At 53 Gabby Logan feels and looks amazing - and she isn’t letting the menopause slow her down. Ahead of a busy Summer of sport presenting the BBC’s coverage of the FIFA World Cup, the presenter chatted exclusively to woman&home, revealing her daily wellness habits and “non-negotiables” that help her stay balanced during hectic schedules, travel and everyday life.

Thankfully Gabby tells us that her menopause experience hasn’t been too challenging and while she’s had “some symptoms,” luckily there was nothing that was “too debilitating” or impacted her ability to work.

This is partly down to the measures she’s put in place. “I feel that I’ve learned a lot about my body and what makes it work well and better in this period of life,” she says, explaining, “So, the way I exercise, the way I eat and the supplements that I use.”

Gabby Logan on Keeping active

As a former international gymnast, sport has always played a “huge part” in Gabby’s life and even amidst her busy schedule, the mum-of-two maintains that it’s “Important to keep your body moving.”

So, what exercise does she focus on? “I like to do Pilates to keep me flexible and strong,” she shares.

“Weightlifting or weight bearing exercises are so important for women in midlife,” the Match of the Day star adds. And she notes that you don’t need to fork out on equipment or dumbbells. “ You can use your own body weight as well, so it doesn't have to be expensive.”

She adds that looking after your cardiac health should also be prioritised. “Cardiac diseases are still the biggest killer for women in this country of a certain age, so we do need to look after our hearts as well as thinking about muscular health.”Gabby adds that aerobic and cardio exercises help with this and are “really important,” reassuring fans “it’s never too late to start.’

Relatably she admits, “Some days I’ll have time for a proper workout, other days I won’t,” but says “I’ve learned that doing something always feels better than doing nothing, even if it’s only ten minutes.”

Therefore, the star “always keeps a resistance band on me”, explaining, “It’s a useful reminder that no matter where I am, I can, and must, get it done.”

Taking super supplements

The broadcaster, who is an ambassador for Vitabiotic’s Menopace range, reveals that supplements “in particular” have been good for helping her “get in some of the things that I’ve noticed I need a bit more of in midlife.”

And her “non-negotiable” that she takes every day is the brand’s Menopace Max, which includes Vitamin B6 to support the regulation of hormonal activity alongside Vitamin B12 and Iron help with normal energy release.

It also contains Calcium, Magnesium and Vitamin D for the maintenance of normal bones - something that is especially important during the menopause due to the declining levels of Oestrogen.

As if that wasn’t enough, it also includes Zinc to support normal skin and hair in addition to Vitamin C to aid the normal function of the immune system.

"Taking supplements are small but meaningful changes that make a difference on how you feel both inside and out," Gabby tells fans.

Thoughts on eating well

When it comes to her diet, Gabby says “It's really important to eat the rainbow and have a good balance of nutrition,” revealing, “I eat quite plant-based during the week.”

And, while fibre can “tend to be forgotten about,” she notes its benefits - it aids gut health and can lower the risk of heart disease and Type 2 Diabetes to note just a few.

“You can get it from all kinds of sources. It's not a matter of just eating whole grain bread,” the presenter shares, adding, “So I try to get things like quinoa, barley, all of the legumes, pulses and things like lentils into my diet.”

Because of her career, which sees her work long hours and travel regularly, Gabby admits, “eating isn’t as structured as I’d like. To combat this and to avoid energy dips, she keeps simple, practical options with her that she can easily reach for between commitments.

“Having simple things with me like nutritious snacks, water and supplements helps me feel a bit more in control of the day,” she tells fans. And one of her favourite snacks is her homemade protein balls (see recipe below). “By carrying things like them and supplements, it means I can stay more balanced and not feel like I’m constantly running on empty.”

Balancing act

While Gabby admits the busyness of her day-to-day life is somewhat of a “balancing act,” she maintains, “I know I can do everything - being a mum, wife, and in my career - better if I'm looking after myself.”

Her concluding message to midlife women is, “It’s about taking that little bit of time to do the exercise, plan your meals, make sure you're getting as much nutrition in as you can, enough sleep and try to destress. It’s important to make those things a priority, I think it’s a holistic kind of view.”

Gabby’s go-to snack: Homemade Protein Balls

• Ingredients:
  • 1 cup ground almonds
  • 3 tbsp Sunflower seeds – a good source of vitamin B6
  • 2 tbsp Chia seeds
  • 1 tbsp grounded flaxseeds
  • 2 large tbsp Almond butter
  • 6 pitted dates chopped – a good source of potassium
  • Optional: Pinch of salt and a couple of drops of vanilla extract

Blend all ingredients until the mixture forms a sticky dough. Roll into balls and store in the fridge for up to 10 days or freeze for up to three months.

Gabby Logan is an ambassador for Vitabiotics Menopace range. For more information or to purchase any products, visit: menopace.com

I've often heard women refer to menopause as a time they 'just didn't feel right'. But ask them to go into more detail, and many can't seem to pinpoint a reason.

I am no different. In my early 40s, I noticed feeling off, not quite myself, but with no idea why. Nothing in my life had changed. I just didn't feel like myself. The fiery Aries I have always had in me was surfacing more and more regularly, and without much provocation.

At 42, I made a doctor's appointment to discuss feeling this way, and, long story short, was prescribed antidepressants. I didn't question it then. I just wanted something to help ease the sense of confusion I felt. But as time went on, new symptoms arrived, and I started questioning whether I was actually perimenopausal.

Years went by, and the medication wasn't really helping. I had countless more GP appointments to try (and fail) to explain this. It all led to a huge amount of frustration at what felt like a lack of wanting to acknowledge that my symptoms might be something other than depression.

So I contacted the team at Menopause Care - the UK's leading menopause clinic, founded by Dr Naomi Potter - who invited me in for a consultation with Dr Eloise Elphinstone. After just 45 minutes with her, I felt a sense of validation, relief and hope that I'd been so desperate for up to that point.

Here, I explain exactly what happened during my consultation, the cost involved, and other options available if it is not within budget, and why I wish I had done it sooner.

The appointment

Arriving at the Menopause Care clinic, I was met promptly by Dr Elphinstone, who immediately made me feel at ease with her warm and inviting nature. We went into a consultation room. It was modern, comfortable and relaxed, despite the more clinical elements of the room, which included an examination area. Whether this area is needed is entirely dependent on individual needs. In my case, blood tests and physical exams weren't necessary, but had they been, everything Dr Elphinstone needed was on hand.

The appointment was called a 'new patient consultation'. It lasted approximately 45 minutes and cost £295. During this time, Dr Elphinstone asked me why I had decided to see her. She then just let me talk and listened as I explained the uneasiness of not feeling right, and a level of rage that often felt unwarranted for the situation.

The whole time I was talking, she smiled supportively and nodded along. I knew she understood what I was saying, and so I felt comfortable being open and speaking without any judgment. She knew what I was going through and, more importantly, she empathised.

As we continued, Dr Elphinstone would occasionally ask for more details, including any physical symptoms I was having, but what I really noticed - and appreciated - was the clear importance she placed on my mental wellbeing as a result of perimenopause.

"I don't know if this reassures you, but what you are saying is really common. I think so many people talk about hot flushes, which is definitely a symptom for some, but actually, the emotional side of things, whether that be mood, anxiety, irritability and rage, is a really big part of it. It's probably one of the most common symptoms that people don't talk about."

This response, honestly, where she told me everything I was feeling was real and true – and all part of perimenopause – was a huge relief. She helped me join the dots, validated my feelings and told me to stop blaming myself. That alone would have been worth the time and cost of the appointment, but there's so much more to gain from seeing a specialist.

Understanding what's happening

After a good 30-min chat about my physical and emotional symptoms, Dr Elphinstone was able to reassure me and spend time clearly explaining exactly what happens during menopause. It gave me a newfound understanding of why I had been feeling such confusion and discomfort.

To finally know what was happening in my body, and how that was responsible for a lot of my symptoms, has allowed me to not only worry less, but be so much more patient with and kind to myself.

But why is it so difficult for some women to get this clarity or a diagnosis? Surely this is something a blood test could help with, I asked Dr Elphinstone.

"The guidance is that if you are above 45, it's a clinical diagnosis. So because in perimenopause your hormones fluctuate, you could do bloods when your oestrogen level looks quite good, and they can look completely normal," she explained. "Do it at a different point, and it would look completely different.

"The other point is, when we do blood tests to diagnose menopause, we look at hormones called the FSH and the LH as well as the oestrogen. They are what the pituitary gland in the brain produces to get the ovaries to work. So when you are having normal cycles, the brain doesn't have to work that hard. The ovaries produce the eggs, and the eggs produce the oestrogen. So if you've got lots of eggs, you're producing lots of oestrogen, your brain doesn't have to do anything.

"As you have fewer eggs as you get older, you have less oestrogen, so the brain thinks you need more, and so the FSH and the LH go up, and your body responds initially. It goes 'okay, we need more oestrogen' so the oestrogen goes up. The brain's done its job. Those hormones come back to normal, and if you do a blood test at that point, it all looks normal.

"It's only as later down the line that the FHS and the LH go up, but when there are no eggs there to produce more oestrogen, they can't respond. It just goes up and up and up, so it's only at that point that you might see something on a blood test. And you can have symptoms of that for quite a long time, and the risk of using bloods, and I've seen this a lot, is GP take bloods and everything looks fine, and that's because of that reason."

Tailored treatment & follow-up

The latter half of my consultation discussed the treatment plan I should start. Dr Elphinstone talked through and showed me various options. Once we had decided which treatment to go for, she advised me to monitor how I feel using a journal or symptom-specific app.

Using a diary to log symptoms during this phase can be incredibly helpful for doctors and other medical professionals to get a holistic picture of what is going on. It can also help with medication and treatment that might be needed. The Flo app is a popular choice, and the one I use to log my daily symptoms now.

The prescription you get from a menopause specialist is not available via the NHS. It's a private prescription, so it comes with a higher cost. The medication I was prescribed would have cost £100 to buy privately. However, Dr Elphinstone advised she could send notes to my GP, and they could write the prescription, which would then incur the usual £9.90 NHS prescription fee. This is the option I chose and had no issues. Dr Elphinstone's notes were promptly sent to my GP, and just 48 hours later, my prescription was being sent to my local pharmacy.

For the last three months, I have been taking the medication Dr Elphinstone prescribed. It has been a huge help with some of my most troublesome symptoms. The dosage is something I am in regular discussions with my GP on, but the difference it has made has been remarkable. I also have better conversations with my GP as they have detailed insights into my symptoms and situation.

I chose to do follow-up appointments with my GP due to cost. However, follow-up appointments are available via Menopause Care - usually three months after the initial consultation. The cost of a follow-up is from £225, but within that time, patients are able to email or call in with any problems, side effects or questions.

Additional support

A new patient consultation at Menopause Care costs £295, and 30-min follow-up appointments are from £225. Not every woman can afford private healthcare - and that's a problem. If seeing a specialist is not within budget, or you are unsure about the support you need, the good news is that there are other avenues you can explore.

During my time at Menopause Care, I also caught up with founder Dr Naomi Potter, who very kindly shared some resources. Below is a summary of Dr Potter's advice for anyone needing further menopause-related support:

• Be clear on what you want when going to see the GP. You have very little time, and so having an agenda the GP can work with will help. I have recently downloaded the Flo app and have been tracking my symptoms to help both me and the GP understand where I am going forward.
• If you don’t feel satisfied after an appointment, try another doctor. A GP Registrar is a fully qualified doctor, in their final year of training to become a GP. Dr Potter explained that these doctors often get longer appointment slots and tend to be more up to speed as they have just come out of training.
• Ask for a referral - some areas have local menopause services, some areas you could ask to see an endocrinologist, a gynaecologist or sometimes a menopause team.
• Women’s Health Concern has a lot of helpful, trustworthy advice, including where to find a menopause specialist in your area.

Menopause is something every woman will go through, and it takes more than a 10-minute GP appointment to provide and determine the best care – which every woman deserves. Seeing a menopause specialist has made a huge positive change to my life, and so I would highly recommend, if budget allows and you are experiencing symptoms, to look into specialist healthcare professionals in your area.

If budget doesn't allow, or you are not quite sure whether a specialist is what you need, the information above will help.

The most common symptoms of perimenopause are reportedly hot flushes, night sweats, mood swings, and poor sleep, but digestive changes actually affect more than 8 in 10 women at this life stage, according to a recent survey by The Menopause Society.

The survey found that bloating, constipation, and stomach pain were the top three issues, and almost every woman (94%) had experienced at least one of them in her life. So, it's fair to say that you're not alone if you've experienced changes to your digestive health after perimenopause.

Yet, it's often one of the symptoms swept under the rug, says Dr Amir Khan, a NHS GP and woman&home's own resident doctor. "Lots of women are surprised to learn that oestrogen and the gut are linked," he says.

Why does bloating happen after perimenopause?

The doctor says that the digestive system becomes more sensitive "as oestrogen levels fluctuate and fall during perimenopause and menopause". The hormone plays a vital role in balancing our gut bacteria, keeping the gut lining strong, and reducing inflammation, so when we don't have enough of it, these benefits are limited.

"There's also a group of bacteria in our gut called oestrobolome, which breaks down oestrogen and brings it back to your bloodstream. During menopause, this bacteria becomes less plentiful and less efficient, meaning less oestrogen is recycled back into the blood via the gut," says Dr Khan.

"All of this means menopause affects your gut, but also your gut health affects the severity of your menopause symptoms, leading to bloating, constipation, and wind," he explains.

How to ease bloating after perimenopause

• Eat more fibre: High-fibre foods like fruits, vegetables, chia seeds, and nuts are great for gut health. They relieve bloating and constipation, and help keep bowel movements regular.
• Add more high-protein foods to your diet: Protein helps keep bloating at bay as well, the doctor says, as it helps produce stomach acids and enzymes. However, too much of it or eating protein supplements too quickly can have the opposite effect.
• Include more fermented foods in your diet: Fermented foods like sauerkraut and kimchi improve gut bacteria diversity, and help reduce inflammation, improving gut health and reducing bloating symptoms. Sprinkle some on a salad or add some to a sandwich at lunchtime.

One underrated high-fibre food to include is legumes, the doctor adds. "Legumes feed beneficial gut bacteria, helping to reduce inflammation, improve cholesterol, and stabilise blood sugars. Their low glycaemic index prevents energy spikes and crashes, too, supporting steady appetite and weight control. Eat them three to four times a week."

Uncomfortable symptoms may stop or become manageable after menopause for some, as hormones stabilise. However, the doctor also urges anyone with new bloating or irritable bowel syndrome (IBS) symptoms to speak to their doctor. "It can be a symptom of ovarian cancer, and they will most likely offer you a blood test and/or a scan," he says.

This advice initially appeared in the March 2026 issue of woman&home magazine. Subscribe today.

Driving anxiety is feeling suddenly fearful, having a racing heartbeat, sweating, or feeling sick at the thought of getting behind the wheel or even being in a car. As one of the many side effects of menopause, it can be scary, frustrating, and confusing.

Dr Amir Khan, woman&home's resident GP, says it's something his own sister has been dealing with. "She's suddenly become really anxious when she gets into cars, either when she's driving or when she's a passenger in the car, and that's when it's worse, when her husband or her kids are driving her somewhere. She has to hold on really tight, and she comments when they're driving, and it's not like her at all. She actually used to be a bit of a girl racer."

It happens to women who've been driving confidently for decades, and the doctor wants all of us to know that it's completely "normal". There's also a reason for it, which means there are several ways to help yourself if you're struggling.

What causes driving anxiety in menopause?

"Chemicals in your brain are linked to oestrogen, so when oestrogen and progesterone levels drop, serotonin, your happy brain chemical, goes down. GABA, which is your calming brain cushion, is taken away. Things that didn't feel like a threat before suddenly feel really threatening, and your brain goes into fight or flight mode," the doctor explains.

"That's what's happening to lots of women during the perimenopause and menopause. They don't even know why. That kind of driving anxiety is linked to low oestrogen and progesterone, causing low serotonin and GABA in your brain.

The doctor's Instagram followers were quick to agree with him - it's something many women experience. "I struggled with this for years and had no idea why...I used to get two minutes down the road and have to turn the car back and come home! Lots of ladies tell me it's worse at night, but I can (I'm postmenopause by many years now) that I love driving again!" writes Claire Hattrick, a menopause coach.

"Yes...it's so debilitating and makes our world a little smaller as just staying home feels easier," wrote another follower.

"This is me! I have to have the radio off so I can see better and if anyone speaks...🤯🤯🤯," wrote another.

Other experts add more to the explanation, revealing why driving anxiety tends to increase at this time. "Plus, oestrogen receptors exist in the retina and optic nerve, so fluctuating levels can alter visual processing. This can affect spatial awareness and depth perception - another reason why driving can suddenly feel harder," writes Claire Hurst, a fellow doctor and menopause specialist.

"At the same time, reduced oestrogen increases light sensitivity, making bright lights and night driving more uncomfortable," she writes. "It's not our imagination, it's our neuro-visual system adapting to hormone change."

What helps?

"It's completely normal, so knowing that might help. HRT might help. Cognitive behavioural therapy might help. Breathing exercises and grounding exercises can help as well," says Dr Khan.

Anxiety in menopause is a very common general symptom, several studies and surveys have revealed over the years. According to a recent study in the American Journal of Translational Research and the Menopause Centre, up to 50% of women experience anxiety in this life stage, ranging from mild to severe.

Other possible ways of dealing with general anxiety in menopause include lifestyle changes like more exercise and prioritising relaxation, along with hormone replacement therapy (HRT), talking therapies, and other medications.

The National Institute for Health and Care Excellence (NICE) greenlit the use of Veoza for women in the UK via the NHS this week.

Now authorised, it's thought that half a million women could benefit from the drug, also known as fezolinetant, where hormone replacement therapy (HRT) is not an option due to contraindication or preference. The 45mg tablet is taken once a day.

Unlike HRT, this drug is a non-hormonal option, and it exclusively eases vasomotor symptoms, which include night sweats and hot flushes. These symptoms are caused by changes to the brain's thermoregulatory zone as oestrogen declines. The drug works by blocking nerve pathways to this area.

It's thought that vasomotor symptoms are among the most common, affecting up to 70% of women, making Veoza a "game-changing" option, as HRT is not suitable for everyone. Those with a history of breast cancer, ovarian cancer, blood clots, or untreated high blood pressure are not eligible, for example.

However, NICE have said that fezolinetant is also not suitable for those with a history of oestrogen-dependent cancers or liver disease, as these groups were not included in the drug trials. Those who have had breast cancer and finished their treatment may be able to have it, but it will be down to individual assessment.

"We know that menopause hot flushes and night sweats can have a profound impact on quality of life and significantly affect overall wellbeing," says Helen Knight, director of medicines at NICE.

"For those who are unable to take HRT for varying reasons, options have historically been limited, and we have heard clearly from patients how difficult that can be," she says. "The evidence shows fezolinetant can meaningfully reduce symptoms, and was found to be cost-effective, offering value for the taxpayer. This decision will give much-needed relief to those for whom HRT is unsuitable.”

Dr Sue Mann, national clinical director in women’s health for NHS England, called it a "vital treatment option which could help hundreds of thousands of women experiencing menopause to better manage their symptoms and feel more in control of their health.”

Can I get Veoza on the NHS?

Yes, Veoza is available on the NHS via prescription when HRT is unsuitable. It has been recommended for the treatment of moderate to severe hot flushes and night sweats.

This decision by NICE is only applicable in England. Northern Ireland and Wales typically follow the same guidance, however. Scotland has the Scottish Medicines Consortium (SMC), which is separate, and this body has not recommended the drug for use on the NHS.

You can also buy Veoza with a private prescription.

Veoza vs HRT

For those eligible for both HRT and Veoza, discuss your options with your doctor, as they will be able to offer personalised advice.

This new drug is a suitable option for managing hot flushes and night sweats, giving those unable or not wanting hormone therapy another option. After decades of limited safe and effective alternative treatment options, despite the number of women affected, this is a win.

However, it's important to look at the options carefully. "The drug has not been directly compared in studies to HRT - the gold standard for treating menopausal hot flushes - nor has it been compared with other non-hormonal treatments either. Currently, there's a lack of evidence on the long-term (more than one year) efficacy and safety, and this drug has not been tested on all ages of menopausal women," says Dr Louise Newson, a menopause specialist.

"Crucially, fezolinetant also won't address the health risks associated with menopause. For example, it won't improve your bone density, reduce inflammation and protect our brains and cardiovascular system from the effects of low hormones. Only by correcting the hormone deficiency with natural, body-identical hormones will this be done," she says.

Much like when you take HRT or other HRT alternatives, the drug must be combined with other lifestyle interventions, such as changes to diet and exercise habits.

We know everyone’s experience of menopause is different. While the conversation around perimenopause and its challenges is more open than ever, knowledge gaps remain - especially around the impact of menopause on our mental health.

A new YouGov poll, commissioned by the Royal College of Psychiatrists, has found that only one in five (21%) of UK adults know that new mental illnesses can be associated with menopause. This is in stark contrast to the 81% of respondents who associated it with hot flushes, the 74% who linked menopause with mood changes, and the 64% of people who associated menopause with a reduced sex drive.

The Royal College of Psychiatrists say that this lack of awareness among the general population and medical professionals means that women aren’t getting the mental health support they need when they’re struggling. It can have serious repercussions.

President Dr Lade Smith says, “Menopause can have a significant yet often overlooked impact on women’s mental health and wellbeing. Women account for 51% of the population, and all will experience menopause at some point. This is a societal issue for everyone. Simply put, we must do better.”

Common mental health issues associated with menopause include anxiety, depression, problems with focus and memory, and mood swings. For some people, the fluctuations in oestrogen, progesterone and testosterone trigger new symptoms, while others may find hormonal fluctuations exacerbate existing issues.

In a position statement released after the poll results were published, the RCPsych highlighted studies that have looked at how the prevalence of serious mental health problems can increase during perimenopause. A study in World Psychiatry found a 112% increase in the incidence of bipolar disorder and a 30% increase in major depressive disorder among participants going through perimenopause. It’s also thought that women who experienced postpartum bipolar episodes may be at higher risk of problems during perimenopause, too.

HRT and cognitive behavioural therapy (CBT) in menopause can be effective in the treatment of low mood and anxiety symptoms. If you’re struggling with day-to-day activities and have had your symptoms for longer than a few weeks, speak to your GP, who will be able to offer support.

Speaking about the poll’s results, TV presenter and menopause awareness advocate Davina McCall, who is also an RCPsych Honorary Fellow, says: "Some women sail through the menopause unscathed. But some don’t, and the impact on their mental health can be devastating and have a huge impact on their lives and their relationships.

“Lack of knowledge and ingrained stigma still prevent open conversations between doctors and patients, in the workplace and among friends and family, leaving women without the crucial support they need at an incredibly vulnerable time in their lives. And it’s just not acceptable. Why are women still fighting to be heard?

“Together, we must make the link between mental health and menopause known across society - among health professionals, NHS, government, members of the public and employers - to improve the policies, care and support provided for all women experiencing menopause.”

The survey also found that just one in four UK women (28%) feel comfortable speaking to a male boss about the menopause. The researchers say menopause-related problems cost the UK economy 14 million working days per year, and thousands of women leave their jobs because of their symptoms.

A Department of Health and Social Care spokesperson said: “It’s unacceptable that women are facing barriers to the care and support they need. We’re taking action – bringing a menopause question into NHS health checks, renewing the women’s health strategy, and investing an extra £688m in mental health services while recruiting 8,500 more mental health workers.

“Women now have access to a wider range of treatments alongside improved training for new doctors to help ensure faster diagnosis and support.”

The conversation around menopause has never been louder. In 2025, it's complemented by an ever-expanding number of supplements and products specifically designed to help (with some more effective than others). But getting simple medical advice, diagnoses, and support for menopause symptoms has remained frustratingly difficult.

However, it appears things are changing in England from next year, as the NHS announced it will add menopause screenings to its health checks for 40 to 74-year-olds.

These free check-ups are carried out every five years and include blood tests for cholesterol and blood sugar levels, and blood pressure and BMI (body mass index) checks. GPs and nurse practitioners also look for early indicators of diseases such as type 2 diabetes, dementia, stroke and heart or kidney disease. It's otherwise known as the 'midlife MOT'.

Dedicated questions about perimenopause and menopause will be part of the health check from next year. Previously, they have not been included in the appointments.

Many women suffer from fatigue, brain fog, hot flushes, and other symptoms for a long time before they seek treatment or support (an average of 14 months, according to one Parliamentary report). Even when women do reach out for help, however, research has shown that we have to push through several hurdles to receive treatment, with 7% going to the doctors 10 times or more before receiving "adequate" help or advice, and 44% of women waiting over a year for treatment, according to data presented at the 2021 Royal College of GP Annual Conference.

The government says it hopes the screening will help identify women who would benefit from HRT (hormone replacement therapy) and HRT alternatives earlier.

Health Secretary Wes Streeting says he wants the move to improve the support offered. "Women have been suffering in silence for far too long and haven't been encouraged to open up about the symptoms they're experiencing. This often means they're left to navigate menopause alone with very little support. No one should have to grit their teeth and just get on with what can be debilitating symptoms or be told that it's simply part of life."

In a press release, the government says it believes the changes will “benefit nearly 5 million women”. Many women start to experience perimenopause symptoms in their early 40s, but the average age for reaching full menopause is between 45 and 55 in the UK. This means women have to cope with symptoms for many years before their periods finally stop. Living with mood swings, irregular periods and sleep problems can affect every part of our lives, but thousands of women will feel unsure about where to turn for help.

Dr Sue Mann, National Clinical Director in Women’s Health for NHS England, says: “Far too often we still hear women say their concerns aren’t listened to or that they aren’t getting enough support for the debilitating symptoms that can come with the menopause, many of which can have a big impact on their lives and can be invisible to others. We want to change that – no one should have to put on a brave face or feel they are facing symptoms of menopause or perimenopause on their own.”

Menopause charities have welcomed the addition to the health check process, but are also keen to highlight that menopause expertise within GP surgeries varies across the country. The Menopause Charity advises asking your surgery if there’s anyone with specific menopause knowledge that you can see.

Signs of perimenopause to look out for

What perimenopause feels like and the age it begins will be different for everyone. Some have debilitating symptoms, while others breeze through without an issue. If you're unsure whether you're experiencing perimenopause, look out for these key symptoms, as per the NHS:

• Irregular periods, with changes to cycle flow and length
• Hot flushes and night sweats
• Mood changes
• Sleep problems, with difficulties falling asleep or staying asleep
• Brain fog, with difficulties concentrating
• Vaginal dryness

If you have any questions about menopause, speak to your doctor. The Menopause Charity and Menopause Matters can give advice and support.

It feels like a particularly cruel twist of nature: just as women are reaching the peak of their careers in their 40s and 50s, menopause strikes. For some women, their symptoms are mild enough not to interfere with their nine-to-five too much. For many, perimenopause can make the daily grind feel like an uphill battle, resulting in missed promotions, sick leave, and even quitting altogether.

The British Menopause Society estimates that around 80 to 90% of women will experience menopause symptoms, with 25% of them describing them as debilitating. Inevitably, this impacts work. A study by The Fawcett Society involving 4,000 menopausal women (the largest survey of its kind) found that 14% of women had reduced their working hours because of their symptoms, 8% avoided going for promotion, and 10% even resigned.

But does it have to be like this? Luckily, conversation around menopause in the workplace is growing louder, with industry leaders and the Government recognising it as a significant health and wellbeing issue. Yet policies for the workplace won’t become mandatory until 2027, and then only for organisations with over 250 employees.

So, what can women do right now, wherever they work, to keep their careers on track while navigating these choppy waters?

Three women in the corporate world tell woman&home how they experienced menopause while holding down a full-time job, and what they did not just to survive but to thrive in their careers. Plus, we ask leading experts to share practical advice on how to manage symptoms at work and keep your professional mojo.

Marriane Dias, 50, sales operations director

In her role leading a team in a large media organisation, Marriane Dias is used to performing in a high-pressure environment. But when she entered perimenopause at the age of 45, things changed.

“I started to feel very anxious and overwhelmed, like I wasn’t good at anything anymore, even though this was a job I’d been doing for years. I would cry a lot, and that’s just not me. At one point, I felt like I was losing my marbles,” she recalls. Alongside her crisis of confidence came physical symptoms, including brain fog and hot flushes, “I could feel them start in my feet and creep up my body with nothing stopping them”.

She wasn’t the only one going through it: her boss was also menopausal, which led to the occasional clash. Not wanting to ruin her work relationships or her performance, Marriane decided that she wasn’t going to struggle quietly with perimenopause. “I manage a predominantly female team, and I’m very frank and candid with them, as I am with other male colleagues. I encourage my team to do the same. One day I might be dripping with sweat at my desk and fanning myself, then another day I’ll completely forget my train of thought in a presentation but say, ‘it’s brain fog, bear with me!’.

“Dealing with symptoms, such as a hot flush in front of everyone in the office, used to make me very anxious. But I’m not ashamed of menopause anymore and don’t feel like I need to apologise for it. If I feel hot in a meeting, the fan comes out."

Marriane recognises that she is fortunate to have an employer that supports women in menopause with an inclusive workplace culture, but she realises it’s not the same for all working women. She’s currently supporting a campaign led by bra-maker Royce that is speaking up about menopause and helping make all workplaces menopause-friendly, particularly small organisations that fall outside of the new obligations.

Marriane continues to be candid on her Instagram platform @40plusandfab, where, alongside her fashion content, she shares the ups and downs of her menopausal journey. From her own experience, she recognises the power of conversation and says to anyone currently suffering in silence at work, “Don't be ashamed, don’t be embarrassed, just talk about it.”

Dominique Kent, 51, CEO of Bluecrest

The first time Dominique Kent experienced brain fog at work is a moment she remembers all too clearly. “I was writing an email and suddenly I couldn’t find the most basic of words. At first, I thought I was just stressed, but when it didn’t go away, I started to panic. I was in my late 40s, but I genuinely thought I might have early-onset dementia.

“When you’re a CEO, your mind is your greatest tool, so losing words mid-sentence or in meetings was frightening. It made me question my confidence and capability in a way I’d never experienced before.” Her symptoms worsened, culminating in a particular low point: “In one 24-hour period, I had 34 hot flushes. It was relentless. I just couldn’t keep pretending everything was fine,” she admits.

She started logging and researching her symptoms, and after failing to get a face-to-face appointment with her GP, she saw a private specialist. “It wasn’t cheap, and I know not all women can afford that, but I was desperate. That appointment changed everything for me – when I learned that word-finding difficulty is a menopause symptom, I felt huge relief.”

After her menopause diagnosis, things improved significantly for Dominque. “It helped me understand what was happening and how to manage it. Alongside HRT, I made practical changes. I took rest seriously, improved my sleep, ate better – including good levels of protein – exercised with an emphasis on resistance training rather than cardio, and I paced my workday. I also tried to stop seeing myself as invincible – although that’s something I’m still working on.”

Although she was now managing her symptoms, as CEO, she hid what she was going through: “There’s still a stigma around menopause, and in leadership there’s the added pressure to appear in control, particularly as a woman in midlife. Looking back, the initial instinct to mask it only made things harder.”

Eventually, Dominque realised that being transparent at work was the way forward – not just for her, but for all the women around her who were quietly going through the same thing. “At Bluecrest, we’ve built a culture where menopause is part of the wellbeing conversation, including a menopause policy that’s active and lived, not just a line in a handbook. Being honest about my experience has strengthened my leadership by building trust, empathy and openness across the team. We’re in it together irrespective of role – that’s important in creating a culture where people feel safe.”

Heather Jackson, 56, CEO and co-founder of GenM

As a woman in business, Heather Jackson understood the power of appearing strong and capable. “I’ve always lived authentically and unapologetically, and believe women shouldn’t feel the need to hide any part of their experience, including menopause. But when my own perimenopause started, I didn’t understand what was happening to me. I wasn’t masking it, but I wasn’t acknowledging it either,” she admits.

It took a frightening episode at work for her to accept it. “I was due to speak at a conference in Edinburgh for my previous business when I woke in the middle of the night with a crushing pressure on my chest. Convinced I was having a heart attack, I went to the hospital. After several tests, I was told it wasn’t a heart attack but a panic attack. I felt embarrassed and confused. Only later did I learn that panic attacks and heart palpitations can be related to hormonal changes linked to perimenopause.”

For Heather, it was a lesson in awareness and acceptance, which made her rethink how she looked after herself: “I started to focus on the quality, rather than quantity, of what I was putting into my body. Sleep was another important focus, so I invested in climate-controlled bedding and a thermo-regulating mattress to beat night sweats and wake up ready to make better choices for my wellbeing. I did trial HRT, but it didn’t work for me personally. It can play an important role for some women, but nutrition, sleep and other lifestyle choices all matter too.”

Looking back, Heather recognises that the instant she acknowledged she was perimenopausal was a pivotal moment in her career: “Everything started to make sense, and within 24 hours the idea for [what became] GenM was born.”

GenM is a menopause partner for brands and retailers, and home of the MTick, a universal symbol that helps women identify menopause-friendly products and make informed choices.

Far from derailing her career, Heather believes menopause has turbo-charged it. “I wouldn’t be where I am today if it weren’t for the challenges and insights it brought. I wasn’t planning to start a new business, but I saw a need that had to be addressed. Menopause is becoming as recognisable as the vegan movement, and my mission is to make the experience better than it was yesterday.”

She adds, “I can say with absolute certainty that I’m now living my best life. I refuse to be the stereotype of a fed-up menopausal woman. Instead, I see this stage as a time to be game-changing, category-making and legacy-shaping.”

How to manage menopause symptoms at work

1. Prepare for brain fog

Struggling to find the right words or losing your train of thought can be frustrating at work. Dr Louise Newson, a GP and leading voice on menopause care, explains that oestradiol, progesterone and testosterone all affect brain function, so when they fluctuate and fall, it impacts memory and clarity of thought.

“This is a biological response, not a personal failing, and it can be improved with the right dose and type of hormones,” she says.

Dr Claire Kaye, a career coach and award-winning former GP, suggests preparation and openness can help you at work. “Before any meeting, write down your key points and the names of the people attending, as these are often the first things to slip your mind.

“If you lose your train of thought, have a few phrases ready to give yourself space, such as, ‘That’s a great point, what do others think?’. Being upfront about it can also help you stay calm and normalise what’s happening," she says.

2. Avoid anxiety spirals

There's a strong link between menopause and anxiety, says Dr Kaye. “It’s a vicious circle: anxiety heightens symptoms, and symptoms increase anxiety.”

To break the cycle, she recommends a ‘box breath’ exercise you can do at your desk. Breathe in for a count of four, hold for four, breathe out for four, hold for four, and repeat.

“You can also try reframing your thoughts. Change ‘I can’t cope’ to ‘this feels harder today, but I’ve done it before and can do it again’,” she suggests.

3. Minimise hot flushes

They can appear at the most inconvenient of times, but you can reduce their severity and frequency, says Dr Newson. “Hot flushes occur when falling hormone levels affect an area of the brain called the hypothalamus, which controls body temperature, making your body suddenly feel overheated even when it isn’t.”

She says that replacing hormones with the right dose and type is the most effective way to reduce or even stop hot flushes.

As an alternative to HRT, Dr Kaye recommends using a fan and sitting by an open window to relieve discomfort. Also, “reduce your intake of caffeine and spicy food, and stay hydrated. Wear breathable layers so you can cool down quickly, and think about colour as well as material to avoid worrying about sweat marks,” she adds.

4. Manage energy levels

Even with all the best sleep aids, most women will struggle with disrupted sleep in menopause. Compounded by low energy during the day, work can feel like wading through treacle.

