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Delaying infertility and menopause: how can you, and does the paleo diet help?

Menopause is inevitable.  It happens to every person near 50 years of age, and nothing we do short of serious medical intervention will ever stop it.   The body has supremely intelligent biological clocks in it.  When the time comes to stop, it stops.

Yet through experimentation with serious medical interventions, we have learned more and more about the precise nature of that clock.    We have known for some time that estrogen supplements mitigate menopause symptoms.  This is because menopause is largely tied to decreases in estrogen levels, and most of menopause’s irritances such as hot flashes come from having low estrogen levels.    Yet what causes the clock to spring and estrogen to decrease in the first place?

Scientists have recently begun exploring a method of feritlity extension that deals primarily with ovarian implants.   Surgeons can now surgically extract tissue from a woman’s ovaries in her twenties or early thirties, and then re-insert slices of it at regular intervals in later life.  What this does is it keeps the ovarian tissue pumping estrogen.    While sounding vastly unnatural, this is actually a better and more natural method of menopause delay than estrogen supplementation.  This is for two reasons: 1) the estrogen is completely natural, produced by your own body, and 2) this method actually prolongs fertility in addition to acting as a bandaid to symptoms, which is the only thing estrogen supplementation can do.

These experiments have demonstrated that it is the state of tissue health and egg availability that determines the onset of menopause.

The female body starts off with around two million eggs.  By puberty, this number has decreased to 300,000 eggs.    It then releases these eggs slowly over time, with each menstrual cycle.   Usually in the mid-thirties, women’s fertility naturally decreases.  By age 35, 5 percent of women are already infertile.    This means that fertility drops off before menopause symptoms set in, a stage called perimenopause.   This is important for all women thinking about having children into their later 30s and 40s to take note of.   Menopause symptoms might not settle in until until your 50s, but perimenopause can be a significant reality by 35.

Factors that accelerate ovarian aging include…

Poor health

Smoking (by about two years)

Never having children, or having children later in life

Having short menstrual cycles


Low socioeconomic status

A vegetarian diet  (by about two years)


That’s right!  According even to conventional wisdom, vegetarian diets are linked to increased ovarian aging at nearly the same rate as smoking!   No one knows precisely why, though it may have to do with nutrient status, with fiber content of the diet (high fiber can decrease estrogen levels), soy intake, or correlations with restrictive behavior.   None of these ideas are proven– they’re just hypotheses I am posing.

Shortening menstrual cycles and decreasing the age of and amount of time a woman spends pregnant ages the ovaries because it makes them work longer and harder throughout life.  Having a shorter menstraul cycle increases the amount of eggs released over time.   This accelerates the onset of both perimenopause and menopause.


Factors that delay ovarian aging include…

Irregular menstrual cycles

High socioeconomic status

Giving birth early and/or frequently

Moderate alcohol consumption (correlation?)

Longer menstrual cycles

Low stress

Positive health


All of these factors act in contrast to those listed above.  They promote  longer menstrual cycles and/or a decreased amount of menstrual cycles, which means they can decrease the amount of eggs released over a lifetime.  This both prolongs fertility and postpones menopausal symptoms.


Factors that have unknown effects

Weight status


Age of menarche (onset of puberty)

Oral contraceptive use

Endometriosis and/or estrogen dominance


Hypothalamic Amenorrhea


All of these questions are exacerbated by the fact that we’re looking at two slightly different phenomena.  Perimenopause is the onset of infertility characterized by decreased egg production and fluctuated estrogen levels.   Menopause is the cessation of menstruation characterized by very low estrogen levels and almost entirely absent egg production.

Postponing perimenopause requires optimizing the health of your ovaries, preserving eggs, and decreasing amount of menstruation enacted throughout a lifetime.  This means it is entirely possible that having a condition such as hypothalamic amenorrhea–which halts egg production–early in life will delay perimenopause, presuming that the woman has recovered between then and now.     The effect that PCOS might have on this is tricky because each woman is individual.  Some women might still produce a lot of eggs with PCOS, but others might not.

One this we do know with absolute certainty, however, is that increased health, stabilized hormone balance, and decreased stress are all key players in postponing perimenopause.


Postponing menopause, on the other hand, requires not just optimizing the health of your ovaries but optimizing your estrogen production.   How do you do this?  How  do you optimize estrogen production?

This means that having a low estrogen condition such as hypothalamic amenorrhea might accelerate the onset of menopause.  On the other hand, having a high estrogen condition such as estrogen dominance or endometriosis might do the opposite.  This is why eating soy can be helpful for women struggle with menopause symptoms.  It replaces estrogen where otherwise it has gone missing.

Yet, again, those are uncertain phenomena, and no one knows the precise effects of PCOS, hypothalamic amenorrhea, or endometriosis on menopause.  What is certain is that optimized health, reduced stress load, having happy adrenal glands and a normal range of body fatness are all significant boosts to menopausal wellness.


So does the paleo diet help?

