Thriving Through Perimenopause: Embracing Lifestyle Medicine with Dr. Ivana Matic-Stancin

How stress affects how you transition into menopause 

As a Lifestyle Medicine GP with a special interest as a perimenopause doctor, I witness the transformative power of lifestyle medicine in empowering women to navigate this often-misunderstood phase of life. 

Recently, I spoke with Dr Shamistra Barathan on her Six Hats podcast about how stress affects how you transition into menopause.

Perimenopause, characterised by fluctuating hormones and a cascade of physical and emotional changes, can feel like a rollercoaster ride. However, instead of succumbing to the negative connotations often associated with menopause, I believe it can be a time of positive transformation and empowerment.

Listen to the podcast here:

Stress: The Silent Saboteur in Peri-Menopause

Stress is ubiquitous in modern life, but its impact can be magnified during perimenopause. The hormonal fluctuations of this stage can heighten our stress response, making us more susceptible to its detrimental effects. Chronically elevated stress levels can exacerbate various perimenopausal symptoms, including:

  • Hot flashes and night sweats: Stress hormones can trigger the release of norepinephrine, a neurotransmitter that contributes to hot flashes, and disturbed serotonin production contributes to hot flashes.
  • Anxiety and mood swings: The delicate hormonal balance in the brain is further disrupted by stress, leading to feelings of anxiety, irritability, and mood swings. As mentioned above, serotonin production, which is our mood hormone, is usually disrupted during this hormonal transition.
  • Sleep disturbances: Difficulty falling asleep, staying asleep, and experiencing disrupted sleep architecture are common consequences of chronic stress.
  • Weakened immune system: Stress can impair the immune system, making us more susceptible to infections and hindering the body's ability to fight off illness. Declining estrogen is making the immune system less robust, as estrogen is a very important hormone in a strong immune response that women have compared to men. Declining estrogen and chronic stress are not good for a healthy immune system.

Recognising the Signs of Perimenopause

While the exact timing of peri-menopause varies for each woman, it typically begins in the early to mid-40s and can last for four to ten years. Recognising the subtle signs of this transition is crucial to seeking informed support and guidance. Common symptoms include:

  • Irregular menstrual cycles: This is often the first noticeable change, with periods becoming lighter, heavier, or skipping altogether.
  • Hot flashes and night sweats: These sudden bursts of heat and sweating can be disruptive and contribute to sleep disturbances. Not all women experience hot flashes. Some women feel very cold and experience shivering. 
  • Mood swings, anxiety, and fatigue: Hormonal fluctuations can impact mood, leading to feelings of irritability, anxiety, and low energy.
  • Changes in sleep patterns: Difficulty falling asleep, waking up frequently, and disrupted sleep quality are commonly reported.
  • Brain fog and difficulty concentrating: Some women experience difficulty finding words, decreased focus, and difficulty managing two tasks simultaneously.
  • Bloating and changes in digestive patterns are common.
  • Skin sensitivity, rashes, new acne, and facial hair are some of the changes that some women can experience while transitioning through perimenopause.
  • Vaginal dryness: Reduced estrogen levels can lead to dryness, discomfort, and decreased libido.
  • Urinary frequency or frequent UTIs

The Importance of a Perimenopause Diagnosis

While these symptoms can offer clues, a diagnosis from a qualified peri-menopause doctor is vital. This involves a thorough medical history, a physical examination, and, potentially, blood tests to rule out other medical conditions. With a clear diagnosis, women can explore personalised management strategies.

5 Key Lifestyle Pillars for a Thriving Perimenopause

By embracing evidence-based lifestyle medicine with the guidance of a peri-menopause doctor, women can empower themselves to navigate this transition. Here are three key pillars to incorporate:

1. Prioritising Quality Sleep

  • Good night sleep starts in the morning: expose your eyes to outdoor light for 5-10 minutes every morning.
  • Establish a consistent sleep schedule: Go to bed and wake up at a similar time each day, even on weekends, to regulate your body's natural sleep-wake cycle.
  • Create a relaxing bedtime routine: This can include taking a warm bath, reading a relaxing book, or practising relaxation techniques like deep breathing or meditation.
  • Optimise your sleep environment: Ensure you switch off from technology and social media at least one hour before bed. Ensure your bedroom is dark, quiet, cool, and clutter-free to promote restful sleep.
  • Aim for 7-8 hours of quality sleep each night: This allows the body and mind to rest, repair, and function optimally.
  • Spending some time in nature, in green or blue areas, greatly impacts the quality of our sleep and overall health. 

2. Mindful Alcohol Consumption

  • Limit alcohol intake: While an occasional glass of wine may be okay, excessive alcohol consumption can disrupt sleep, worsen hot flashes, and contribute to anxiety and mood swings. In fact, alcohol consumption that a woman used to be able to tolerate in her 30s can be too much for the liver and for her body to deal with during her 40s and 50s. 
  • Be mindful of timing: Avoid alcohol close to bedtime, as it can interfere with sleep quality. Avoid alcohol whenever you can. After the hormonal transition, it's not your friend anymore.

3. The Power of Movement

  • Engage in regular physical activity: Three types of exercise are vital for perimenopausal women. Aerobic, strength and restorative exercise. Aerobics includes brisk walking, swimming, cycling, dancing, or any activity you enjoy that makes you puff.
  • Incorporate strength training: Include activities like weightlifting, resistance bands, or bodyweight exercises to maintain muscle mass, bone density, and overall physical function.
  • Restorative exercise is the gentle stretching of ligaments, muscles, and body fascias like yoga, pilates, and Thai chi. 
  • Embrace variety: Choose activities you enjoy to ensure long-term consistency. 
  • Any movement counts gardening, walking to the shops, playing with kids/grandkids or pets, or taking stairs instead of escalators or lifts.

4. Eat whole plant-based food

Noninflamatory diet like the Mediterranean diet is very important during this life transition. Minimise or eliminate processed food and drinks. Left 20%of your belly empty after each meal; its known as Hara hachi bun me in Japan.

5. Stress management

Slow down to notice what the stressors in your life are. Examine which one you can eliminate, which you can minimise, and which you need to learn how to deal with in a new way. 

Making these lifestyle adjustments can be an excellent way to start managing peri-menopause symptoms, identify what might help mitigate some of these, and start to thrive in menopausal years.

Dr Ivana Matic-Stancin is a Melbourne-based medical doctor (GP) with over 25 years of clinical medical experience working with people of all ages, from various socio-economic, ethnic, and cultural backgrounds, and suffering from different medical conditions. Her passion lies in advocating for women's health, with a specific focus on promoting well-being during the peri/menopausal transition. It's a crucial period for women in their 40s, 50s, and 60s, marked by hormonal shifts that can lead to various symptoms and health concerns. Unfortunately, these significant changes are frequently overlooked or downplayed. Ivana is a member of AMS and BMS (Australian Menopause Society and British Menopause Society), and she offers a unique combination of medical expertise in women's health, particularly perimenopausal health, with coaching skills to help women make important lifestyle changes to transition easier and healthier in the third stage of their lives.


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