Alongside hormone treatments, Dr Newson recommends creating plenty of healthy habits in your routine. “Gentle movement, like walking or stretching, can boost circulation and focus, while a balanced diet with wholegrains, protein and healthy fats helps maintain energy levels throughout the day. On low-energy days, listen to your body, pace yourself and take short breaks.”

Dr Kaye adds, “If you can, arrange flexible working so you can start later or focus on demanding tasks at the time of day when you naturally have more energy.”

5. Change your mindset

Changing your attitude towards menopause can make a big difference. “This is a time when women are at their most experienced, capable and valuable: menopause doesn’t take that away. This stage can be an opportunity to pause, reflect, and redefine what you want and need,” says Dr Kaye.

“Buddy up with someone at work who understands. Having a ‘menopause buddy’ provides empathy, reassurance, and a reminder that you’re not alone,” she adds.

Influencing managers and colleagues also helps nurture a menopause-friendly workplace for everyone. “Employers play a vital role,” says Dr Newson. “By introducing proper support systems and creating open, safe spaces where women feel heard and understood, employers can make a significant difference in women’s health and wellbeing.”

We often talk about the imbalances that come with menopause, from the hormones themselves to symptoms like mood swings. Rarely do we hear about a symptom of menopause that leaves us feeling flat - irritated, yes, flat, not so much.

Anhedonia is that symptom. It's characterised by low mood and a 'meh' feeling, even when life is good. As one woman I spoke to neatly put it, “It’s like having your emotions turned off".

Despite anhedonia being a recognised symptom of perimenopause and 75% of people with depression (and, conversely, those on antidepressants) experiencing it, we don't discuss it. My personal experience is shame - I can’t justify my disinterest in a life I know I love, but I can’t feel. When I asked around, some of my friends didn't even know there was a word for how they felt.

Keen to know more, I contacted Tanith Carey, a psychotherapy counsellor and author of Feeling 'Blah'?: Why Life Feels Joyless and How to Recapture Its Highs, and Donna Morgan, an integrative counsellor and trauma therapist specialising in menopause.

What is anhedonia?

It’s normal to get fed up or bored occasionally, but anhedonia changes how you engage with life. “You become disconnected from your emotions,” says Donna. “Life becomes muted and flat, and you stop enjoying things that made you feel alive.”

It can feel as if you’re sleepwalking through life, says Tanith. "You may notice things that used to make you feel good don’t do the trick any longer. It could be anything from that celebration you feel you're supposed to be enjoying, to not feeling chills from music you’ve always loved," she says.

"You may also find that senses, like touch and taste, are less intense,” she adds. “No one enjoys life all the time, but if that spiral continues downwards, and you can’t think of anything that makes you feel good anymore, it’s time to take action.”

Perimenopause and anhedonia

If you’re peri- or postmenopausal, perhaps you’ve dismissed anhedonia as tiredness, apathy, or getting older. However, hormones (or the lack of them) play a significant role here. “Research from Cambridge University Press shows how menopause alters neurotransmitter activity in the brain, which can affect mood, cognition and emotional resilience. It’s a real, neurobiological experience, not just in your head,” says Donna.

Not only does low oestrogen affect dopamine and serotonin, it buffers the effects of the stress hormone cortisol, so when it falls away, cortisol can get the upper hand, explains Tanith. “Other hormones and neurotransmitters also stop working in harmony - progesterone, a hormone which naturally calms you, also drops off. Meanwhile, to add to the mix, testosterone, which gives us a sense of confidence, and GABA, a moderating neurotransmitter, also fall away.”

It’s little wonder, then, that anhedonia commonly materialises during this transition. HRT can help, but it’s not an option for all women.

What does anhedonia feel like?

Everyone's hormones are different, so what perimenopause feels like will be different for everyone. I spoke to two women with anhedonia to reveal what the symptom can feel like.

Anonymous, 53

Anhedonia crept up on me. I didn’t feel sad or low. However, I developed problems with concentration, memory and decision-making and then lost interest in daily activities, even ones I found enjoyable. Everything felt like a chore.

Living with anhedonia feels like the world’s been drained of colour. Food is flavourless, being with friends or family isn’t enjoyable, and TV and films are boring. I spend hours trying to find something – anything – that sparks joy, but all I want to do is sleep or lie on the sofa alone, as I find social interactions draining. It’s like having your emotions turned off and looking at the world through a thick pane of glass. I feel completely disconnected.

I had depression in response to a traumatic life event, so I know what that feels like. This feels different – the symptoms are similar to depression, but I feel more suicidal. In hindsight, I believe it could be connected to unprocessed trauma, made worse by perimenopause.

CBT in menopause enabled me to identify and change negative thought patterns. I set small, manageable daily goals, even if they don’t feel enjoyable at first. This gives me a sense of achievement, even if it’s just texting a friend back.

I'd recommend that people schedule activities that used to bring pleasure, try new activities that might spark interest, or exercise or practice mindfulness to increase awareness and appreciation – even if they don’t immediately feel rewarding. Making an effort to connect with loved ones can provide emotional support.

My mantra is ‘this too shall pass’ and I live by that. I’ve been patient and compassionate with myself, and I set achievable goals, even if it’s having a shower or eating well. I've found that a daily gratitude journal can also be useful.

Anhedonia is isolating and frustrating, but it’s important to remember it’s not a personal failing. It takes time, but keep engaging with the world, even when it’s difficult.

Rhona, 48

I hadn't heard of anhedonia until recently. It hit a chord as numbness is something I've described to various counsellors. Cycles can last days, weeks or months. I’ve felt it since childhood. I remember not wanting to play or be around people, or I'd lack enjoyment, curiosity, inspiration, happiness or sadness. Just existing, feeling numb. At uni, I’d frequently feel disconnected, not having joy for life or a desire to do anything. I missed out on a lot, and continue to do so, but at the time, I didn't care.

It’s isolating knowing that you're physically here but not connected to anything or anyone. As an adult, it spills into not having any desire or pleasure in doing anything. I once described it as feeling like an out-of-body experience. I get numb during stressful periods – more since I developed ME and fibromyalgia, conditions exacerbated by perimenopause and long Covid.

I was also recently diagnosed with ADHD and autism. I discovered that I've been having autistic shutdowns since childhood without understanding what they were – I then transition into numb mode. Numbness can also stem from overwhelm. No one identified it other than saying it's a symptom of depression, and while I’ve had treatment for my mental health, no professional mentioned anhedonia.

I’ve started talking to friends – saying it aloud and labelling it is helping me identify it. I think it's also important to recognise feelings and non-feelings (i.e. numbness). You could write your thoughts down when the numbness is apparent, and reflect on it, though the desire to write may be lacking. With age and greater understanding, I’ve found it’s important to keep discussions going. When our experiences are voiced, it can be powerful for someone else.

What are the symptoms of anhedonia?

"If you’ve stopped enjoying things you love or feel emotionally ‘blank’, pay attention,” says Donna, who recommends you watch for the following:

• Withdrawing from social life
• Dreading the idea of leaving the house or driving
• Lack of motivation or feeling numb around people you care about
• Loss of sexual interest or pleasure
• Feeling like you're going through the motions

Why modern life makes anhedonia worse?

Unfortunately, many aspects of contemporary life harm our brains and our perception of the world. “Our brains were designed to get measured releases of dopamine to motivate us to meet our basic needs, but since convenience became the currency of modern culture, every product and service we use is designed to keep dopamine coming in deluges,” explains Tanith.

“When everything is provided, it’s not surprising that this primal pleasure system gets overloaded and your reward system becomes less sensitive and more blunted. Gradually, your brain’s neurons can lose their dopamine receptors, so it no longer circulates as easily," she says.

Then there’s information overload, which, from an evolutionary viewpoint, our brains struggle to process. “We’re almost constantly in a state of stress due to the always-on nature of tech, world events, the cost-of-living crisis and the 24-hour news cycle,” says Tanith. “This means cortisol levels are constantly raised, with little time to reset, and we feel the effects of elevated cortisol, which makes us feel overwhelmed and burnt-out.”

What's the link between anhedonia and depression?

If you've read this far and are thinking that anhedonia sounds very similar to depression, you're not alone, as the two are often confused by health professionals and those going through it alike. But while concerning and a condition in itself, anhedonia isn’t classed as a mental health disorder.

It is a symptom of numerous conditions, though, including depression, bipolar disorder and PTSD, as well as grief and trauma. It may also be more prevalent in neurodiverse people. It’s thought to be caused by the disruption of, or a deficiency in, the ‘pleasure centre’ of the brain, or an imbalance of neurotransmitters such as dopamine, which is responsible for motivation and reward.

“Anhedonia is often a symptom of major depression, but it’s also a standalone condition, and it doesn’t necessarily mean you’re depressed,” explains Tanith.

Sometimes, we feel it for no obvious reason. "If you have standalone anhedonia, you may not be happy, but you may not be miserable either. There’s a good chance that you often don’t feel like getting out of bed in the morning, but you do anyway," she says.

Is there treatment for anhedonia?

Fortunately, there are various ways to ease anhedonic feelings. “The first is to realise that anhedonia is a ‘thing’ and name it,” says Tanith. “It’s hard to address what we can’t name or describe.”

1. Lifestyle tweaks

Tanith suggests lifestyle tweaks to improve the functioning of your brain's reward system. “Diets high in sugar and preservatives can cause inflammation in the gut and kill microbacteria, which help make feel-good chemicals like serotonin,” says Tanith.

"Eating an anti-inflammatory diet (e.g. more whole foods), encourages the supply of serotonin. Lack of sleep has also been found to interrupt the release of dopamine into the reward system,” adds Tanith, so aim to improve your sleep hygiene and get more core sleep.

2. Find your dopamine hit

Tanith also recommends ‘behavioural activation'. "The principle is that doing something you once enjoyed, no matter how small, is better than doing nothing, even if you don’t feel the good effects right away.”

Try having things in the diary to look forward to, to build dopamine, suggests Tanith.

3. Get around negative thinking patterns

One of the biggest obstacles to overcoming anhedonia is negative thinking patterns. “Our brains are wired to focus on threats (known as negativity bias). It helped our ancestors survive, but now it often keeps us stuck in cycles of fear and emotional shutdown,” says Donna.

“Our minds don’t process negatives well, so when we say, ‘I don’t want to feel numb,’ we’re actually reinforcing that feeling. Instead, reframe. Say, ‘I want to feel reconnected'. This linguistic shift teaches your brain to focus on what you want, not what you’re trying to avoid. Over time, these micro-adjustments can reignite your sense of purpose and pleasure," she says.

4. Reach out for help

Talk to friends, family or a therapist if you're ready to. “Talking therapy can make a massive difference. A good therapist will help you explore what’s going on underneath and give you tools to reframe your thoughts,” says Donna.

You can also ask your GP, but if they’re unsympathetic, “you have every right to ask for a referral or see someone else".

With the right information, therapeutic support and medical care, recovery and reconnection are possible, says Donna. “Start small. Choose one thing each day that brings a flicker of calm, comfort, or joy, and trust that those flickers can grow. You deserve to feel fully alive again.”

Energy fuels everything. It’s the oomph that gets us out of bed in the morning, and it keeps us going when life gets tough. So, what happens when fatigue is top of your list of perimenopause symptoms?

A new survey led by Land of Beds found that over half of women rated their sleep as 'poor' or 'very poor' during menopause, and two out of three reported an impact on their mood and concentration.

"The lack of sleep really affects my concentration during the day, and the fatigue can be overwhelming. The dread when I wake up is impacting my quality of life a lot," said one woman who contributed to the report.

If you’re finding that lethargy is getting in the way of life, it's time to speak to your doctor, as this is often what perimenopause feels like, but that doesn't mean you should put up with it. There are options available, including medication and alternatives to HRT. In the meantime, maybe it’s time to fine-tune your energy levels. Often, it’s not more hours in the day we need, but a get-up-and-go hit to power us through.

Does perimenopause cause fatigue?

Yes, perimenopause can cause fatigue as fluctuating hormone levels impact sleep and have a knock-on effect on mental and physical wellbeing, says Dr Nerina Ramlakhan, a sleep physiologist.

"Poor sleep increases irritability, anxiety, and depressive symptoms. Insufficient sleep impairs emotional regulation, decision-making, and concentration, creating a vicious cycle in which hormonal shifts lead to poor sleep, which in turn intensifies mood problems," she says.

This poor sleep is caused by an imbalance of oestrogen, progesterone, and testosterone that comes with the lead up to menopause, but other factors can also play a crucial role.

For starters, women and men tend to get more tired with age thanks to a loss of muscle mass. "We lose 8% of our muscles every decade from the age of 40," explains Imogen Watson, dietitian and medical manager at Abbott Healthcare. "Muscle strength, energy balance, and feelings of exhaustion are strongly dependent on each other and can create a lasting feeling of fatigue as we age."

High cortisol levels can be the other key contributor, as well as the lifestyle habits (like drinking alcohol) we may rely on to try and lower our cortisol levels. "Excessive stress that is not managed properly and eventually becomes chronic will weaken your adrenal glands and impair your ability to cope, ultimately depleting your energy," says Yuri Elkaim, health and fitness expert and author of The All Day Energy Diet.

Certain medical conditions, such as an underactive thyroid, diabetes and chronic fatigue syndrome, can cause low energy. Tiredness can also cause extreme fatigue, and these aren't connected with perimenopause.

Look out for red-flag symptoms that accompany your low energy. If you have weak muscles, breathlessness or feel generally unwell, see your GP. If you’re in the UK and want to fast-track, a private health check will get to the source of your sluggishness through tests on blood health, thyroid function and protein levels.

How to combat perimenopause fatigue

1. Look at your diet

When it comes to eating for energy, nutritionist Angelique Panagos, author of The Balance Plan, suggests foods that balance your blood sugar levels. "Try to focus on nourishing, energising foods that are simple to prepare. Enjoy wholegrains and complex carbs such as sweet potatoes and oats for a hit of lasting energy, and vitamin B-rich foods, which help to convert food into cellular energy," she says.

"Also, make sure your diet includes plenty of essential fatty acids. These aid our energy production, improve our metabolism and increase the rate at which oxygen is used. For the ultimate energy-boosting meal, add in protein and some chromium-rich foods, such as rye bread, apples or eggs," she says.

There's also plenty of research that suggests a vegan diet for menopause could be more beneficial as it "allows for a higher consumption of macro and micronutrients, causes less inflammation generally in the body and sees improvements in the gut microbiome,’ says Dr David Jack.

"It’s possible to experience a surge of energy, either by switching from meat completely or upping the plant-based meals you eat," he says.

2. Prioritise movement

If you're dealing with menopause fatigue, exercise is probably the last thing you'll want to do, but it's proven that working out can actually help you feel less tired and boost energy levels. For example, a review in BMC Women's Health found that doing aerobic exercise (like walking) three times a week had the most positive effect on women in menopause.

"Regular exercise that becomes part of your daily and weekly routine is what will boost your endorphin levels and consistently lift your mood. It will also improve the blood flow throughout your body, which means everything gets transported around more quickly and efficiently, especially blood and oxygen, which are vital for energy, leaving you ready to go," says Liz Shaw, health and fitness tutor at The Training Room.

We all like different kinds of exercise, so do what works best for you. If you'd rather do an outdoor walking workout than 15 minutes of Pilates at home, pull on your trainers and head out the door, and vice versa.

As much as many people don't do enough exercise in menopause, many do too much. "Warning signs [that you're doing too much] might include having excessively sore muscles for days on end, or arms or legs that feel like dead weights," says Liz.

"Feeling irrationally irritable is another indicator, as is experiencing a desperate need to sleep or not being able to fall asleep. Either of these suggests the body has gone into 'stress mode' rather than getting the positive gains of just enough."

3. Rethink your rest

First things first, ditch the eight-hours-a-night myth. "It’s the amount of sleep over 24 hours that is important, rather than the amount of sleep that takes place during the night," says Dr Chris Idzikowski, director of the Edinburgh Sleep Centre and author of Sleep Well.

"Researchers divided an eight-hour sleep period into two four-hour periods and kept one of those at the same time every day. This is called anchor sleep. They found that sleep rhythms quickly reestablished themselves if anchor sleep was maintained, and it didn’t really matter when the other four hours occurred," he says.

That means naps are doctor-approved - but when you wake up, avoid hitting the snooze button to get better core sleep. "Falling asleep again will leave you feeling groggy because you put your body and brain out of sync with their natural rhythm," says Rob Hobson, nutritionist and author of The Art of Sleeping.

It's also a good idea to wake up and fall asleep at the same time every night. "We all want to catch up on a few extra hours’ sleep, and many people look forward to the Sunday lie-in. But changing your sleeping pattern can knock your body out of routine for the coming week. It’s best to try and stick to the same bedtime and wake-up time if possible," says sleep and insomnia specialist Dr Irshaad Ebrahim. Napping can also help improve performance.

4. Stock up on supplements

It's not possible to supplement your way to a better menopause, but adding more vitamins and minerals to your diet may help. "Increasingly, women are turning to natural supplements, and although the research outcomes are still unclear, it can be worth exploring for many. These include omega-3 fish oils, vitamin D, probiotics, and magesium" says Dr Ramlakhan.

Magnesium can be particularly beneficial for those dealing with perimenopause fatigue as it "helps the body to activate our energy cells", says Dilan Patel, a personal trainer and nutritional advisor. "Not getting enough can lead to fatigue, nausea, and a loss of appetite. It also aids muscle relaxation and binds to a neurotransmitter that reduces anxiety, in turn reducing insomnia. There's no better energy boost than good sleep."

You can do this through oral supplements or by eating more foods rich in magnesium, such as nuts, bananas, and leafy greens.

What does perimenopause fatigue feel like?

Perimenopause fatigue will feel like deep exhaustion that can leave you feeling drained, with brain fog, struggling with regular activities, and generally unmotivated and lethargic. There might even be physical symptoms - like having a weaker grip.

Another participant in the Land of Beds survey described her sleep problems and associated fatigue as "the worst time of my entire life", with the constant interruptions making her "irritable in the day and very tearful".

Welcome to the woman&home Quiz of the Day. It's our fun, quick quiz you'll find here every Monday to Friday, which will test what you know about the biggest talking points and topics of the moment.

October is Menopause Awareness Month - and with Menopause Awareness Day just days away on the 18th, it's time to see if you really know the menopause myths from the truth about the change.

Whether it's symptoms of the perimenopause, the pros and cons of HRT or the link between menopause and hair loss, we think it's important to be clued up.

Share your scores and let us know how you did in the comments section below!

“Getting my four kids into the car, I sighed, feeling exhausted and unmotivated. I was 43 years old and everything was incredibly hard, yet I had no idea why,” says Katie Taylor, now 56.

“Up until that point, I’d been coping with life just fine. Yes, it was busy juggling being a mum and working in marketing for a charity, but I’d got through it all.

“Now, I found everyday things difficult; it was like walking in sticky treacle.

“Over the next four years, I experienced heart palpitations, aching joints and insomnia – most nights, I was getting just three hours of sleep.

“My mood was also extremely low. While watching a comedy series with my husband, Hugh, and the kids one evening, they all laughed along, but I could barely raise a smile.

“At work, things were also tough. I had brain fog all the time. I couldn’t think straight and I’d lost my confidence. Most meetings, I’d end up crying, feeling like I was a fraud.

“Throughout this period, I saw my doctor multiple times. He suggested I was depressed and offered to prescribe me antidepressants, but I didn’t want them. My life looked good on paper; I didn’t think I was depressed.

“I was convinced that I had early-onset dementia and my doctor agreed that it could be a possibility, but an appointment with a neurologist ruled it out.”

Losing confidence in myself

“With no answers, I continued ploughing through, feeling the shell of the woman that I once was. Struggling at work, I even had to get Hugh to help me write a presentation as I couldn’t think straight.

“I felt so paranoid and convinced that I was going to be fired that I ended up quitting my job.

“The turning point came when I was on holiday in Italy with Hugh and the kids. Watching them all giggling together in the pool, I felt impending doom. Usually, I felt amazing when I was on holiday, but all I wanted to do was go home.

“When I did get back, I spoke to my dad, Michael, who was a breast cancer professor. ‘I don’t know what’s wrong with me,’ I cried. He told me to see a gynaecologist he knew who specialised in hormonal health.

“Within 10 minutes, she said, ‘This is classic perimenopause, these HRT patches will help.’ Back at home, I felt relieved, but also angry. I’d spent four years feeling like this, even thinking it was dementia.

“Why has it taken so long to get the right diagnosis?”

Creating a community

“I decided I wanted to help other women, so I set up a Facebook group, calling it The Latte Lounge. Whenever I met up with a friend for coffee, we put the world to rights and that’s what I wanted to create here.

“Incredibly, overnight, 1,000 women joined the page, sharing their similar frustrations. ‘Oh my god, I’ve needed this,’ women wrote, as they shared their stories of losing jobs, being dismissed by doctors and even feeling suicidal from the perimenopause.

“I wasn’t alone – there were women all over the world suffering and I wanted to help.

“I put a team of medical experts together and built a website that was brimming with articles, tips and advice to help guide women through this stage of life. To reach more women, I even started a podcast, interviewing medical specialists about menopause.

“As for my own journey, within two weeks of using the HRT patches, I felt like a new woman. The brain fog cleared, I had bundles of energy and I slept like a baby. Watching the same comedy series as before with Hugh, I now chuckled throughout it. ‘I’ve not seen you laugh in such a long time,’ he said.

“I finally felt like myself again.”

Helping the next generation

“Running The Latte Lounge led to me writing a book, Midlife Matters, where I spoke about my own experience and brought together 48 health specialists to help women as they tackle midlife. It’s like a bible for my daughter and the next generation as they navigate this tricky chapter.

“Alongside this, I also ran panels at companies, where their employees could come and listen to experts discuss the menopause. A real ‘pinch-me’ moment was when I went to 10 Downing Street and delivered a panel to their staff.

“I’ve also worked with others on campaigns to make sure that we are all more educated and informed on the menopause. I even created ‘The Midlife Festival’, an annual online event where women can listen to talks from multiple experts that’ll support and guide them through this stage of life.

“Although I went through hell myself, I never imagined I’d achieve everything that I’ve done with The Latte Lounge and without my own journey, I wouldn’t be doing the things that I’m doing today.

“There are women all over the world struggling through menopause, but I want them to know that they’re not alone and with the right support, it can be a much more joyous experience."

"When I had a meltdown in Sainsbury’s at the age of 45 because they didn’t have the strawberry yoghurt that I wanted, I had no idea that it was actually down to perimenopause,” says MTick founder Heather Jackson, now age 56.

"It was a weird time. I’d sold my previous business, the kids had gone to uni, and I was finally free to start ticking things off my bucket list. I should have been excited and happy, but instead, I was experiencing daily heart palpitations and feeling utterly exhausted.

"Minor insignificant things in life became a big problem, and I was suffering from a bad shoulder ache. Over the next few years, I saw my doctor multiple times. He suggested it could be depression and even tested my thyroid, but nothing seemed to be the right diagnosis.

"‘The kids have gone and you’ve sold your business, maybe you’ve lost your purpose?’ one friend suggested. But I knew that wasn’t the case; working towards this moment had been my purpose.

“So why was I feeling this way?”

Finding the answer

"Speaking about it with my friend and eventual co-founder, Sam, she said, ‘I don’t think you’re depressed, you’re experiencing perimenopause symptoms. I’m going through it too.’

"Typing it into Google, I saw that everything I’d been facing was a sign of perimenopause. It made sense. Finally, I had answers, and now that I knew what it was, I thought I could get on with my life. Little did I know it wasn’t the case at all…

"I needed advice to help me with my signs, but there was hardly anything out there. Whether it was sourcing cooling bed sheets to help with the night sweats or haircare products to support my thinning hair, finding the right products was incredibly hard. Brands that I’d trusted my whole life were now letting me down.

"And when I searched the word menopause on the internet, it was underwhelming. There was little to no information. Surely I wasn’t the only woman going through this?

"‘We need to build a one-stop shop with items specifically for menopause,’ I told Sam. She agreed."

Making a change

"Thinking about it more, I realised that we needed to make menopause the new veganism. Just like the universal ‘V’ for vegan products, I wanted to create an ‘M’ symbol for menopause-friendly products.

"We commissioned an independent report, The Invisibility Report, to find out if women in the UK really needed help with this stage of their life. It turns out they did – a shocking 87% of menopausal women felt invisible and let down by society and brands.

"Sam and I decided we needed to do something about this. So, we created GenM, a movement dedicated to helping women as they go through menopause, ensuring that their experiences are better.

"I knew we had to take the fear out of the menopause and encourage women to thrive during this time.

"We started meeting with retailers, explaining that there was a commercial problem when it came to menopause-friendly products. During a conversation with Boots, I floated my idea of adding a symbol to products that have been verified as being menopause-friendly.

"Sketching out an M with a tick on it, I told them that this was the future, calling it the MTick. They loved the idea and agreed to test the symbol on thousands of their products.

"It was a huge success, and now, they have specific categories on their website showcasing menopause-friendly products."

A symbol of trust

"Since then, we’ve collaborated with hundreds of brands and retailers to showcase the MTick, the universal shopping symbol for menopause-friendly products – empowering women to search, source and shop with confidence, to find products that ease or relieve one or more of the 48 symptoms of menopause.

"Every single product that gets the MTick certification goes through a rigorous process first. We have a compliance team that will review the product against our MTick menopause-friendly criteria, created alongside Boots’ legal and pharmacy teams, to make sure the products have evidence to support how they can help support one or more of the multiple menopause signs.

"We also ensure our brand partners are in adherence with the ASA (Advertising Standards Authority) to ensure that it’s accurate when products are marketed as menopause-friendly.

"Whether it’s cream for itchy skin or toothpaste for receding gums. Our symbol is one of real trust, and we’re encouraging retailers to lead differently, giving women the change that they need and deserve.

"The response from retailers and brands has been incredible – and it’s not hard to see why."

Shop MTick bestsellers

In a candid interview to mark the paperback release of her bestselling book, Want, Gillian Anderson has shared the much-needed reminder that neither "life" nor pleasure ends at "50 or at menopause" – in fact, you might just be beginning.

When we reviewed Gillian Anderson’s Want upon its release late last year, we shared in the general consensus that the book was a completely “addictive and compelling read.”

Sharing 174 sexual fantasies sent in by women of all ages and backgrounds across the globe, the collection gives a raw and unfiltered look at women’s connections to their bodies as well as to sex – and it’s certainly got people talking more openly about their own desires.

That’s just what Gillian wanted, she’s revealed in a new interview. And she’s especially delighted with the way the book has resonated with women whose desires have traditionally been put on the backburner.

Speaking with Stylist, she revealed, “Sadly, I think many women worry that at a certain age they won’t be desirable any more, or that they won’t feel desire as it will disappear with menopause or post-menopause.

"But, what I’m hearing is that perimenopause and menopause are almost like a new frontier, where women feel more curious and bolder than they perhaps were previously.

“I’ve heard from women in their late 50s and 60s who are on dating apps and are getting interest from much younger men, and I think that’s fascinating,” she added.

“Women are starting to realise that life does not end at 50 or at menopause and that there is a whole new world of pleasure out there that they can embrace and lean into.”

If, like us here at woman&home, you are a fan of her book, you’ll be delighted to know that it’s getting a sequel – though Gillian isn’t 100% sure what the next book might look like.

“We don’t know what it will look like at the moment – and that’s really exciting,” she said. “It might be the same but different. It might be a whole new conversation. I’m just very curious to see the degree to which our participants give themselves free rein to expand and share deeper and bolder desires.”

Her plan starts with you, the readers. Gillian explained, “I want to read each and every submission to figure out what the next book will look like. During the first book, we started to put some letters aside that felt like they were attempting to open up more conversations about sex in general, the nature of fantasy and the impact of fantasy psychologically. So maybe that will be the direction of the next one.

“We don’t know what it will be at the minute – and that’s fascinating in itself – so I don’t want to put any pressure on it.”

While there’s no release date for her new book, and the submissions only just closed last month, we’ll keep you updated with any and all news on Want’s sequel.

Perimenopause is usually assumed to be something that women start going through at around 45, but many women notice changes in their bodies as early as their 30s.

Indeed, a 2025 study from Menopause Care found that for 39% of women, perimenopause began earlier than they had expected.

When women did eventually suspect that their symptoms might be hormonal, only 56% felt supported and understood during their first GP appointments. Dismissed by medical professionals, women are forced to soldier on through their life-controlling, crippling symptoms until they plead their case long enough to be seen and heard.

We spoke with three women who kept advocating for themselves to doctors until they were finally prescribed HRT for early perimenopause.

Overlooked symptoms

For many women, perimenopause symptoms – from changes to their menstrual cycle lengths, to hot flashes, sleep problems, and vaginal dryness – are often just excused away, by themselves and doctors, as a normal part of getting older.

Near the end of 2019, Jenny Lucas, then 35, a mother of two and full-time music teacher in Berkshire, UK, constantly felt overwhelmingly tired and foggy-brained.

“Sometimes I would struggle to find the right word when I was talking,” she tells us. I was worried it might be early-onset dementia, as it does run in my family.

“I went to the doctor and had blood tests, which came back normal, three times over a period of 18 months."

Emily-Pomroy-Smith, 37, founder of a haircare business in Wiltshire, UK, also initially struggled to find explanations for her symptoms. Having always been able to sleep well, Emily suddenly found she couldn’t drift off once she turned 35.

“I would just lie awake at night, not able to shut off my brain,” she tells us.

“There was the knock-on effect of not having sleep – brain fog and irritability. The insomnia got worse, and alongside that, I was struggling to shift weight despite exercising and eating healthily, and I had low libido and lots of hot flashes. My periods had also become shorter, but very painful.

“Doctors did all the blood tests and just said I was a bit iron-deficient.”

Facing a similar experience, Anita Guru, now 44, from Surrey, UK, started to get erratic periods, hot flashes, low mood, brain fog, and anxiety when she was 39 – changes that holistic therapists, friends, and family suggested were “just stress.”

Why we thought it could be perimenopause

In the last 10 years, menopause symptoms have been talked about much more than in previous generations. Women are now armed with information and able to identify changes in their bodies, understanding that the cause could be down to hormone fluctuations.

“I’d heard on TV that perimenopause can start early, and thought that all of my symptoms could be down to that,” Jenny says.

“It was my mom who suggested I might be perimenopausal when she watched me have a hot flash while talking with her,” Emily says. “She told me she had gone through it early too, and wished she had gotten on HRT earlier. She pushed me to see another doctor.

"As far as I know, none of my peers have gone through this, so had it not been for my mom, perimenopause wouldn’t have even been on my radar.”

It was heartbreaking to be dismissed

Having built up the courage to speak to doctors, women often feel let down by the doctors they’ve seen. Menopause Care’s study found that only half of women felt supported and understood during their first appointment about their menopausal symptoms, with one in five saying their symptoms weren’t diagnosed correctly on their first visit.

When Jenny told her doctor she thought she might be experiencing menopausal symptoms, he “dismissed” her concerns.

“He said I was too young – that I was just a busy mom,” she says. “Another doctor told me it was just a natural part of life, and that I just needed to adjust my diet.

“It was heartbreaking to be dismissed, and I didn’t know who else to speak to.”

Gearing up for her second round of IVF, Anita told several GPs, gynaecologists, and a fertility doctor about her unusual period pattern, hot flashes, low mood, brain fog, and anxiety.

“They all told me I was too young to be perimenopausal,” she tells us. “I felt gaslit. It was like I was screaming into an echo chamber and not being heard.

“But all the symptoms were getting worse. It was all having a huge impact on my mental health and on IVF treatments. I would wait for my period to come so I could start IVF, but then my period wouldn’t come as planned.

“I spent hours researching perimenopause, convinced this was what was happening in my body.”

Listened to at last

For a couple of months being initially dismissed by doctors, Jenny doubted herself, thinking perhaps she wasn’t perimenopausal. “But things weren’t getting better,” Jenny says. “If the exhaustion carried on, I knew I might have to quit my job.

“I requested to speak to the women’s health doctor at my health practice, and pushed her to let me try HRT. I told her I couldn’t live the rest of my life this tired. She was reluctant, but said I could try it for three months to see if it worked.”

Only a few months ago, in April, Emily also booked in to see the women’s specialist at her GP practice.

“She listened to me, and said it did sound like it could be perimenopause,” Emily says. “After doing blood tests, she said my hormone levels did indicate that I could be perimenopausal. She offered to prescribe me HRT if that was the route I wanted to go down.

"It was a huge relief for someone to tell me that this wasn’t ‘all in my head’, and that something could actually be done about it.”

Anita finally spoke to a GP who identified that her symptoms could be due to perimenopause.

“I later found out that my early perimenopause could be traced back to endometriosis I’d been diagnosed with in my early 30s,” she says. “I had a lot of surgeries and my egg count dropped as I shed layers of my ovaries through surgeries, leading to premature menopause.”

The impact of HRT

All three women were eventually prescribed HRT, and each experienced some degree of reprieve from their perimenopause symptoms.

“I’ve now been using HRT for two years, and it has reversed my symptoms,” Jenny says. “It’s so wild the difference HRT can make. It’s been life-changing.”

Emily is currently using a combination of estrogen patches and progesterone tablets. “In just two months of using HRT, my insomnia has gotten better and I’ve been able to lose some weight,” she says.

“My periods are more normal, too. I think there are still some tweaks to be made – my temperature regulation still isn’t great. But the women’s health doctor I saw has planned check-ups with me to reassess what we can do differently.”

Anita was prescribed estrogen gels and progesterone tablets a year after her symptoms had started. “The HRT has hugely improved the hot flashes, but I’m still struggling with my brain fog, lack of concentration, and low mood.

"HRT has been helpful, but it isn’t a magic pill,” she says.

“I’ve heard about women who feel hopeless when they don’t feel seen or heard. And I get it. We do all we can to help ourselves and nothing works, and no one listens. If I hadn’t kept pushing, I don’t know what my life would look like now.”

There are lots of proven ways to deal with menopause symptoms like hot flushes, including exercise, avoiding trigger foods, and wearing light clothing. This is one of the few studies suggesting that including more of something in your diet could be the way forward.

The study, published in Menopause, the journal of The Menopause Society, found that following a vegan diet for menopause can significantly reduce the severity of hot flushes.

The results came after researchers reviewed data on the benefits of a low-fat, plant-based diet. After 12 weeks, severe hot flushes were reduced by 92% in a vegan group of participants who supplemented the traditional plant-based diet with soybeans.

No significant changes were seen in the control group that followed an omnivorous diet.

Interestingly, the level of processing in the soybean product didn't make a difference either, confirming experts' theories that animal- and plant-based foods affect our bodies differently, even if they are equally processed.

The soybean-rich diet was also found to help sustainable weight loss, with a mean loss of 3.6kg for the vegan group and 0.2kg in the control group.

"This study highlights the potential positive effects of a plant-based diet rich in soy (regardless of the level of processing) in terms of both hot flash and weight management," said Dr Stephanie Faubion, the medical director for The Menopause Society. "Given these and the other known benefits in terms of lowering heart disease and cancer risk, women in midlife should consider leaning into a plant-based diet."

While this study is unique in linking soybeans of all processing types with a lower severity of hot flushes, it's not the first to suggest a vegan diet for menopause.

Research published in the Complementary Therapies in Medicine found a link between a soybean-rich vegan diet, gut health, and perimenopause. "A vegan diet with soybeans is rich in fibre and compounds called isoflavones, which help increase the abundance of gut bacteria that fight inflammation and stabilise oestrogen levels, which helps fight hot flashes," said Dr Hana Kahleova, the lead author of the study.

"Avoiding meat also helps to decrease the amount [of] gut bacteria linked to increased inflammation," she said.

What are soybeans?

Soybeans are a legume, part of the pea family. They are used to make different foods in Chinese and Japanese cuisine, with the products becoming more popular in the UK in recent years, according to the British Dietetic Association (BDA).

The BDA says some people believe soya foods can reduce the risk of heart disease and a reduction in menopausal symptoms (due to the isoflavones they contain), as the research above found.

