A Beginner’s Guide to The Menopause

Menopause isn’t for the faint of heart, but it does impact every woman at some point. No matter which stage of menopause you’re in, knowing what you should expect is the key to surviving the menopause with a smile. That way, you can learn how to manage your menopause symptoms at home, naturally.

So, with that in mind, let’s dive into the beginner’s guide to the menopause. Let’s survive (and thrive) during the menopause!

What is the menopause?

Menopause is when your periods have stopped for good. It’s diagnosed after one year without a menstrual period, any vaginal bleeding or spotting.

Every woman is different, and they reach menopause at unique stages. That said, the average age to reach menopause is 52.

Menopause is a natural part of life (but just ‘cause it’s natural doesn’t mean it’s without struggle!) when your ovaries stop producing reproductive hormones.

There’s also such a thing called surgical menopause (induced menopause). Surgical menopause is when menopause occurs sometimes overnight, after surgery or medical treatment.

What are the stages of menopause?

There are three stages of menopause. You’ll naturally go through each of these menopause stages, unless your menopause is induced medically:

1. Perimenopause: otherwise known as menopause transition. Perimenopause can start around 8 to 10 years before reaching menopause. This is when your body naturally transitions and creates less oestrogen. Perimenopause usually happens in your 40’s and can last from months to a good few years.
2. Menopause: once you’ve reached menopause itself, you no longer have periods and haven’t for at least a year. Your ovaries won’t release eggs and your body won’t produce as much oestrogen.
3. Postmenopause: After menopause, you’ll reach the postmenopause stage, and this is where you’ll stay for the rest of your life. For some women, most of your symptoms will have lessened or even disappeared when you’re post-menopausal. Others have ongoing symptoms, particularly urinary and vaginal symptoms. That said, it is possible to have mild menopause symptoms for a fair few years in postmenopausal.

What’s the difference between perimenopause and menopause?

“How do I know if it’s perimenopause or menopause?”

So many women have wondered which stage of menopause they’re in. So, let’s take a look at the main differences between perimenopause and menopause itself.

Perimenopause, according to the NHS, is when you’re showing menopause symptoms but still having periods. You are perimenopausal until you have had no periods or vaginal bleeding for 12 consecutive months.

What are the symptoms of menopause?

Menopause symptoms crop up during perimenopause and can sometimes stay until you’re post-menopausal. With the drastic change in hormones, women can experience physical and emotional symptoms.

The good news is that these symptoms don’t last forever and there are ways to lessen the severity.

So, with that in mind, let’s take a look at menopause symptoms and why they happen.

Common symptoms of menopause

There are many different symptoms of menopause. Every woman is unique and will, therefore, experience menopause in a unique way. Some lucky women get away with very few and mild symptoms. Others experience a whole range of menopause side effects.

The most common symptoms of menopause include:

• Anxiety
• Mood swings and irritability
• Difficulty sleeping and night sweats
• Low sex drive
• Discomfort during sex
• Feeling like you’ve lost your identity and self-confidence
• Hair loss and/or thinning
• Headaches
• Hot flushes
• Brain fog
• Vaginal dryness
• Weight gain

Keep in mind that there are many more symptoms of menopause. That said, these are the most commonly experienced ones.

Physical symptoms of menopause

Physical symptoms of menopause may (note: may – every woman is different!) include:

• Hot flushes and night sweats
• Difficulty sleeping
• Tender breasts
• Changes to your skin (often itchy or dry)
• Changes to your hair
• Fatigue
• Vaginal dryness
• Loss of libido
• Migraines
• More intense PMS
• Feeling achey
• Bloating
• Urinary issues
• Weight gain

Hot flushes and night sweats in menopause

Hot flushes (also known as hot flashes) and night sweats are common menopause symptoms. They affect around 80% of menopausal women.

Usually, they’ll start around the chest and then spread out to your upper chest, neck and face. Sometimes, they can spread all over the body.

So, what do hot flashes feel like in menopause? The best terms to describe a hot flush are burning and overheating. The skin might also redden and you might get a little (or a lot) sweaty.

You’ll probably notice a pattern when we say that every woman’s experience of menopause is unique. It’s no different for hot flushes.