Yes.  Being happy and healthy seems to be the best way to simultaneously delay perimenopause and menopause.  The paleo diet is also supremely good for hormone balance, for healthy egg development, and for a regular and fertile menstrual cycle.    This is because a diet built around evolutionary foods evades the insulin-poisoning effects of high calorie, high sugar, and inflammatory meals.   It avoids soy, which is complicated, but can be definitively detrimental to fertility status.  It decreases the risk for reproductive diseases such as PCOS, endometriosis, and hypothalamic amenorrhea, as well as metabolic and autoimmune diseases such as diabetes and celiac.  And it is finally because paleo foods maximize nutrient status, which is necessary for reproductive success (for example, without sufficient calcium and vitamin D, a woman’s eggs will never full develop).

Stress reduction and play are also crucial.  I consider these a part of the evolutionary framework–what does my body demand of me?  Yes, it does demand laughter– so we can throw that on top of the paleo wagon as well.

All of which is to say that a wide variety of factors influence the onsets of perimenopause and menopause.   But the specific health- and reproduction- enhancing and balancing effects of a paleo diet are a serious help.   No studies have come out so far as I can tell that deal with whether or not the average ages of these events have changed in recent years.  I wouldn’t be surprised at all, however, if in coming decades we find out that the landscape of menopause and perimenopause shifts along with the rapid decline in public health.

Does the paleo diet delay infertility and menopause?



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Managing director of Paleo for Women and author of Sexy by Nature.


  1. Regardless of whether a diet like this will affect menopause directly, it certainly will indirectly. Supplying the body with what it needs and keeping your cells clean only works to help you function better. This can only be a good thing, regardless of symptomotology. Having said that, since I’m a man discussing menopause, I’ll just shut up now 🙂

    • It’s okay, Doc. All my doctors are males. As long as male doctors know their craft, female doctors may or may not be any superior. Perhaps female doctors have better position of empathy, but I’ve never jumped ship because I know my male doctors have my best interest at heart. 8-)Aloha & Mahalo.

      • Unfortunately, Ruthie, not all male doctors are schooled in menopause. I went to see a male doctor because my female doctor was unavailable. Looking off my chart he observed, ‘I see you’re 41? You must have entered menopause by now’. I was shocked at his ignorance. Of course this was an older doctor who may have trained at a school ‘in the old days’ when women’s health was not a subject well covered, but still. All sorts of worries started going through my mind about his competence with female patients’ reproductive health.

  2. Your work fulfills such a great need in this community and beyond. Every post is eagerly anticipated and devoured. Thanks Stefani!

    • This was so good for my self-esteem and determination to keep working, friend. Thank you. 🙂

  3. You mentioned falling estrogen several times, but did not mention progesterone at all. Thoughts on fluctuating progesterone levels on delaying menopause?

    • Good point. Estrogen and progesterone tend to decrease in general on the long term in tandem… as with LH and FSH. So increasing levels of any of these hormones can delay menopausal symptoms. On the other hand, estrogen and progesterone are antagonistic to each other, so if one is higher than the other, or if you supplement with one of them more than is decent or ‘necessary’, then that can further disrupt hormone balance.

  4. The body regenerates new cells all the time and as our body cells replace each other, we end up with a new body every couple of years apparently.

    So what we eat and how we feel places a vital role into how our body regenerates. Depending on our lifestyle will determine how new our body becomes as we age…..apparently. 😉

    Thanks for the post…never heard of this before….so thanks. 🙂

  5. Hi, I would like to suggest to all the female readers following a paleo lifestyle and experiencing menopause symptoms that they read Dr John Lees book – What your Doctor May not tell you about Menopause. Also Balancing Hormones by Dr John Lee. It seems many of the horrible systems of Menopause can be rectified by supplementing with Bio Identical Progesterone. The Paleo Diet on this occasion alone wont make you feel 100%

  6. Can ovarian transplants using donor ovarian tissue/estrogen work for extending fertility in someone already experiencing menopause symptoms?

    • An interesting theory… there are a few aspects I don’t know about– whether someone else’s tissue would implant properly, for example, or whether that would be effective as an intervention in menopause. I don’t know if it would be sufficient enough, to be honest, but that’s purely speculation.

  7. To keep from gaining weight while taking contraceptive pills, ask for a pill that contains a lower amount of estrogen. Pills with high doses of estrogen increase your fluid retention, which can give you a bloated, heavier appearance. Talk to your doctor about the different types of pills available and choose one that will compliment your weight loss goals.

  8. Any advice for someone dealing with surgical menopause, endometriosis, adenomyosis, sjogren’s syndrome, hashimoto’s and celiac? My allergies are OUT OF CONTROL after the hysterectomy. I’m on estrogen therapy and the autoimmune protocol but I can’t breathe or sleep no matter what I do!

  9. Would all of this information be the same for someone hoping to stave off premature menopause? I am 18 years old and both my mother and maternal grandmother went through menopause when they were 32 years old, so ideally I would like to optimize my chances of that not happening to me…

    • I’d guess that it can definitely help — particularly making sure you have good nutrition and nutrient quality, and as stress-free a life as possible, too.