Where can you find soya-rich products?

• Edamame
• Tofu
• Soya-based mince and meat alternatives
• Soya milk
• Soya-based yogurts
• Miso
• Tempeh
• Soy sauce
• Some types of protein powder

A note on ultra-processed foods

The study highlights the benefits of a vegan diet for menopause and suggests that, regardless of whether the soybean product is an ultra-processed food or not, you'll see the benefits.

It's important to note that ultra-processed foods have been linked to adverse cardiometabolic and mental health conditions and overall higher mortality risk, so they are not suitable as a large component of any diet.

Where possible, soya-rich natural foods and products that have undergone limited production will be best. Edamame, for example.

Oprah Winfrey might be one of the most - if not the most - famous talk show hosts in the world, but she's also become one of the celebrities most open about her experience of menopause in recent years.

As we hit midlife, it can be really difficult to work out what perimenopause feels like - whether a problem is a symptom, down to stress, or something else entirely. Add to this the fact that we all go through this transitional stage in different ways and that information on menopause isn't as expansive as we'd hope it would be, and it can feel like an uncertain time.

No one knows this more than Oprah Winfrey, who opened up about her experience in an interview on ABC News' Good Morning America ahead of releasing her new show, An Oprah Winfrey Special: The Menopause Revolution, which is available to watch in the UK on Disney+ from today.

The 71-year-old appeared on the show to talk about her menopause symptoms and how they affected both her personal and professional life.

Alongside mental health and cognitive challenges, Winfrey said she experienced an issue for two years before she knew it was a perimenopause symptom that was so severe, she felt like she was "going to die every single night".

She told the hosts: "I didn't have night sweats, and I didn't have hot flashes, but I had never heard that heart palpitations was a symptom of menopause. When I was going through it, there was nothing. There was nobody. I felt literally like I was going to die every single night."

She said her symptoms were missed by doctors, even when her heart rate hit 212 beats per minute, and it was only when she read about palpatations in a book that she put the two together. “That was the first time that I learned that those were symptoms that the change was coming," she said.

The British Heart Foundation says heart palpitations are a common symptom for some women as oestrogen levels fall, although the exact cause isn’t clear. The charity recommends trying relaxation techniques such as meditation or yoga to ease anxiety, stress, and other menopause symptoms.

Winfrey said she wanted to talk about her experience to encourage other women to share what they’re going through. "Because it affects every cell in your body, the first time you have any of the symptoms, that's when you need to go find a doctor who will listen to you, hear you and take action for you," Winfrey said.

The star said another symptom she really struggled with was a loss of concentration, which affected her ability to enjoy one of her favourite hobbies. "The worst part for me, this is when I knew I was really in trouble, is when I couldn't concentrate reading," Winfrey told ABC News' Kayna Whitworth. “I love reading so much, but I let go of the book club because I could not concentrate when I was reading. I could no longer finish a book.

“I brought [the book club] back when I started taking oestrogen because I could concentrate again, but I actually never shared that before, that the real reason I had to stop it is because I could no longer concentrate. It makes me want to cry,” she said.

Winfrey started the book club on her talk show The Oprah Winfrey Show in 1996, and it ran until 2011. She re-launched it as Oprah’s Book Club 2.0 in 2012, and it still runs today.

It’s our fluctuating and declining oestrogen levels that cause many perimenopause symptoms, such as hot flashes, night sweats and low mood, which is why many women choose to start HRT (hormone replacement therapy). Winfrey doesn’t say whether she started taking HRT specifically but suggests her symptoms improved when her oestrogen levels rose again.

Celebrities Maria Shriver, Naomi Watts and Halle Berry also appear in An Oprah Winfrey Special: The Menopause Revolution. Berry is another star who’s been speaking openly about her menopause journey recently, discussing her exercise habits in menopause and why she does 'no cardio' these days.

Watts has talked openly about starting to experience her first perimenopause symptoms when she was just 36. She has spoken in interviews about how it caused fertility struggles with her then-partner Liev Schreiber. The actress, who is now 56, released a book called ​​Dare I Say It: Everything I Wish I’d Known About Menopause earlier this year.

The Elitone pelvic floor trainer is the go-to for those with more to spend who want the easy life when it comes to improving the strength of their pelvic floor. Having never used a trainer before, I had some doubts, but the results I saw after six weeks made me a big fan of the brand.

Bladder leaks and drips are no joke and can land anywhere from a minor inconvenience to a life-changing problem, trust me. As a woman in menopause who's birthed two children, I know these issues only too well. I also know I'm far from the only one, with a study by the Royal College of Obstetricians and Gynaecologists finding that at least 60% of us suffer some form of incontinence and other issues related to a weak pelvic floor, mostly due to childbirth and menopause. Finding ways to deal with the issue is vital.

Of course, you can strengthen your pelvic floor without using one of the best pelvic floor trainers. Kegel exercises are proven to help and are completely free to do. But if you're like me and struggle to do them or wish something could just do them for you so you don't have to think about it, these devices can offer hands-free help - and the Elitone is one of the very best. I tried it for six weeks and haven't looked back.

Elitone pelvic floor trainer review

Specifications

• Material: Non-toxic hydrogels
• Dimensions: 20 x 9 cm gel pad
• Charge time: 1 hour
• Battery: USB rechargeable
• Running Time: 3 days of use maximum
• Warranty: 6 months
• Waterproof: No
• Storage: Charging case for controller and cables but not the gel pads.

Who is the Elitone pelvic floor trainer for?

Elitone says the pelvic floor trainer is for everyone - all ages and incontinence severity - but those with a weak pelvic floor postpartum, those going through menopause, and those with urgency symptoms will find particular benefit.

Most pelvic floor trainers are worn internally and require you to do Kegel exercises around the device. Not only is this invasive, but it requires a good knowledge of how to do Kegel exercises before you've even spent money on the device. Not the Elitone - it works by delivering small electrical signals to the pelvic floor muscles, mimicking the effects of Kegel exercises without you actually doing them, making it perfect for beginners and those who'd rather avoid using a device internally.

You will need to use the Elitone pelvic floor trainer at home, however. As the device is made up of a controller and gel pads, it's not very portable - unlike other devices, such as the Elvie pelvic floor trainer, which is woman&home's top pick. The controller itself and charging cables fit nicely into the provided storage case, but the gel pads are too big and don’t fit the case. This makes it a difficult device to travel with, but unless you're looking to take your pelvic trainer on holiday with you, this shouldn't be too much of an issue.

What is the Elitone pelvic floor trainer like to use?

First things first, the Elitone pelvic floor trainer is made up of a controller and 10 gel pads - and is unlike any other one I've tried. The gel pads are stuck to plastic sheets, about the size of a DL envelope. When you peel the gel pad off its plastic sheet for the first time, you’ll see just how sticky the gel is.

Positioning them around your vagina is a little tricky initially, but I soon got the hang of it. The gel pads fit around your anus and vagina, all the way up to your pubic bone. Once in place, the gel pads are comfortable, and you could easily forget you’re wearing them. If you have a lot of pubic hair, there may be some trouble getting the gel to stick to your skin, but I didn’t find this to be an issue. And don't worry, it's not like ripping off a plaster when you remove the gel pads - they peel away from the skin very easily.

Once the gel pad is in place, the gel pad cable can be clipped on. This is attached to the controller at the other end. Switch on the controller by holding down either the plus or minus button and press the plus button until the electrical pulses are at the level you feel comfortable with. The controller has a belt clip so you can attach it to your clothes and go about your business while the Elitone goes through its program. It’s completely silent, which I appreciated, so no one would know you’re wearing it.

When the 20-minute cycle is over, simply remove your Elitone. The gel pads can be used at least three times or until they lose their stickiness, which I found to be around five times and enough for six weeks of usage. Once you've bought the device, you'll need to replace the pads to keep using it. These can set you back between £25 and £30, depending on where you buy them from, so there is some continued cost.

Elitone recommends using the device four or five times a week, spacing out the sessions. I found this doesn’t leave many rest days, so it was difficult to space out the rest days at first. I started out using mine every other day and gradually added in more days once I’d got used to it.

I did have some teething problems with the Elitone. If you hit the plus button to increase the level of stimulation without a slight pause in between each tap, the controller issues a red light warning and switches off. I had to contact support over this as I thought my controller had malfunctioned. The answer was to turn it back on, and if the green light shows, which mine did, to tap the plus button more slowly, which worked for me. But the controller is very sensitive. A few times, I simply picked up the controller and accidentally turned it on.

Once you get the hang of using it, though, and you learn how to handle it with care, it is really simple. Getting used to the intensity of the pulses was more of a learning curve for me than using the controller. I started off light, unsure of how quickly to go all in, but after a couple of weeks, I turned the intensity up and found this completely bearable. I also felt like it was having more effect. In hindsight, I would have turned the Elitone up higher from the beginning if I’d known how comfortable it is.

Despite the teething problems, the only issue I actually found with the Elitone was charging. It needs to be charged very regularly - between every second use, I found, and sometimes every use if I turned the stimulation up high. This was a little inconvenient as I would attach the gel pads and be set to use it, only to find the battery was dead. I'd like to see a longer battery life for this price tag but it does only take an hour to charge.

Results after 6 weeks

I used the Elitone pelvic floor trainer for six weeks, as is recommended to see results, and I really liked it. It's non-invasive and easy to use once you get the hang of it. I also liked that you could go about your day while wearing it, unlike other devices (such as the Juno Femfit pelvic floor trainer and Intimina pelvic floor trainer) where you do prescribed programs a couple of times a week. There are benefits to the little-and-often method and it may work better for some people, of course, but I preferred this way of training my pelvic floor.

But most importantly, it actually works. After six weeks, the main difference I've found (that's truly life changing) is the reduction of urgency symptoms. Anyone who suffers from urgency incontinence knows how inconvenient this can be, so I was very impressed with this. I also have a lot less bladder leakage, which is the end goal for any pelvic floor trainer. All without having to do any Kegel exercises or wear an uncomfortable device.

If you are considering buying an Elitone, keep in mind, after the recommended six weeks of use, most women do feel the need to continue using it, though less frequently, to keep on top of leaks.

Is the Elitone pelvic floor trainer worth buying?

Yes, without a doubt, if your budget can stretch to the £399 price tag, then the Elitone pelvic floor trainer is a winner. With such ease and good results in just over a month, I do think it's worth it - without a doubt. The benefits I've found are completely life-improving, and I'll keep using the trainer for as long as I need to.

However, you do trade money for convenience here. There's no getting away from the fact that this is an expensive device to buy, and the ongoing cost of replacing the gel pads (between £25 and £30) is worth considering as well.

No matter your age, a fulfilling sex life is always important, whether with a partner or by yourself, and no matter what 'a fulfilling sex life' looks like for you.

From navigating your own personal journey around sex and the menopause and the ups and downs that may bring, to getting out of a sexual dry spell or improving intimacy in your relationship, or even exploring ways to be intimate without sex, we can all stand to work on some areas of our sex lives as we get older.

We spoke to these five women who are working to ensure we can all spice up our sex life as we enter mid-life and beyond – and you might be surprised at just how much there still is to explore. Here's what they've learned.

1. Explore cervical orgasms

"I burnt out in my 30s, working in a corporate job I didn’t enjoy, so I took time out to travel and rethink my life. In Southeast Asia, I discovered yoga and meditation, and knew I wanted a more fulfilling purpose. At the same time, I felt blocked sexually. I’d had a string of one-night stands and hated my body. I had no understanding of pleasure, but at a tantra-focused yoga school, I explored my sexuality. The breakthroughs were incredible," shares Mangala Holland, a female orgasm expert.

"With the help of a guide, I discovered how to achieve mind-blowing, cosmic, cervical orgasms, which result from gentle, sustained stimulation on the cervix. It tends to feel very different to the ‘peak’ orgasms that we have from clitoral stimulation, creating a long-lasting sensation that’s like gentle, warm waves across the whole body. Many women find that these cervical orgasms feel more emotionally satisfying.

"I wanted everybody to know what their body was capable of, because I’d got to my late 30s thinking that short clitoral orgasms were all there was. I went on to train in a variety of wellbeing practices, including coaching programmes, energy healing and massage.

"I have now been teaching this material for over a decade, to women all over the world. The work is non-confrontational, in that there is no nudity. I invite my clients to do the practices and explore themselves alone.

"Many women tell themselves they will never enjoy sex, alone or with a partner. But whatever blocks people have can be worked through. It is never too late to find your peak sexual pleasure. I have clients in their 70s having the best orgasms of their lives."

2. Work on emotional connections

"My job as a paediatric clinical psychologist, working with families affected by the onset of life-changing chronic illnesses, and seeing the impact this often had on couples, led me to specialise in relationship and psychosexual therapy," begins Dr Amani Zarroug. "Now, I see those who want to work on relationship and sexual issues, such as mismatched sexual desire or various diagnosable conditions. Others are trying to overcome infidelity or psychosexual issues.

"With erectile dysfunction, the root cause is usually psychological. However, I always advise people to rule out any medical conditions prior to therapy.

"There are always dynamics to unpick, life transitions to address and a journey to owning who we are sexually. For those in long-term relationships, sexual satisfaction can dwindle. But sex harnesses an emotional connection, so it’s important to nurture it. When couples make improvements in their sex lives, it improves other areas of their relationship. It works the other way too.

"It’s important to focus on all the things that bring us pleasure. When I’m not working, I love spending time with my children, and I’ve discovered an amazing Angolan dance called Kizomba, which has become a passion.

"But watching my clients transform their wellbeing gives me joy. They will get to a point they didn’t think possible, and it impacts every area of their life. It is beautiful."

3. Invest in sensual lingerie

"Turning 60 was a profound milestone for me. I’d spent decades focused on raising my son and caring for my elderly mother, and I didn’t know who I was any more. The feeling was all the more apparent when I found some underwear I hadn’t worn in years. I knew I’d never fit into it again because my figure had changed as I’d aged. It made me sad that most lingerie only looks beautiful on younger, thinner women," says Maria Chapman, founder of luxury lingerie and loungewear label Club M.

"Where were the lingerie and bras for mature ladies who still want to feel sexy? I’d done some online research and rang several manufacturers, who confirmed what I’d suspected – there was a gap in the market for women like me. So I decided to fill it myself. I knew little about the lingerie industry, but everything about being a woman who deserves to feel beautiful.

"So I am now busy sketching designs and sourcing fabrics for my new luxury lingerie and loungewear label, Club M, designed to make women over the age of 60 feel stylish and sensual. Ethically made in the UK, the first line launched in October. My quest is to make mature women feel fabulous, loved and comfortable, no matter their shape or size."

4. Feel proud of sex toys

"A few years ago, I was shopping for pleasure products. I was nearly 40, but the toys looked the same as when I was a teenager – all bright pink, phallic things that screamed, ‘I’m a sex toy!’" says Jemma Sawyer, founder of women's sexual health and wellbeing platform ILOH.

"I should have felt empowered shopping for my sexual needs, yet I was looking over my shoulder, feeling shame. The experience led me to set about creating that difference for other women.

"In November 2020, I launched ILOH, an online platform providing sexual health and wellbeing products; the name comes from ilo, which means ‘pleasure’ in Finnish. I aim to help women shift their mindset by providing a shame-free shopping experience. All the products are designed to be kept in the open, not shamefully stuffed away in a drawer. Business boomed.

"Ignore the sex we see on TV. Two thrusts and everyone orgasms in unison? It’s unrealistic. Find out what kind of pleasure you are into and bring products into the bedroom to help you get there. The best sex toys aren’t a substitute, but an accompaniment to your lovemaking."

5. Explore your post-menopause sexuality

"My marriage ended 25 years ago, and since then, I’ve had other sexual partners. But when the menopause hit, sex became so painful and uncomfortable, I didn’t want it at all. Many menopausal women struggle with vaginal dryness, which causes discomfort during sex. Fortunately, an oestrogen pessary helped transform my sex life, making it pleasurable once again," shares Suzanne Noble, host of the podcast Sex Advice for Seniors.

"As we age, our bodies and arousal patterns are different, and low libido in menopause is common. It’s not just women – half of all men over 40 struggle with erectile dysfunction. We need to realise that penetrative sex doesn’t have to be the goal, or even on the agenda. It’s OK to spend time hugging and kissing with no pressure for it to lead anywhere.

"In 2022, I started my podcast, Sex Advice for Seniors , to help older people ask questions and, yes, have sex. It has helped thousands of listeners explore their sexuality.

"If you want to have sex as you get older – and not everybody does – it can be the best ever. You might need lingerie to help you feel sexy. You might need lube and vibrators to reach orgasm. But if something is holding you back, there are always solutions. We can all enjoy the journey to great sex."

More tips

If you'd like to shake up your sex life, these tips might help you out:

• Slowing down your touch, movement and breath makes you more aware of every micro-sensation, which can heighten your pleasure and orgasms.
• If you struggle with self-pleasure, try repeating permission-giving affirmations in your mind to help you relax as you touch yourself.
• Rediscover yourselves with new dating ideas.
• Make the effort to appreciate each other by creating excitement and changes to the familiar – you could even try one of the best sex positions after menopause to mix things up in bed.
• It’s never too late to buy a sex toy. There are many to choose from, but start with a bullet vibrator or a small wand vibrator that is easy to hold and operate, preferably USB-rechargeable.

Continue reading

Age, hormonal changes, exercise routine, and other lifestyle factors can take a toll on the body, leading to stiff joints and aching muscles. But you don't need to spend hours stretching out to work out how to loosen stiff joints, a simple 10-minute routine will do.

Stretching and mobility exercises can help alleviate the discomfort - but if it's not done correctly or frequently enough, stiff joints can put us at risk of injury down the line, says Laura Wilson, physiotherapist and founder of The Swiss Touch. "Stiffness reduces the joint's range of motion and is accompanied by pain, limiting activities and creating a cycle of inactivity and worsening stiffness. To compensate for restricted movement, the body also often adopts unnatural patterns, placing added strain on other joints and muscles and increasing the risk of secondary issues."

Even a 10-minute stretching routine like this one can help loosen stiff joints and keep you moving. You could also pick up one of the best stretching apps to see a difference. However, if the problem continues, it's important to speak to your doctor and/or a physiotherapist as stiff joints can signal other health conditions and you may need more intervention.

How to loosen stiff joints

Physiotherapist Laura Wilson reveals how to loosen stiff joints with these five simple stretches. All you need is a yoga mat or some comfortable floor space to do them.

What else can help stiff joints in menopause?

Regular walks and weight-bearing exercises, along with a good protein and vitamin intake can help build bone and muscle mass to help keep joints moving smoothly, says Dr Aarthi Sinha, a GP who works with menopause platform Issviva.

This might include prioritising getting in 10,000 steps at home, including a quick 15-minute Pilates workout in your routine, or upping the number of protein-rich foods you eat every day.

"You can also take some simple over-the-counter pain remedies and use a warm compress at times. In my clinic, I see a lot of women who have tried these measures and are still experiencing significant pain on a daily basis. In these cases, I suggest a trial of HRT, which can also often be beneficial," she says.

Without proper intervention, stiff joints can cause serious issues - including an increased risk of falls, muscle strains, sprains, and joint degeneration. "Lack of movement can further accelerate the breakdown of cartilage within the joint, worsening stiffness and pain over time. This can lead to osteoarthritis and other degenerative joint conditions," says Wilson.

"Ultimately, tackling stiff and painful joints doesn't have one straightforward solution. The best thing is to speak to your doctor and implement a healthy holistic lifestyle approach to tackle various aspects. This will give you the best long-lasting solution," says Dr Sinha.

What causes very stiff joints?

• Lifestyle: Exercise routine, diet, and weight can all impact mobility.
• Sleeping position: Some sleeping positions - such as sleeping on your side or 'prone' on your front - have been linked to lower back pain and stiffness in the morning, per research linked to Curtin University.
• Vitamin D deficiency: There is some research that suggests stiff joints may be down to a vitamin D deficiency.
• Decreasing hormone levels: Stiff joints are a very common menopause symptom. "Oestrogen has anti-inflammatory properties and helps to retain water and promote hydration in the joints, connective and soft tissue. These properties gradually decline during menopause," says Dr Sinha.
• Other conditions: "Other conditions may be more likely to present during the menopause time, such as osteoporosis and osteoarthritis," says Dr Sinha. This is why it's important to speak to your doctor if you are experiencing stiff, painful joints.

This mushroom has been shown to boost cognitive function, memory, and mental clarity - so are there benefits of eating or drinking lion's mane for brain fog in perimenopause? Health Writer Kat Storr finds out.

Lion’s mane (hericium erinaceus) is a type of mushroom that, as the name suggests, resembles the mane of a lion. It mainly grows in East Asia and has been used as a food and herbal medicine in traditional Chinese medicine for centuries. It's recently become popular among those of us experiencing menopause symptoms like brain fog, where you forget words mid-sentence or what you did at the weekend (and it's only Monday).

I’ve always been quite proud of my ability to remember conversations and facts or information about people. However, in recent years my mental clarity has started to fade and my brain just doesn’t feel as reliable. I started to wonder if there were ways to improve my menopausal brain fog from the inside. ie. What could I add to my daily supplement regime to help with this? That’s when I started reading about lion’s mane and the positive impact it’s reported to have on some people’s memory and general cognitive function.

Lion's mane for brain fog - does it work?

Yes, the experts say, lion's mane may very well help ease brain fog in some people with perimenopause symptoms. "It contains compounds that may promote nerve growth and improve brain health, and it's been shown to support memory and focus," says Helen Bell, a nutritionist at UK Care Guide. "Studies have also shown it may help reduce brain inflammation, which can be beneficial for cognitive clarity."

Alongside brain fog, nutritionist Michaella Mazzoni says she has been using the mushroom to support "cognition and focus in those with ADHD, long Covid, post-viral conditions, and MS. Some studies have also suggested a potential benefit [of lion's mane] for supporting mental health too".

Brain fog, low mood, sleep problems and memory loss can be very frustrating to deal with, which is why many of us turn to supplements to try and alleviate these symptoms.

Lion’s mane can be ingested in different ways such as gummies, tablet supplements, as a tincture, or as a powder in drinks such as coffee, tea and smoothies. It can also be grilled or sauteed and eaten - but it’s quite rare to find it in the wild in the UK.

Benefits I found after taking lion's mane for brain fog

Starting the tablets in the middle of November in the lead-up to Christmas and a lot of family birthdays, felt like the right time. My brain gets completely overloaded at this time of year and the perimenopause-induced foggy symptoms I’d been experiencing over the past few months weren’t going to get any better with the extra stress.

I took the tablets with water before bed each night to try and lower my stress levels naturally, and because I sometimes have trouble sleeping. I wanted to see if they could work as a natural insomnia cure. This time of day is also when I take my other supplements, so it was easy to just add these to the ever-growing pile.

I soon discovered that the impact of taking lion’s mane can be quite significant.

1. Better mood

I’m a generally positive, happy person but when life can feel too much or I’m tired, I start to experience the early signs of burnout. I lose my patience with my family easily or get moody. These mood swings have become worse as I’ve got older so I was interested in seeing if lion’s mane would make a difference.

It probably took me a week of taking the tablets before I noticed the improvement in my mood. There were fewer incidents of me getting angry or stressed and everything felt on a much more even keel emotions-wise. I felt like I was better at handling stressful situations and was generally happier. There were a few tough situations to deal with - such as family illness - but I found it easier to stay positive and not become overly anxious. This had not been the case before taking lion’s mane when I would easily catastrophise and panic about these situations.

2. Sharper focus

Stress and brain fog often go hand-in-hand and I’ve found I’ve been suffering from this more as life gets increasingly complicated and busy. Some weeks I can feel like I’m dropping balls all over the place - forgetting appointments, leaving birthday presents to the last minute, and more.

However, once I started taking lion’s mane I felt like my brain was more switched on. I would wake up feeling alert and positive about the day. Getting ready for the school run with my three sons felt much less fraught because I was more organised and less scatterbrained.

Away from family life, I also felt like I was a lot more productive when tired. I work from home and can be prone to procrastination and distraction. However, after a few days of taking these tablets, I found that my concentration had really improved. I could focus on one task at a time and complete it before moving on to the next thing.

3. Stronger immune system

Research into the benefits of lion’s mane, particularly on humans, is still developing but some studies published in the Food and Function Journal have shown taking lion's mane can increase the activity of your intestinal immune system, which can help protect you from germs that enter the gut through your mouth or nose.

Admittedly, it's hard to know how my health would have been if I didn't take the lion's mane. However, it’s winter and everyone around me is sniffing or coughing, including my children and husband - but I've managed to avoid them. I’ve dodged all of the bugs going around - even those inside my house - and have felt healthy and energised. In turn, this has given me the motivation to get back to exercising regularly and eating well, which is always difficult in the festive season.

The anti-inflammatory and antioxidant properties in lion’s mane can also help support your immune system and give your gut extra protection - provided you start taking it well before you notice any symptoms.

However, always consult your GP before adding any new supplements to your routine and always read the label. Lion's mane isn't suitable for everyone.

4. Improved sleep

I'm always eager to know how to sleep better, being a light and restless sleeper. It could be the consequence of having three children but I find it hard to switch my brain off at night. There's also a strong link between menopause and insomnia.

I didn’t notice an immediate impact after taking the lion's mane but again, after a week or so, I realised that I was getting to sleep much faster. The tossing and turning had eased and I was also sleeping through the night a lot better. My sleep felt deeper too, which is probably why I was waking up feeling more alert and positive.

I am also taking other supplements that have been shown to improve sleep, such as magnesium, so I was pleasantly surprised to see that taking the lion's mane made a tangible difference.

The w&h verdict

I was quite dubious about the benefits of lion’s mane before I started taking it. The amount of supplements marketed towards perimenopausal women feels overwhelming, and I already take a couple, so I was reluctant to add another one to my daily routine. But now, I'm never going back.

The fact that I’ve experienced a noticeable difference in my mood, cognitive function and sleep means I will definitely continue to take it daily, and will also be telling all of my friends about it too.

Who can't take lion's mane?

While lion’s mane is generally considered safe, there are some people who should avoid taking it for health reasons. Kate Booker, nutritionist at Nutrition Geeks, says it should be avoided by anyone who is allergic to mushrooms. If you’re pregnant or breastfeeding, you should check with your GP or midwife because insufficient information exists on its safety in these circumstances.

Booker says lion’s mane can stimulate the immune system so “people with autoimmune conditions like lupus, rheumatoid arthritis, or multiple sclerosis should consult their doctor before use”.

Sanchez adds that “people taking specific medications for blood thinning (eg. warfarin), thyroid or high cholesterol should avoid lion's mane unless advised by a healthcare provider”.

This article is for general interest and is not intended to suggest a course of action that might be suitable for you. Always consult a licensed healthcare professional before making decisions concerning your health and wellbeing.

For uncomfortable and sometimes debilitating physical and emotional menopause symptoms, hormone replacement therapy (HRT) is the go-to relief for many women. However, no one really talks about what happens when you don't want to take it anymore.

You may be on it - or thinking about taking HRT - and wondering how long you can take it for and what'll happen after you stop. Will menopause symptoms come back?

Coming off HRT can be a complex decision, says Dr Aarthi Sinha, GP and menopause expert, and the effects may not be the same for everyone. "I always review patients regularly in practice to assess if they still need the HRT and how they feel about continuing it. Women can certainly try coming off HRT, but I find that it is important to have a detailed conversation first so that they be adequately supported in doing so."

What happens when you come off HRT?

1. Symptoms may come back

The main side effect of coming off HRT is a return of the symptoms that have many women being prescribed hormone replacement therapy in the first place, says Dr Sinha. "Common symptoms include hot flushes and night sweats. These are caused by the lack of oestrogen in the perimenopause and post-menopause phase," she explains. "HRT contains oestrogen, which replenishes the body’s levels, resulting in improved symptoms. However, once the HRT and therefore oestrogen is stopped, these symptoms can often recur."

For this reason, fellow menopause specialist Dr Susanna Unsworth recommends coming off HRT slowly if you do decide to come off it. "I recommend gradually reducing the oestrogen element (if taking progesterone, keep this the same). If symptoms remain controlled, HRT can be stopped (including progesterone)," she says.

2. You might get new symptoms

Many women choose to take HRT earlier rather than later in perimenopause, meaning some breeze through the transition with few symptoms. However, as the doctors have noted, if you stop the therapy then symptoms may appear for the first time.

"Staying on HRT doesn't delay menopause symptoms," explains Dr Unsworth. "They resolve in the background with the therapy bridging the time it takes for your body to adjust."

3. Your mood might change

Equally, some women find they struggle with mood swings and low mood after coming off HRT, says Dr Sinha. "This can significantly affect quality of life, and again, it's the lack of oestrogen in the body once HRT is stopped that's causing this," she explains.

4. You might experience body aches

Oestrogen and progesterone stimulate bone formation, slow bone resorption, and help maintain bone density, so when the body stops receiving these hormones, many women experience some generalised aches and pains with fatigue and low energy when they stop HRT, Dr Sinha says.

"These levels are replaced with HRT and stopping it means that often these symptoms can recur as the levels drop again," she says.

Similarly, these hormones help protect against conditions like osteoporosis - a condition that causes the bones to become fragile and increases the risk of fractures. Stopping HRT raises this risk again.

5. Lifestyle changes may be needed

Often when we discuss HRT, it's an 'all or nothing' approach, when actually, many doctors advocate for a double or even triple-thronged approach to dealing with menopause symptoms. So, whether you choose to stay on HRT or come off the medication, you may need to make lifestyle changes.

For example, you might decide to use one of the alternatives to HRT alongside lifestyle changes like exercise and drinking less alcohol, all of which have been found to ease symptoms.

6. You might want to consider alternatives

If you decide to come off HRT, you may want to think about other options, given that there's no guarantee symptoms will disappear if you do. Along with lifestyle changes, there's evidence that cognitive behavioural therapy (CBT) in menopause can make a big difference, for example. This can help ease symptoms like low mood, night sweats, insomnia in menopause, and calm hot flushes.

"There are also other medications that can be used to treat hot flushes – such as selective serotonin reuptake inhibitors (SSRIs) and oxybutynin, along with a new medication called fezolinetant. These don’t have all the benefits of HRT, but could help if someone has to stop sooner than planned," says Dr Unsworth.

Whatever you decide, speak to your doctor first.

Do you have to stop HRT at some point?

While most people find their menopause symptoms improve with age, it's a myth that all women have to stop HRT after a fixed number of years. If you continue to experience menopause symptoms, are under 60 years old, and are not at high risk of breast cancer or blood clots, NHS advice is that the benefits of it are likely to outweigh any risks.

"There’s no limit on the duration of taking HRT, but no ideal length of treatment either – it’s individual," says Dr Unsworth. "Bone health, cardiovascular health and potentially cognitive function may be improved with longer-term use."

CBT for menopause has been a recommended option to treat some symptoms for almost 10 years now, either in combination or instead of HRT. With new draft guidance from the National Institute for Health and Care Excellence (NICE) set to bring this up the priority list in 2024, Laura Williams reveals what happened when she tried it for herself.

When I turned to my GP for help with brain fog, irregular cycles and ridiculously heavy periods, insomnia, crippling anxiety and panic attacks, uncontrollable rages, migraines and muscle fatigue, I knew deep down it was perimenopause. But, like many women in their early 40s, I was initially greeted with scepticism.

"You’re only 41, which is a bit early," my GP told me. "And we can’t really diagnose perimenopause - even menopause is a retrospective diagnosis. We know you’ve been through it when you’ve not had a bleed for over a year." Any hope I had of confirmation, a diagnosis, immediately disappeared.

"But we can still try and address some of the symptoms," she said. After talking through the cacophony of symptoms I was struggling to cope with, my GP informed me that the national guidelines had recently changed and psychological therapy had moved up the list as the first line of defence against menopause symptoms - mental and physical. So, instead of being prescribed hormone replacement therapy (HRT) as I'd hoped I would be, I was referred for cognitive behavioural therapy (CBT) classes.

What is cognitive behavioural therapy (CBT)? 

Cognitive behavioural therapy (CBT) is a talking therapy that can help manage issues by changing how we think and behave. While it's most typically used to help deal with conditions like anxiety and depression, in recent years studies have shown it can be effective to help manage other mental and physical health conditions, per the NHS.

The therapy is based on the idea that thoughts, feelings, sensations, and actions are interconnected and negative thoughts and feelings can lead to a negative cycle with physical repercussions. CBT aims to deal with the cycle by breaking problems down into smaller parts.

From as early as 2015, guidance from NICE (which offers evidence-based recommendations for health and care in England and Wales) has suggested CBT as one of the alternatives to HRT for some people. This has lead some GPs to change their approach to how they deal with women battling menopause symptoms, moving away from hormone replacement therapy (HRT) and towards cognitive behavioural therapy (CBT).

In light of HRT shortages and the changes in NICE guidance, my GP explained that there was emerging evidence to show the benefit of CBT for managing a range of menopause symptoms and limited evidence to show HRT could - except for when it came to hot flushes, which was about the only menopause symptom I was not experiencing.

Can CBT help with menopause? 

Cognitive behavioural therapy (CBT), when developed specifically to help deal with menopause symptoms, has been shown to help some women manage common symptoms of menopause - including hot flushes, night sweats, menopause-induced insomnia, low mood and depression, as a non-hormonal alternative to HRT.

But, as every woman has a different experience of menopause, there's no guarantee that it will help everyone. My GP referred me for group CBT classes and after a two-month wait, I headed to my local community centre for six lots of two-hour evening sessions. It was my turn to be sceptical. I’ve done group CBT before when I was suffering from antenatal and postnatal depression, and it connected me with women experiencing similar pregnancy woes and equipped me with the tools to put processes, framing and self-care in place to cope with what life throws at me. But most of the perimenopausal symptoms I was experiencing were grounded in my physical health. I could not see how group therapy would alleviate these.

This time, my catch-all therapy class was dominated by older men struggling with depression - very different needs from mine. The issues and approaches discussed centred around self-care basics - going to bed early, eating healthily, getting outside, ectera. Whether I went to bed at 5 pm or 11 pm, listened to Enya or lit a lavender candle, I was still waking up at 3 am and unable to get back to sleep til 5 am. I was already eating a healthy diet, swimming multiple times a week, doing Pilates and daily dog walks. I still felt crap.

During one of the sessions, we looked at introducing dedicated ‘worry time’ each week where, in theory, we could store up all the worries through the week and pay attention to them only during these dedicated 30 minutes. Unfortunately, my hormones don’t work to that timetable - the panic attacks and uncontrollable rages still turned up as I got my kids ready for school, or my husband left a drawer open, and the worry and anxiety around bleeding through my clothes from heavy periods didn’t adhere to a set time. It happened whenever my temperamental uterus decided to shed its lining.

My cycle was so irregular it would turn up at any time and the only way I knew was that the premenstrual rage would take over a few days before, so potent that it would make the Incredible Hulk look tame. When my period did show up, it came so thick and fast that I had to change my tampons and pads every 20 minutes. My brain fog was such that I would forget words mid-sentence, misspell the simplest words and use the completely wrong word to describe something - a real problem as a journalist and editor. Having never really suffered from headaches and migraines, they were hitting me like a ton of bricks. Paracetamol didn’t even touch the sides and my muscle fatigue made me feel exhausted just climbing the stairs.

CBT has undoubtedly helped some people back from the brink, but it wasn’t solving my perimenopause issues.

Just before the changes in NICE guidance, the first Women’s Health Strategy for England, launched in 2022. This highlighted how many women found it difficult to access appropriate menopause care, due in part to a reluctance among some healthcare professionals to prescribe the commonly used HRT. The strategy recommended that GPs offer women a range of treatment options, including HRT. I knew this because I worked with Bristol Women’s Commission, who helped inform the strategy.