Some women might get hot flushes that only last a short amount of time. Some get mild flushes. Others could have more than 15 per day.

If you’re wondering “what causes hot flushes in menopause?” – us too. The reality is that we don’t actually know, 100%.

We do know that the lower amount of oestrogen levels will influence the temperature regulation part of the brain. So, there’s a strong link there.

Studies have shown higher levels of stress and anxiety can increase intensity and frequency of hot flushes. Of course, food choice will also have an effect on your hot flushes as well as alcohol intake and caffeine.

Struggling to sleep during menopause

Sleep disturbance can actually start during perimenopause, and it’s a pretty common side effect. In women aged fifty to sixty four, 25% suffer with some form of sleep problem. Whether that’s insomnia or struggling to stay asleep, not getting your forty winks can lead to even more side effects. Soon we’re wondering whether it’s menopause or lack of sleep that’s causing us to feel like crap!

Not to mention, a lack of sleep can lead to further health problems. There’ve been links between sleep issues and heart disease, weight gain, mood swings and disorders and diabetes.

So, what causes sleep disturbance in menopause? Sleep problems during menopause can be due to:

• Drastic changes to your hormone levels (mainly melatonin, cortisol and prolactin)
• Mood disorders
• Hot flashes
• Night sweats
• Other physical symptoms (eg: restless leg syndrome)
• A change to your circadian rhythms (cycles that help to regulate your sleep and waking)

Psychological and emotional symptoms of menopause

Some of the psychological and emotional symptoms of menopause include:

• Feeling frustrated and irritated
• Feeling anxious and panicked
• Finding it tricky to concentrate
• Brain fog
• Low moods and mood swings
• Forgetfulness
• Feeling overwhelmed

How does the menopause cause memory loss?

One of the most frustrating menopause symptoms is memory loss and forgetfulness. But why does it happen?

Essentially, when your oestrogen levels drop, it’ll impact the way your brain functions. Oestrogen works to control how much fuel your neurons receive.

It’s these neurons that help to build memory and communication from the brain. So, if the cells inside the brain aren’t getting enough fuel (provided by oestrogen), they won’t perform as well.

Let’s also remember that sleep deprivation and disturbance is one of the most common symptoms of menopause. If you’re not sleeping properly, your memory and ability to focus will be impaired, too.

The good news, though, is that it calms down after your menopause. For the majority of women, memory loss and a lack of focus will go away once your hormones balance. For those whose memory loss continues to be a problem, there are things you can do.

What causes menopause?

Menopause is caused by lower oestrogen levels and a loss of ovarian follicular function. Realistically, though, menopause is a natural part of life. It will happen to every woman – whether that’s surgically induced menopause or natural passing of time.

How is menopause diagnosed?

So, how do doctors confirm menopause? How can you tell if you’re menopausal?

GPs can often diagnose menopause based on symptoms and, frequently, correlate this to age. However, you can also get a blood test to measure your hormone levels if you’re between the ages of 40 and 45. Testing is less useful after 45 and not routinely used to diagnose menopause.

If you’re under 40 but seeing menopause symptoms, you can request a blood test to diagnose premature menopause.

Managing menopause symptoms

Now that we know some of the symptoms of menopause, let’s take a look at how to manage them. As a menopause nutritionist myself, I believe we can heal with a meal. However, there are lots of other methods you can practice to lessen the severity of your menopause symptoms.

How to cope with menopause symptoms

Each menopause symptom presents an opportunity to put specific practices into place to help lessen the severity of them. So, let’s look at common menopause symptoms and how to manage them.

How to cope with hot flushes in menopause naturally

Hot flushes are one of the most common symptoms of menopause, and they can be draining. So, how exactly do you cope with hot flushes during menopause?

1. Identify and avoid triggering hot flushes

Hot flushes are unpredictable and can crop up whenever they fancy. That said, you might find that you trigger a hot flush after eating spicy food, having a few alcoholic drinks, consuming caffeine or smoking.

The first step is to identify your triggers by keeping track of when you experience your hot flushes. That way, you can pinpoint any patterns and triggers and avoid them.

2. Wear light clothing and opt for more breathable layers

Experiencing hot flushes? Time to update your wardrobe!