  10. Juribe2 brings up my question as well. I had am 40 in surgical menopause due to ovarian cysts AND diagnosed with Celiac after. I am convinced the celiac is the cause of the rest. Now, a year after the surgery, on on estrodial, I am 20 lbs heavier. I ran all this summer on a daily basis and was able to lose 6 lbs. Any advice? Just found the paleo diet and have thought maybe low carb/low starch, but a month of that has seen a loss and gain back of 3 lbs. Is this hormonal?

    • It seems as though it might be, Lori. There’s a lot of complexity there, however, and I’d want to get a full hormone panel done and such with my doctor before trying to change anything. Hormones play a serious role in weight management, however, so I would not be suprrised if some sort of imbalance or deficiency or excess is tipping you one way or the other.

  11. I’m 48 and still cycling regularly (not sure if that includes ovulation). More regular, in fact, in my mid-40s than ever before: which is a sign of change in itself. Never been pregnant. My mom was menopausal at 52 (whatever that means, probably not formal definition of a year’s cessation). However, my mom had one kid at 29 and another at 31. I wish she’d remember more details. Active and healthy, I look and feel young (it gets remarked upon: people who don’t know how old I am compliment me on my skin) but was solid vegetarian from 1999-2009. I’m hoping for another two years before I enter that crucial, milestone, year. Do you think I have a shot?

    • Hi Barb,
      You can easily find out if you’re still ovulating by buying a couple ovulation tests (cheap at the dollar store) and taking them about 10-17 days after the first day of your period. That’s what I do. And yep, I’m still ovulating at 47!

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  15. eating for quick weight loss is the best method in my best choice to lose bodyweight and keep it off the stomach.

  16. While I greatly appreciate the summary of factors affecting menopause, I would really love to citations or a reference section citing the source material used in the summary. As a researcher, I love to follow the trail back to the original research findings and evaluate the methodology, as some studies are more thoughtfully designed and control for confounding factors better than others. Particularly when there is conflicting information about delaying menopause on-line or in other media, it’s nice to be able to compare the source material to develop an independent opinion.

  17. Hey, I’ve enjoyed reading this site but it leaves me wondering about something. Birth control pills stop ovulation. According to what you’ve written here then, a woman who takes birth control pills for 20 years would experience menopause later than other women, if its true that the number of eggs left determine when perimenopause etc begins. So I think this might be incorrect. What is your source?

    • The eggs are one factor but not the only one. The literature so far as I can tell is far from conclusive in this regard. You are right to question it – but this scientists seem to think plays at least SOME role in the final age factor (for example, leftover eggs can just die/be shed nearing the menopausal age, etc)

  18. But how short is too short? I first started experiencing PMS on a low carb Paleo diet and my cycle lengthened from 29 to 40 days. I had PMS, lots of sticky black blood and fevers/body aches.
    Then I started taking DIM and milk thistle and at first my cycle was around 29 days again with very mild cramps only. Now I don’t have any cramps, I can’t even tell that I am going to have my period, I have no breakouts or signs, I just start bleeding red, liquid blood lightly out of nowhere. But my cycles have shortened to 26 days. I now worry that is too short. I will be 32 and already have one child and hope to have another soon so I worry that something is wrong…

    • Oh and I’m not on LC Paleo anymore, I eat plenty of starches now and about 140-220g of carbs a day.

  19. Great article, and very well-written (as always). There’s a dearth of information out there targeted for us older gals. I’m 52, completed menopause 2 years ago, and am still searching for good information about (naturally) managing my body now that all the changes are done.

    Any chance of you writing something targeted at healthy hormonal management for us post-change gals? It’s frustrating to experience loss of sexual interest, dryness, sleep disturbance, etc and have the medical community tell us the only answer is to take a pill.

  20. Like Beth, I’d be interested in what happens postmenopause on a paleo diet.
    For me, I’m 53 next month, no signs of menopause. 11 years had one period (during that time 2 pregnancies and breastfeeding). Anemic (by doctors definition but better since going paleo) but haven’t had a blood test for 6months.

    • Yeah. The eleven year delay is probably what’s got you running a bit late. No worries there 🙂

  21. I am looking on your site for help in figuring out what’s going on with my hormones. Nothing major but PMS (as you defined, brain-mood stuff 2-3 days before Day 1 of cycle). I would like to hear your opinions on this approach, particularly the seed regimen

    I don’t know yet how to determine if I actually have estrogen dominance. In general, I have a slightly shorter cycle than I used to have, which is that I used to have 27-28 day cycle before I had children. It’s now around 26 days.

    I started doing the hormonesbalance seed rotation a couple of cycles ago. I do it religiously so that I can see if it’s making any difference.

    Result? I had an even shorter cycle this time! 24 days this time! Now, this could be a fluke. Every once in a while I have a shorter cycle. Of course that could be very natural. BUT, usually not 24 days and it hasn’t been that short in a long time! So, after 2 months of this seed rotation, I have a short cycle. Curious indeed.

    I am interesting in getting a consult with you to talk over my specifics.

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