When I was refused HRT at the doctor's office, I thought back to my many conversations with older female friends and acquaintances who had dubbed it a "life-saver" or a "complete game-changer". One of these women was Jo Fuller, founder of The Merry Menopause. She dedicates her working life to supporting women through menopause and credits HRT with helping her manage her physical menopause symptoms: “I was always active, exercising regularly to stay fit, but I had significant muscle and joint pain and it was getting worse. And, at 52, my knee gave way. I realised that the muscles and bones supporting my knee could no longer do their job. Until then, I’d been hesitant about starting HRT, questioning whether I really needed it after managing so far in my menopause journey without it. However, seeing the positive impact it had on friends and clients for a range of symptoms made me reconsider.

“The Advanced Practice Nurse at my GP surgery, the menopause specialist, was knowledgeable, supportive, and prescribed it without hesitation. Within 24 hours of starting on oestrogen gel, I noticed a dramatic reduction in my body pain, not just in my knee, but in my feet and hips as well. There was also a noticeable shift in my mood and outlook, which was a bonus. Two years on, I’m still using HRT and have had no adverse effects. It’s been a crucial part of my recovery," she says. "While CBT is a valuable tool, particularly for managing change and stress, it couldn’t have repaired my knee."

Does CBT work for hot flushes? 

CBT is already prescribed to women struggling with low mood and increased anxiety in menopause but the updated guidance from NICE teased last year, with added guidance for GPs from the British Menopause Society (BMS), now recommends its use for alleviating physical symptoms of menopause too - including hot flushes and night sweats.

There is evidence to support this - with research from King's College London finding CBT was effective at reducing the impact of hot flushes and night sweats regardless of age, body mass index, menopause status, or psychological factors within six weeks.

While CBT and HRT can go hand-in-hand, using the therapy exclusively for managing physical symptoms has been criticised. GP Dr Louise Newson, member of the UK Government’s Menopause Task Force, founder of Newson Health and the free balance menopause app, gathered evidence from hundreds of women to respond to NICE’s consultation around the guidance update - due for full publication in November 2024.

Among the comments received were: "talking therapies cannot help with physical aches and pains, loss of libido, mental sharpness, mood swings and cannot replace lost hormones" and "maybe talking therapy would help women deal with the enormous frustration many feel whilst trying to access HRT".

Is there a third option?

HRT has hit the headlines over the years for a range of reasons - from scare stories about the risks of taking the hormone pills, patches and gels to how they have saved women’s lives. CBT didn't work for me and with the change in guidance, HRT seemed off the table, but was there a third option?

I spoke with Dr Paula Briggs, Consultant in Sexual & Reproductive Health at Liverpool Women’s Hospital, and former Chair of the BMS. She highlighted that HRT is a multi-million-pound industry and that GPs and women these days are under huge pressure to use HRT for menopause management. She believes it is not necessary, or healthy, for all women to go down the HRT route.

“CBT may not necessarily be useful for women in your position, but neither would HRT,” explained Dr Briggs, who has worked in women’s healthcare for 30 years. “While CBT might not help, there’s a chance it could, and it certainly won’t do any harm - and could give you some helpful coping strategies. HRT can cause harm - such as more bleeding, migraines and unplanned pregnancy."

At the end of the day, treatment is an individual choice. Decisions should be made by women in conversation with their doctor. Just as there is evidence to show that CBT can be beneficial, there is evidence to show that HRT can be as well - and it is considered safe for most women.

"Many women we consult in our clinic are told incorrectly that they can not have HRT or even that they are 'not allowed' to have HRT. Taking HRT is an individual decision, and all women should be central to the decision-making process," Dr Louise Newson tells woman&home.

For me, psychological therapy alone didn't cut it. As a physiological change, I would have appreciated HRT being an option - my perimenopause issues have certainly not been solved by reframing my thoughts.

Refreshingly, Dr Briggs confirmed that HRT and CBT are not the only options for managing menopause. Some newer, lesser-known estradiol contraceptive pills - such as Qlaria, Zoely and Drovelis - can help ease perimenopause symptoms such as flushes, mood swings, heavy periods, erratic periods, and the combined impact of endometriosis and menopause, particularly in younger women - without the need to go down the HRT route.

Needless to say, group therapy did not solve my own perimenopause hell. I was still bothered by my symptoms leaving me desperate for other interventions. As I returned to my GP six months later, a year older but no better off, I asked what waas next. She suggested the coil might help with the irregular, heavy periods part of my symptoms and I was recently fitted with one, which has certainly eased the bleeding and some of my anxiety. Unfortunately, I’m still battling many of the other symptoms and may need to head back to my GP to explore those contraceptive pills for menopause instead.

Together, PCOS and menopause are rarely discussed. While we are getting better at talking about female health conditions like these, the combination of PCOS with menopause often slips under the radar - and it can be a confusing and difficult time for many.

PCOS is a hormonal disorder affecting 1 in 10 women (about 3 million people) most typically during the reproductive years. A mixture of hormonal imbalances, insulin resistance, and/or genetic factors causes it - so what happens when you bring perimenopause into the mix?

Symptoms of menopause can include hot flushes, night sweats, insomnia, low mood, anxiety, and changes to your sex drive. If you deal with PCOS as well, adding these symptoms to the mix can feel daunting - especially with so many myths around PCOS and menopause. Here, woman&home speaks to gynaecologists and doctors specialising in women's health and PCOS to dispel the myths and reveal how to manage your symptoms as you navigate menopause and PCOS together.

PCOS and menopause: The myths

PCOS disappears after menopause

Sadly, it's not true that PCOS magically vanishes when you hit menopause. Some symptoms of PCOS, like irregular periods, won't be a problem post-menopause but the underlying hormonal imbalances don’t just go away. Even after menopause, you may still deal with high levels of androgens (male hormones) and insulin resistance, which can lead to health conditions like diabetes or heart disease.

“While some symptoms of PCOS and menopause may overlap, making it difficult to distinguish between them, it’s crucial to understand these nuances,” explains Jodie Relf, a PCOS dietician who works with MyOva.

“Recognising and adapting to the changes during the transition to menopause can help women manage their symptoms better and reduce the risk of developing serious health conditions like diabetes, hypertension [high blood pressure], and cardiovascular disease.”

PCOS causes early menopause

While many people think that PCOS causes earlier menopause, that's not always the case. It's very personal, says Relf, but research shows that women diagnosed with PCOS typically enter menopause later.

Friends a similar age to you may start to experience perimenopause symptoms in their early 40s, as is typical, but you could be a little further behind. This can be confusing, the dietitian says. “This delay can make it more challenging to recognise the onset of menopause, as PCOS symptoms can mask its early signs.”

However, "the experience of PCOS during menopause can vary widely among women", she says. "The symptoms of PCOS and menopause can be managed and minimised through making lifestyle changes."

You can't be diagnosed with PCOS in menopause

PCOS can be difficult to identify even when you’re not going through menopause - with one new study led by Philips Lumea revealing that 72% of women experience at least one of the signs of PCOS without knowing it could be linked to the condition. Weight gain (24%), acne and oily skin (17%) and excess hair growth (10%) are the most common.

So PCOS can be even more difficult to spot during menopause or perimenopause due “to the similarities in symptoms. This can also mean it’s difficult to spot symptoms of perimenopause if you already have PCOS,” explains Dr Shirin Lakhani, a GP and menopause and hormone expert.

Yet, just because it can be more difficult to spot the signs of PCOS during perimenopause doesn't mean you can't be diagnosed with PCOS. “Look out for any new symptoms you don’t recognise, as well as irregular or missed periods, fertility problems, mood swings, difficulty sleeping, hair loss, unwanted hair growth, or weight gain. These can all be symptoms related to PCOS or perimenopause unfortunately, so you just have to be aware of your own body and what feels right and normal for you, especially if you are over the age of 40," she says.

HRT can help PCOS in perimenopause

Hormone replacement therapy (HRT) is a treatment used to replace female hormones (estrogen and progesterone) that women produce less of when they go through menopause.

However, it's important to speak to your doctor before deciding on HRT. When you also have PCOS symptoms, your needs and symptoms could be different. Valentina Milanova, the founder of Daye, a gynaecological health research and development company, says: “While HRT can help manage menopausal symptoms like hot flashes and vaginal dryness, those with PCOS may have unique considerations.

“Since PCOS is associated with higher androgen levels, some women may not experience the same severity of oestrogen-deficiency symptoms during menopause. Additionally, PCOS increases the risk of cardiovascular disease and metabolic issues, so the potential risks and benefits of HRT should be weighed individually," she says. "A healthcare provider may recommend lower doses or different formulations of HRT for women with PCOS to balance symptom relief with minimising risks."

Can PCOS symptoms get worse in menopause?

While PCOS does not necessarily worsen the menopausal transition, it is associated with a higher risk of developing type 2 diabetes, hypertension, and cardiovascular disease, explains Relf. “This is due to the prolonged exposure to inflammation, insulin resistance, and abdominal weight gain that often accompany PCOS.”

While symptoms of depression and anxiety in menopause are unfortunately common, they can also intensify in those who also have PCOS. "The compounded impact of emotional and physical symptoms can make the menopausal period particularly challenging for women with PCOS," she says.

How to manage PCOS in menopause

Dietary changes

Getting enough protein via high-protein foods such as chicken, eggs, and tofu, can help to “improve insulin sensitivity. Plenty of fruits, vegetables, and whole grains will help to prevent dyslipidemia, improve blood glucose levels and reduce inflammation," says Relf.

Foods to avoid include anything that could cause further inflammation. For example, research from the University of Lublin has shown that ultra-processed foods (UPFs) - foods that are far from their original state after being altered in a factory - plus red meat and saturated fats can contribute towards raised levels of bodily inflammation.

Swap saturated fats for omega-3 fatty acids and UPFs for whole foods, which are rich in antioxidants.

A good exercise routine

Dr Haleema Sheikh, a hormone specialist at the Marion Gluck Clinic, says PCOS and menopause symptoms may make us feel like not doing any exercise but "any type of movement is beneficial to manage symptoms and improve our mental wellbeing".

She recommends Pilates, brisk walking, jogging, and swimming as a workout. "Strength training is also beneficial for lowering insulin resistance and speeding up metabolism," she says, as well as contributing to muscle mass maintenance, which lowers the risk of conditions like osteoporosis in turn.

"Weights are essential for maintaining bone density as you go through the menopause tradition," Relf agrees. "Regular exercise can also play a crucial role in mental wellbeing during this challenging and emotional time."

An established sleep routine

Menopause will bring new symptoms that could cause havoc with your sleep - including night sweats and hot flushes.

However, Dr Sheikh explains that establishing a sleep routine and learning how to sleep better can help. This starts with creating a “consistent schedule, even during weekends and holidays,” she says. Research from the University of Houston suggests that if we go to bed and wake up at the same time every night, we'll wake up naturally at the same time every day too.

Getting better sleep also means "getting at least eight hours a night", she says. "Avoiding rich, fatty foods before bed, and making your sleep routine as calm and stress-free as possible" can also help. "For example, doing gentle stretches before bed, making sure there is no artificial light to disturb you during the night and reducing screen time."

Supplements

Supplements are a multi-million-pound industry and there are a lot of supplements and foods that (wrongly) suggest they can ease symptoms of menopause and PCOS. So, it's important to research and always consult your doctor before adding new supplements or medication to your routine. Much like other alternatives to HRT, depending on your circumstances, they could do more harm than good.

However, there is evidence to suggest that some make a difference. "Omega 3 minimises inflammation and supports heart health. Inositol [vitamin B] can be beneficial for improving insulin sensitivity, reducing cravings for sugar foods, and helping with weight management," says Relf.

Talking to others

While it could feel like you’re going through PCOS and menopause symptoms alone, many other people are going through the same thing you are.

Relf says it's important to build a network of people. “Connect with others who are also managing PCOS during menopause. Sharing experiences and receiving support can significantly ease the emotional aspects of this transition," she suggests.

Hot flashes, mood swings and insomnia might be some of the more obvious menopause symptoms, but hormonal changes can cause issues to specific areas of the body - including ones you might not expect like the teeth, gums, mouth and tongue. 

In fact, in a study looking at menopause symptoms by Delta Dental, it was found that 84% of women approaching menopause didn't know how the hormonal change would affect their oral health. Yet, it's one of the most common symptoms of perimenopause.

"Oral health problems during menopause are incredibly common. As a cosmetic dentist, many of my female patients seek cosmetic dentistry treatment around the age of 45 to 55, as this is when they notice the most significant changes in their teeth,” says Dr Sam Jethwa, the president-elect of the British Academy of Cosmetic Dentistry and an award-winning cosmetic dentist. 

Some of these changes include increased tooth sensitivity, tooth decay, pain and inflammation in your gums (known as gingivitis). Here, woman&home speaks to several dentists and menopause experts to reveal more about exactly how menopause affects oral health - and what to do about it.

Does menopause affect teeth and gums?

Yes, menopause has the potential to affect every part of a woman’s body - and the teeth, gums, and mouth are included in this. During menopause, oestrogen levels naturally decline and as the hormone is needed to maintain bone density, this can contribute to bone loss in the jawbone - as well as other parts of the body like the spine and hips.

Bone loss in the jaw increases the risk of several dental issues, including loose teeth, tooth loss, and the onset of gum disease, all of which have uncomfortable or painful symptoms. 

Tooth pain

Menopause and tooth pain can, unfortunately, go hand-in-hand - and tooth decay is one of the more common causes as teeth and gums become very susceptible to hormonal changes in the body. According to research by Shree Bankey Bihari Dental College and Research Centre, this decreases the body's ability to fight off minor infections and maintain a balance of 'good' and 'bad' bacteria within the mouth.

"Menopause can lead to decreased saliva production and saliva is essential for washing away food particles and neutralising acids. Without it, the risk of tooth decay increases," says GP and women's health specialist Dr Deepali Misra-Sharp.

Hormonal changes also make gums more sensitive and prone to swelling, which can be painful and cause tooth pain.

Tooth sensitivity

Tooth sensitivity - often manifesting as a sharp feeling when you eat or drink something cold - happens when the protective layer of enamel has worn away and the layer of soft dentine within the tooth is revealed. 

The enamel ends where the tooth and gums come together. If you have receding gums, the tooth roots will be exposed. As these don't have a protective layer, it's bound to cause some sensitivity. 

Some women might find that brushing their teeth too hard and eating and drinking certain foods causes this protective layer to wear away, leading to tooth sensitivity. 

"Bone loss in the jaw thanks to the decline in oestrogen can also cause increased sensitivity, as well as loose teeth and teeth falling out," says Dr Jethwa. He recommends using a soft-bristled toothbrush if your gums are painful, along with an anti-bacterial mouthwash.

Clenching and breaking

Bruxism - grinding the teeth or clenching the jaw - is linked to anxiety, stress, and insomnia. These three conditions, as many unfortunately know already, skyrocket during menopause. 

Dr Jethwa says bruxism can damage the teeth by wearing down the enamel, flattening the teeth, chipping them and sometimes causing them to become loose. He says: “Your GP or dentist will advise the best treatment for your case, but this may include a mouth guard (this protects the teeth, but it does not stop the motion), masseter Botox (to relax the muscles) and cosmetic braces (if teeth grinding is caused by the bite).”

Teeth grinding or clenching can lead to face, neck and shoulder pain, headaches and disturbed sleep too. 

Sarah Shah, who is a menopause coach, had serious problems with her teeth when she went through menopause but it took her a while to understand that the cause was down to her changing hormones. Dental treatments she needed included “fillings, both in teeth and on the front of teeth, an implant to replace a tooth, aligners to straighten teeth after grinding, having to wear a retainer every night to stop my teeth grinding and my teeth moving back."

If you're worried about your teeth in menopause, it's best to go to the dentist regularly. That way, you can get ahead of the problem before it starts.

Tooth loss

As noted by both our experts, tooth loss is unfortunately a side effect of the bone loss in the jawbone. The hormonal changes can also make you more susceptible to gum disease, which can lead to periodontitis - a more severe type of gum disease which affects the bone supporting your teeth.

Dental hygienist Alice Garside, from the Neem Tree Practice in Esher, says she has had two patients in her surgery who have had such bad oral health problems during menopause that they’ve lost almost 50% of their teeth. “So many women will say to me, ‘I don’t understand, I do so much more than my husband and my teeth are in such a state’, and I say to them ‘Yes it’s because you’re a woman’,” she says on menopause and tooth pain. 

This is also something Shah experienced: “I was brushing twice a day, using a water flosser and tape floss and doing everything I could to protect my teeth. It made me feel like an old woman and I thought I would end up with dentures.” 

Oral infections

The oral health problems linked to menopause don't just affect the teeth and gums though. "Reduced saliva and hormonal changes can make you more susceptible to oral infections like thrush (oral candidiasis), which is a yeast infection in the mouth," says Dr Misra-Sharp.

"This reduction in saliva may also lead to more sores, ulcers or cuts inside your mouth, which can be painful," she says.

How to avoid tooth pain in menopause

Avoid citrus fruits

One of the ways to protect your teeth in menopause is to avoid eroding the enamel on your teeth. When you lose enamel, the soft dentine is exposed and this commonly leads to tooth sensitivity and pain. 

"Avoid any food or drink that will affect the enamel on your teeth, especially those that are acidic like citrus fruits," says Dr Jethwa. Apples, grapes, blueberries, pineapple, peaches, pomegranates, fizzy drinks, fruit juices, vinegar-based products, and some gut-healthy foods like sauerkraut are also best avoided to protect the teeth as well. 

Increase calcium and vitamin D intake

Vitamin D and calcium, which can be taken together as one supplement if you need to, are essential for maintaining strong teeth and bones. 

"Ensure your diet includes plenty of calcium-rich foods (like dairy, leafy greens, and fortified products) and get enough Vitamin D, either from sunlight or supplements," says Dr Misra-Sharp. 

If you wear sunscreen on your face year-round, you'll likely need a vitamin D supplement even in the sunnier months. However, consult your doctor before adding any additional supplements to your routine or changing your diet significantly.

Stay hydrated

When it comes to protecting your teeth in menopause, proper saliva production is essential. Some people experience dry mouth during menopause, which means there isn't sufficient saliva to keep bacteria off your teeth.

Dr Misra-Sharp advises drinking plenty of water and using “saliva substitutes or moisturisers that can help and that can be prescribed by your GP," she says. 

Regular dental care

It sounds simple, but making sure your oral hygiene routine is in the best shape possible is one of the best ways to avoid teeth issues during menopause. When it comes to brushing your teeth properly, "you need to brush the outside of the teeth, inside of the teeth, tongue (can you tongue scraper if prepared, but a toothbrush is fine) and the roof of the mouth," says Dr Jethwa.

Dr Misra-Sharp and Dr Jethwa both also advise using an anti-bacterial mouthwash and Dr Jethwa says you should make sure your toothpaste “contains the correct amount of fluoride, this should be 1,350-1,500ppm for adults”. 

Professional treatments

Should you need more help, speak to your dentist about your options. Professionals can carry out fluoride treatments to strengthen the enamel - although there is a limited amount even professionals can do with lacking enamel. 

Cosmetic teeth treatment may also be needed if your teeth are damaged or need to be removed, such as veneers or composite bonding. "These can help to both strengthen the teeth and allow them to appear aesthetically pleasing - fixing any chips, cracks and discolouration," says Dr Jethwa. 

Can HRT help your teeth?

Hormone Replacement Therapy (HRT) replaces the hormones lost during menopause so it can be a useful tool if you're struggling with teeth issues resulting from hormonal changes during menopause. 

"Oestrogen replacement can help maintain bone density, including the bones that support your teeth. Some studies suggest HRT might reduce the risk of gum disease and tooth loss by mitigating the effects of oestrogen deficiency," says Dr Misra-Sharp. 

In a study linked to the Federal University of Bahia, published in the prestigious Menopause journal, it was found that rates of gum disease in women taking HRT were 44% lower than in those who were not. 

Menopause teeth vs menopause mouth

It’s not just your teeth which can be affected during menopause. You might also experience changes and problems with your mouth and tongue.  

• Dry mouth: Dr Misra-Sharp says the drop in saliva might cause "dryness, difficulty swallowing or speaking, a sticky feeling in the mouth, and an increased need for water. Dry mouth can also cause bad breath (halitosis) and make you more prone to cavities". 
• Burning mouth syndrome: An unpleasant symptom which some studies suggest can occur in 15% of women during menopause. Dr Jethwa says it’s when you’re left with a “burning sensation, and sometimes tingling and numbness” in your mouth. Dr Misra-Sharp says the cause of BMS is unclear but it seems to be linked to hormonal imbalances. She says: “Reduced oestrogen may lead to changes in nerve function in the mouth, causing a burning sensation.”
• Change in taste: Some women may notice changes in their sense of taste and experience a metallic or bitter taste in their mouths, says Dr Misra-Sharp. Our taste buds and sense of smell can change as we age and this can become worse during menopause. Our taste buds don’t regenerate as fast as they did before menopause which means we have fewer buds to taste food and drink with.     

Perimenopause can last for up to 10 years before menopause finally happens, so why is it a shock to many when it starts? With the lasting taboo around the subject and the widely-held belief that it's 'just' one of life's natural stages, many people go into perimenopause unknowingly. Here Kathryn Williams reveals her own journey and speaks to other women about what perimenopause really feels like.

I was well prepared for my first period. Well, sort of. I remember my mum telling me that the whole thing would be something of a non-event to begin with, a mere ‘smudge’ on my underwear, so light I’d probably barely notice it. So far so good, right? Except that when my period did arrive a few months after my 13th birthday, it was less of a smudge and more of a flood. Menstruation, it seemed, had arrived with a vengeance.

Still, while the event itself wasn’t quite what I was expecting, at least my mum and the school curriculum had deemed periods a major enough life event that I should probably be given a heads up on the whole matter. Based on that, you can imagine my surprise when perimenopause symptoms came knocking on my door a few days before my 41st birthday without anyone so much as saying a word.

Suddenly, I found myself dealing with debilitating nausea and fatigue, insomnia, an inability to think clearly, and a level of worry and anxiety I’d not experienced before. But I had only just entered my 40s, so it couldn’t possibly be perimenopause - could it?

When does perimenopause start?

According to menopause expert Dr Mary Claire Haver, a board-certified OB/GYN and founder of Mary Claire Wellness, there's a variation in the ages women can experience menopause - from 45 to 55 is most common. “The average age of that one year after your cycle stops, so menopause, is 51 to 52 years old. However 'normal' is 45 to 55 and there’s a big variation. Perimenopause begins 7 to 10 years before that last menstrual period,” she said in a recent interview with neuroscientist Dr Andrew Huberman.

I know it sounds like a strange thing to say, but I like getting older. Perhaps it’s because my sister died at the age of 25 from Cystic Fibrosis and I understand all too well that growing old is a privilege denied to many. Or maybe it’s just that I’ve always been an old soul and I feel like I’m finally growing into myself.

Either way, I’ve always seen each life stage as a gift. And yet, part of me has been slightly caught off guard by this transition, which arrived earlier than I thought it would. Most doctors consider 41 to be on the young side but it turns out, I'm not quite the outlier I thought I was. In fact, 1 in 100 women experience menopause under the age of 40 - like 38-year-old Rachel.

“The hardest part for me is the social isolation,” she says. “No one in my peer group is going through this," she tells me. And even if they were, Menopause Support UK reports that 45% of women haven’t spoken to their GP about the symptoms they’re experiencing and very few women talk about menopause symptoms or the transition with other women.

What does perimenopause feel like?

Whether you’re peri, post, or just plain meno, the three stages of menopause can leave you feeling like a different person. It’s rare to meet someone like my dear friend Liz, who describes her menopause journey as a completely smooth ride. “I didn’t have a single symptom except for one night of hot flushes,” she tells me, almost with a tinge of guilt. "One month my period didn’t arrive and that was it. I guess I was just really lucky.”

According to Menopause Support UK, there are approximately 13 million peri and post-menopausal women in the UK. Of those, 3 in 4 will experience symptoms with 1 in 4 having symptoms classed as debilitating - like Kate, who at the age of 45, started suffering from heavy periods so bad she eventually required surgery.

“The most challenging symptoms were physical,” she told me. “Heavy periods meant having to think through travel logistics for work. That was really challenging. I had to be very well organised and it was tricky as I was anaemic several times, which impacted my energy levels and my ability to exercise.”

Kate is far from alone though. In 2022, Channel 4 commissioned a landmark study based on the largest-ever survey of perimenopausal and menopausal women in the UK. The resulting report, produced by the Fawcett Society, showed that 77% of women have at least one menopause symptom they find ‘very difficult’ and 44% have three or more symptoms they describe as ‘severe’.

Of the more than 4,000 women who took part, 84% said they found sleeping difficult, 73% had issues with brain fog, and a further 69% said they struggled with menopausal anxiety and depression. All symptoms I can relate to - and I'm not the only one.

At 45, Sarah knew something was shifting inside when she started to feel overcome with incessant worry. “It wasn’t my usual feeling of anxiety,” she told me. “It was more of a gnawing anxiety that I couldn’t shake.”

She didn’t need to explain it to me further. I resonated with her words immediately. While research into this area remains limited and we need to be cautious of how we interpret the data that is available, studies appear to support the premise that women experience greater incidences of both anxiety and depression during the perimenopausal years.

A 2024 study of more than 9,000 women around the world published in the Journal of Affective Disorders found that perimenopausal women have a 40% higher rate of depression compared to premenopausal women. An earlier study published in 2014 in the journal Menopause, tracked close to 3,000 women across 10 years and found that those aged 40 to 55 were 51% more likely than premenopausal women to report feelings of anxiety. Women with low anxiety during their premenopausal years were also more likely to report high anxiety during perimenopause.

Like everyone, I have experienced feelings of worry and anxiety throughout my life. But I have been very fortunate that these feelings have always been situation-specific and time-limited, and have not impaired my ability to function. While that remains the case, like Sarah, I’ve noticed that these feelings of anxiety and worry have taken on more of a gnawing quality.

I find myself fretting that everyone in my life is going to die and I’ll end up like Bridget Jones, alone and discovered weeks after my death half-eaten by Alsatians. There are less dramatic worries - just to reassure you - but worry and anxiety certainly take up more space in my mind than they used to. On the upside, I’m also struggling with brain fog and memory loss, so perhaps they’ll come a day sometime soon when I won’t even remember I had these worries.

“It’s embarrassing. I meet people in the street, people I know well, and I can’t for the life of me remember their names,” says Jenny, a 58-year-old mum of two grown children who has struggled with brain fog and memory loss since she was in her early 40s.

We pondered together when the cognitive wheels started falling off, although rather ironically, neither of us could remember. We settled on sometime in our 30s because that’s the decade we suddenly realised we couldn’t go to the supermarket without a shopping list.

“It’s so frustrating to know that you know something and can't recall it,” Jenny told me. “I feel like I’m going crazy.” And yet, she’s not. It’s estimated that women lose around 20% of their cognitive metabolism after 40. A 2021 scientific review of multiple studies published in the World Journal of Psychiatry revealed that cognitive decline in women undergoing the menopausal transition has a prevalence of between 44% to 62%.

My once-sharp mind feels frustratingly sluggish these days and I often feel a sense of shame and guilt that I’m perhaps not living up to my potential. Would I be a better wife and stepmum if I had more energy and brain power? Could I achieve more in my career if my mind didn’t feel like a giant jar of treacle?

On top of all the symptoms that come with this rather monumental life transition, almost all of the women I spoke to shared one common struggle: a difficulty in accepting that they’re growing older.

If growing up with a seriously ill sibling taught me anything, it’s that there’s so much in life we can’t control. People we love die, our bodies change, and things that were once predictable, familiar and known become unpredictable, unfamiliar and unknown. Rather than fight what is, I’m learning to adjust, adapt, and begin again. Being present with what’s here, rather than longing for what isn’t is a skill I’m working on cultivating. But just because we learn to embrace what is, doesn’t mean we can’t also grieve what was.

We’re sold a story when we’re younger that grief is something we’ll only feel when someone we love dies. But that’s not true. We can grieve our bodies changing just as much as we might grieve the end of a relationship, career or our children leaving home. For women who may have wanted biological children but for whatever reason, were unable to do that, the end of their reproductive years can also trigger profound feelings of sadness and loss.

But it’s important to remember that life is cyclical, not linear. Just like nature, we are constantly moving through our inner seasons. All of us will winter at one time or another. Most of us will winter frequently and some of us will winter far more than others. But none of us can escape those times in our lives when our branches are stripped bare. These times are essential, and if we’re brave enough, they may be the very making of us.

What causes a UTI? Even though women are 30 times more likely to develop a UTI than men, a number that rises in menopause, we don't talk about them nearly enough. 

Whether due to social stigma or the presumption that we'll 'just know' how to deal with it, urinary tract infections (UTIs) are often dismissed in the conversation about women's health and wellbeing in perimenopause and postmenopause. 

"UTIs can also mimic other conditions like bladder stones or sexually transmitted infections. If left untreated, a UTI can spread to the kidneys and cause more severe health issues, such as kidney infections or even sepsis, which is a life-threatening condition," says Dr Elise Dallas, a women’s health specialist. 

That is to say, they are a serious health condition that can have long-term implications. Here, woman&home speaks to doctors to reveal what causes a UTI most often, why they tend to be more common at certain points in life, and what you can do to avoid one before it happens.

What causes a UTI?

1. Travelling bacteria

A UTI occurs when bacteria that shouldn't be there starts to grow inside the bladder, entering via the urethra - the sphincter at the lower end of the bladder, says Dr Deborah Lee, a sexual and reproductive health specialist who works with Dr Fox Online Pharmacy.

"The bladder opening in women – the urethra - is perilously close to the anus, hence it is easy for bacteria to find their way to the urethra and pass up inside the bladder. The bacteria grows on the bladder wall, causing inflammation of the bladder wall (also known as cystitis)," she says. "This leads to well-known UTI symptoms, such as abdominal pain, urinary frequency, blood in the urine, and pain when passing urine."

To prevent this from happening, wipe from front to back when using the loo, use the loo immediately and shower after having sex, says Dr Lee.

2. A weakened immune system

Conditions like diabetes, arthritis, flu, and chronic stress (otherwise known as burnout) can weaken the immune system and leave you more susceptible to UTIs. "This is because the body is less able to fight off infections, making it easier for bacteria to multiply and cause an infection," says Dr Dallas, who works with The London General Practice.

"Additionally, if the bladder does not completely empty, residual urine can become a breeding ground for bacteria, further increasing the risk of UTIs," she says. "These causes often interact, increasing the risk and severity of UTIs."

3. Perfumed products

Perfumed products - such as baby wipes, vaginal douches, perfumed soaps, and bubble baths - can irritate the urethra and potentially lead to a UTI.

"The vagina is self-cleaning, so it will clean itself," says Dr Lee. "All these products contain colourants, foaming agents, thickeners, preservatives, fragrances, and more, and they can cause extreme irritation to the delicate skin of the vaginal walls and the urethra."

4. Poor gut health

Gut health has been the health buzzword for the last few years now - and for good reason. Research shows that the bacteria in our gut has a direct link to our mental and physical health - and that includes the risk of developing a UTI.

A new study, linked to George Emil Palade University of Medicine, found that within a group of women with a history of recurrent UTIs, more than 70% of participants had an imbalance of gut microbiome.

To ensure that poor gut health isn't the cause of a UTI in the future, Dr Lee recommends adding plenty of probiotics to your diet. "These are healthy bacteria needed to keep the vagina and bladder functioning optimally. Some of the best gut-healthy foods include live yoghurt, kefir, sourdough bread, pickled vegetables, and cottage cheese."

5. Tight pelvic floor muscles

The pelvic floor is the hammock of muscles that extend from the tailbone to the pubic bone. While we often talk about doing kegel exercises to strengthen the pelvic floor and why it's important to do so, we don't often think about the other side of the coin: the effects of a pelvic floor that's too tight.

One such effect is a UTI, says Jane Clarke, a continence nurse working with The Confidence Club. "Tight pelvic floor muscles can interfere with the flow of urine, causing it to be weak. This can prevent it from effectively flushing out bacteria and lead to UTIs," she says.

6. Genetics

While certain genetics don't promise to cause a UTI, some women are just more prone to getting a UTI due to certain genetic factors. "Those with a family history of recurrent UTIs as well as conditions like urinary incontinence, difficulty fully emptying the bladder, and pelvic organ prolapse in midlife increase the risk [of developing a UTI]," says Dr Dallas.

7. Menopause

Menopause, much like genetics, isn't a direct cause of UTIs but those who go through menopause are more likely to develop one thanks to the natural drop in hormone levels.

"Urinary symptoms are a common feature of genitourinary syndrome of menopause (GSM)," says Dr Lee. "This condition is an umbrella term for the common urogenital symptoms a woman suffers in perimenopause. They include vaginal dryness, painful sex and urinary symptoms, including recurrent UTIs."

Why you're more likely to get a UTI in menopause

During perimenopause, oestrogen levels drop by 90%. "The pelvic floor, vagina and bladder are rich in oestrogen receptors and when this hormone is lacking, it can lead to shrinkage of the vaginal skin. The urethral opening becomes less competent and hence more likely to allow bacteria into the bladder," explains Dr Lee.

Another important development that can cause a UTI in menopause is a change in the bacteria makeup of the bladder and urinary tract. "This is known to differ between pre-, peri, and post-menopausal women," the doctor says. "Premenopausal women have large numbers of lactobacilli in the vagina and the bladder which produce lactic, which keeps the pH acidic. This helps prevent other bacteria from growing. However, in perimenopause and beyond, the numbers of lactobacilli fall, and less lactic acid is produced, so the pH rises and becomes more alkaline. This is when UTIs, as well as bacterial vaginosis (BV), can set in."

How can I prevent a UTI during menopause?

• Topical treatments: The National Institute for Health and Care Excellence (NICE) endorses the use of topical oestrogen – a cream (Ovestin) or a pessary (Vagifem) – which is directly applied to the vagina and genital area, says Dr Sharer. "The improvement can take a few weeks to become obvious, so you need to persist, but you may need to use the topical treatment long-term."
• Make sure you stay hydrated: When you are dehydrated, you go to the loo less, which gives the bacteria a chance to multiply. Water is best, while caffeine, fizzy drinks, and alcohol are best avoided.
• Keep the genital area clean: While I'd hope most of us shower every day, keeping this area means wiping from front to back, using the loo straight away after sex, and showering after sex.
• Wear natural cotton underwear: There's no proof that synthetic underwear directly causes UTIs but the experts recommend keeping this area breathable anyway, to help prevent bacteria from growing. "Avoid tight jeans and sitting for long periods where you get hot and sweaty down below," says Dr Lee.
• Talk to your gynaecologist: If you're worried about recurrent UTIs in menopause, speak to your doctor. They may be able to prescribe D-mannose for you. "This is a special type of sugar molecule that sticks to the bladder wall and helps prevent bacteria from adhering to the bladder wall cells. Some studies suggest this may be as effective as antibiotics," she says.

Does a UTI go away on its own?

In many cases, a UTI will go away on its own. "In around 20% of cases, a UTI will resolve itself with no treatment other than increasing the amount of fluids," says Dr Sharer. "Although, there is no evidence for the effectiveness of cranberry juice despite the commonly-held belief. It's certainly important to drink plenty of fluids to flush the bacteria, cell debris, blood, and white cells out of the bladder though."

Some old wives' tales do stand true for the treatment of a UTI, however. "Dissolve one to two teaspoons of baking soda in a glass of water and drink it all right away," advises Dr Lee. "This makes the urine more alkaline, and it will hurt to pee less."

However, there are some cases where you will need to go and see a doctor about a UTI.

When to go to the doctor about a UTI

If you're having recurrent UTIs, see your GP as you need tests to check for any underlying causes, says Dr Lee. Also, if your symptoms haven't cleared up on their own after a few days, you'll need to see your doctor for antibiotics.