Go for clothes that are made of breathable material and fabrics. Think: cotton, silk and thinner, softer wool. These fabrics will help keep you cooler. Opt for looser clothing rather than tight so your body has room to breathe.

During the winter when the temperature drops, it can be tricky to dress for hot flushes as well as the colder atmosphere. So, you want to go for lots of layers. That way, you can stay warm but easily cool down by removing layers if a hot flush makes itself known.

3. Thin layers on your bed will help with hot flushes and night sweats, and keep that fan on!

Just as you should opt for lots of layers in terms of clothing, the same goes for your bedding. The cooler you can make your bedroom before bed, the better.

Swap out your one duvet for a few, lighter blankets. Make sure both your blankets and sheets are made from natural fabrics. If in doubt, go for 100% cotton.

You can also find cooling pillowcases, too. Think: the cool side of the pillow but all the time. Even without menopause, that sounds like a win to me!

A fan in your bedroom, even in the winter, is a good idea for when night sweats set in. You can stay warm under your blankets while the fan is on, but if night sweats do crop up, it’s better to have your fan on and ready to help cool you down.

4. Keep a fan and cooling spray with you for when you have a hot flush

You can pick up really cheap battery-powered fans online to keep in your bag (or you can go classic with a hand-held fan.) While you’re shopping for a fan, it’d be worth grabbing a small spray bottle that you can fill with water to spritz on yourself when a hot flush hits. Don’t underestimate the little things! They can cause big relief.

4. Hot baths feed hot flushes. So, swap to having lukewarm showers instead

A hot bath can trigger hot flushes, made worse when your body temperature is already elevated. So, switch the hot baths for lukewarm showers.

How to cope with sleep issues during menopause naturally

Not sleeping properly can really elevate other symptoms and make you feel dreadful. While it’s a pretty common side effect of menopause, there are things you can do to help get your forty winks.

1. Keep your room as cool as possible

One of the leading reasons why you’re not getting a proper night’s (or month’s) sleep is because of night sweats.

So, you’re going to want to keep your body temperature low. Keep your windows open, pop on your fan (even in the winter) and use layers of light blankets rather than a big duvet.

The National Sleep Foundation suggests keeping your room temperature between 15.6 – 19.4°C. It’s easier to warm up than to cool down – especially during a hot flush – so it’s important to keep your room as cool as possible.

2. Invite darkness – hello Darkness, my old friend!

It sounds obvious, doesn’t it? That darkness will help you sleep? But I’m also talking about lights that flash up on your phone, TV and other electronic devices. You want your room to be completely dark, so turn off your phone altogether or switch it to airplane mode to get a good night’s sleep.

3. Eat dinner earlier and don’t snack for an hour before bed

A study in 2021 discovered that, if you eat within an hour before going to bed, your chances of waking up are higher. Don’t go to sleep on a full stomach!

4. Keep a symptom tracker

Not only could eating too late cause your sleep to be disrupted, but you might also get heartburn and acid reflux. Those pesky issues can keep you up at night, too. So, all in all, ditch the midnight snacks for a better night’s sleep!

How to cope with vaginal dryness during menopause naturally

Vaginal dryness is uncomfortable to say the least. Vaginal dryness causes some real issues during sex, including pain and discomfort.

Vaginal dryness happens during menopause because the tissues inside the vagina get thinner and get irritated easily. You can blame the decline in oestrogen for that (as is the case for so many other menopause symptoms!).

The good news is, though, that there are things you can do to cope with vaginal dryness during menopause. Let’s take a look.

1. Use a water-based lubricant before sex

Water-based lubricants are so much better during menopause as they’re less likely to irritate the vagina. That said, they do dry up quicker, so you’ll need to reapply a fair few times.

You can use silicone-based lubricants if irritation isn’t a problem. They do last longer and are more slippery than your water-based alternative. However, as vaginas are more sensitive during menopause, pay attention to your symptoms. Make the switch if need be.

2. Put those perfumed products back on the shelf

Perfumed products are never a good idea for the vagina: specifically not when you’re menopausal. Opt for non-perfumed soaps instead.

3. More sex will improve blood flow and keep your vagina (and yourself) happy!

Be generous with lube. If it’s comfortable and pleasurable for you, the more sex you can have, the better blood flow will be. That’ll keep things healthier down there and also strengthen your relationship or marriage, too. Everyone wins!

