyle,” says Dr. Connor. 

10 triggers that worsen perimenopause symptoms

Health & Her identified the top 10 triggers for perimenopause symptoms impacting women in the U.S., outlined in the stats below. We spoke to experts to learn more about what makes these triggers impactful and what you can do for each one.

Caffeine

The stat: “More than half of the women (54%) reported they started to experience more sensitivity to caffeine as they progressed through perimenopause.” 

The reason: “The increased sensitivity can result in feeling hot flashes anxiety and difficulty sleeping,” says Christine Greves, MD, gynecological surgeon at Orlando Health Winnie Palmer Hospital for Women & Babies.

The fix: “If you find you start to experience more sensitivity to caffeine as a result of entering perimenopause, you may want to consider drinking decaf, or switching to green tea as it has less caffeine,” says Dr. Connor. “Coffee has approximately 80-120 mg of caffeine while green tea has approximately 25-50 milligrams of caffeine, as well as the added benefit of antioxidants that can fight arthritis, inflammation and cancer, as well as aid in overall heart health.”

Stress at work

The stat: “Just over half (53%) of the women reported stress at work is a major trigger for them. Examples of work stressors might be meeting a tight deadline, presenting in front of clients, attending performance reviews and even company social events.”

The reason: “Certain work-related stress, like tight deadlines and other aspects causing stress at work, may trigger symptoms, such as hot flashes [and] anxiety,” says Dr. Greves. 

The fix: “Incorporate ‘micro-recovery’ into your life—5-minute breathing breaks, walking meetings, or a short walk at lunch,” says Cathleen Brown, DO, board-certified ob-gyn and medical director at telehealth company Winona. “Consider consulting a therapist or coach who understands midlife transitions. Hormonal changes are natural, but emotional support is essential too.”

A stressful event

The stat: “Just under half (49%) of the women in our research reported this as [a] trigger alongside anxiety, poor concentration, memory loss and even heart palpitations. It is not necessarily the event that exacerbates symptoms but how a woman responds to that event.” 

The reason: “Stress can increase cortisol levels, which can result in contributing even more to a hormonal imbalance, which can result in increased feelings of menopausal symptoms like hot flashes,” says Dr. Greves. 

The fix: “Reflective exercises, writing in a journal and reframing reduce ruminating,” recommends Dr. Brown. “There is strong evidence to support cognitive behavioral therapy for helping women cope with this stage with increased resilience.”

Sugar

The stat: “Sugar posed a moderate issue for 49% of the women.”  

The reason: “During the perimenopausal and menopausal stage, it is harder to regulate glucose in general,” says Dr. Greves. “Therefore, eating more sugar can result in higher feelings of fatigue and hot flashes.”

The fix: “Reduce consumption of processed, high-sugar foods, swapping out whole foods with natural sugars like fruit (at the very least, start by making healthier choices by opting for foods with minimal added sugars),” says Dr. Connor. “Because sugar spikes can exacerbate mood swings, fatigue and/or bloating, incorporating the Mediterranean diet can stabilize and maintain blood sugar and hormone levels.”

Fatty food

The stat: “The research found fatty foods were reported as moderate trigger for 36% of the women.”   

The reason: “Depending on what it is, certain foods can impact hormonal levels by increasing the estrogen levels,” says Dr. Greves. “When those decline, the symptoms are exacerbated.”

The fix: “Limit deep-fried food and/or meals that are high in saturated fat,” says Dr. Connor. “I’d make this recommendation for anyone looking to be healthier, not just women who are in perimenopause. Opting instead for healthy fats like avocado, nuts, fatty fish like salmon, and cooking with olive oil.” 

Very hot weather

The stat: “In the research, 36% of women reported hot weather as a severe trigger.”   

The reason: “During this period, the hypothalamus, which controls the body’s temperature, is more sensitive to temperature changes,” says Dr. Greves. “So, if the temperature increases, the symptoms may be even more intense.”

The fix: “Stay indoors in air-conditioned spaces during peak heat, dress in breathable layers and use fans and/or cooling towels to help neutralize the heat, as it can exacerbate hot flashes, skin irritation and even fatigue,” says Dr. Connor. “Wear lightweight, moisture-wicking fabrics (particularly if you have to go outside) and hydrate to help mitigate the effects.”

Very cold weather

The stat: “One third of women found cold weather a trigger, setting off symptoms of joint aches, skin changes, dizziness and digestive issues.”   

The reason: “If you were wearing more layers of clothes due to cold weather, along with hormonal changes in your body, the hot flashes may be intensified along with night sweats due to the sensitivity during this time,” says Dr. Greves. “Also, the fatigue and joint changes may be more noticeable because of the reduced sunlight and physical activity.”

The fix: “Exercise or movement plays a role—stretch or practice yoga to enhance circulation,” says Dr. Brown. “Moisturize skin with creams containing ceramides, and supplement with omega-3 or collagen for joint and skin health.”

Alcohol

The stat: “Twenty-seven percent of the women taking part in the study found they experienced an issue with alcohol tolerance.”  

The reason: “Alcohol can interfere with the regulation of hormones so that combined with perimenopause can exacerbate the symptoms,” says Dr. Greves. 

The fix: “Reduce the quantity and/or frequency of alcohol consumed,” says Dr. Connor. “Again, this is something I would say to everyone, or switch to non-alcoholic alternatives.”

Dietary changes

The stat: “Just over 22% of women noted dietary changes were a mild or moderate trigger for them, resulting in digestive issues, bloating and skin-related symptoms.” 

The reason: “Hormones can even affect the gut,” says Dr. Greves. “The fluctuation of estrogen and progesterone can result in certain foods that normally wouldn’t cause bloating to perhaps become more noticeable, like beans, if that never bothered you before.”

The fix: “Because sudden changes to your diet can cause bloating, digestive issues, and even skin reactions, introduce changes gradually and monitor for any difference that you notice in either the way you feel, the way your digestion works, or how your skin responds,” says Dr. Connor. “If you find that you’re having increased sensitivity to foods, you can try removing them individually (such as eating gluten-free or dairy-free), again monitoring how your body feels or responds. You can also always talk to your doctor about any dietary changes they might recommend as you enter perimenopause.”

Illness

The stat: “Twenty-one per cent of American women stated that sickness was a trigger of perimenopause. Many women find that they are more vulnerable to getting colds and flu during perimenopause.” 

The reason: “Usually when someone is sick, that may involve inflammation,” says Dr. Greves. “Estrogen is anti-inflammatory. When the estrogen is going down during this perimenopausal period of time, the symptoms of menopause may be even more noticeable.”

The fix: “Because perimenopause isn’t just about fluctuating hormone levels, it’s about supporting the whole body (especially the nervous and metabolic systems) through the transitory period, you should prioritize rest, hydration, and adequate nutrition, and resume activity only as your body allows, starting with gentle physical activity like walking,” says Dr. Connor.

Ultimately, perimenopause symptoms impact different people differently. You can avoid all of these habits and emotional states and still be affected, but knowing what behaviors and actions may increase your likelihood of experiencing symptoms puts the power back in your hands.