Equally, if you think your UTI could be down to menopause symptoms, it's worth visiting your doctor to discuss treatment options for this, such as hormone replacement therapy (HRT). "Urinary symptoms are commonly a feature of genitourinary syndrome of menopause (GSM). This condition is an umbrella term for the common urogenital symptoms a woman suffers are perimenopause. They include vaginal dryness, painful sex and urinary symptoms including recurrent UTIs," says Dr Lee.

Menopause is something most women will go through at some point in their life but the symptoms we experience can vary. While hot flushes, weight gain and mood swings can be really unpleasant to deal with, there’s another distressing symptom we may not think about until it happens: hair loss.  

It’s not precisely known how common it is to experience menopause as one of the causes of hair thinning in women, but research from the West Pomeranian University of Technology has shown that it can affect between 20 to 60% of women before they reach 60. Hair loss in women is different to men because it tends to cause thinning across the scalp and temples rather than typical bald patches. Hair restoration specialist Michael Mouzakis says, "It’s not commonly talked about as one of the menopause symptoms, but it happens to a lot of women. It can cause a lot of stress. Losing hair can decrease confidence and negative impact on a person’s mental health as well."

The fact that perimenopause and menopause symptoms can last years, or even decades for some people, means they can have a dramatic effect on your health and wellbeing. We’ve spoken to experts, including specialist doctors, to find out more about the link between hair loss and menopause, and what can be done to prevent it. 

Can menopause cause hair loss? 

Yes, there is a clear link between menopause and hair loss. Our aging process affects the whole body, and this includes our hair follicles. As our body starts to produce lower levels of oestrogen and progesterone during perimenopause, our hair grows slower than it used to and it can fall out faster. Mouzakis, who works with The Private Clinic, says, "These hormones are essential for hair growth and health. After menopause, oestrogen no longer counters testosterone and DHT (an androgen) can cause a change in the hair follicles on the scalp so that they become smaller in diameter, shorter in length and lighter in colour until they eventually shed." 

Hair thinning and hair loss in women during menopause doesn't just apply to the hair on the head - it can also occur elsewhere on the body too. You might also notice hair in places that you haven't seen before, such as your upper lip or chin.

Is it normal to lose hair in menopause? 

As the research shows, hair loss and menopause don't go hand-in-hand for everyone. Some people will go through menopause, becoming postmenopausal, without seeing any impact on their hair thickness while others will. 

Dr Fionnuala Barton, a GP and British Menopause Society-accredited specialist explains that telogen (the hair follicle's resting stage) is a normal part of the hair cycle. Anyone can expect to experience hair shedding when you wash or brush your hair during this time, but menopause can contribute to a prolonged phase of telogen shedding or an imbalance of the hair growth schedule, which means your hair can come out in clumps. 

While hair loss and menopause may be something that many women have to deal with, Dr Barton recommends looking at other common causes of hair loss in women along with menopause. She says: “There may also be indirect effects on hair health because of the changes to immune and metabolic health that also occur as our hormones change, including an increase in susceptibility to autoimmune disease and nutritional insufficiencies.” Other causes include hereditary conditions, female pattern hair loss, stress, and medical treatment such as chemotherapy. 

Symptoms of menopausal hair loss

Dr Dilan Fernando, a hair transplant surgeon and co-founder of The Treatment Rooms, says there are several ways to spot menopausal hair loss. It might not be obvious at first, but over time you may start to notice symptoms like dryness, a thin ponytail, and a widening hair parting. 

It can be useful to take photos of the hair loss or places where hair is thinning to show a doctor if you’re seeking treatment. 

Here are the most common signs of menopausal hair loss:

• Your hair parting widens
• Your hair doesn’t grow as long as it used to
• Your hair becomes drier and thinner in texture
• You scalp becomes more visible in places
• Your ponytail feels thinner
• Hair on your temples looks thinner
• Your hairline looks less dense

Will hair loss from menopause grow back?

Hair loss during menopause can be temporary or permanent depending on the person, says Dr Roshan Vara, a hair transplant surgeon who also works with The Treatment Rooms. "The rate it falls out can reduce once the hormone levels stabilise so it's important to explore how treatments can help limit the loss. We recommend consulting with a healthcare professional with a specialist interest in hair to see how they can help."

With so many changes happening to a woman’s body at this time in their life, Dr Fernando agrees that it’s important to speak to a medical professional for advice on how to stop thinning hair or hair that's falling out. "For some individuals, particularly those with underlying genetic predispositions to hair loss, the regrowth may be limited," he notes. 

How to look after your hair during menopause

• Maintain a balanced diet: Dr Vara says it’s important to make sure you’re eating a diet rich in iron, zinc and vitamin D and taking supplements, if recommended by your doctor.
• Use a medical treatment: A scalp foam containing minoxidil can help stimulate hair growth and prevent it from falling out. You don’t need a prescription for it but should discuss whether it’s the right treatment for you with your doctor.
• Reduce stress: Dr Fernando says stress or burnout from work can cause your hair to thin, so make sure are getting enough sleep and exercise, learn how to deal with stress, and speak to your doctor if you’re feeling very anxious or overwhelmed.
• Use gentle hair care: Try not to tug or overbrush your hair as this will exacerbate the hair loss. Dr Barton also recommends learning how to protect your hair from the sun, “cleansing the scalp regularly and protecting the scalp from UV radiation, avoiding excessive chemical or heat treatments or styling habit that may damage the hair shaft or follicles, avoiding haircare products containing irritant compounds such as Sodium lauryl sulphates (SLS) and using silk hair accessories to reduce friction." Consult a trichologist if you're not sure what products could be making the condition better / worse, and if in doubt, consider for one of the best shampoos for fine hair as these will be easier on the follicles. 
• Consider hormone therapy: Some women find that starting HRT (hormone replacement therapy) can help reduce hair loss because it increases your oestrogen levels which will support hair follicle growth.  

Can menopause cause dry eyes? It's a fair question to ask. It's not one of the symptoms we immediately associate with menopause, but it's actually more common than you might think. 

During the various stages of menopause, many symptoms pop up that we either don't see coming or don't immediately link to the hormonal changes in our bodies. As everyone is different, these symptoms can come about at once as perimenopause begins or appear gradually through the years. 

Dry eyes are one of them and it's one of the more unexpected symptoms of menopause that could affect your day-to-day life the most. As many of us don't think about our ocular health outside of the bi-annual eye test, it's one to think about. We spoke to optometrists about why it occurs in the first place, what to do about it, and the other eye health issues to be aware of.

Can menopause cause dry eyes?

Yes, menopause can be why your eyes feel dry, itchy, and comfortable. Whether you’re just starting to experience the symptoms of perimenopause or have hit menopause already, it's common to find your ocular health changes just as much as anything else.

Optometrist Maria McAllister, who works at Specsavers, explains that this change is down to the decline of one hormone in particular: androgen. "During menopause the androgen hormone decreases, affecting the meibomian gland in the eyelids," she says. "The meibomian glands produce the essential oils for the tears, so the reduction in oil results in increased tear evaporation and drier eyes."

Changing hormone levels can also affect all three layers of the tear film, reducing the quantity and quality of your tears. 

To solve the issue in the short term, consider trying some preservative-free artificial tears, which are eye drops that hydrate dry and/or tired eyes on the go. You can speak to your pharmacist about options, and book an eye appointment to speak to a doctor about other options and possible longer-term treatments.  

 Does menopause cause eye problems? 

Unfortunately, it’s not just dry eyes that can be caused by menopause symptoms. There are several other side effects that can show up and start affecting your eyesight and overall eye health. We asked optometrists what other conditions can be expected through menopause and why they surface during this time. 

1. Change in eye shape

This may sound a little more frightening but don't worry, the change is minimal. It's also very common and happens for plenty of other reasons aside from menopause as well. 

When experiencing menopause, the fluctuation and sudden change in hormones can lead to a slight change in your eye shape, optometrist Charlotte Cook, who works with Bayfields Opticians, explains. "This can cause problems for women who wear contact lenses," she says, "So it can be a good idea for you to have your eyes checked to ensure you're wearing the right lens."

Most people won't even notice the change, but if you wear contact lenses and are suddenly finding them uncomfortable, it's something to consider.

2. Blepharitis

Blepharitis is a chronic inflammatory condition where an excess amount of bacteria can gather on the eyelashes and eyelids, says Dr Elizabeth Hawkes, a consultant ophthalmic and oculoplastic surgeon. 

The hormonal imbalance in menopause affects the tear ducts in the eyes which, as noted, can not only dry the eyes out but also force them to produce too much of the protein (lipid) that protects the eyes' surface. 

It can lead to symptoms such as "red eyes, burning, sticky eyes, excessive watering, ocular discomfort, light sensitivity, and foreign body sensation," the surgeon says. 

It's a condition that doesn't tend to go away on its own, unfortunately, so if you're experiencing any of these symptoms, it's best to visit an eye doctor for treatment. 

3. Change in vision

If you wear glasses or contacts then there's a chance you may experience a change in prescription during any one of the stages of menopause. 

"Low oestrogen levels reduce the elasticity of the cornea, thereby altering the light travelling into our eyes," explains Nimmy Mistry, a professional services optician at Vision Direct. "Along with a possible need for a new prescription, undiagnosed or untreated visual changes can lead to eye strain, headaches, and even posture issues due to constant squinting or adjusting focus." 

Wonder how often you should have an eye test? NHS guidance suggests we all should be going to the opticians at least once every two years for a regular eye test so if you think your prescription has changed recently, don't hesitate and book an appointment. 

How to keep your eyes healthy during menopause 

• Keep hydrated: Making sure you're drinking plenty of water is one of the best steps to help with your eye health, and this means hydration from both the outside and inside. Mistry says, "Drinking plenty of water can help alleviate discomfort and promote ocular health. Also, as we approach the winter months it is important to remember that dry air when indoors can affect eyes, so it’s a good idea to get a humidifier." 
• Increase your intake of fatty acids: There are so many health benefits to upping your intake of fatty acids and your eye health is one of them. Mistry says that Omega 3-rich foods such as salmon and walnuts have been shown to reduce your risk of developing dry eye disease. However, she does recommend speaking to your doctor before taking any type of Omega 3 supplement. 
• Wear UV-protective sunglasses: Wearing sunglasses with UV protection is key, says Mistry. "With recent studies linking reduced oestrogen levels to cataracts, women undergoing these hormonal changes should be keeping sunglasses handy all year round as a preventative measure," she explains. 
• Getting plenty of rest: Unfortunately, menopause can cause insomnia as well. Working to understand how to sleep better given this change can be extremely beneficial for your eye health though, as well as everything else. As Mistry says, "During sleep, the eyes rest and repair and this is essential in maintaining eye health and reducing symptoms of potential dryness." 
• Book regular eye tests: Perhaps one of the most important steps to take once you start experiencing menopause and coming across any potential symptoms. Booking regular appointments with your optometrist can allow you to keep tabs on your eye health and be early at finding any developing issues on the horizon.  

If you've previously had a healthy sex life, it can be worrying to find yourself with a low libido in menopause. There are many reasons it can happen, from hormonal fluctuations to lifestyle changes, but it's important to know there are things you can do to get your sex life back on track - if you want to. 

First things first, low libido in menopause is very common. It's one sign of the hormonal changes we don't tend to talk about too often thanks to the taboo around sex, but according to research by the University of North Carolina, about 50% of women between the ages of 40 and 60 years old report a decline in their libido compared to previous years.

Of course, it's completely okay if you don't want to have sex - with proper communication, the experts agree you don't need to have sex to maintain a relationship. However, if you want to understand this change better (as it's one of the most common symptoms of menopause) and learn how to boost libido now and in the future, we've got the answers for you. Here, woman&home speaks to a doctor and a sexologist to reveal what you need to know. 

Low libido in menopause: Why does it happen?

"Changes in libido are commonly seen around perimenopause and menopause for many reasons, but the biggest factor is the change in hormone levels," explains Dr Susanna Unsworth, menopause and women's health specialist. "Libido is a complex process though and there are both physical and psychological effects that can impact it. It's also quite difficult to quantify as it can refer to desire, level of arousal, the ability to have an orgasm and personal satisfaction,"

During menopause, as you may know, hormone levels fluctuate during perimenopause and drop post-menopause. These lower levels directly impact the vaginal tissues, causing them to become dry and increasingly sensitive, which naturally has an impact on arousal and orgasm. 

Dr Unsworth, who is also the in-house gynaecology expert for INTIMINA, says that this change can have an impact on the brain too, reducing overall desire. "Combined with additional symptoms like anxiety in menopause, mood changes, and hot flushes, the overall effect is not conducive to good levels of libido."

However, it's also important to note that one person's libido during menopause may be different from another's and each symptom may impact someone differently. "Factors such as stress, relationship dynamics, and overall health can also all play a role in the fluctuation of sexual desire during this stage of life," says Megwyn White, a certified sexologist and the director of education at Satisfyer. 

There's nothing to say that you have to have sex during menopause, even if you've previously enjoyed it. Equally, you may be able to continue to do so if you feel comfortable. It's about finding what works for you and your relationship, the experts say. 

If you are looking to get your libido back, even if it doesn't look quite the same as before, here's what the experts suggest. 

How do I get my libido back after menopause? 

1. Reduce stress

There's no doubt about it, libido is tied in with our mental wellbeing just as much as our physical wellbeing. When we feel relaxed and satisfied generally in life, we're much more likely to open ourselves up to affection from a partner and intimate experiences. 

"Stresses in daily life are often the key reasons for a reduction in libido," notes Dr Unsworth. While she also says that "no amount of medical or herbal treatment is going to improve that", there are small changes you can make to your daily lifestyle to learn how to reduce stress and avoid burnout.

2. Change up your lifestyle

While exercise won't be the cure-all to low libido in menopause, research from Shahid Beheshti University of Medical Sciences suggests it can certainly help by improving circulation, increasing energy, limiting weight gain, and limiting the severity of mood swings for some people. 

Not only that, but many find that menopause affects their confidence. Taking up a new sport or really investing in one you do already can help boost this thanks to those precious endorphins, changes to how your body looks, time spent outdoors, and interaction with other like-minded people boosting your social batteries. 

If you're new to exercise, try going for a walk 30 minutes a day. You can progress this into longer sessions or try a more intensive version, such as power walking or running every day. 

3. Take a look at your relationship

Low libido can be an effect of hormone changes and lifestyle factors but it's also worth looking at your relationship, especially if you're in a long-term partnership and struggling with low libido. 

It's something that White says is a common issue for couples. "Communication issues and relationship dynamics can also play a role. Sometimes being in a long-term partnership can lead to complacency, which can ultimately impact sexual motivation. It's important to understand that these experiences are relatable and can affect many women."

In this case, the best thing to do would be to talk to your partner. "It's crucial to communicate openly and honestly with your partner about your desires, boundaries, and any challenges that you might be facing," says White. 

4. Talk to your doctor

If you're dealing with low libido in menopause, want to change things, but are struggling to know what to do next, speak to your doctor. As with all symptoms of menopause, your doctor will be able to advise further on the best course of action for you. 

Some hormonal replacement therapy (HRT) options have been shown to work for boosting libido during menopause. "Having adequate and stable levels of oestrogen will help resolve many symptoms which can have a knock-on effect on improving overall wellbeing and libido," Dr Unsworth says. "It can also have a direct effect on improving your sex drive and improving the health and sensitivity of vaginal or vulval tissues."

Testosterone, another hormone doctors may prescribe, may also be beneficial. "This is usually most effective when used alongside oestrogen. It's most apparent in the postmenopausal time, in those who experience an early menopause or in those who undergo a surgical menopause," she says.

While HRT won't be for everyone, the doctor urges caution around so-called "natural remedies" without proper testing. "Most of the natural remedies marketed for improved libido have very little evidence to support their use," she warns.

5. Find other ways to be intimate with your partner

While it's entirely down to personal circumstances and dynamics, physical connection in this way isn't the be-all-and-end-all of relationship satisfaction and there are other ways to physically connect that don't involve classic ideas around penetrative sex, says White.  

"Alternatives can range from cuddling and skin-to-skin contact to sensual massages and outercourse," she says. For more ideas, take a look at our guide on how to intimate without sex. 

As with other relationship issues, the key to making this work will be open communication with your partner. "By exploring and embracing different forms of intimacy, we can create a fulfilling and satisfying sexual connection that caters to both partners' needs and desires," says White. 

6. Reduce the chance of painful sex

You may also decide you want to continue having sex during menopause. For those who want to, the main piece of advice the experts have is to make sure that sex isn't painful. 

As noted, the drop in hormones during menopause impacts tissue around the body - including vaginal tissue - causing skin to become dry and increasing the chance of tears. "Make sure to use lubricant or vaginal oestrogen treatment to keep things as comfortable as possible, but also address any potential psychological issues that might be affecting things," says Dr Unsworth.

Does HRT bring back libido? 

As Dr Unsworth says, HRT can stabilise levels of hormones like oestrogen, which will help to lessen the impact of many menopause symptoms that make sex - either the act or the idea of it - uncomfortable. However, it may not be a singular fix for boosting low libido in menopause.

The doctor does note that, particularly when it comes to vaginal tissue, "the use of topical vaginal oestrogen can be especially beneficial."

Can menopause cause insomnia? If you're lying awake tossing and turning, unable to sleep, it's a question you may be asking. While there are many uncomfortable symptoms of menopause that differ from person to person, the impact of changing hormones on our sleep is often reported as one of the worst.

Insomnia not only makes day-to-day life difficult, what with its impact on our brain's ability to concentrate, stress response, and pain thresholds, it can actually make some symptoms of menopause worse. With a lack of good quality sleep comes a higher chance of mood swings, anxiety, and rapid temperature changes. 

However, there is something you can do about it. Here, we speak to a doctor and a sleep specialist to get down to the bottom of one of the most frustrating menopause symptoms out there and find out how best to tackle it, so you can sleep better from tonight onwards. 

Can menopause cause insomnia?

The short answer is yes. Unfortunately, insomnia is quite a common symptom of perimenopause and menopause. As well as having a knock-on effect and leading to other symptoms flaring up, the insomnia may be caused by other symptoms. As Dr Clare Spencer, a GP and menopause specialist, explains, "Broken sleep can be directly connected to some of the physical symptoms of the menopause. You may be woken up by joint pains or hot flushes and night sweats, for example, or you might need to get up in the middle of the night to go to the loo more frequently." 

You may also simply find that your sleep is directly affected by the fluctuating and falling hormone levels.  

It's important to point out that there may be other reasons you might be struggling to sleep too, such as stress or anxiety, but if you’re experiencing other menopausal symptoms it may be the cause of your insomnia. 

While it may not help you sleep better, it may be helpful to know that if you're experiencing insomnia during menopause, you're not alone. According to data provided by the homeware brand Dunelm, two-thirds of women said that menopausal insomnia has had a negative impact on their emotional wellbeing. Even more interestingly, the research revealed that the most common time menopausal women wake up through the night is 3:29 a.m, proving just how disruptive hormonal changes can be for our sleep schedule. 

It’s not just physical symptoms however that can cause insomnia and steal away your sleep. "Psychological symptoms, such as anxiety and increased stress, can leave you tossing and turning and we know that sleep is affected by low mood and depression as well,” Dr Spencer adds. 

Should you already suffer from a pre-existing sleep condition such as sleep apnoea or even restless legs, then there is also a chance that menopause will worsen it. 

If you have any concerns about your sleep or menopause symptoms, consult your doctor as they will be able to suggest the best route forward. 

How long does menopause insomnia last? 

Similar to all other symptoms of menopause, it is completely dependent on the individual as to how long something will last. As Sammy Margo, sleep expert at Dreams, says, “For some women, insomnia may be a temporary issue, lasting a few months to a couple of years during the perimenopausal and early postmenopausal stages.”

It can also be the case that insomnia and other sleep disturbances might persist for an even longer period and into the postmenopausal years, should they not be properly addressed and treated. So if you’re wondering how to deal with sleep deprivation or perhaps asking yourself why do I keep waking up early on a regular basis, then it's time to speak to a doctor. In the meantime, this is what the experts suggest to try...

What helps with insomnia during menopause?

• Avoid alcohol: One of the simplest first steps is controlling what you drink before bed, Dr Spencer specifically warns against alcohol. She says, “Alcohol may be able to get you off to sleep, but the resulting quality of sleep can be poor. You experience a lighter sleep and don’t feel rested when you wake.” Instead, consider cutting down on alcohol if you can by reducing your intake or picking one of the many alternatives to alcohol. 
• Go decaf: Another drink to avoid too close to bed is tea or coffee. Dr Spencer also recommends decreasing your caffeine intake throughout the day as your body may be more sensitive to caffeine which will affect you when you’re trying to sleep. Many women have found that quitting caffeine in menopause helped other symptoms too. 
• Lifestyle changes: There’s a little more to this, but trying to manage your overall stress levels and worries can really help with insomnia and other menopause symptoms. Dr Spencer says, “This could be with yoga and meditation, exercise or other talking therapies such as cognitive behavioural therapy.”
• Cut down on smoking: Along with alcohol and caffeine, smoking can be a very disruptive stimulant when you’re trying to sleep. The nicotine more often than not will keep you up, so if you do smoke, Dr Spencer recommends trying your best to quit or at least cut down and avoid smoking later in the day. 
• Learn about sleep hygiene: Sleep hygiene refers to the practice of setting up a consistent routine before bedtime which helps your body get into the mood to sleep. “For example, avoiding screens for around an hour before going to bed, having a soothing bath and waiting until you are tired before going to bed can all help," explains Dr Spencer.

Can menopause cause a loss of taste and smell? If you've experienced this symptom and are wondering what it's all about, you're not alone. While we often associate changes in how we smell and taste with colds, flu, and Covid-19 in recent years, there's more to this than you might think. 

Fortunately, the conversation around both perimenopause and menopause has grown in recent years with a push by charities to break taboos around topics like hot flushes and mental health, and celebrities like Davina McCall and Shania Twain opening up about their personal realities of this life stage. Yet, there are still a fair few informational gaps on the lesser-known symptoms, the ones you could easily mistake for something else. 

Here, woman&home speaks to a selection of doctors, nutritionists, and sleep specialists to reveal the more uncommon symptoms of perimenopause and menopause and why they appear during this time in life. 

Can menopause cause a loss of taste and smell?

Yes, it turns out that menopause can cause a loss of taste and smell, confirms Emma Bardwell, a registered nutritionist and women's health specialist. "For starters, oestrogen is linked with saliva production, so when hormone levels drop, women can find their mouths become drier, and because saliva is important for stimulating taste buds, having a dry mouth can affect the taste of foods,” she says. 

In fact, according to consumer-collected data from PinkLady, with which Bardwell works, more than one in three women experience sensory changes like this. 46% reported a change in smell and 42% reported a change in taste. However, a concerning 91% of women were completely unaware that this was common during the stages of menopause. 

Unexpected signs of menopause

However, it's not just changes to taste and smell that many women get surprised by in menopause. There are a lot more that may not be as common - but can be just as problematic as hot flushes, sleep problems, and feelings of intense anxiety brought on by menopause. 

1. Vivid dreams and nightmares

Thanks to the change in hormones during this time, menopause affects our sleep cycles. Insomnia and being unable to fall asleep fast as well-known symptoms - but many menopausal women also report changes in their dreams. 

Sammy Margo, a physiotherapist specialising in sleep, explains that decreased oestrogen and progesterone can lead to an increase in REM sleep. "During this sleep cycle, you’ll be closer to waking, causing you to experience your dreams more vividly. This can entail dreaming in very specific colours and all the images you see can appear very bright." 

Margo, who works with Dreams, says, "There will also be a heightened level of detail compared to other dreams. Your dream could almost feel life-like, and you may experience a wide range of sensations, such as touch, taste, smell, and sound."

Not only can these dreams be more vivid visually and turn into lucid dreams in some cases, but they can also start becoming uncomfortable too. We spoke to Maria, 44, who lives in Edinburgh and is currently dealing with vivid dreaming in perimenopause. She says, "For the 5 days up to my period, I dream very explicit imaginings. They can range from very detailed and often grisly murder scenes to pornographic, I have no idea why.”

2. Menopause mouth

As most of us will know, menopause can quickly take over some of the body's everyday functions and where we previously might never have had an issue, one arises. A not-so-spoken-about symptom is the so-called 'menopause mouth', an uncomfortable change that can happen in the mouth when a lack of moisture is produced.  

According to GP and women's health specialist, Dr Sarah Jenkins, this strange sensation is actually quite common. She says, "Many women (including me) have burning tongue syndrome as a symptom of menopause. We all worry we are deficient in Vitamin B12, or folate, or worry our tongue suddenly got bigger and sore." However, it can be down to the decrease in oestrogen, a crucial hormone for our mouths and saliva glands, as noted. 

If you're struggling with 'menopause mouth', Dr Jenkins suggests first going to the doctor for a deficiency check. However, should your dry mouth be a menopausal side effect then she says it's best to just drink plenty of water and fluids. 

3. Thrush

When it comes to our skin in later life, there are a lot of factors that can begin to affect it and one of these is menopause. You may have found that menopause has been affecting your self-tan or perhaps you're looking at how to treat menopausal acne. It's not just the skin on our face that's affected though, notes Dr Jenkins. 

“Thrush, recurrent urinary infection and lichen planus/sclerosis are sadly common symptoms which are underreported," Dr Jenkins, who is also a skin expert at Skin Excellence Clinics, notes.  "As the skin changes due to the oestrogen levels falling in our bloodstream, we don't produce as much collagen and elastin to maintain healthy, plump, elastic skin. This affects our whole body as skin is the number one organ." 

When entering menopause, the vaginal canal can shorten. The skin can get thinner and lose its natural lubrication with a sudden lack of natural discharge. All these changes can quickly lead to problems like thrush and other vaginal issues. Whilst this can be worrying, and you should always consult your doctor if you're concerned, it's a completely normal symptom of menopause. 

4. Cold flushes

We know about hot flushes during menopause but cold flushes can be just as problematic. 

Adele Johnston, a certified nutritionist and menopause coach, discusses how she often struggles with this symptom herself. She explains, "One of the more uncommon symptoms of menopause but one I myself have suffered with and still have days I suffer with is cold sweats. Cold flushes are as they sound. Rather than a hot flush whereby you’d feel the heat from inside your body resulting in sweating, cold flashes cause your bones to feel so cold you can’t get heat." 

To try to combat this recurring coldness, Johnston recommends keeping layers on your person at all times, even on a hot day. "I tend to have hot water bottles, blankets and even thermal socks for times it gets too much," she says. 

5. Brittle nails

Much like skin, the health of your nails can start deteriorating from the very beginning of perimenopause. Where you may have had strong nail beds that grew quickly and kept their strength, you may now be seeing that they break more easily and look a little duller. 

"During the perimenopause and menopause, nails can become thin or soft, meaning they can split, crack or break more easily," explains Dr Louise Newson, a GP and menopause specialist. "Your nails are made of a protein called keratin, which gives them structure and helps keep them hard and strong. Oestrogen helps to produce keratin, so when levels are lower, your nails may be more susceptible to breaking.” 

Maria has also struggled with this. "I find the only way I can keep my nails from breaking is to have them shellac-ed on a permanent basis. I have done this for the past 2 years and though I worry about the state of my natural nails, before that my nails were always splitting, breaking and really, really fragile.”

6. Dizziness

This may be perhaps one of the more common symptoms within this list, with a larger number of women saying they experience this regularly. 

According to Dr Rebeccah Tomlinson, a GP and menopause specialist at Health & Her, around 25% of women describe dizziness as one of their symptoms of perimenopause. "It is not entirely known why this happens but it is thought that oestrogen plays a role within the inner ear and balance symptoms so fluctuation of this hormone can cause balance fluctuations too," she explains. 

However, it's always worth checking in with a doctor if you have regular spells of dizziness, especially if they come out of the blue. There are other conditions that could be causing the symptoms, including those linked to low blood pressure, dehydration, and stress. 

No matter what symptom you may be experiencing and in what capacity, it’s important to keep track of how you’re feeling and make sure you reach out for help when you need it. Whether that’s talking to loved ones or consulting a doctor when a symptom arises, it’s key to communicate what you’re experiencing so you can receive any help you might need. 

Bardwell is quick to highlight the importance of prioritising your general wellbeing during menopause when she says, "Life can feel overwhelming during this stage of life so be kind to yourself always."

Can menopause affect your confidence? When we talk about menopause, it can be all too easy to focus on the physical symptoms as these are the ones that can crop up first and cause the most issues for many people. 

However, it's so important to recognise the impact that menopause can have on our mental health. Along with the link between menopause and anxiety, depression, mood swings, and burnout, many women find their self-esteem and confidence take a hit.

If that sounds like your experience, it's important to know you're not alone. According to an NHS survey, 67% of women find their confidence knocked by the symptoms of perimenopause and menopause, and everything else that comes along with it. Here, woman&home speaks to several experts to reveal the key signs to look out for and what can be done about it. 

Can menopause affect your confidence? 

Yes, can certainly affect your confidence. Whether it's physical changes impacting how you feel about your body, mood swings, brain fog impacting your day-to-day work, or persistent sleep issues, many of the symptoms of menopause can make you question how you feel about yourself.

According to Dr Jo Perkins, a chartered coaching psychologist and counselling psychologist, there are two key reasons for this: 

• Biological: "As we go through the stages of menopause, our hormones change and our oestrogen and testosterone levels dip. These hormones play an important role in regulating a range of different functions in our bodies and brains, including our energy levels, memory function, sleep, appetite, metabolism, our adrenal glands, musculoskeletal and skin health," Dr Perkins says. 
• Circumstantial: Naturally this will differ from person to person but for many women, "menopause coincides with significant life changes that can include children growing up and leaving home, becoming a carer for relatives, a change in routine, leaving work through choice or being made redundant, changes to friendships, separation, divorce and bereavement, all of which can affect self-esteem, purpose and identity, as these changes are navigated," she says. 

So, it makes sense that experiencing these life changes would affect how we think, look, feel, and behave, all of which are so closely intertwined with our levels of confidence. 

According to Dr Deborah Lee, a women's health specialist who works with Dr Fox Online Pharmacy, low confidence and self-esteem are most commonly a problem for pre and perimenopausal women and those postmenopause. "Menopausal symptoms usually improve a few years after the last menstrual period, and as these symptoms slowly disappear, many women start to feel very much better physically and emotionally," she says. "But all women are different and unfortunately, 5% of women have hot flushes for life, for example. Their problems may well continue well into the postmenopausal years." 

Key signs of low confidence in menopause

1. Feeling anxious, worried, or stressed

There's a clear link between menopause and anxiety, depression, and low self-esteem. It's vitally important to seek help from a medical professional if you find yourself struggling with your mental health, such as your doctor. 

While we're constantly reminded how much of a role our hormones can play in our mood and mental health with years of having a period, the reduction in oestrogen levels permanently can cause new side effects. 

"The reduction in oestrogen affects the function of the adrenal glands, which help to regular our body's response to stress," explains Dr Perkins. "This physical cause can create a psychological response as it can increase anxiety, stress, and worry, which in turn, affects confidence."

2. Negative self-talk

Self-doubt and a loss of confidence can lead to negative self-talk very quickly, explains Dr Perkins. "You may be overly critical about yourself, your ability, your experience, your skills, your worth, your body and your self-image. Talking negatively to yourself can create a vicious cycle as it makes you feel worse about yourself which further reduces confidence and self-esteem," she says. 

For Tanya, 55, an estate agent in London, it was the brain fog that was the biggest issue for her confidence. "One afternoon I left to show someone around a property, got in my car and everything. As I pulled away to the appointment, I remembered I'd already had it that morning. I was so confused but I'd put it in my calendar twice...or something like that. I missed an appointment completely for the first time ever a couple of weeks later. It made me start double and triple-checking my calendar, confirming via email before each appointment. I didn't trust myself that I'd got it right for ages."

3. Negative body image

"Women experiencing menopause may become more critical of their bodies due to the physical changes associated with this life stage," says Dr Rina Bajaj, a counselling psychologist and the author of The Magic In Me. 

Unwanted weight gain linked to menopause is common, even for those who've never had an issue with their weight in the past. Our skin, hair, and nails may also change in appearance due to the decline in certain hormones. 

This, the psychologist says, "can manifest in self-doubt, self-consciousness, and a diminished sense of attractiveness, leading to some avoidance of social situations or intimacy due to these concerns."

And of course, societal expectations of youth and its associated beauty ideals have hardly helped with this, she adds. "It can exacerbate these feelings of low body confidence," she says.

4. Socialising less

A lack of confidence can lead to social withdrawal and isolation. "It's common for women to want to avoid social gatherings, networking events, or even regular interactions with friends and family," explains Dr Bajaj. "They may worry about how they will be perceived by others and a fear of judgement or criticism." 

This is why having a support network around you, especially during menopause can be so beneficial. 

5. Difficulty at work

Many find their menopause symptoms so disruptive that leaving work is the only option. A survey conducted by balance, one of the best health apps for menopause, reveals that of 4,000 respondents, 99% said that their symptoms impacted their career and 59% had to take time off. One in five women also passed on the chance for a promotion due to concerns about menopause. 

"When confidence dips, anxiety increases and the inner critic becomes lively," says Dr Perkins. "It can feel safer and easier at this life stage to withdraw from professional situations rather than risk exposing yourself to situations that take a lot of mental and physical energy and effort. It can lead to feelings of inadequacy and negative comparisons." 

It's something that Kelly H, now 58 but 45 when the main symptoms hit, can relate to personally. "Most of my friends are older than me so they warned me what it would be like. But I didn't expect my hot flushes to be as bad as they were. When I got a hot flush, I went so red and I felt so embarrassed, especially when they happened at work. As the only woman on a team with men and much younger women, I was always checking for sweat marks on my clothes and going outside to cool down. It made me so nervous to go into the office that I started working from home more often."

Earlier in the year, a proposed UK menopause law hit the headlines, designed to make menopause a protected characteristic under the Equality Act 2010 and prevent women from losing out professionally during this stage of life. However, the British government rejected the proposal. 

How to boost your confidence in menopause

• Seek support: If you're struggling with your mental health and low confidence at any time in life, the first step should be to reach out for support from a doctor who can offer both mental and physical health advice, but even just talking to family and friends can make a big difference. 
• Make a plan: "Tackle each of the challenges you are experiencing," says Dr Perkins. "Write down each challenge and consider what, if anything, you can do to address it.  For example, if you are feeling exhausted, look at how much sleep you are currently getting, what is getting in the way of good quality sleep, could reducing or quitting caffeine in menopause or alternatives to alcohol help, look at your daily routine to see what you can change, stop and introduce to boost your energy." 
• Consider how you see yourself: "Make time and create space to step back and meet yourself at this stage of your life," says the doctor. "Reflect on all that you have experienced, learned and achieved over the course of your life. Start to appreciate who you really are, what you have to offer and how much you have grown. Regular acts of self-appreciation will help you to know, value and love yourself, which will lead to increased self-esteem and confidence." 
• Reframe your narrative: You can learn how to be confident again. "You may benefit from getting inspiration from others who have talked positively about ageing and this stage of life," she says. "You can start to reframe your narrative so it is more balanced, optimistic, and confident. Although you may not fully believe it from the beginning, over time it will change your perception." 
• Find confidence elsewhere: As revealed in our series, How Exercise Changed My Life, many women have found confidence somewhere new after going through menopause. Triathlete Donna McConnell, for instance, dealt with menopause symptoms by training consistently. It was a habit she found helped her mental and physical health significantly. 

Can HRT help? 

Yes, says Dr Lee, hormone replacement therapy (HRT) can be a "very helpful way of improving self-confidence" related to menopause simply because it helps alleviate some of the more troublesome symptoms. 

"Oestrogen replacement often helps to improve sleep, clear brain fog, and it helps women cope with many other symptoms of menopause, including vaginal dryness and urinary symptoms," she explains. "Once you're sleeping better and have more energy, you can function better at home and in the workplace, all of which is likely to lead to an increase in confidence and self-esteem."