A quick note, though: if sex is uncomfortable or painful, you should never force yourself to continue. If you’ve had vaginal dryness for several weeks and it’s impacting daily life, it’s important to see your GP. If you notice any unusual discharge or bleeding or you’re bleeding after sex, book a Doctor’s appointment.

How to cope with mood swings during menopause naturally

Mood swings when you’re menopausal feels like PMS but on steroids. You can go from laughing to crying to screaming in the space of a minute, and it can cause real issues inside the home.

So, let’s take a look at how you can manage mood swings during menopause.

1. Don’t underestimate the importance of knowledge!

As with so many other menopause symptoms, finding triggers and patterns puts you in control. Then, you can put practices in place to avoid the symptoms taking over.

In terms of mood swings, a tracker or diary is even more important. Record your symptoms daily – even if you don’t experience any. Not only will this help inform you of your triggers, but when working with specialists, they can put the pieces of the puzzle together.

You’re also able to see if your mood swings correlate to other symptoms. For example, if you’ve recorded a lack of sleep for 3 nights in a row and your mood is low, it makes sense that sleep is the problem.

2. Don’t underestimate how food can improve your mood swings during menopause

Low mood can be cured with food!

Prioritise eating healthily, consuming less caffeine and sugar to avoid energy spikes and crashes. You don’t have to compromise with flavour, though. If you’ve got a sweet tooth, take a look at my Chocolate Avocado Moose recipe: the perfect menopause dessert.

If you’re deficient in certain vitamins – think B12 and magnesium – it can manifest with low moods. That’s why it’s so important to eat plenty of foods that are rich in these specific nutrients. Leafy greens and vegetables, whole grains and eggs, for example, will help to stabilise and improve mood.

Begin your day with a smoothie or juice (take a look at my Berry Smoothie post: delicious berries for dealing with menopause symptoms!).

Add oily fish to your shopping list, too, due to it being rich in omega-3. On top of this, foods that are high in oestrogen-like compounds (known as phytoestrogens) should be incorporated into your diet. Foods like soya beans and lentils and pulses can help reduce menopause symptoms as a whole, specifically low moods.

3. Quit the booze. Alcohol can intensify low moods during menopause

There’s a pretty unhealthy association with alcohol and managing strong emotions. Alcohol is a sedative and can worsen depression, which – clearly – lowers your mood.

I’m not saying you need to cut it out entirely. Keep moderation in mind when it comes to alcohol consumption.

4. Exercise (even when you don’t feel like it!)

There have been many studies that have suggested that people who exercise more regularly are happier. Not only does exercise release endorphins, it can also help to improve your sleep quality and self-esteem.

Whether you choose to join an exercise class, a gym or a dance class, exercise will make you feel so much better.

Does eating certain foods help with menopause symptoms?

As a menopause nutritionist, I can absolutely confirm that eating certain foods will help with your menopause symptoms.

Making strategic adjustments to your diet can really help to relieve your menopause symptoms and boost your health status. That’s why it’s well worth understanding the best foods to eat.

Obviously, the same goes for what not to eat, because some foods will worsen your menopause symptoms. You should avoid highly processed and sugary and salty foods. Drinks contain alcohol and caffeine should be consumed in moderation.

It’s for these reasons why the Mediterranean Diet is so popular among the menopause scene. Not only is the Mediterranean Diet packed with much needed nutrients during menopause, it’s also delicious. No need to compromise!

The transition from perimenopause to menopause

Transitioning from perimenopause to menopause can be a little confusing. When does perimenopause end and menopause begin? How are you meant to know? Let’s take a look at the path between perimenopause and menopause.

What is perimenopause?

Perimenopause is the phase before full-blown menopause. Usually, you start to see some menopause symptoms but you’ve had a period or spotting within the past year.

It’s important to remember that you can have periods in perimenopause, but they will likely differ from what you’re used to.

Perimenopause symptoms are mostly because of the changes to your hormone levels. As these hormone levels adjust, your menstrual cycle and sleep cycle can change too. These changes can bring on symptoms like hot flushes and vaginal dryness.

How to manage perimenopause symptoms

Remember that perimenopause is gradual. You don’t just wake up one day being perimenopausal.

