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Writer's pictureBeth Buchanan

The Power of Nitric Oxide During Perimenopause

Updated: Aug 17


Beet smoothie
Beets and Nitric oxide

Nitric oxide (NO) is a vital molecule in the body that plays a crucial role in various physiological processes. During perimenopause, a time when hormonal changes can significantly impact a woman's health, maintaining adequate levels of nitric oxide becomes even more essential. NO supports a wide range of functions, from enhancing mood and cognitive performance to improving sexual health, managing depression and anxiety, boosting energy levels, and promoting cellular and heart health. Below, we delve into the specific ways nitric oxide benefits each of these areas during perimenopause.


Nitrate Conversion Process:

  • Ingestion: When we consume foods high in nitrates, the nitrates are absorbed into our bloodstream through the digestive tract.

  • Oral Microbiome: The nitrates are then concentrated in our saliva. Here, the oral microbiome (the community of bacteria in our mouth) plays a crucial role. Specific bacteria in the mouth convert nitrates into nitrites.

  • Stomach: When we swallow saliva containing nitrites, the acidic environment of the stomach further reduces nitrites to nitric oxide (NO) and other bioactive nitrogen compounds.

  • Absorption and Circulation: The nitric oxide and its intermediates are absorbed into the bloodstream, where they exert various physiological effects.

Role of Gut and Oral Microbiomes:

  • Oral Microbiome: Bacteria in the mouth, such as Veillonella and Actinomyces, are essential for the initial conversion of nitrates to nitrites. Maintaining a healthy oral microbiome is crucial for efficient nitrate metabolism.

  • Gut Microbiome: A balanced gut microbiome supports overall digestion and nutrient absorption, enhancing the overall nitrate-nitrite-NO pathway.


Mood and Cognition

  1. Enhanced Cerebral Blood Flow: Nitric oxide (NO) increases blood flow to the brain, ensuring a better supply of oxygen and nutrients. This improved circulation supports cognitive function and overall brain health.

  2. Neurotransmitter Regulation: NO influences the release and regulation of neurotransmitters such as serotonin, dopamine, and norepinephrine. These neurotransmitters play critical roles in mood regulation, memory, and cognitive processing.

  3. Neuroprotection: NO has neuroprotective effects, helping to shield neurons from damage due to oxidative stress and inflammation. This protection can mitigate cognitive decline often associated with perimenopause.

  4. Plasticity and Synaptic Function: NO contributes to synaptic plasticity, which is essential for learning and memory. By enhancing synaptic strength and flexibility, NO can improve cognitive performance and adaptability.

Sexual Health

  1. Improved Blood Flow: NO is a potent vasodilator, which means it relaxes blood vessels, enhancing blood flow to sexual organs. This increased circulation can improve arousal and sexual responsiveness.

  2. Lubrication Enhancement: Better blood flow facilitated by NO can also improve vaginal lubrication, reducing discomfort during intercourse and increasing sexual satisfaction.

  3. Erectile Function: In males, NO is critical for achieving and maintaining an erection. For females, improved clitoral blood flow enhances sexual pleasure and response.

  4. Overall Sexual Well-being: Enhanced NO levels can contribute to a general sense of sexual well-being by improving physical function and reducing anxiety related to sexual performance.

Depression and Anxiety

  1. Stress Response Modulation: NO helps regulate the hypothalamic-pituitary-adrenal (HPA) axis, which is involved in the body’s response to stress. Proper HPA axis function can reduce symptoms of anxiety and depression.

  2. Anti-inflammatory Effects: By reducing inflammation in the brain, NO can alleviate depressive symptoms linked to neuroinflammation.

  3. Neurotransmitter Balancing: NO influences the synthesis and release of mood-regulating neurotransmitters, helping to maintain balanced levels and improve mood stability.

  4. Sleep Quality: NO can improve sleep quality by regulating the sleep-wake cycle, indirectly reducing anxiety and depression by ensuring better rest and recovery.

Energy Levels

  1. Mitochondrial Efficiency: NO enhances mitochondrial function, improving the efficiency of energy production within cells. This boost in cellular energy can translate to higher overall energy levels.

  2. Improved Oxygen Delivery: By dilating blood vessels, NO enhances oxygen delivery to muscles and tissues, reducing fatigue and improving stamina.

  3. Enhanced Exercise Performance: Increased NO levels can improve exercise performance by increasing endurance and reducing the perceived effort during physical activities.

  4. Reduced Fatigue: By improving circulation and oxygen utilization, NO can help reduce feelings of tiredness and lethargy, common during perimenopause.

Cellular Health

  1. Antioxidant Properties: NO has antioxidant effects that help protect cells from oxidative damage, a key factor in aging and various diseases.

  2. Regulation of Apoptosis: NO plays a role in the regulation of apoptosis (programmed cell death), which is crucial for eliminating damaged cells and maintaining healthy cellular turnover.

  3. Enhanced Immune Function: NO supports the immune system by enhancing the activity of immune cells, helping the body to fight infections and maintain overall health.

  4. Promotion of Angiogenesis: NO stimulates the formation of new blood vessels (angiogenesis), improving tissue repair and regeneration, and supporting overall cellular health.

Heart Health

  1. Blood Pressure Regulation: NO helps maintain healthy blood pressure levels by relaxing blood vessels, reducing the risk of hypertension and associated cardiovascular diseases.

  2. Improved Endothelial Function: NO is essential for endothelial function, the performance of the inner lining of blood vessels. Healthy endothelium is crucial for vascular health and preventing atherosclerosis.

  3. Reduced Risk of Blood Clots: NO inhibits platelet aggregation, reducing the risk of blood clots and the associated risk of heart attack and stroke.

  4. Anti-inflammatory Effects: NO reduces vascular inflammation, which is a contributing factor in the development of cardiovascular diseases. This anti-inflammatory effect supports overall heart health.


Top 10 Nitrate-Rich Foods

  • Beetroot: Extremely high in nitrates, known for boosting athletic performance.

  • Spinach: A versatile green leafy vegetable rich in nitrates.

  • Arugula: Another leafy green with a peppery taste and high nitrate content.

  • Lettuce: Especially romaine lettuce offers a good nitrate supply.

  • Celery: A common vegetable that can contribute to nitrate intake.

  • Radishes: Not only high in nitrates but also beneficial for digestion.

  • Bok Choy: This Asian green is another excellent nitrate source.

  • Carrots: Known for beta-carotene, carrots also provide a decent amount of nitrates.

  • Cabbage: Both green and red varieties are good for nitrates.

  • Parsley: An herb that can be easily added to dishes to boost nitrate intake.



Including these nitrate-rich foods in your diet can support the conversion to nitric oxide, promoting overall health and alleviating some perimenopausal symptoms. There are also supportive supplements if you just want an extra boost or have trouble getting these nitric oxide supporting foods.


Check out my favorite Nitric Oxide Supplement here:



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