Plus, she adds, "Oestrogen is more effective than traditional antidepressants in treating menopausal anxiety and depression." In fact, research from the University of Adelaide shows that HRT is the most effective treatment generally for hot flushes and night sweats too, reducing the chance of these being an issue as well. 

To understand more about HRT and whether it's suitable for you, consult with your doctor. 

This collection of relationship podcasts is approved by experts for those looking to understand themselves and their partners a little better. While every relationship is as different as the people in it, some common themes tend to crop up for all of us. 

Whether you're struggling with a lack of communication, a long-term relationship that's lost its spark, or feelings of confusion around newly-found singledom, listening to the stories of those who've been through similar situations and insights from experts in the field can help us understand our love lives better.

From Jay Shetty's On Purpose to the New York Times' Modern Love, complete with its new host, these are the best relationship podcasts to listen to in 2023. You'll learn how to spice up your relationship, improve intimacy, and prevent relationship burnout in the future. 

Best relationship podcasts

1. Where Should We Begin?

Esther Perel is a Belgian-American psychotherapist and one of the most famous relationship experts working today. Under the belief that 'the quality of our relationships determines the quality of our lives', Perel aims to help couples improve their relationships via better communication. 

"I highly recommend Esther Perel's podcast Where Should We Begin?," says Lyndsey Murray, couples counselor and AASECT certified sex therapist. "She counsels real couples as they reveal the most intimate, personal, and complicated details of their relationships. On this podcast, you get to hear about how Esther counsels them and learn about her expertise. I recommend it because I think Esther is brilliant in her approach, and it will also give couples an insight into how couples therapy and consulting with an expert can be beneficial to them." 

2. Love Machine

"The Love Machine Podcast is hosted by the UK's leading dating coach, James Preece," explains relationship psychologist Mairead Molloy. It's one of the best self-improvement podcasts as well, for those looking to better themselves as well as their relationships. 

"It's the ultimate destination for anyone looking for relationship advice, inspiration, and for ways to bring more love into their life," says Molloy, who is also the global director at Berkeley International, a specialist dating agency. "Each week, James dives into the world of dating, interviewing experts, sharing personal experiences, and truly understanding how relationships work. With over 150 episodes already released, each other is full of wisdom, humor, and unique perspectives."

It's such a great one for anyone looking for a combination of entertainment and sound advice. "There's everything from self-love to better communication to truly having a life that makes you happy. Dating and relationships has never been so entertaining," she says. 

3. Modern Love

Most people will know Modern Love from the New York Times column, which is where it was born. The column gave (and still gives) readers an insight into the fascinating love lives of real-life people, and it's been such a success that the column's been turned into three books, a television show, and a podcast.

Every Wednesday, producer and host Anna Martin brings a story and a wider conversation about love to the table. Along with relatable situations (like How to Find the One, how to work out whether you're in a rebound relationship, and more) and fascinating insights to apply to your own life (How to Learn My Love Language), there are truly unique stories (Falling for Your Sperm Donor) to entertain and inspire. 

Modern Love is a woman&home favorite, one of the best LGBTQ+ podcasts, and one of the top-rated relationship podcasts on Apple Podcasts (with 4.4 stars) and on Spotify (with 4.8 stars), so we had to include it in this list as well. 

4. We Met At Acme

Newly single? Whether you're thinking about downloading one the top-rated sex apps, considering signing up to the best dating sites for over 50, or just looking to learn more about the dating world today, We Met At Acme has plenty of relatable (and hilarious anecdotes). It mainly looks at millennial dating but if you're new to singledom, you're bound to find something that resonates at any age. 

"My favorite podcast for those who are single is We Met At Acme. It's hosted by New Yorker Lindsey Metselaar, who breaks down rules for dating and critiques the dating world in a very fun but real way," says Laurasia Mattingly, a meditation and mindfulness expert who focuses on self-love. 

Taking a tongue-in-cheek approach to dating topics, host Lindsey Metselaar interviews dynamic experts, professionals, celebrities, and those with unique personal experiences of dating, love, and being single. Key topics include: A Complete List of Red Flags, How Marriage Changes A Relationship, What Happens After You Get Sober, and What A Healthy Relationship Looks Like. 

5. Mark Groves Podcast

"Mark [Groves] is a human connection specialist who breaks down human behavior and why we do what we do in relationships," says Mattingly. "Not to mention, he has some incredible renown guests in the relationship space, such as Ether Perel and Dr Alexandra Solomen."

The Mark Groves Podcast specializes in relationships, connection, and communication. There are 260+ episodes already available to listen to on Apple Podcasts, Spotify, and wherever else your like to listen, so it's one you can get stuck into straight away. 

No topic goes untouched in this series. You'll find conversations on complex topics that get to the root of the issue, like Healing the Political Divide and Overcoming Perfectionism, alongside debunking of popular terms like toxic positivity, sex positivity, and radical self-love. 

6. On Purpose

Jay Shetty is an English author and life coach, whose mantra is that if we don't work on the core of a relationship, values, and communication, and if we don't learn how to build trust, very little can be achieved. As a former monk, Shetty wants to make "wisdom go viral" by tackling a great variety of topics around these subjects - including Proven Strategies For Dating, Scientific Reasons Why We Lose The Spark, and How to Get The Most Out of Therapy. 

Sometimes it's with the help of certified experts like personal development coaches, psychologists, and therapists, and other times it's with celebrities. You'll hear Drew Barrymore speak on reframing expectations of love in one episode, John Legend discuss growing from grief, and Gwyneth Paltrow's take on building better daily habits, among many others. This is one of the most relaxing podcasts and one of the best podcasts for anxiety too, thanks to the many episodes available and soothing tones of the guests.

7. Jillian On Love

If you're looking for a podcast that takes on big topics around relationships and gets straight to the point, then you'll probably love Jillian on Love.  Jillian Turecki is a certified relationship coach, teacher, and writer, who has been working for 20 years to help people find and create more satisfying personal relationships.

Some episodes are on self-chosen topics - like sexual anxiety, how to end a relationship, why people cheat, and the truth about emotional unavailability - while others focus on listener questions. These are perhaps the most interesting as they deal with topics we might find relatable in our own personal relationships - but don't tend to want to speak about. Highlights include: Dating someone you're not attracted to, the issues with long distance relationships, and stopping your life for a 'maybe'.

As well as delivering her own insights on these topics, Turecki brings clients onto her podcast to discuss their relationships in real time. Conversations are always candid and no nonsense, while being reassuring and delicately handled. There are insightful 'how to' episodes as well, looking at personal subjects like how to be intimate without sex and ways to start trying to overcome childhood trauma. 

How to get the most out of your relationship podcast

• Take Notes: "Listeners can take notes of what resonates with them and their biggest takeaways," says Murray. This will help you remember the points most important to you, whether to mull over by yourself later or speak to someone about. 
• Discuss with your partner: Then, if your goal in listening to the best relationship podcasts is to improve your relationship, you can discuss them with your partner. "You may hear a feeling someone describes and if it sounds like something you're feeling, it's an easy way to tell your partner, 'I really want you to know this about me'," she says. "It's a great way to get through conflict and come back closer together."

The benefits of CBD oil for menopause are often undervalued - or entirely unheard of. As a hairdresser for the last 30 years and mum of 2, Lesley Hirniak, 54, always relied on her high energy and bubbly personality to keep up with life’s demands. But the onset of menopause left her feeling out of touch with her identity and struggling to get through the day. 

Menopause is a natural transition where estrogen and progesterone plummet to usher the body into a new phase of life. It's when your body reaches the end of its fertile potential (no more periods!) and, so many say, going through menopause can give you a sense of freedom and a fresh perspective on life. Although there is light at the end of the tunnel, the journey can feel long and arduous with 90% of women experiencing symptoms – some of which can be debilitating. 

From the more common hot flushes and hormonal mood fluctuations to lesser-known menopause symptoms such as ‘burning tongue syndrome’ and loss of bone density, there is a bounty of side effects that need managing. While hormone replacement therapy (HRT) and selective serotonin reuptake inhibitors (SSRIs) are the go-to treatment options on the NHS, women all over the world have always relied upon traditional folk medicines like plants including black cohosh, sage, and red clover. And, as it turns out, cannabis.

CBD oil for menopause

In the US, where cannabis is now legal across 38 states, a huge number of women use cannabis as their medicine for menopause, which has been documented for hundreds of years. A brand new study affiliated with Harvard Medical School and published in the Journal of The North American Menopause Society surveyed 250 menopausal participants. Researchers discovered that a staggering 86.1% use cannabis, with 78.7% saying they endorse cannabis use to treat menopause symptoms. The most common modes of use were smoking (84.3%) and edibles (78.3%), and the top menopause-related symptoms for cannabis use were sleep disturbance (67.4%) and mood, with menopause and anxiety frequently reported (46.1%).

In the UK, although cannabis prescriptions are legally available in the UK too, women like Lesley Herniak are more likely to reach for cannabis-derived supplement CBD oil.   While it is an active ingredient, unlike tetrahydrocannabinol (THC), it's not psychoactive. But does it really work? And if so, how?

What I learned about the benefits of CBD oil for menopause

1. CBD oil helps keep the menopausal body in balance

“My first menopause symptoms started really out of the blue when I was 48,” recalls Lesley. “I was out for a friend’s birthday and couldn’t stop sweating. I was excruciatingly hot and dripping wet. It was downhill from there. I started getting terrible aches in my knees, hips, and shoulders, which made my work as a hairdresser really difficult. I wasn’t able to sleep through the pain, it was so bad.”

Lesley’s friend had just launched her CBD company, Hapi Hemp, at the time and offered her some oil to try. Although skeptical, Lesley decided to give it a go. 

“I’d tried CBD oil I bought from a shop on the high street before that, but found it did nothing for me. So I didn’t really believe it would have any effect this time. But, thankfully, I was wrong. Within a few days, the aches had gone completely.”

A preclinical study by The State University of New Jersey, published in Frontiers in Pharmacology, has shed some light on why CBD might have had this remarkable impact on Lesley’s joint and muscle pain. The research shows that when estrogen-deficient mice were fed CBD, their bloodstreams more readily disposed of glucose. They burned more energy, their bone density improved, they had less inflammation in their gut and bone tissues, and they possessed higher levels of beneficial gut bacteria. These findings have led scientists to believe that CBD could be used as a possible treatment for postmenopausal women, whose ovaries no longer make estrogen.

Further to this, there are also studies to indicate that with menopause and diminishing estrogen levels comes endocannabinoid deficiencies – a lack of neurotransmitters produced by our full-body regulator, the endocannabinoid system. This system, according to research by Warsaw University Medical School, plays an essential role in the secretion of hormones relating to the reproductive system and our stress response. 

There are also thousands of studies that show CBD supports the endocannabinoid system, encouraging synthesis and the release of these vital neurotransmitters, therefore contributing to keeping the body in balance, or bringing it back into balance when necessary.  

2. You may need more than CBD in your oil to experience all the benefits

Lesley managed on CBD oil alone for a year, but while it kept her aches and pains at bay entirely and helped to keep her mood stable, it didn't help to calm hot flushes. Eventually, she decided to try HRT instead but found that it brought on new problems on its own.

“When I started taking HRT, my periods came back," she tells woman&home. "They were so heavy they left me low on iron. My breasts were incredibly painful, my skin broke out, and I’d just spend days crying. I was like having awful PMT." 

After 8 months, Lesley decided to stop HRT and try CBD again, but this time a higher strength ‘full spectrum’ CBD, which contains a range of cannabinoids including a very low, legal limit of THC – the main psychoactive substance in cannabis. 

Although the THC in shop-bought CBD oil is incredibly low, it is possible to get a prescription for higher doses, which may be very helpful for women suffering from hot flashes and pain. With the right dose, Semmelweis University research shows, THC can help regulate body temperature and it's frequently prescribed for chronic pain conditions.

Dr Dani Gordon is a world-leading expert in CBD, cannabis medicine, and integrative medicine, as well as the vice chair of the Medical Cannabis Clinicians Society. She believes THC-rich cannabis, otherwise known as full-spectrum CBD oil, could be hugely beneficial for some menopausal women.

“CBD and sometimes medical cannabis with small amounts of THC can help with many menopausal symptoms including anxiety and irritability, low-stress tolerance, fatigue, and disrupted sleep," explains Dr Gordon. “Cannabis, including THC, can be prescribed to treat difficult symptoms where other first-line drugs have failed, whether that’s for depression, anxiety, insomnia or other related conditions that are often also symptoms of perimenopause.”

3. CBD can be used with HRT

In the end, Lesley found the best results using 1500mg, full spectrum CBD oil and HRT together. 

“Although CBD helped with my pain, sleep, and mood, it didn’t control my hot flushes as HRT did. The profuse sweating at work made me anxious that my co-workers would laugh at me behind my back, and it was incredibly uncomfortable. I really found it upsetting and it made me feel like I was losing my identity. Fortunately, the combination of CBD and HRT is working well for me now. All of my symptoms are under control, the only thing I have to deal with now is itchy skin whenever I get hot. I don’t love the heavy periods I get on HRT, but CBD helps me manage those too.”

Dr Gordon describes the combination of HRT and CBD, also known as medical cannabis, as “immensely helpful” for treating menopause symptoms, particularly those that have been difficult to shift or for which there are no good drug treatment options.

What other types of cannabinoids are useful during menopause? 

There are so many benefits of CBD for women's health in general, outside of menopause. But cannabinoids come into their own during this time, with several studies detailing the full impact of full-spectrum CBD oils on our hormone receptors. 

These include cannabichromene (CBC), cannabigerol (CBG), and tetrahydrocannabivarin, which together have been found to "stimulate bone growth and they may be able to prevent osteoporosis after menopause", leading neurologist Michele Ross PhD, says. 

While cannabidiolic acid (CBDA), which is found in hemp tea and 'whole plant' CBD oils, is 1000 times more potent on the serotonin receptors than CBD, according to research by the University of Guelph. This is huge news for those experiencing menopause symptoms, as many of these are caused by a drop in serotonin. 

If you’re struggling with perimenopause symptoms and want to try CBD oil but don’t know where to start, you can get advice on the best products to try from the independent CBD consultancy or book an integrative medicine consultation and assessment with Dr Dani Gordon. 

As always, if you're unsure about how to handle the more difficult symptoms of menopause, want more information about the different stages or what to expect, or you want more general support, talk to your doctor. 

Quitting caffeine was an alien idea to me - I’ve been a tea drinker for almost all my life. It seems strange to us now, but my generation’s mothers routinely gave us warm sweet tea in our baby’s bottle when we were just mere toddlers. I can’t remember a time when I didn’t drink tea. Still, I never considered myself to be addicted to caffeine. My daily expression of ‘I need a tea’ never felt like an expression of dependence. But, it turns out it was. 

I was perimenopausal from my early 40s onwards when I began to suffer from an overactive bladder. Being a woman who had birthed children not that long before, I didn’t think much of this. I was used to those toilet dashes in the night and always looking for the location of the loos wherever I went. But when I reached the age of 50 and my GP confirmed I was experiencing menopause symptoms, something shifted. I’d never suffered from urinary tract infections (UTIs) before, but suddenly I had four in one year. On the fourth occasion, my GP told me I couldn’t keep on taking antibiotics, which was fair enough. He suggested an estrogen cream which would help with vaginal dryness, which, he said, was probably causing the UTIs. But I didn’t suffer from vaginal dryness.  

I’ve always been pretty good at listening to my body, so I went home and I listened. I began to notice that my beloved morning mug of tea just didn’t taste the same anymore. Something was off. I drank it and I felt a little bit sick. It reminded me of when I was first pregnant and just the smell of coffee turned my stomach. It wasn’t that obvious, but it was there. My body was trying to tell me not to drink that tea. Then, the more I thought about it, the more I realized that it was after drinking my mug of tea that my bladder was at its most active. After the first two mugs of the morning, I was rushing to the loo and I had that frustrating feeling of not properly emptying. I could sit there for a while, trying to empty, or I could get up and have to sit back down again within a few minutes. 

The link between caffeine and UTIs

A little research told me there's a definite link between caffeine and bladder issues. A study by the University of Michigan shows that reducing irritating beverages like coffee, tea, alcohol, and carbonated and/or artificially sweetened beverages results in a reduction of negative symptoms, including the urge to urinate, the inability to delay urinating, and other bother with the issue. 

It's these problems of needing to go more frequently and needing to go quickly when the urge arises that are contributing the rise in UTIs in menopausal women, says Dr Hoda Makkawi, a consultant family medicine physician and integrative holistic medicine specialist. 

“There have been studies that have shown there is a direct correlation between too much caffeine and incontinence. Women who consume high levels, 400 mg or more, are 70% more likely to have urinary incontinence," Dr Makkawi, who works at EuroMed Clinic Dubai, explains. "Caffeine raises blood pressure, and this can cause your bladder to become overactive. It increases the blood flow to the kidneys, decreasing the absorption of water and sodium, resulting in a desire to urinate more often. This diuretic effect can also contribute to dehydration. While it doesn’t cause UTIs, it can be a contributing factor to them because inadequate bladder emptying is one known trigger.”  

This makes a lot of sense to me. The caffeine was causing my overactive bladder, which in turn was causing the UTIs. And the point about dehydration rings true in my case too. My regular headaches increased during my menopause, which I’m sure was due to dehydration. I’ve definitely felt more dehydrated in the last few years than I ever have before. I now keep a bottle of water with me at all times, which really helps. 

Drinking water in this way is a bit of a vicious cycle if you’re drinking caffeine though, as caffeine causes dehydration and an overactive bladder. When you need to pee a lot, the tendency is to drink less, so you pee less. But with caffeine causing dehydration, drinking less will only make you feel worse, heightening the chance of UTIs and bringing on more headaches. The answer is, of course, to drink less caffeinated drinks and more water.

For me, it seemed like caffeine was the biggest contributing factor, at least to those UTIs. I’ve suffered many symptoms in my menopause so far: hot flashes, brain fog, aching joints, menopause-related anxiety, and ‘menopause feet’, and I’ve been able to cope with all of them. But UTIs are different. If my sudden onset of recurring UTIs really was down to my menopause I needed to know what was going on and what I could do about it, so I quit caffeine.

What I learned after quitting caffeine in menopause

1. Caffeine, menopause, and UTIs are all related

“UTIs become more common in menopause because of the loss of estrogen,” says Sophie Elletson, a hormone specialist and nutritionist. “Since we have estrogen receptors throughout our body, loss of this hormone can disrupt our microbiome in the bladder and the vagina."

Elletson, who also works with Future Woman, explains, "In menopause, our hormone production is taken over by the adrenal glands, so we want to support our adrenals by reducing stress and caffeine. Increases in stress can compromise our body's ability to produce the small amounts of hormones we do have. So more caffeine equals less estrogen, and higher chances of UTIs.”

2. We become more sensitive to caffeine in menopause

Although quitting caffeine, in my case, was all about my bladder, it's also beneficial in other areas of menopause and perimenopause. Health & Her recently conducted research into the triggers for symptoms during this time in women’s lives, and caffeine was shown to have detrimental effects in various areas. 

The study revealed two in five women reported they started to experience more sensitivity to caffeine as they progressed through perimenopause. Dr Rebecca Tomlinson, GP and menopause specialist, explains why. 

“Typically found in tea, coffee and energy drinks, caffeine accelerates your nervous system, increases alertness, and interferes with the absorption of vitamins and minerals," she says. "While it might seem like a good pick me up after a bad night’s sleep, caffeine can also have a detrimental effect on sleep, causing insomnia which is one of the most common symptoms of perimenopause.”

3. Going cold turkey is hard

On discovering that my successive UTIs and daily cup of tea could be linked, I decided to give it up for good there and then. Completely cold turkey. It was a journey of discovery for me and having gone on that journey, I can confidently tell you that going cold turkey is hard! 

I probably should have quit gradually, but I was so sure I didn't have any dependency on caffeine. I didn't think it would be an issue.

4. The side-effects are even harder

I would wholeheartedly recommend quitting caffeine but not doing it the way I did. Weaning yourself slowly from the powerful drug of caffeine will give you a much more manageable experience.

I stopped suddenly and I felt terrible. I had constant dull headaches that I couldn’t shift and I had the feeling of not really being there, as if I was operating from some kind of sludge. The first two weeks of feeling like this were really difficult and I almost gave in a couple of times because I knew one simple mug of tea would make me feel better - it was challenging to stick to my guns and hold out. But the thought of those UTIs kept me determined, through banging headaches and feeling like I was living underwater, until at last I came out the other side. 

5. But swapping regular tea for decaf helps

I switched my regular tea to decaffeinated tea, which pretty much tastes the same as one of the healthy alternatives to coffee and tea, to give me the illusion of drinking tea and also because I still do really like tea. Even with this though, I felt so exhausted for the first few days without the caffeine buzz. 

I know some people who quit caffeine and subsequently went back to it, but despite its challenges, I never will. I feel brighter with the alternatives to caffeine, I have more energy, and I like the fact that I’m no longer reliant on a drug to wake me up every day. Plus, the thought of those four UTIs in a year is enough to keep me on the course of no caffeine for good. 

You've likely heard that there are benefits of protein powder when it comes to maintaining a healthy lifestyle - particularly for women. But if you don't hit the gym or exercise every day, you might be wondering if this nutritional supplement is really for you. 

And we don't blame you. When it comes to supplementing your diet outside of your normal breakfast, lunch, and dinner, there's so much misinformation out there designed to sell products and nothing else. It gets even harder when it's a supplement associated with the fitness industry, as those pushing it towards you may look nothing like you, or have a lifestyle totally different from yours.

So, do you really need one of the best protein powders in your daily diet? Maybe, maybe not. Here, we speak to a nutritionist about the benefits of protein powder and whether it could be right for you.

What are the main benefits of protein powder?

1. Muscle growth and repair

Regardless of whether you're a man or a woman, protein is the essential building block of your muscles. So naturally, by eating more of it, you're giving your muscles more of what they need. 

When combined with physical activity like strength training, a study by the US Army Research Institute of Environmental Medicine outlines, this leads to muscle growth and muscle repair because exercise damages the fibers of the muscles and protein works to repair them, they grow stronger to cope with the force.

2. Fat loss

If you're aiming to achieve a solid calorie deficit for weight loss, then protein powder could become your new best friend as it helps keep you fuller for longer. "Protein can reduce hunger," confirms nutritionist Rob Hobson. "This subsequently reduces snacking, leading to fewer overall calories consumed. What's more, it has been linked to a slightly higher metabolism, meaning you burn more calories throughout the day, and even while you sleep at night."

Here, Rob points to a study by Yale University's School of Medicine which explains that the thermic effect of food (i.e. how much energy it takes for your body to digest, absorb, and metabolize the food you eat) increases when more of that food is protein based. This means that you use more energy to metabolize the food and so burn more calories. 

It's also very common to find yourself hungrier than normal post-exercise - it's actually one of the reasons why you shouldn't exercise on an empty stomach. Consuming protein before a workout can help to balance your appetite, meaning you eat with more stability throughout the day.

You can supplement your diet with protein by making savvy additions to your regular meals, like adding chicken to your salad, but some people find protein powder a more convenient way to make sure they're getting enough of the nutrient. 

"Protein is, of course, present in animal products like meat, poultry, and fish, and through plant-based options like beans, pulses, and nuts," notes Gareth Nichols, a nutritionist for sports supplement brand Maximuscle. "However, protein powders are very convenient and make for a great alternative vegan protein source if you buy the right one." 

But it's also important to note that protein can work against you for fat loss if you have too much of it. As a study by Hospital Universitari de Sant Joan de Reus points out, protein is still calories at the end of the day and even if you push yourself out of your calorie deficit with protein, you're still above your recommended intake and will likely struggle to lose weight. 

3. Reduces the urge to snack

Now, there's nothing wrong with a late night snack or munching on a couple of squares of chocolate when you're bored - we all do it. But if snacking is getting in the way of your regular eating habits or you're looking to learn how to stop eating chocolate, then it might be time to incorporate more protein into your diet.

While one of the only studies on the topic looks at men, there are comparable elements which means this could work for women too. The study by the University of Missouri looked at overweight men and found that increasing protein intake so that it made up 25% of daily calorie intake reduced cravings by an impressive 60%, and the desire to snack late into the night by almost half. 

Researchers weren't entirely sure why this was the case but the argument, from another study by Missouri University, is that protein improves the function of dopamine, otherwise known as one of the 'happy hormones' and one of the main ones involved in creating cravings. 

4. Combat the effects of menopause on muscles and bones

As we grow older, it becomes more important for women to eat enough protein since one of the biggest signs of menopause is a loss of muscle mass. For the same reasons, taking creatine for women can be beneficial. 

As a joint study by the University of Minnesota and Jyväskylä confirms, this is because of the natural decline in estrogen that starts during perimenopause. 

While a loss of muscle mass may not seem like a significant issue when compared with some of the more immediate symptoms of menopause, muscle atrophy can have a serious impact on your overall health and disrupt your life more than you may think. 

Signs of muscle atrophy include: 

• Numbness or tingling in your arms and legs.
• Struggling to walk or balance
• Difficulty swallowing or speaking
• Facial weakness
• Gradual memory loss

Another important plus point of eating more protein as you get older is to improve bone density. As much as an estrogen deficiency will reduce muscle mass, it also reduces bone density, according to a study by Near East University of Medicine, and makes you more prone to conditions like osteoporosis.

"Protein is extremely important as we age," stresses Hobson. "Women going through menopause may see a decrease in muscle mass, and protein can help avoid this. Plus, bone mass density also declines due to a drop in the hormone estrogen."

Just like with healthy fat loss though, protein powder can't do all the work. Strength training, whether it's bodyweight exercises at home or working out in the gym, is essential for forcing those muscle fibers into action. 

4. May reduce your risk of heart disease

There's no one supplement, food, exercise regime or anything that will reduce your overall chance of heart disease, unfortunately, but various studies have suggested that incorporating whey protein into your diet could be beneficial in combination with other preventative measures. 

As a study in association with Tehran University of Medical Sciences explains, high cholesterol (especially LDL cholesterol, otherwise known as bad cholesterol) is a serious risk factor for heart disease. In this case, researchers looked at overweight individuals and found that those who consumed 65g of whey protein, an animal-based protein, every day for 12 weeks experienced a significant reduction in their overall cholestrol and particularly LDL cholesterol levels. 

Another study, looking at women between the ages of 34 to 59, found that the risk of ischemic heart disease was lower in those who followed a diet higher in protein. The research by Harvard School of Public Health looked at both animal-based and plant proteins, and also discovered that replacing carbohydrates with protein may also be associated with a lower risk of heart disease. 

However, not all studies on the subject have reached the same conclusion and researchers from Harvard warned that with higher protein intake often comes a higher intake of saturated fats, which are a contributor to higher cholesterol levels. 

How much protein should I consume?

How much protein you should eat varies depending on how much you weigh. According to the British Nutrition Foundation, women aged between 19 and 50 years old need around 0.6g of protein per kilogram of body weight every day. This means that a woman weighing 11 stone - approximately 70kg - would need 42g of protein daily. 

For the reasons mentioned above, this goes up to 0.8g per kg for women over 50 years old. So post-50, the same women at 11 stone would now need around 56g of protein, according to the same advice.

Do you think you're postmenopausal? While you may believe you've got a good grip on what happens in the run-up to menopause, you're probably less clear on what takes place after. This stage of life, which can arrive for women anytime between their 40s and 60s, comes with its own changes and challenges. 

It's worth getting acquainted with how your body will evolve since these post-menopause symptoms will then last until the end of your life. We've enlisted the experts to explain exactly what happens after menopause—which takes place at an average age of 51 in the United States—and why women may have very different experiences, due to varying hormonal fluctuations. 

They'll also reveal nine of the key changes that lay ahead, positive as well as negative. Because while you may have to deal with postmenopausal hot flashes and weight gain, menopause can be associated with more liberating sex and no need to worry about regular bleeds. So, if you're well aware of key menopause symptoms and want to understand what comes next, then you're in the right place. 

What does it mean to be postmenopausal?

"The menopause is when a woman has not had a menstrual cycle for 12 months," says Dr Laila Kaikavoosi, a GP, menopause specialist, and founder of the Online Menopause Centre. "After this point, she has entered the post-menopause stage and will remain post-menopausal for life."

What's happened to the body? "The main change is the absence of female hormones—estrogen, progesterone, and testosterone—which affect the body in many different ways and cause a whole host of symptoms," explains Dr Kaikavoosi. "These include everything from hot flashes to aches and pains, and much more." 

Post-menopause symptoms

There is much overlap between menopause and perimenopause symptoms, and the same goes for post-menopause symptoms. "Menopause is a single moment in time, exactly 12 months after the last menstrual cycle," says Dr Kaikavoosi. "Beyond this time women stay in the post-menopausal stage, and there are a wide range of signs and symptoms."

Does everyone have the same experience? No. "These don’t all happen together and in everyone, so what each woman will experience is very individual," continues Dr Kaikavoosi. "For example, some might report a worsening of joint pain and skin, or the emergence of thyroid disease, as well as osteoporosis and muscle weakness."

Ways the body changes after menopause

Changing hormone levels can cause several things to happen—positive as well as negative. "The effects of menopause can last indefinitely without treatment, and may worsen with time," explains Dr Sarah Brewer, GP and medical director of Healthspan. "However, they are not always troublesome."

Dr Kaikavoosi adds, "Women can enjoy an active and productive post-menopause life, especially once their hormones have been balanced and replaced using hormone replacement therapy (HRT). It is always best to seek help and treatment from a menopause specialist who can advise on the correct treatment path depending on symptoms."

1. Postmenopausal hot flashes

Although there are plenty of things that cause hot flushes apart from menopause, this well-known symptom may persist, unfortunately. "There are estrogen, progesterone, and testosterone receptors in almost every cell and organ in our body and, so when there is a drop in the levels of these hormones, there may be symptoms like hot flashes," explains Dr Kaikavoosi. Indeed, it may take a while for them to settle and get better after menopause.

There is another factor that may influence their length. "If you are not on HRT, you may continue to have hot flashes for at least a year after menopause, with some having them for as long as five years afterward," notes Dr Brewer. "Around 29% of women aged 60 still experience hot flashes. Eventually, however, they will cease as your body and hypothalamus, a part of the brain that triggers them, adapts to lower estrogen levels."

2. Sex

While you don't need to worry about an accidental pregnancy, you may come across some other more intimate changes. "A medium-term symptom of the menopause can include thinning of vaginal tissues and increased dryness, leading to discomfort, especially during sex," reveals Dr Brewer. "There may also be reduced sensation in the skin, nipples, and genitals." Which could all impact the enjoyment you receive from intercourse.

However, there are upsides too. "Sex may become more liberating," adds Dr Brewer, speaking on how this period of life can come with less stress and responsibilities, helping you get in the mood. "Although it's best to use an intimate moisturizer." You may want to stock up on lube to help things go smoothly, and one of the best sex toys could aid you in rediscovering your libido. 

3. Postmenopausal bleeding

It's important to know that bleeding doesn't just disappear overnight as you go through perimenopause and beyond. "The main reason for excessive bleeding at this time is due to a lack of progesterone," explains Dr Kaikavoosi. "Ovaries are still making some estrogen which builds the lining of the womb, known as the endometrium, but the counterbalancing hormone, progesterone, which stabilizes the endometrium is absent. This is because progesterone is released when ovulation has occurred and perimenopausal women have more and more anovulatory cycles as they come closer to their menopause."

So what about post-menopause? Well, this is defined as vaginal bleeding that happens a year or longer after the last menstrual period. While it may be a symptom of vaginal dryness as previously discussed or polyps, there could be something more serious happening. If this is a symptom you're experiencing, it's best to consult your doctor as research by the National Cancer Institute has found that post-menopausal bleeding happens in 90% of cases of women who have endometrial cancer, among other serious conditions. 

4. No more PMS symptoms

However, postmenopausal women can enjoy a huge benefit—saying goodbye to their periods. "The main positive changes at menopause are the lack of monthly menstrual cycles, as well as not worrying about unwanted pregnancies," says Dr Kaikavoosi. 

In addition to there being no need to fear being caught short without menstrual products, there are further perks. Dr Brewer adds, "You don't have to worry about monthly premenstrual symptoms, like mood swings and bloating. Similarly, you can forget about contraception."

5. Postmenopausal weight gain

There is a natural tendency for weight gain after menopause. "From middle age onwards, your metabolism starts to slow, sometimes by as much as 3% per year," says Dr Brewer. "Between the ages of 25 and 70, the average woman sees her body fat percentage increase from 27% to 40% and she loses 5kg of muscle." She continues, "Falling levels of female sex hormones also mean you start to store excess fat compared to when you were younger. Rather than gaining weight on your breasts, hips and thighs, for example, you put it on around your abdomen.

Can anything be done to ward off menopausal weight gain? "If your exercise levels remain the same, you then need to reduce your calorie intake," explains Dr Brewer. "By the time you are 75, a woman needs around 300 calories less per day than when she was 18, and 130 calories per day less than when she was 50." 

6. Postmenopausal cramping and lower back pain

While PMS-related discomfort may fade, some other pains can arise. "Post-menopause effects can include muscle cramps as well as aching ankles, knees, wrists or shoulders and waking up with sore heels," notes Dr Brewer. This can be due to declining levels of estrogen, which is known to help reduce inflammation.

Suffering from lower back pain? This is common in postmenopausal women. Research from Rutgers Robert Wood Johnson Medical School noted that low levels of vitamin D—a nutrient deficiency highly prevalent in many women especially—were linked to degenerative disc disease in the spine.

Additionally, there is some pain that you should pay closer attention to. For example, if you are experiencing cramping post-menopause, then it could be a sign of conditions such as constipation, endometriosis and uterine fibroids, as well as ovarian or uterine cancers. As always, seek the advice of your doctor if you experience any of these symptoms.

7. You'll have more energy

Very often the focus on this life stage can be negative—which is why menopause needs an image rebrand—including a greater ability to rattle off your to-do list. "You may find you have more energy from working fewer hours, retirement and the kids having left home," says Dr Brewer.

If you're struggling with postmenopausal fatigue, due to changes in hormone levels and difficulty sleeping, then there are some lifestyle tweaks you can make. Indeed, a study by the University of Georgia showed that moderate or high-intensity exercise could boost energy levels. So, as well as investing in the best sleep aids, it may also be worth picking up a pair of the best running shoes or walking shoes and heading out to break a sweat. 

8. Tender breasts after menopause

While the likes of hot flashes and disappearing periods may be better-known aspects of the various stages of menopause, one of the lesser-known side effects is what happens to your breasts. They may shrink, change shape and lose firmness, due to hormone changes and weight fluctuations. 

If your breasts feel more tender after menopause, it could be due to a condition called mastalgia, as research from Istanbul Medeniyet University found it affects 70% of women during their lifetime. While before menopause it will be linked to the menstrual cycle, once you're postmenopausal it's non-cyclical. It may be caused by certain types of medication, infection, or a lack of bra support. If it's accompanied by breast lumps or nipple discharge, then it could be a sign of breast cancer—the risk of which increases with age—and, as such, you should check with your doctor.

9. Health conditions

Some post-menopausal changes may take a while to arise. "Long-term problems due to lack of estrogen tend not to appear for at least five years after your last period," says Dr Bewer. "Estrogen has lots of important effects on many different parts of your body, including your arteries, bones, and brain. As your levels fall, your metabolism starts to change which can lead to an increased risk of high blood pressure, coronary heart disease, and stroke, as well as type 2 diabetes, ‘bad' LDL cholesterol, and dementia."

It is also the reason why women in later life are at particular risk of osteoporosis, adds Dr Brewer. Bone loss speeds up post-menopause, with the possibility that you could lose 20% of your density within five to seven years. The risk can be reduced by eating a healthy diet—full of the best foods and supplements for menopause—and doing activities that build strength.