Symptoms will vary throughout time and their severity also. Plus, remember that no two perimenopause journeys are the same. That said, there are a few things you can do at home to manage perimenopause symptoms:

• Eat better, feel better As you enter perimenopause, your risk of osteoporosis and heart disease increases. That’s why it’s so important to keep your diet healthy. You’re looking to create (and stick to) a diet that is lower carb with healthy fats and high-fibre. Your shopping trolley should contain lots of fruits, vegetables and whole grains, as well as foods that are rich in calcium. Now’s the time to cut down (or give up) alcohol and caffeine, too, as they can trigger hot flushes and night sweats and mood swings.
• Get moving with regular exercise Incorporate exercise into your routine so you can prevent weight gain (another common menopause and perimenopause symptom). Exercise will also help with sleep quality and mental health during perimenopause, when mood swings are common. You want to exercise for around 30 minutes or more on most days of the week. That said, you should also have some time off to recover. Don’t exercise directly before bed, either, as this can hinder your sleep.
• Get plenty of sleep Don’t underestimate the importance of sleep! A sleeping routine will really help with your sleep cycle. Don’t consume caffeine or drink too much alcohol before bed, as you may struggle to fall and stay asleep.
• Make time for things that help relieve stress Whether you find relaxation in yoga, knitting, singing, or journalling, prioritise these practices. This is important to take into the menopause phase, too, as it will help with mental health and low mood. Stress can worsen other perimenopause and menopause symptoms, so make sure you’re making time to do the things that keep you calm.

Mental health and menopause

Everyone experiences menopause differently. For some women, this can include a knock to their mental wellbeing. Menopause can trigger:

• Anxiety
• Memory issues
• Difficulty focusing
• Low moods
• Mood swings
• Panic attacks
• Low energy
• Lack of motivation
• Low self-esteem
• New fears and phobias

If you’re going through the menopause at the moment and you’re overwhelmed, stressed, anxious and/or depressed, you’re not alone. Your hormones are changing, your physical symptoms are taking a toll, and let’s not forget that menopause can feel really lonely. That’s why it’s so important to talk about how you’re feeling. There’s no shame in it and knowing that others are going through the same thing can feel reassuring.

What can I do to help me with my mental health during menopause?

Before we explore how to improve mental and emotional health in menopause, let’s look at the most important thing. You must be open to asking for help. We are happy to ask for help when we’re feeling physically unwell. Why is it any different when it comes to emotional and mental wellbeing?

First up, make sure you’re eating a healthy and balanced diet. Eating well, when combined with regular exercise, can alleviate some menopause symptoms and make you feel better in yourself. Consider joining a yoga or pilates class, where you combine both exercise with relaxation techniques. Even a quick walk to the shops every day will help to make you feel better.

A lack of sleep can really intensify emotional and cognitive symptoms. With so many women struggling with sleep issues during menopause, it’s clear why mental health is such a concern at this phase.

As such, it’s time to prioritise your sleep! Improve your sleep quality and:

• Ditch the duvet and replace it with layers of thin blankets to help with night sweats
• Have a lukewarm shower before bed
• Don’t eat for an hour before bedtime
• Make sure you’re going to bed at the same time every night
• Create a healthy and consistent bedtime routine

While all of this seems obvious, don’t underestimate the impact it can have on your mental (and physical) health.

Finally, never ignore how you’re feeling. Menopause does increase the risk of depression, so talk to someone you trust about how you feel. If you’re suffering from depression, it’s really important to speak to a healthcare professional. Again, you should never feel shame when asking for help.

How long does menopause last?

Everyone’s experience of the menopause is different.

In reality, menopause is one day! When we talk about menopause symptoms, we’re actually talking about perimenopause. Severe symptoms are present for about 4 years.

Surviving the menopause: summed up

Menopause can be a rollercoaster with countless loop-the-loops, inversions and drops. That said, if you enter your menopause aware and prepared, the menopause doesn’t have to rule over your life.

There are many natural techniques to help improve your menopause symptoms. These techniques will also better your overall health at the same time, including your mental health.

Keep talking to the people around you, explaining how they can help you with this transition. And, of course, prioritise your diet to reduce the severity of your symptoms!