By Sarah Curran MSc, Exercise & Nutrition | Lifestyle Medicine
Let’s get one thing clear from the start,you’re not going mad, and you’re definitely not alone.
The symptoms that creep up in your 40s or suddenly smack you in your 50s? They’re real. The mood swings, the hot flashes that feel like your internal thermostat is broken, the night sweats that ruin your sleep, and the sudden memory blanks? Also real. For many women, menopause is a full-body experience, not just the end of a menstrual cycle.
In my coaching work, I’ve helped women who feel like their energy, motivation, body composition,and even their sense of identity,have gone completely off track. So if you’re feeling overwhelmed, it’s not your fault. Let’s break it all down and go through what’s actually happening and, more importantly, what you can do about it.
First Things First: What Is Menopause?
Menopause is officially diagnosed when you haven’t had a period for 12 consecutive months. But the process begins long before that in a stage called perimenopause, which can last up to 10 years. During this time, your estrogen and progesterone levels fluctuate wildly before declining for good.
That hormonal shift triggers a wide range of symptoms some obvious, some subtle, and some downright infuriating.
Common Menopause Symptoms (a.k.a. the Ones You’re Probably Dealing With)
Here’s a list of the most frequently reported symptoms, with an honest note: you might not get all of them, but if you’re getting some, it can still affect your quality of life massively.
- Hot flashes and night sweats (also known as vasomotor symptoms): These affect up to 75% of women and can last for years.
- Sleep disturbances: Waking multiple times during the night, or struggling to fall asleep at all.
- Mood changes: Anxiety, irritability, crying for no reason, or just feeling like you’ve lost your spark.
- Fatigue: The kind that doesn’t improve no matter how many early nights you get.
- Brain fog and memory issues: Losing your train of thought mid-sentence or forgetting names you’ve known for years.
- Weight gain, particularly around the belly, and difficulty losing fat despite doing “all the right things.”
- Joint and muscle aches, sometimes mistaken for arthritis.
- Dry skin, thinning hair, and brittle nails.
- Low libido and painful sex due to vaginal dryness.
- Urinary urgency or infections that seem to crop up more often than before.
It’s a lot, I know. And because some of these overlap with other health issues (like thyroid dysfunction or depression), many women are either misdiagnosed,or worse, dismissed.
What’s Causing All This?
The main issue is the drop in estrogen, which plays a role in hundreds of functions in the body,from temperature regulation and mood balance to collagen production and muscle maintenance. When estrogen levels decline, it can feel like your body is in revolt.
That hormonal shift also affects testosterone, dopamine, and serotonin, which explains the fatigue, mood changes, and motivation dips. It’s not just in your head,it’s in your hormones.
Hormone Therapy: Is It Worth It?
Menopausal Hormone Therapy (MHT),also called HRT,remains the gold standard treatment for vasomotor symptoms, vaginal dryness, and prevention of osteoporosis.
For women under 60 or within 10 years of menopause, with no history of breast cancer, heart disease, or clotting disorders, MHT can be a game-changer. It typically includes estrogen (with or without progestogen depending on whether you still have a uterus), delivered via a patch, gel, spray, or tablet.
But HRT isn’t for everyone, and that’s okay. Some women don’t want it, some can’t take it, and some are put off by outdated scare stories. The good news? There are more options than ever before.
Non-Hormonal Treatment Options
If hormone therapy’s not for you, here are evidence-based alternatives:
- SSRIs and SNRIs (like paroxetine or venlafaxine): Originally used as antidepressants, these can reduce hot flashes and night sweats by up to 60%.
- Gabapentin: Often prescribed for nerve pain, but also helpful for night sweats and improving sleep.
- Clonidine: An older medication that helps with vasomotor symptoms but can have side effects like dry mouth or low blood pressure.
- Vaginal treatments: Local estrogen, DHEA, or ospemifene can help with dryness and sexual discomfort without raising systemic estrogen levels.
- Emerging drugs: Neurokinin B receptor antagonists are a new class of non-hormonal meds that show promising results for hot flash relief.
Mind-Body Therapies That Actually Work
One of the most underrated treatments? Cognitive Behavioural Therapy (CBT). It’s been shown to significantly reduce how bothersome hot flashes feel and is great for managing anxiety, low mood, and sleep problems.
Other therapies with growing support:
- Hypnotherapy
- Mindfulness meditation
- Acupuncture
- Yoga
These may not eliminate symptoms completely, but they can reduce stress reactivity and help you cope better.
The Power of Lifestyle: Why It Still Matters
Lifestyle changes won’t necessarily “cure” menopause symptoms overnight, but they’re crucial for long-term health and symptom relief.
Exercise
- Resistance training maintains muscle, supports bone density, and improves metabolism.
- Cardio supports heart health and boosts endorphins.
- Even 20 minutes of movement a day can improve mood and reduce fatigue.
Nutrition
- Focus on high-quality protein, omega-3s, leafy greens, calcium-rich foods, and phytoestrogens (like soy).
- Reduce ultra-processed foods, sugar, and alcohol, which can worsen inflammation and trigger hot flashes.
- Support gut health with fibre and fermented foods,it plays a bigger role in hormone metabolism than most people realise.
Sleep Hygiene
- Create a wind-down routine, reduce screen time at night, and avoid stimulants late in the day.
- Use cooling sleepwear and fans to manage night sweats.
Stress Management
- Cortisol is your menopause anti-ally. Chronic stress makes symptoms worse.
- Daily walks, breathwork, journaling, or 10 minutes of meditation can make a real difference.
The Takeaway: You Don’t Have to Suffer in Silence
Menopause is not “just something to get through.” It’s a whole-body shift that deserves real attention and personalised care.
Whether you choose HRT, non-hormonal meds, mind-body tools, or lifestyle strategies,or a combination of all four,there’s help available, and your symptoms are valid.
No one-size-fits-all solution exists, but with the right support, you can feel like yourself again,or even better.
Want Support?
If you’re navigating this stage and need real, evidence-based help from someone who understands how nutrition, fitness, and hormones all interact, I’m here. I blend strength coaching, personalised nutrition, and lifestyle medicine to help women regain control of their energy, body, and mood.
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