If you're wondering can you get pregnant during perimenopause, then we just want to reassure you that it's a perfectly normal question to ask. Because, from finding love to career progression, there's no right or wrong time to start considering children—it's simply when is best for you. 

However, while you may be aware that female fertility changes with age, it can be less well known how it alters during this life stage thanks to natural hormonal fluctuations. Whether you're looking at your options for future motherhood, or are already embarking on your journey to try for a baby, we've called on the experts to explain all you need to know about conceiving during perimenopause. 

A menopause specialist and GP will reveal at what age it usually takes place, the key things that will happen to your body, as well as whether it is still possible to get pregnant and the likelihood. What's more, they'll share their main advice for what to do if you want to start or expand your family, even if perimenopause symptoms have arrived.

Can you get pregnant during perimenopause?

Yes, it's still possible to get pregnant during perimenopause as you may still be ovulating—which is when an egg is released, Dr Sarah Brewer, a GP and medical director at Healthspan, says. This means that if you don’t want to expand your family, then you should still stay protected.

“You should check with your GP how long you should continue to use contraception—most will say for two years after your last period for women under age 50, and until one year after the last natural menstrual period in women over age 50,” she adds.

But what exactly is perimenopause? “The menopause is diagnosed when a woman has missed her menstrual cycles for 12 months or more,” says Dr Laila Kaikavoosi, a GP, menopause specialist, and founder of the Online Menopause Centre. “Any time before this, when women are experiencing symptoms of menopause but still have regular—or irregular—menstrual cycles, is called perimenopause." This first of the stages of menopause can last from seven to ten years before menopause, which takes place in the United States on average at 51 years old.

This means that while some women can begin perimenopause in their 30s, it is usually from their 40s. “Common symptoms include hot flushes, night sweats, vaginal dryness leading to discomfort during sex, disrupted sleep, problems with memory as well as concentration and mood swings,” explains Dr Brewer. “Symptoms can be worse in slimmer women, among female smokers and also those who live stressful lives due to differing levels of estrogen." Indeed, learning how to relax your mind is always important.

What are the chances of getting pregnant during perimenopause?

However, while pregnancy is possible, the likelihood does change. “Of course, the chances of getting pregnant are less as women become perimenopausal,” notes Dr Kaikavoosi. “This is because women have fewer eggs and their hormone levels fluctuate massively, making the environment not suitable for pregnancy to continue. Women may continue to have regular menstrual cycles during perimenopause but this does not mean they are ovulating." 

Indeed, the chances of these ‘anovulatory’ cycles increase as women enter their 40s. However, even with eggs maturing, and periods becoming erratic and either heavier or lighter, there is still a possibility. "You can still ovulate, and may release more than one egg, which is why conceiving twins becomes more common with increasing age,” notes Dr Brewer. 

That said, the chances of conceiving naturally around perimenopause are very low. “Usually no more than around 2%,” reveals Dr Larisa Corda, an obstetrician and gynecologist for the NHS. “Even techniques such as IVF are limited due to the low number of eggs available and their significantly lower quality compared to younger eggs. In addition, the risk of miscarriage becomes much higher, reaching 50% in women aged 45, as well as the risk of certain congenital abnormalities.” She also points to the added risk of being pregnant at an older age, which can cause complications like pre-eclampsia, preterm labor, placental problems, and growth restriction of the baby.

Tips for getting pregnant during perimenopause

“It is really important to look after yourself and ensure that your body is as capable as possible of supporting a healthy pregnancy," says Dr Corda. "As well as producing the best possible quality of eggs, it can also improve the chances of conception and lead to a healthier baby.

"There is no doubt that using donor eggs at this stage leads to the best chance of success of up to around 40%. However, for many women, this is not an easy decision. And it can be complicated if she already has biological children of her own,” she notes. 

As such, if you want to try and conceive naturally, here are some things to bear in mind. 

1. Get personal

Every woman is different, so it’s worth getting an individual evaluation for possible next steps. “My best advice is to consult with a specialist,” suggests Dr Kaikavoosi. “They will be able to help you balance and regulate your hormones to give your body the best chance to continue with pregnancy should you conceive.” 

If you’re unsure where to receive the best guidance, an ideal starting point would be with your doctor who can refer you.

2. Track ovulation

“Use an ovulation predictor kit which measures urinary levels of a hormone called luteinizing hormone (LH), which is produced in a surge before ovulation to stimulate the production of eggs, estrogen and progesterone by the ovaries,” recommends Dr Brewer. 

“Ovulation can occur immediately after the start of the LH surge, or within 24 to 36 hours following it. Using a urinary ovulation prediction kit will tell you the best time to have sex which should be as soon as possible after the LH surge is noted by a positive test and also the next day too," she says.

3. Cut back

There are certain things to avoid to bolster your chances of pregnancy. “Eat good, nutritious and organic food where possible, that has not been affected by chemicals or pesticides and is predominantly plant-based,” advises Dr Corda. "Decide to use products whose composition is predominantly natural to reduce the risk of disrupting any hormone signaling in the body, and minimizing toxic exposure by cutting out smoking and alcohol is also important for you and the baby." Indeed, curbing a drinking problem will help your overall health too.

4. Add in

Get plenty of movement, rest, and relaxation. “Exercise is vital for improving blood flow to the main reproductive organs, as well as keeping your body weight in the normal range and reducing the chance of miscarriage,” explains Dr Corda.

“Additionally, sleep is important for improving immunity and getting rid of excess hormones, while regular sex throughout your cycle can help improve the quality of sperm as well as the internal womb conditions for the baby. Then there’s learning how to deal with stress, which is often underestimated but is important when it comes to keeping the sex hormones in balance."

5. Think ahead

“Aside from lifestyle interventions, it’s important to consider fertility preservation sooner rather than later if you think you may be deferred in being able to start a family, whether it’s through lack of a suitable partner or due to career progression,” notes Dr Corda. 

“Sometimes the desire to have a child is aroused later on in women and sometimes it occurs because of a new relationship—but where possible, preservation via egg or embryo freezing up to the age of 40 is something that will provide the best chance of success later on.”

Can you get pregnant after menopause? 

Yes, it is possible to conceive if you're postmenopausal—but it might look a little different from before menopause. This is due to changes in hormone levels that mean your body no longer goes through ovulation and releases an egg.

It is likely you won’t be able to conceive on your own. “Falling pregnant after menopause is only possible with assisted conception techniques and donor eggs unless you have previously had some of your eggs harvested and frozen,” explains Dr Brewer.

While we talk as if menopause lasts years, it's actually only a moment in time: 12 months after your final period. In the years before, we're actually going through perimenopause, characterised by irregular periods and classic symptoms like hot flushes, sleep disturbances, and mood swings.

Menopause signals the end of perimenopause and the start of postmenopause, when symptoms begin to ease. However, you may still need the medications (i.e. HRT) and lifestyle changes you took up to deal with the perimenopause symptoms.

To help us understand this life stage a little better, I've spoken to leading voices in menopause care about the symptoms to look out for, how to work out which stage of menopause you're in, and the help available.

What is menopause?

Menopause occurs when a woman hasn't had a period for a year, says Dr Louise Newson. "It's caused by the ovaries no longer functioning properly, which leads to a decline in hormone levels," she says.

A blood test also isn't needed to confirm that you've been through menopause, says Dr Aarthi Sinah, a GP and an ambassador for menopause platform Issviva. "At this stage, the ovaries no longer release eggs and oestrogen levels remain low. There may be less intense symptoms of the perimenopause (such as hot flushes and mood swings), and other symptoms may become more prominent, such as vaginal dryness, urinary symptoms and general aches and pains."

In the UK, the average age for menopause is between 51, according to the NHS, but everyone is different, and it depends on factors like genetics and other medical conditions. For example, many women of South Asian and Afro-Caribbean descent tend to go through menopause earlier.

What are the symptoms of menopause?

In perimenopause, you may have irregular or heavy periods, but when you've been through menopause, your period stops completely. If you have any bleeding or spotting after menopause, it's vital to see a doctor.

Otherwise, you'll notice that the symptoms of perimenopause and menopause are very similar.

• No periods: You'll know you're officially menopausal when you haven't had a period for 12 months.
• Vaginal dryness: According to a study by the University of California Davis, around 19% of women experience the symptom in the first few years of perimenopause, increasing to 34% of women aged between 57 and 69 years old. It's uncomfortable and can cause issues when having sex in menopause.
• Aches and pains: Aching joints are caused by a drop in oestrogen, which would otherwise protect the joints from inflammation. We also lose bone density with declining hormones, which can lead to conditions like osteoporosis without intervention.
• Low mood: “Psychological symptoms such as low mood, reduced energy, intrusive thoughts, feelings of reduced self-worth and low self-esteem, loss of confidence, and irritability can take place during menopause,” says Dr Newson. “Some women even have suicidal thoughts during this time.
• Hot flushes: "If you are experiencing random feelings of intense heat that come on suddenly, spread throughout your body and face, and leave you feeling overheated, sweaty, and flushed, where your skin takes on a red hue, you could be having hot flushes," says Dr Kate Burns, a GP with a special interest in menopause at Health & Her. However, for many women, these become less frequent after perimenopause.
• Gut changes: “Hormone changes during menopause have been linked to a range of digestive issues such as nausea, diarrhoea, and cramping, alongside bloating,” says Dr Burns.
• Brain fog: “Women may struggle to remember why they came into a room, forget about routine tasks and simple activities, find it difficult to find the correct words, remember people’s names, and just generally feel a bit mentally out of kilter. It may also be difficult to concentrate or focus on a task at hand," says Dr Burns.
• Weight changes: It's very normal to notice changes in your weight and to see more weight around your middle (known as the 'menopause tummy') as declining hormone levels shift fat to this area.
• Sleep disturbances: “Hot flushes can also occur at night, so some women experience night sweats as a result,” says Miss Tania Adib, consultant gynaecologist at The Lister Hospital, part of HCA Healthcare UK. “Alongside this, women report experiencing insomnia or changes to their sleep pattern.”

What is early menopause?

Early menopause often occurs in women under the age of 45. It’s unusual, but it can happen, as Dr Newson explains. “Early menopause is known as premature ovarian insufficiency, and it occurs in women under the age of 40,” she says. “It’s very common and can affect around one in a hundred women under the age of 40 and one in a thousand women under the age of 30."

Dr Newson explains, "Sometimes early menopause can occur without any unknown triggers, whereas for some women it is because their ovaries are removed due to an operation or they are damaged by medication or radiotherapy, for example. Women of any age can become menopausal, even as young as a teenager.”

Early menopause must be diagnosed and treated, as those who go through menopause early are susceptible to greater health risks than older menopausal women.

What can help with symptoms menopause?

Hormone replacement therapy (HRT) is the most effective option for treating many symptoms of menopause, and most women can safely take it under their doctor's care. It can be hugely beneficial for those with hot flushes, night sweats, mood swings, and vaginal dryness, which can lead to issues like pain during sex.

You can get HRT in many forms, including creams, gels, or sprays. For those dealing with vaginal dryness, topical forms applied directly in the vagina via creams, pessaries, or rings can be useful.

However, not everyone can have this treatment, or wants to. Luckily, there are plenty of alternatives to HRT. These include different medications that target certain areas of the body to deal with particular symptoms (for example, antidepressants may be prescribed for those with low mood, anhedonia, or anxiety in menopause) and lifestyle changes.

Speak to your doctor if you're seeking help for menopause symptoms, as they will be able to advise the best course of action for you.

What are the stages of menopause?

We often refer to the time when we first see symptoms of menopause through to postmenopause as 'menopause', but there are actually three distinct stages. Here's how to tell them apart:

Perimenopause is the start of and the transition phase from being premenopausal (when most women have a period) to postmenopausal. "Women’s oestrogen and progesterone levels fluctuate significantly with a gradual decline, which can cause a variety of symptoms including hot flushes, mood changes, insomnia and irregular periods. This phase can sometimes last several years," says Dr Sinah.

Menopause is the day that marks one year since the last period. "When a woman has had no periods for 12 consecutive months, they are in menopause. It marks the natural end of fertility and periods, and this comes after the perimenopausal phase," she says.

Postmenopause is the time immediately after this. It's negatively characterised by increases in certain health conditions like heart disease and osteoporosis, but it can also be a hugely positive time for many women.

Tips to deal with menopause symptoms

• Manage your stress: It's easy to say 'reduce stress' to help manage menopause symptoms, but lowering your cortisol levels will have a seriously positive impact, the doctors say.
• Stay active: Stick with your favourite activity but "mix some resistance training with cardio work to maintain bone density and heart health", suggests Dr Sinah.
• Improve your sleep: Many people find "mindfulness and relaxation techniques such as yoga" useful for this, says Dr Sinah.
• Take a look at your diet: "Try to incorporate natural sources of oestrogen such as soya and plant compounds (always check with your doctor first), reduce alcohol, stop smoking and have lots of protein," she says.
• Speak to your GP: Your doctor will be the best person to advise on all treatment options, including medications, HRT, and any additional supplements you should add to your diet.

If you're experiencing menopausal weight gain, you're certainly not alone. It is a common side effect of this bodily change—and can be caused by factors including natural hormonal fluctuations and a slowing metabolism that comes with age. 

Some may find that changes in their weight begin during the perimenopause, which often starts in your early 40s, but it can persist until the end of the menopause in your 50s.

The good news? Weight gain during the menopause is not inevitable and there are steps you can take, such as learning which diet is best for you going forward, to minimise its effects. We've called on the experts to explain exactly what is causing it and how it might also be related to increased bloating, as well as the best plan of action to take for healthy, sustainable weight loss.  

Menopausal weight gain—why does it happen?

It could be down to imbalanced hormones, for example, too little progesterone and not enough estrogen—or vice versa. "Weight gain could also happen due to the thyroid not functioning optimally, which is very common during the period of menopause, and is often misdiagnosed or undertreated," explains clinical nutritionist and founder of JSHealth Vitamins, Jessica Sepel. 

"Stress—which, as a result, causes high cortisol—could be another reason women gain weight around the stomach area," she adds. As well as being an appetite stimulant, one study from Ohio State University found, the cortisol hormone causes calories consumed during periods of high stress to manifest largely as fat round the middle. 

"Additionally, hormones can affect insulin and glucose levels, which can, in turn, lead to weight gain."

Many women also experience a natural decline in muscle mass with age, which in turn slows down their metabolism, the same study found. This is one of the reasons why strength training and good protein intake during this period of life is essential, as it can slow down this process. 

One thing that is not responsible, however, is hormone replacement therapy (HRT). While the medication—prescribed to help with menopause symptoms—may promote fluid retention and bloating, it can actually increase your resting metabolic weight and may aid healthy weight management.

So how can you tell if your weight gain is down to menopause or something else? "The most important this is for women to seek professional advice to understand what could be going on," advises Sepel. "This may include getting a diagnosis for an imbalance in the thyroid or hormone levels, which could help explain what could be causing their weight gain."

As always with medical concerns, if you're unsure, seek the guidance of a doctor. 

Can the menopause also cause bloating?

In short, the answer is yes. Regardless of fluctuations in your weight, it is possible that you may experience bloating during the perimenopause and menopause. "It may be as a result of imbalanced hormones," says Sepel. "This could include higher levels of estrogen." 

This imbalance in particular can encourage water retention and intestinal gas. On top of this, reductions in bile—which keep the intestines lubricated—can trigger constipation, which may cause further bloating. What's more, as previously mentioned, HRT can trigger some bloating to take place. 

But there are also non-menopause-related factors that could be playing a part in your bloating, Sepel adds. "It could be caused by diet and stress, which affect the digestive system," she warns. 

You'll be pleased to hear that bloating should ease after the menopause though, once your ovaries stop producing estrogen and progesterone.

If you're in the midst of it, there are a number of steps you can take to reduce its effects. According to the NHS, this includes drinking plenty of water and herbal teas like peppermint, spearmint and fennel. It may also be helpful to eat smaller meals, more frequently and incorporate regular, gentle exercise into your daily routine to aid digestion—like going for a walk or doing some yoga for beginners. 

Additionally, it can be useful to be aware of foods that could be making you 'gassy'—like cabbage, beans or lentils as well as processed, sugary, spicy or fatty foods. Consuming lots of fizzy drinks, alcohol or caffeine may likewise be worsening the problem. If you're worried about persistent bloating, it is important to seek the advice of a doctor, since it may be a symptom of something else. 

What to do about menopausal weight gain

Start with medical help first, our expert says. "It can be wise to begin with health checks to understand what could be going on, especially hormone and thyroid checks and the relevant treatments," Sepel advises. This will help to rule out any menopause-related conditions that could be making you gain weight. 

Then, if you want to lose weight, it's a case of making a couple of lifestyle changes. "Eat a wholesome balanced diet and incorporate enjoyable movement in your day," Sepel says. 

Research from Maastricht University estimates that women require 200 fewer calories a day in their 50s than they did in their 30s and 40s. This is partly due to the natural slowing of the metabolism and a gradual decline of muscle mass, but also because typically those who are older tend to do less exercise. However, it can entirely differ person to person. 

Naturally, learning how to eat less than you normally would is a good first step to making that reduction and any exercise, from walking for weight loss to HIIT training, can help to supplement this weight loss. 

But as previously mentioned, building strength during this weight loss process is crucial. Lifting weights or using one of the best resistance bands during your strength training workout will help you burn calories while also preventing muscle loss over time.

Thirdly, it's also important to reduce general levels of stress. With those who go through high periods of stress throughout their day burning 104 less calories over 24-hours than those who don't, according to the Ohio State study, not combating sources of worry in your life could reverse any gains you make with your workout or nutrition plans. 

Menopause diet—the foods to add

“A high intake of fiber will help you manage your weight as it encourages satiety, so you stay full and don't search for sugary snacks in-between meals," says Rob Hobson, registered nutritionist with Healthspan. "Also, make sure there is protein with every meal, since you do not want to lose weight at the expense of muscle mass which naturally deteriorates slowly as we age with a slight increase during the menopause."

Try and eat whole foods to support the gut and liver, like legumes, vegetables and fruit, says Sepel, who reveals: "Key nutrients during this time include vitamin B6, fish oil, magnesium and zinc for hormone support." This can be via supplementation if you can't get enough in your diet. She adds that limiting alcohol and sweet foods is also a good idea where possible, to reduce sugar cravings and ensure you're only meeting the recommended daily sugar intake.

There are some other things to consider too. According to the British Nutrition Foundation, women who are post-menopausal are also at an increased risk of cardiovascular disease, so keeping your heart healthy is imperative during and after this life stage. With this in mind, try to avoid saturated fats, and instead replace them with alternatives like olive and sunflower oils and spreads. Alongside this, aim to eat two portions of oily fish a week and keep salt to a minimum.

How long does menopause weight gain last?

Once again, weight gain during the menopause can be down to numerous things. "The hormonal changes of menopause may make you gain weight, but they alone don’t necessarily cause weight gain during this time, and aging, lifestyle and genetics are often factors," explains Dr Samantha Wild, women’s health lead at Bupa Health Clinics. "What's more, menopause impacts each woman differently—for example, symptoms like night sweats may leave her inactive and low on energy which could contribute to weight gain. Drinking more alcohol and eating the wrong foods to ‘self-medicate’ low mood may also add to this."

But remember, you're not alone. "Weight gain during menopause is common," notes Dr Laila Kaikavoosi, a GP, menopause specialist and founder of the Online Menopause Centre. "This is due to declining hormone levels and subsequent changes to metabolism and fat distribution. Women often find they gain fat around their abdomen and this can be distressing as it can also result in chronic diseases like diabetes. Replacing and balancing hormones at this time can certainly help, but this is also the perfect time for a woman to have a closer look at her nutrition, exercise and general lifestyle."

Menopause weight gain natural remedies

"Menopause is different for each woman and something that may have worked for a friend or family member may not necessarily work for you," says Dr Wild. "Speak to a doctor who will be able to recommend a treatment plan to help manage symptoms."

If you're wondering whether herbal remedies may help, proceed with caution. "There is no good evidence that any of the herbal remedies promoted for use in the menopause are beneficial, however this does not mean they do not work—there has just been little research in this area," explains Dr Wild. "Agnes Castus is said to improve some symptoms such as mood swings, tension and anxiety, while Black Cohosh and Red Clover may help with hot flushes. There is some evidence that St John's Wort may be of benefit for this too."

But it's important to seek medical advice first. "There are several natural remedies that can ease menopausal symptoms like hot flushes, sleep disturbance and muscle cramps," notes Dr Kaikavoosi. "There is no 'one size fits all' remedy and women should seek specific advice from menopause specialists and healthcare professionals who have an in-depth knowledge of women’s health and menopause. This is particularly important for those on medications for other conditions, as interactions and side effects should be weighed up before starting any new remedies."

There are other steps you can take too. "In Chinese medicine, menopause is viewed very much as a normal life transition with many women taking herbs, making dietary changes and having acupuncture as part of their daily lives," adds Asha Chong, a Five Element acupuncturist. "There has been lots of research into the effectiveness of acupuncture for easing menopausal symptoms. It’s also so important not to overwork and overdo, especially late into the evening. Avoid too much screen-time stimulation before bedtime, and try and limit stimulants such as refined sugar, coffee, alcohol and avoid spicy and fried foods. Stay well-hydrated and do gentle exercise."

Hot flushes (also known as hot flashes) are one of the main symptoms of the menopause, alongside night sweats, mood changes, and sleep disturbances. In fact, eight in 10 women experience them for an average of seven years. While they are completely normal and down to natural hormonal fluctuations at this time of life, they can be both uncomfortable and debilitating. 

The good news is, you don't have to suffer in silence, as there are plenty of treatment options to help this particular perimenopause symptom. That includes HRT but also one of the many alternatives to HRT. There are also ways to manage your temperature away from treatment entirely, using simple lifestyle changes.

As always, if you have any concerns about menopause symptoms, speak to your doctor, as they will be able to deliver advice suitable for your specific needs. In the meantime, we've called on the experts to explain which lifestyle changes are best to make, as well as the common triggers to watch out for...

What are hot flushes and when do they begin?

If you're of menopausal age (usually between 45 and 55 years old) and are finding that you need to suddenly fling open the window or wake up drenched in sweat, then you could be experiencing hot flushes.

In perimenopause, hot flushes are caused by a disruption in the brain's body temperature regulation system, triggered by hormonal fluctuations - and particularly a drop in oestrogen levels.

The intensity varies, but they are usually recognisable as a sudden, creeping feeling of intense warmth or heat. A hot flush can often come from nowhere and quickly spread through the face, neck, chest and body. Sweating, palpitations, and dizziness may accompany them.

Hot flushes tend to start with the onset of perimenopause and may last through menopause, which happens on average at the age of 51 in the UK, says Dr Louise Newson, a GP and author of Menopause. Genetics, underlying medical conditions and treatment for cancer could cause the menopause to begin early, which is defined as being before the age of 40.

"Hot flushes can last anything from a matter of seconds or up to an hour," notes Dr Newson. For some women, they’re mild, but others report that their flushes make them feel like they’re trapped in a furnace. They can disrupt routines and knock confidence levels. However, it's worth noting that while they are a common menopausal symptom, they can also occur for other reasons.

How often is normal? Every woman will experience menopausal symptoms differently. This means there’s no ‘normal’ when it comes to the frequency of hot flushes. Having between five and ten flushes a day is considered to be average. However, some women may suffer from more than this, while others will report having none at all.

What makes hot flushes worse?

1. Alcohol

Drinking causes the blood vessels to expand in the body, and the increased blood flow through the vessels can make you feel hot and cause the skin to flush. All types of alcohol can bring on one, but red wine, in particular, is a known trigger. Sweating is also common with a hangover, so drinking may also worsen night sweats.

To minimise the effect of alcohol on menopausal symptoms, it could be advisable to switch to drinks with a low-alcohol content or drink spritzers to reduce your intake. Mindful drinking is another way to cut back on your units.

2. Spicy food

Some food ingredients and spices can bring on a hot flush. This is due to a ‘fiery’ food compound called capsaicin that is found in peppers and chili powder.

3. Caffeine

A cup of coffee may leave you feeling alert and raring to go, but it could also cause a hot flush. That's because caffeine speeds up the heart rate, so blood is pumping through the body faster, leading you to feel hotter. Rely on your daily cuppa as an energy boost? There could be something else going on if you frequently feel tired in winter.

Other common triggers include:

• Hot food and drinks
• Smoking
• Stress
• Tight clothing
• Hot baths
• Using a hairdryer

Identifying and steering clear of your own ‘triggers’ can help to reduce the frequency and severity of your flushes.

How can you treat hot flushes?

Hormone replacement therapy

Often the first line of treatment for women suffering from menopausal symptoms, hormone replacement therapy - often known as HRT - could be an option. One US study found that low-dose estradiol, which is a form of estrogen, helped to reduce hot flushes by 50%.

Other types of HRT include combined HRT patches, which contain an effective duo of estrogen and progestogen. Speak to your doctor to find out if it’s the right option for you.

Other medications

If you don’t want to take HRT, other prescription medicines - including certain antidepressants and clonidine (usually prescribed to help with blood pressure) - might help.

Stay cool

Heat triggers flushes for some women. Using a fan and taking cooler baths and showers may help. You could also try cooling gels or placing a cold compress on the back of your neck when you feel one coming on.

Cultivating a good bedtime routine is important, too. Wear layered clothing and switch your duvet for layers of sheets and a cooling pillow. And, strange as it sounds, some women wear socks to bed because it helps to lower their core body temperature.

Reduce stress

Keeping your stress levels down is often easier said than done, but it can really help. Try relaxing with one of the best meditation apps. Some women also do slow, deep abdominal breathing to ease symptoms - and it can be worth doing 15 minutes in the morning and evening, as well as when a hot flush starts, to help control the severity. Yoga for beginners and tai chi may also help.

Eat well

Phytoestrogens are found in plant foods like soy beans, chickpeas, lentils, ground flaxseed and red clover. These natural compounds have a similar chemical makeup to estrogen, and as a result, there's some evidence that eating foods rich in phytoestrogens can help to reduce the frequency and severity of hot flushes.

Women’s health specialist Dr Sally Moorcroft suggests eating green vegetables daily, since they’re packed with magnesium. She also advises drinking kefir for gut health, explaining: "A happy gut leads to less inflammation in the body, which can reduce your symptoms." The adaptogenic herbs ashwagandha and tulsi may help to reduce the effects of stress on the body and ease flushing.

Supplements for hot flushes

• Folic acid: Taking 1mg of folic acid a day has been found to reduce the severity, duration and frequency of hot flushes
• Vitamin E: Taking 400IU of vitamin E a day has likewise been found to help ease hot flushes
• Ibuprofen: Some women find that taking an anti-inflammatory, non-steroidal painkiller relieves their hot flush symptoms.

This article is not intended as medical advice. Always speak to your doctor before taking an new supplements for treatment for hot flushes and other symptoms of menopause.

Complementary therapies for hot flushes

Hypnosis

It may seem like an unusual solution, but hypnosis can help with hot flushes and night sweats. “It may also be beneficial for anxiety or low mood that accompanies them,” says Dr Caroline Houlihan-Burne, clinical hypnotherapist at The Princess Grace Hospital.

Want to try it at home? “Close your eyes, breathe deeply and count down from 10 to one on each 'out breath'," explains Dr Houlihan-Burne. "Repeat a positive suggestion in your mind, such as ‘I’ll remain cool and calm all day’. When you’re ready to come out of self-hypnosis, count from one to 10. On the count of 10, your eyes will open and you’ll come out of the trance."

Cognitive behavioral therapy

Cognitive behavioural therapy for menopause is a form of talking therapy. It identifies negative thought patterns to create positive changes in feelings and behaviour. It’s particularly effective during the menopause, explains clinical psychologist Professor Myra S Hunter.

“CBT has been found to help women handle hot flushes and night sweats, as well as improve mood, sleep and quality of life,” explains Professor Hunter. Talk to your doctor about whether it may be suitable for you.

Acupuncture

A study found that women given 15-minute sessions of acupuncture weekly, for five weeks, were significantly less troubled by hot flushes.

So, how does it work? Mark Bovey, head of research at the British Acupuncture Council, explains: “Acupuncture’s effect on neurotransmitters linked to pain relief and mood regulation may influence the thermoregulatory centre in the hypothalamus region of the brain.”

Here’s a happy thought. As a post-menopausal woman, I’ve now waved goodbye to 40 years of periods. That’s four decades of discomfort, expense, and—cringe!—the occasional disaster with a white skirt and an unpredictable cycle. So long PMT. Farewell, stomach cramps. Adios the drain on my purse caused by the £5,000 spent in my lifetime on sanitary items.

Just a century ago, women went through ‘the change’ towards the end of their lives. Women were taught to fear the stages of menopause thanks to well-publicized and unpleasant menopause symptoms the milestone can bring—from night sweats to hot flushes and reduced sex drive to vaginal dryness. Today the average age of menopause is the same but we’re living longer and menopause does not signal the end of life—or even life as we know it. With better self-care, good sleep hygiene, healthy food, moderate exercise, and the energy to carry on learning new skills (take a look at our list of hobbies for women if you need more inspiration), we could be done with periods and still have half our lives left to enjoy. 

Menopause—a wonderful surprise?

I’m not alone in wanting to give menopause a little credit. Remember Kristin Scott Thomas’ famous speech in TV’s Fleabag? 

"Women have pain on a cycle for years – and then, just when you feel you are making peace with it all, what happens? The f***ing menopause comes, and it is the most wonderful f***ing thing in the world." Exactly!

"Yes, your entire pelvic floor crumbles and you get f***ing hot and no one cares," says Kristin, "but then you’re free, no longer a slave, no longer a machine with parts. You’re just a person."

And hurrah for journalist Caryn Franklin’s take on what she sees as the joy of change—"In menopause, our body roars. All these years it has put up and shut up, and now will not tolerate abuse or disrespect any longer. It is a demand from your newly awake self for quality, not quantity, for re-evaluation and rebalancing. It is your body’s hormonal call to action."

Menopause is a woman's 'second spring'

Of course, it’s a call to action that’s not without pain. Many women have horrendous experiences of menopause—so many celebs have spoken about their midlife trials that one UK newspaper unhelpfully dubbed this period the 'moanopause'. Hot flushes, sleepless nights, vaginal dryness, and brain fog are horrible, but there is now more medical and therapeutic support available than ever before. Meanwhile, HRT is back in favor, smoothing the road towards our next phase.

And it’s a phase that can be really exciting. In Chinese medicine, menopause is called ‘second spring’ and celebrated as the gateway to an energetic and independent older age that women can look forward to. If we’re lucky, these years can be the most healthy and enjoyable of our lives—a time to follow passions, value our experiences and cherish our newfound liberty. Sex and menopause can go hand in hand too—there's no reason physical intimacy should be off the menu. In fact, many women find this phase of life to be sexually liberating. 

Many of us will get fit in our 40s and 50s, learn a new language, travel, and even change careers. With grown-up children no longer at home, fewer expectations of us, and hopefully greater financial security, the possibilities are enticing. With the privilege of age, we can be selfish and command rank and respect for our decades of hard-learned skills. Freedom from menstruation and pregnancy should boost our confidence. We can dress how we like and eat what we choose, prioritizing what is most important to us.

Yes, menopause is the final raw deal a woman must endure but, as someone who is out the other side, I can tell you that life gets better. I’m no longer a slave. No longer a machine with parts. Just a person. Free.

The menopause is a completely normal transition for women, but that doesn't mean that it comes without challenges.

The life stage brings with it plenty of obvious physical symptoms, due to a depletion of oestrogen; no more periods, hot flushes, night sweats, and menopause weight gain to name but a few. It's therefore no wonder that it can also end up having an impact on our mental health. 

As well as the effects of the physical symptoms, the menopause can leave many women battling emotional symptoms too, including mood swings and insomnia, which can have a knock-on effect on our wellbeing.

It's no surprise then that menopause help is necessary to help us deal with all the changes going on.

And while it may feel like you're alone in your struggles, there is actually plenty of menopause support out there—and lots of different ways of coping with menopause.

Coping with menopause

We're all aware that the menopause can be a difficult time, but there's no doubt that talking about it can help.

As with any problem, getting it out in the open is often the first step in making thing feel more manageable.

Dr Rebecca Lewis, from themenopause and wellbeing centre Newson Health, explains that talking about the menopause can be feel awkward, but it's vital for all sorts of reason.

"Some women are intensely private—after all the symptoms are often very personal—vaginal dryness and irritation, uncomfortable sex, low libido etc," she said.

"Talking to other women going through the same thing is incredibly helpful as often women feel isolated and ’cut off‘ emotionally from their family and peer group due to their symptoms. Talking to other women helps them realise they are not alone in their experience, and will help raise awareness of how severe symptoms can be in some cases.

"Also, talking with other women will help them understand the symptoms better and how to get effective treatment. Talking empowers women and helps them cope knowing that several other women they know are going through the same thing."

So where can you speak to someone, if you don't feel comfortable sharing with your loved ones? We rounded up a list of options so you can find the right one for you. 

Menopause online support communities 

If you feel slightly shy talking about your experiences with strangers face-to-face, an online menopause support group might be for you. Speaking to people virtually, with a degree of anonymity, can help you air your menopause grievances from the comfort of your own home.

Dr Rebecca recommends chatting online, but warns that it's sensible to question any information and medical advice you might find in chatrooms or similar.

If you're not sure where to get started, here's our list of the best online menopause support communities. 

1. Peanut Menopause

A subset of the popular women's social network Peanut, Peanut Menopause is designed to connect people experiencing all stages of menopause through a supportive digital community. Here's everything you need to know to get started: 

• Peanut Menopause is designed to lift the mystery surrounding the hormonal shift by creating a safe space for members to share their stories, post questions and discover relevant content.
• To sign up, users are asked to identify which stage of menopause they are at—perimenopause, menopause or postmenopause. 
• You will then be granted access to a private network of people in the same situation, where they will be free to seek information, ask for support or simply have a friendly chat. 

2. Menopause Matters 

The forums of Menopause Matters are some of the most well-known, online groups for discussing all things menopause. With members posting every day, there's not much that isn't spoken about on here—including everything from menopausal sex, the ups and downs of HRT, and post-menopausal bleeding. Here are the basics for getting started:

• Set up your own personal account here by creating a username and password. 
• You'll then having access to countless menopause discussion groups, where you can search for information, share your own experiences, or just enjoy the company of supportive people. 

3. Menopause ChitChat

Menopause ChitChat is another chat-filled forum where members open up about a whole range of topics. One of their most popular threads surrounds discussion about menopause symptoms, so users can open up about what they've gone through and how it compares to others. Here's what you need to know to sign up: 

• After you sign up by creating a username and password, you'll be given a free guide to managing menopause. 
• You'll also gain access to forums where you can post your concerns and questions about menopause, particularly those related to symptoms. 
• You can even start your own topic of discussion too, for anything that's particularly niggling at you.

4. The Daisy Network

For some people, menopause doesn't arrive when you might expect, in your late 40s or early 50s. For many women, early menopause can happen for a variety of reasons. Officially termed premature ovarian insufficiency (POI), it typically refers to menopause that comes far earlier than normal—for some women, that could be as early as your teens, 20s, or 30s, although others have it happen in their early 40s.

During early menopause, your ovaries stop producing eggs years before they should—meaning falling pregnant can be very difficult. During POI, your hormone production is also affected, which can have an effect on your well-being.

The diagnosis can be life-changing—which is where the support of the Daisy Network comes in.

• The Daisy Network was set up to help support women—and their loved ones—who are going through early menopause. The charity uses an innovative scheme of 'networkers'—members of the organization who are there to act as contacts—for other members to talk to, based on their own experiences.
• As well as that, many members of the Daisy Network also arrange local networking, menopause support groups for real-life meets up, so you can offload face-to-face if you want.
• Membership costs £20 for a year, and the money is used to keep supporting women across the UK who may be struggling.

5. British Menopause Society

Although you don't have the opportunity to speak to other women here, on the Women's Health Concern website, the patient arm of the British Menopause Society, you can find everything you need to help answer your menopause questions. If that sounds of interest to you, here are all the details you need to know:

• Full of verified and impartial advice, the service is there to offer support and education to women about the menopause.
• There is a range of different resources on there, such as the opportunity for telephone calls with specialist nurses, factsheets, detailed and informative email newsletters, and even meetings, seminars, and workshops on all kinds of topics.
• Many of the helpful guides are available to download on their website here for free, but you'll have to pay for some of the other services; £20 for 10 minutes of telephone advice, and a minimum £10 donation for email help.
• There's also a super-handy function that can help you find a 'menopause specialist' in your area. Simply type in your location, and the radius within which you'd want the specialist to be, and it'll take you to another web page containing the name and location of the specialist, if you want to get in touch. They are specific BMS specialists, so you can rest safe in the knowledge that they're reliable.

6. North American Menopause Society

The North American Menopause Society is another great resource for people navigating menopause. This nonprofit organization, used by medical professionals and patients alike, offers everything from advice on how to find a menopause practitioner to answers on the most FAQs menopause questions. It also offers free notes written by menopause experts in a range of different languages. 

7. Red Hot Mamas 

Launched back in 1991, Red Hot Mamas is now the largest menopause education program in America. Its program is currently being rolled out in over 200 hospitals across the US and Canada, but plenty of its resources can also be found for free online. 

• Users can expect access to an online support community, expert advice and regularly updated, comprehensive information. 
• Red Hot Mamas also host special education events related to managing other midlife symptoms, like osteoporosis, vaginal health, and hot flashes.
• You can join the community for free here. 

8. Menopause Cafe

Perhaps one of the best and most unique objectives out there for menopause support is the Menopause Cafe. 

• At the Menopause Cafe, groups of people meet up for a coffee, where they're then free to discuss any aspect of the menopause that they like.
• The Cafes, which take place around the country on various dates across the year, are welcome to everyone; even people who aren't going through it. The aim is to open up a conversation to help those in the throes of the menopause, and to help their loved ones understand it better, to help give support.
• Spouses, families, friends, and colleagues are all welcome to attend. 
• You can find out when and where your local menopause cafe is next on here. 

But most importantly, if you're finding the menopause difficult to cope with, visit your GP. Talking about it is vital, but medical help from your doctor can help to alleviate some of the pressures and symptoms of the life stage.

Many menopausal women favor HRT, but there is a range of treatment options, as well as more holistic options that can offer some relief.

The most important thing to remember is that you're never alone—and there's always someone out there who can help with what you're going through.

As women, we battle against our hormones, arguably from our teenage years through to older age.

And there are waves to overcome in later life, in the forms of the three stages of menopause: perimenopause, menopause and postmenopause.

There was a time when 'menopause’ was a forbidden word. Known as ‘the change’ and typified by hot flushes, mood swings, loss of libido and changes in skin, hair and body, it was nothing to celebrate, and certainly not spoken about.Today, though, there’s a different agenda. Led by women in the spotlight, from Viola Davis and Gwyneth Paltrow to Meg Mathews and Lorraine Kelly, plus a whole host of women who are writing and podcasting about the menopause, the ‘M’ word is becoming part of our vocabulary.

But ‘menopause’ is no longer a one-name-fits-all term. For every woman, it looks and feels different, and the three key stages of perimenopause, menopause and postmenopause bring their own challenges.Whether you are at the beginning of your menopause journey, midway through or approaching the end, there’s probably one thing you have in common with many other women – it’s still hard to talk about. You either feel like ‘the only one’, or you wonderif your symptoms are the worst.

A survey from Superdrug found that 50% of women who hadn’t yet experienced menopause were worried about approaching it. Symptoms that most concerned them included, at number one, hot flushes, followed by weight gain, mood swings, depression and anxiety.Meanwhile, 63% of working womensay that menopause has had a negative effect on their working life, while the British Menopause Society found that only half of women with bothersome symptoms consult their GPs for help.

Menopause has so many effects, it can be hard to know where to start to help yourself, but a good place is to understand which stage you are at or might be approaching. Read on to discover more.

Stages of menopause: perimenopause

When does the menopause start?

Menopause typicallyhappens between the ages of 45-55, with the average woman starting at 51.

What's happening?

Women are often unaware that they’re entering the perimenopause, which can be distressing. Hot flushes and night sweats can start five or more years before your periods stop at menopause.

Dr Sarah Brewer, GP and Healthspan Medical Director, says, "During perimenopause, ovaries produce fewer and weaker follicles until, eventually, you stop ovulating. Only 12% of women wake up one day and never have another period. The other 88% notice fluctuations, with their cycles being longer or shorter, heavier or lighter and, in some cases, with intermittent spotting.

"In early perimenopause, oestrogen levels are still high enough to allow for ovulation. However, these levels are lower than your body is used to, so symptoms may be felt before the cycle changes."

MORE:We asked menopause experts about HRT alternatives following news of a national shortage

Tania Adib, Consultant Gynaecologist at The Lister Hospital, adds, "Menopausal symptoms can start many years before the menopause, while women are still having periods, so they often don’t connect the two. Often, the levels of the hormone progesterone reducefirst, causing mood swings, low mood,anxiety, poor sleep and weight gain without the classic hot flushes.

"As the ovaries “run out” of eggs, so the levels of the hormones normally produced by the ovaries reduces, and this causes symptoms of the menopause."

Not yet 45?

‘Early’ menopause (before the age of 45) may occur for medical reasons, including surgery (for example, removal of the ovaries with or without hysterectomy), chemotherapy or radiotherapy.

But menopause can also happen ‘prematurely’ (before the age of 40). There’s a fairly rare condition – premature ovarian insufficiency (POI) – which is said to have occurred when periods stop before the age of 40.

"POI means the ovaries stop producing eggs, years – sometimes decades – before they should," explains obstetrician and gynaecologist Dr Marie Gerval, who is co-chair of The Daisy Network, the UK’s only POI support charity. "There’s a rapid drop in the production of the hormones oestrogen and progesterone, which play vital roles in women’s health and wellbeing,’ she adds. ‘Studies show that symptoms of menopause can be more severe if it occurs early, one theory being that we’re programmed for it to happen slowly at 50-55."

The causes of spontaneous POI are relatively unknown. ‘For 90% of women, there’s no explanation, though it’s thought some are simply born to produce fewer eggs or their cycles are programmed to accelerate faster,’ says Dr Gerval. "Some rare genetic disorders, as well as gynaecological issues such as endometriosis, have also been found to have a slight link."

A lack of awareness means women with POI are often misdiagnosed, most often with depression. See your GP if symptoms of the menopause are troubling you or if they start before you are 45.

Stages of menopause: the menopause

When?

The menopause itself is said to have been reached when a woman has been period-free for 12 continuous months.

What's happening?

Periods are officially over. Your ovaries no longer have enough follicles to maintain your menstrual cycle.

Dr Sarah Brewer explains that, due to lack of oestrogen, joints can be affected, particularly hips and knees, as well as hands and fingers, "Muscles, tendons and ligaments may all become more prone to stiffening and aches."

Tania Adib says, "The average age of the menopause is 51 in the UK, but it can start many years before that. It’s estimated that around 1 in 100 women go through it under the age of 40, and 1 in 1,000 under the age of 30.

"When a woman has not had a period for a year, she is considered fully menopausal. However, symptoms can continue for many years after – in some cases for 10 years or more."

MORE:Delay the menopause by substituting these common household items says Dr Marilyn Glenville

She adds that as hormones (oestrogen, progesterone, testosterone and DHEA) deplete, some hormone is still produced by the adrenal glands, but very little from the ovaries. This decreased level of hormone production causes significant changes in the body.

"Some women sail through with no problems," she says. "Others have terrible symptoms which very significantly affect the quality of their lives and can cause loss of confidence and problems coping at work and socially. Even if they have no symptoms, over time they will be more at risk of heart disease and osteoporosis. They may also experience vaginal dryness, the need to go to the toilet to pass urine more frequently, incontinence and prolapse."

While the symptoms listed as part of perimenopause are also part and parcel of the menopause, there is plenty we can do, from recognising them to seeking natural solutions, diet, exercise and even therapy.

Did you know there is no such thing as a typicalmenopause? This magazine will guide you through the unknown with tips, personal experience and expert advice and help you to navigate the symptoms and stresses of this rite of passage. The Smart Woman'sGuide to the Menopause is on sale 20 February, only £2.99.

3. Stages of menopause: postmenopause

What's happening?

After the menopause, the adrenal glands continue producing small amounts of a type of oestrogen called oestrone. Excess stress can reduce this adrenal output, so de-stressing is key.

Dr Brewer explains, "Progesterone levels fall to as little as one-twentieth of premenopausal levels, which may contribute to some postmenopausal symptoms, such as mood swings."

Your hormones explained

These hormones are essential for every aspect of life, but what’s what?

OESTROGEN

Nutritionist Yvonne Bishop-Weston explains that, in the thick of the menopause, ovaries stop producing as much oestrogen. "This, along with tailed-off progesterone, can impact on bone health and be an osteoporosis risk factor. It also leads to symptoms such as thinning skin and hair, loss of skin elasticity, low mood and vaginal dryness."

PROGESTERONE

Premenopause, progesterone is produced by the ovaries after ovulation, typically halfway through the monthly cycle. "In perimenopause, women ovulate less often, so have the oestrogen but not the balancing progesterone," says Yvonne. "This period of oestrogen dominance can lead to irregular periods and mood swings." Tania adds that progesterone can "normalise blood clotting, reducehot flushes, restore libido and regulateblood sugars".

TESTOSTERONE

Primarily a male sex hormone, this is produced by women, too. "In women, testosterone increases libido, boosts muscle mass and strength, increases energy levels and improves mood, vitality, memory and bone density," says Tania, adding that low levels can cause fatigue, irritability, depression, and decreased bone density. It’s also vital in preventing heart disease.

OXYTOCIN

AKA ‘the love drug’, Alison Cullen, nutritionist for A.Vogel, explains that oxytocin can fall during menopause, causing a drop in libido. Magnesium and cholesterol are needed for its formation, as is vitamin C. Eating healthy fats like avocados, walnuts and olives help keep ‘good’ cholesterollevels up, while vitamin C is present in all fresh fruit and veg.

If you've ever woken up in the middle of the night, with you and your covers soaked to the bone, you've experienced night sweats. And they are fairly common. In fact, in a US study of 2,267 people who visited doctors, 41% said they experience night sweats.

Sometimes, they are nothing to worry about, and can be solved through simple adjustments or treatments. But a lot of the time, seriously excessive sweating at nighttime can have some worrying causes. So what might cause night sweats in women?

See below for the following night sweats causes...

Causes of night sweats in women

1. Night sweats during the menopause

Hormonal shifts within your body, such as those thatoccur during the menopause, or during the perimenopause, can often trigger hot flushes and night sweats.

Vicki Whiteley, Director of Aesthetics at The Whiteley Clinic explained, “Most women will experience hot flushes when going through the menopause. They're often described as a sudden feeling of overwhelming heat that seems to come from nowhere and spreads throughout the body."

And they often happen due to dropping levels of estrogen. Dr Shahzadi Harper, GP and menopause specialist at zoomclinic.co.uk, also revealed exactly why night sweats might happen during the menopause. She told w&h, "Women commonly get night sweats during perimenopause. Not all women suffer, but three out of four women do. Its due to fluctuating and declining hormonal levels. A woman’s ovaries produce less estrogen, progesterone, and testosterone, and menstrual periods become irregular.

"It is particularly the led lining and fluctuating levels of the hormone oestrogen which is responsible for night sweats."

MORE:Menopause magnets: what are they and do they really help ease menopause symptoms?

Vicki said, "One way to keep your body as cool as possible during the menopause is to wear clothing made of natural fabrics that will allow the skin to breath, such as lightweight cotton or linen. People who dress inappropriately with very warm clothes in conditions where they are not needed can cause themselves to sweat excessively, as the body’s eccrine sweat glands are forced to produce sweat to cool the body down. Losing unnecessary clothing layers will instantly reduce your sweat production and keep you feeling cool."

Some women have had success in easing menopause symptoms with menopause supplements or menopause magnets - though it's worth nothing that these solutions have also been unsuccessful for many others. It's a case of working out what's right for you.

2. Certain medications

Some medications can also prompt night sweats in women. Frequently, antidepressants can trigger night sweats, as can, ironically, medication you might take to lower a fever - such as aspirin. Some drugs used to treat diabetes can also contribute.

To make things even trickier for menopausal women, it's also thought that some hormone therapy medications could also be a cause of night sweats, so if you're suffering with them whilst going through the menopause, it might help to reconsider whether they are right for you.

3. Some infections

Sometimes night sweats can be an indication of something more serious going on in your body. It's thought that more worrying infections, such as tuberculosis, endocarditis (inflammation of the heart valves), abscesses in any part of your body, or a HIV infection could also trigger night sweats.

MORE:Lightweight summer sleepwear that’s also great for menopausal women

If you suspect any of these it is important to see a doctor as soon as possible.

4. Anxiety

People who experience anxiety or anxiety disorders might also experience night sweats. Anxiety can easily manifest itself in physical symptoms, which can often include sweating. And if you experience these symptoms during the day, they can often come out at nighttime too while sleeping.

5. More serious illnesses such as cancer

In rarer circumstances, night sweats can be a symptom of some cancers.

Sometimes, night sweats accompanied by things like unexplained weight loss can be a sign of cancer such as lymphoma. If you have night sweats alongside other worrying symptoms such as localised pain or a temperature, it is important to get them checked out with a doctor.

6. Hyperhidrosis

Hyperhidrosis is a condition in which you sweat excessively for no obvious reason. It is not necessarily related to increased heat outside or more physical activity, and can cause night sweats. The NHS note that excessive sweating can happen as a result of "another condition you may have ,or as a side effect of medication you're taking."

7. Lifestyle factors such as increased alcohol consumption

Drinking more in one day can contribute to increased and excessive sweating at night. However, it can also occur if you are drinking to excess too, as sudden withdrawal from alcohol can sometimes result in night sweats.

MORE:10 causes of hot flushes that have nothing to do with the menopause

Other lifestyle choices could also cause women to sweat more at night. For example, if you eat a lot of spicy food, drink a lot of caffeine, or wear thicker or non-breathable pyjamas, you may be more prone to night sweats. If you find yourself struggling and have ruled out any other causes, it might be worth adjusting these or avoiding certain triggers for a while to see if it helps.

When you should seek medical help for night sweats

Night sweats might not need treatment if you can easily pinpoint the cause, but if you are unsure why you are excessively sweating at night, it might be a good idea to seek the advice of a GP.

The NHS advises seeing a doctor if you are having night sweats if:

• you have night sweats and are losing weight for no reason
• you are having night sweats regularly
• you are simply worried about your night sweats
• have night sweats and also a very high temperature, a cough, or diarrhoea
• they interrupt your sleep
• they come on years after you have been through the menopause

How to stop night sweats

Dr Shahzadi advises that you can help ease night sweats with some simple methods.

"Avoid triggers such as alcohol, caffeine and spicy food especially near bed time. Or, try some meditation. And keep a fan nearby and a cool glass of water. For the menopause, HRT which helps to replenish the oestrogen loss, does ease the night sweats significantly."

If persistent night sweats are bothering you - you can also try these natural tips and remedies:

• Wear lightweight sleepwear, that will keep you cool during hot flushes
• Keep the room temperature low and let in some air throughout the night if possible
• Take a cool shower before bed
• Run cool water over the wrists before bed
• Maintain a healthy weight
• Destress before going to bed

Menopause magnets are growing in popularity thanks in part to the allure of a hormone-free way to treat some of the most debilitating symptoms of menopause.

Magnets have been used to treat painful conditions since Ancient Egypt, though using them to combat menopausal symptoms is a relatively new phenomenon.

LadyCare are the British brand behind the leading menopause magnet on the market, the LadyCare Menopause Magnet. According to the magnet's creators, LadyCare Lifetime Limited, 71% of women who tried it out found it helped them cope with hot flushes.

But how exactly do menopause magnets work? Do they work? Are claims by brands such as LadyCare substantiated and - most importantly - are menopause magnets safe?

What actually are magnets for menopause?

Menopause magnets are magnetic devices designed to be fixed onto the front of your underwear. They're drug-free and marketed as an effective, natural alternative to HRT - though there is not yet any scientific or medical evidence to support this claim.

What does a menopause magnet do?

LadyCare, one of the leading manufacturers of menopause magnets, claims to reduce or eliminate menopausal symptoms. These symptoms include hot flushes, water retention and bloating in perimenopausal and postmenopausal women. It also claims to help mood swings, anxiety, irritability, menopausal weight gain, memory lapses and fatigue, according to the product's description on Amazon.

How do menopause magnets work?

Menopause magnets are said to work by balancing the activity of the two branches of the autonomic nervous system (ANS).

More precisely, they're said to reduce excessive sympathetic nervous system (SNS) activity and increase parasympathetic nervous system (PNS) activity. The SNS and PNS work together to regulate the activity of every organ system in the human body. However, hormonal changes around the time of the menopause can affect their equilibrium. This can cause SNS activity to increase at the expense of PNS activity.

The LadyCare Magnet's creators claim that it is this kind of imbalance which underlies many of the most common symptoms of menopause - the dreaded hot flushes. The SNS activates our ‘fight or flight' responses, increasing heart rate and body temperature.

The PNS should regulate SNS activity. However, if hormonal balance is disturbed, the SNS may rule relatively unchecked. The LadyCare Menopause Magnet claims to boost PNS activity whilst curtailing SNS activity. Though it's worth noting these claims haven't been medically or scientifically proven.

Do menopause magnets really work?

The National Center for Complementary Health (NCCIH) state that magnets used in this way don't work. And various medical research papers published in 1976, 2007 and 2013 found magnets to be ineffective at treating pain and symptoms of illness. No specific research into menopause magnets has been conducted, but evidence suggests that they too would not work.

However, LadyCare, the menopause market leader, has received mixed reviews.

In 2014 Belinda Carlise told the Daily Mail that although she was sceptical, “Within 48 hours, I went from having 30 to 40 hot flushes to having none at all. I felt like the old Belinda again — in fact better than that”

But, Dr Jen Gunter wrote a scathing review of the LadyCare Menopause Magnet onher health blog. She claimed that there is 'no evidence they do anything but lighten your wallet'.

Worryingly, in 2014 LadyCare Lifetime Limited was listed as a non-compliant advertiser with the ASA and CAP due to misleading claims in an advertorial in the Daily Express.

A official statement from the ASA read, 'The ASA investigated whether LadyCare Lifetime Limited could substantiate efficacy claims for the LadyCare magnet in an advertorial published in the Daily Express. The advertorial claimed that the product was a natural solution to relieving the menopause and the symptoms of menopause.

'The ASA considered that the advertorial misleadingly implied adequate objective evidence existed to substantiate claims that LadyCare could contribute to relieving the symptoms of menopause.'

But what about those who have tried the product?

For many LadyCare owners, the user experience has been disappointing.

'It didn't work at all for me. Everyone's unique of course, but I've done everything to alleviate my menopause symptoms including acupuncture and nothing works, so I've succumbed to HRT', wrote one Gransnet user. 'I tried it a few years ago. I didn't notice any benefit at all,' said another.

MORE:Lightweight summer sleepwear that’s also great for menopausal women

TV presenter Yvette Fielding appeared on Lorraine last year, discussing how the menopause has affected her. While Yvette revealed she had tried the menopause magnets, unfortunately they didn't work for her. "You clatter when you walk!" She exclaimed. Followed with, "It didn't work."

Other reviews have been more positive.

'I bought one approx 6 months ago best thing I ever did. I was told that it could take weeks to work. But it worked straight away the first week,' wrote one user onMumsNet.

MORE:Perimenopause symptoms: key signs and how it differs from the menopause

'Works brilliantly for me, placebo or not!' wrote another.

Are menopause magnets safe?

Although there has been no evidence to say that menopause magnets could cause harm, we would suggest approaching the device with caution and to seek medical advice first.

Always consult your doctor before reducing/coming off HRT and if you have a pacemaker, insulin pump or other internal device. NICE reports menopause magnets are not recommended if you've been diagnosed with breast cancer.

Here’s how you can tune in to her one hour-long discussion as part of a free live event for World Menopause Day aimed to get women talking about their health struggles.

Davina McCall has revealed “messing up” her autocue was one of the signs she was going through the perimenopause.

Ahead of World Menopause Day on Sunday 18th October, woman&home readers have access to an exclusive clip of Davina in action.

The TV presenter talks all things connected to the menopause alongside fellow Menopause Charity ambassadors Lorraine Kelly, Liz Earle and Menopause specialist Dr Louise Newson.During the 4-way chat, Davina, 53, recalled, “I couldn’t read autocue. My eyesight went funny and I was messing up on words all the time."

READ MORE:Davina McCall on her ‘happy’ dress size and her next big project that involves the kids

"I even got asked by a producer who I work with all the time, they said, ‘Are you OK or is something going on because you’re not your usual self here with work’. And I was like, ‘Yes I’m fine’ but I was thinking ‘What is wrong with me?’ I was having periods but they were just a little bit different. So I thought I’m still having periods, I’m not menopausal. I didn’t understand what the perimenopause was.”

Meanwhile Lorraine, 60, said her menopause “crept up” on her. She described feeling very tired and miserable, so she consulted Dr Hilary and Dr Louise on her symptoms.

• VIEW THE CLIP IN FULL HERE

View The Menopause Charity Ambassadors clip - Davina McCall, Lorraine Kelly, Liz Earle and Dr Louise Newson

This clip has been taken from the group’s one hour long discussion that will air in full on Sunday in a bid to educate women on all things menopause.

The free one-day live event will launch on Davina McCall’s online gym channel via theOwn Your Own GoalsFacebook page. Featuring talks and advice from some exciting special guests, along with a series of symptom-specific workouts by the OYG trainers. All you have to do is sign up for free access and tune in on the day - where there’s plenty of other activities to partake in.

What other activities are there for World Menopause Day?

Symptom-specific workouts by the OYG trainers, including

• A F.I.T Jam dance workout with Faye Edwards - Start with an uplifting workout and communicate the importance of taking part in fun exercises during the menopause.
• A resistance class with Sarah Gorman - she will educate you on the importance of this type of exercise for bone density and muscle atrophy.
• A core strength workout with Jay Ballinger - teaching you the importance of core strengthening exercises improving your balance and stability.
• A mindful yoga flow with Roisin Hope to help those who struggle with mental health while going through the menopause.

What are the charity benefits of the day?

The event is in partnership with Dr Louise’s charity, The Menopause Charity, which is raising money to give an essential guide to all things menopause. Providing accurate medical information on the huge range of symptoms and the safest hormone replacement therapy (HRT).

The charity recognises that a holistic approach to wellness matters for women too.

Sign up for the OYG Menopause Day Event and start your 14 day free trial hereas it will equip you with the tolls needed to spot your own menopause symptoms.

In women, it is more common in mid-life due to a number of factors including menopause, family history, general ageing and even stress and diet.

That is why during lockdown you may have noticed more hair in your brush and down the drain than usual. The pandemic has been hugely stressful for everyone and coupled with a lack of access to hair care professionals and treatments, we have all been left with hair that is in need of reviving. The key to healthy hair growth is a healthy scalp.

We spoke to Dr Serkan Aygin about what you can do to best prevent hair loss. With 24 years of experience in scalp dermatology, he is no stranger to helping out those in trouble. So read on to find out what you can do to help.

How should I be washing my hair for a healthy scalp?

A healthy scalp care routine involves regular cleansing to remove bacteria, sweat and excess oil from the skin. Taking steps to prevent over-drying and to boost the skin cell turnover process may also be necessary, depending upon your skin type and the environment in which you live. Really, it is just like the skin on the rest of your body.

To help keep scalp healthy year-round, follow these tips:

Shampoo regularly:Cleansing is one of the most important parts of scalp care, but what you shampoo with is just as important as how often you do it. Rather than shopping for shampoo at random, look for brands that have their basis in natural ingredients or those geared toward your specific scalp problems.

Exfoliate:If you suffer from dry skin or psoriasis, you may need to exfoliate two or three times per week; otherwise, exfoliating once weekly is generally adequate to remove dead skin cells from the surface of your scalp. Look for ingredients in shampoos such as white willow extract and salicylic acid. You can also purchase a gentle facial scrub and use it as a pre-treatment before you shampoo.

Massage:Once per week, spend 5 to 10 minutes massaging your scalp, using gentle circular motions. For the ultimate indulgence, consider getting a professional scalp massage.

Preserve moisture:Many common scalp problems arise from dry skin. When you shower, avoid exposing your scalp to hot water whenever possible. Instead, use warm or cold water for rinsing. Once or twice per week, skip blow-drying and allow your hair to naturally air dry to give the skin on your scalp a break from the drying heat of your hairdryer.

Is there anything else I could be doing?

Try a regular oil massage

Oiling your hair once a week is essential to provide it with nutrients and hydration.Mix essential oil with a carrier oil of your choice, warm it up and then apply to your scalp. Gently massage the oil into your scalp for 5 minutes and leave on for about an hour. Rinse off using shampoo and warm water.

Avoid tying hair up too often

Tying your hair up can cause breakage and even result in hair loss eventually. This happens because the roots are constantly being pulled that eventually causes them to break.

Use a hair mask

Just as a face mask works to nourish and hydrate your skin, a hair mask works in a similar way to boost the condition and health of your hair. The best hair masks for hair growth often contain ingredients, such as argan, jojoba, and other natural oils, that help nourish and strengthen hair follicles. But remember, diet and genetics play an important role in your hair, so a hair mask won't necessarily speed up growth, but it will prevent hair breakage and can improve the length and strength of your hair over time.

So what are the best products for scalp care?

Each scalp type should lookout for a number of specific ingredients. If you use some or all of these you should be well on your way to having a healthy scalp which will aid with hair loss.

For sensitive and irritated scalps:Oat extracts, milk-based ingredients and honey

For dry & flaky scalp:Salicylic acid, panthenol and natural oils

For oily scalps:Zinc-based ingredients such as, salicylic acid.

Often feel anger bubbling up inside over something as unimportant as a board game? You’re not alone. A new survey by onbuy.com found 35% of Brits say they’ve become so riled up playing one it’s almost led to a break up with their partner. We ask experts for their advice on anger management.

The good news is that like chin hair, while annoying, anger is perfectly normal. The problem only starts when you don’t process it properly. That is when you might benefit from using anger management techniques. “We all feel angry at times,” says Professor Margareta James, a psychologist from Harley Street Wellbeing Clinic.

“There is nothing wrong with anger – at times, it can be justified. Some people use it in a positive way to spur them to change things for the better. And when we feel out of control, anger makes us feel that we are in control. The problem is when anger and rage rule your life. It robs you of your peace of mind.”

Anger can affect relationships, careers, mental and physical wellbeing for the worse. It can weaken the immune system and has been linked with health issues, such as colds, flu and digestive issues, cancer and heart disease. “Plus, anger contributes to mental illnesses,” says Professor James. “That’s why it’s pivotal to understand anger better.”

Whether you want to learn anger managment techniques so you can control outbursts, or discover how to tackle more serious issues, we’re here to help. Find out how to control anger with our step-by-step guide.

Do I have anger management issues?

Feeling angry from time to time, or even quite frequently, doesn't necessarily mean that you have anger issues. Anger is a normal, healthy human emotion. It only becomes a problem when it is expressed in unhelpful ways which negatively affect your mental or physical health, relationships or career.

“Anger is defined as ‘a strong feeling of annoyance, displeasure or hostility’,” says relationship expert and psychotherapist Neil Wilkie, creator of The Relationship Paradigm® and author of Reset: The Relationship Paradigm. “It normally creates a strong or uncomfortable response to a perceived threat or provocation.”

There are three ways to define anger. Neil says:

Sudden Anger:“This is a primeval instinctive response to help self-preservation. This is situational.”

Deliberate Anger:“Deliberate anger is is a conscious reaction to perceived bad treatment by others.”

Dispositional Anger:“This is linked to a person’s character and includes irritability and grumpiness.”

Not sure if you have an issue with anger or anger managment? “Ask yourself each question below,” says Neil.

• Is my anger having a negative effect on me and those around me?
• Is it getting worse?
• Could my anger be impacting on my ability to feel other emotions?

“If you answered yes to any, then your life would be better if you dealt with your anger issues,” adds Neil.

What can cause mood swings?

Feel angry one day and not the next? It could be a mood swing.“We all experience mood swings as changes inside us and around us influence our mood,” says Professor James. “Normal fluctuation in mood is just a part of normal life, and usually won’t interfere with our lives.”

But there are times when mood swings become a problem. “The red flag is when mood swings become too intense and disrupt our normal daily life,” says Professor James. “There can be underlying medical issues associated with it including diabetes, thyroid-related diseases, Parkinson’s and Multiple Sclerosis. Intense shifts in mood can also be a sign of bipolar and borderline personality disorders.”

Usually, there is a simple trigger for mood swings.

“They can be triggered by sleep disturbances, allergies and poor diet (such as too much sugar or caffeine). How long these mood swings last varies from person to person. Some experience rapid change while others may stay in a mood for prolonged periods,” says Professor James.

The first step to getting help is finding the trigger.“Identifying what causes mood swings and how long they last can help eliminate them,” says Professor James. “Regular exercise can really help. Plus, changes to your diet, creating a better sleep routine and learning relaxation techniques to deal with stress better.”

What are the signs you need help with anger management?

1. Outward aggression

This can range from shouting and slamming doors to throwing things and being physically violent, verbally abusive or threatening.

“The signs of this in someone else are obvious and can be very scary,” says Neil. A huge part of outward aggression can be caused by not processing a situation you are in properly. Instead, you jump to conclusions and act on these false perceptions in an aggressive manner.

“Outward aggression is much easier to recognise as there are clear patterns of behaviour including shouting, swearing, violence and threatening behaviour,” says Professor James. “People tend to be triggered by even the slightest criticism and become confrontational, defensive and aggressive.”

You may or may not realise you have outward aggression.“You should be aware of this in yourself unless you are in denial,” says Neil. “Ask others close to you whether they are aware of any outward aggression.If this is a repeated pattern rather than a really unusual and short term reaction to a bad situation, it needs to be dealt with.”

2. Inward aggression

This can include self-harm, talking to yourself in a derogatory manner or denying yourself basic needs, such as food.“Inward aggression exists to varying levels in everybody,” says Professor James. “We refer to it as ‘beating ourselves up’ about something.We all have an inner voice. It can be soothing, helpful and supportive. However, it can also be critical, attacking and antagonistic. The critical voice fuels destructive thoughts, leading to hostile behaviour.”

Find you isolate yourself from others? It could be a sign of inward aggression.“Inward aggression can also include shutting ourselves off from the world,” says Neil.

Not sure if a loved one has inward aggression? “You can tell if someone you know has it, if they have changed noticeably, look unhappy, take less care of themselves or talk disparagingly about themselves,” says Neil.“Facial expressions and posture will also show their perception of the world. Look for slumped shoulders, lack of smiles and downturned mouth.”

Think you are experiencing inward aggression?“You may have it if you are feeling down, that everything is your fault and if your emotions are flatlining,” says Neil. “Also, listen to what your inner voice is saying – is it critical or supportive?”.

3. Passive aggression

This may include ignoring the person you are angry with or responding in a sarcastic or sulky manner. It can also include deliberately doing things that they ask you to do poorly, late or at the last possible moment.

“Passive aggression is aggression that is suppressed internally but leaks out to the rest of the world,” says Neil. “It includes sarcasm, sulkiness, ignoring people and being self-centred and unhelpful. If someone else has it, your gut feel will probably pick up that they are best avoided. You will also be able to tell by their look and negative language.”

Not sure if you are passive aggressive?“Check your grumble ratio. How many nice things do you say in a day to other people compared to complaints and negatives?" says Neil. "Ask yourself, if you could say anything to anyone, without any consequences, what would you say and to whom?”

Being passive aggression is often down to upbringing.“It stems from not being able to express feelings and opinions when growing up,” says Professor James. “And, sometimes, it’s from growing up witnessing similar behaviour. They use this behaviour to get what they want."

How to control anger

You need to learn to recognise the warning signs first. When we become angry, our heart rate and breathing quicken to prepare us to take action. You may also notice your shoulders tense, your fists or jaw clench, your feet tap or your face flush.

“When you very first become aware that you are starting to become angry, notice what is happening in your body,” says Neil. “Be aware of your heart rate, blood flow, muscle tension and then what you are thinking and feeling.”

If possible, remove yourself from the situation as soon as you recognise your personal warning signs. Take a 10-minute walk, or simply lock yourself in the bathroom and spend a minute or two practising deep breathing exercises.

“Breathe slowly with a longer out breath than in breath,” recommends Neil. “Imagine the anger flowing out with your out breath. Relax your muscles as you don’t need to run away.”

Calming your immediate physical responses will enable you to act with a clearer head. “Now focus on asking yourself: ‘What you would like to have happen’, instead,” says Neil.

If you can’t get away, count to 10 before you react (or wait for two minutes if you are involved in a text or email exchange) as part of your anger management.

How to stop hormonal rage

Mood swings can also be caused by changes in hormones. The effect can be extreme.“PMS and menopausal anger is not a myth,” says Dr Anne Henderson, a gynaecologist and menopause specialist at gynae-expert.co.uk.

“There is a wealth of legal data confirming this. In fact, women are more likely to be convicted of criminal acts, such as road rage, shoplifting, GBH, manslaughter and murder in the premenstrual phase of their cycles. In some cases, hormonal causes have successfully been used as a mitigating factor to reduce a jail term.”

Not sure if your rage is caused by hormones? Start tracking how you feel at different times of the month as part of your anger managment program.

“In most cases, there will be a pattern to mood swings, including irritability, aggression and anger,” says Dr Henderson. “This tends to form part of a broader pattern of PMS. Women will usually also experience headaches, bloating, breast tenderness, skin changes, food cravings, weight gain, sleep disruption and general fatigue.”

Need help with hormonal rages? “HRT can help if symptoms are becoming problematic,” says Dr Henderson. “Or consider a herbal support with phytoestrogens, such as A.Vogel’s Menopause Support. This contains soya isoflavones, magnesium and vervain which can counteract low mood and fatigue.”

https://www.youtube.com/watch?v=oByJpMHFM1g

How to release anger

Lashing out may not help, but neither does bottling it all up. When it comes to anger management, “it is best to release anger in a safe space where others will not be affected,” says Neil.

Anger management techniques include:

• “Go to a beach, a forest or a hilltop, where you will have privacy and just shout loudly, whatever you need to say,” says Neil.
• “Get a rolled-up newspaper and a wooden chair,” recommends Neil. "Make the chair the focus of your anger and just hit it with the newspaper, repeatedly saying what you want to."
• Try writing in a journal, going for a run, meditating, doing some colouring or taking an online yoga class. Immersing yourself in a mindful creative or physical activity can help release pent-up emotions.
• If you’re stuck in a traffic jam, turn up the radio and sing your heart out.
• Practise expressing your feelings in an assertive manner. Try to state your concerns and needs clearly and directly, without making demands, threats or accusations.

How to control anger issues in the longer term

Want to get over your anger issues? “The first step is self-awareness,” says Professor James. “When we are aware of what is happening and we decide to change, we are ready for progress.”

Talking about your feelings with a friend or family member may help you to unpick your triggers.Need more help? If you’re anger issues are deep rooted, you may need professional guidance.“Techniques, such as hypnotherapy and Neuro-linguistic programming(NLP) can help you discover the root cause," says Neil. "Cognitive behavioural therapy (CBT), mindfulness and medication can help you control the symptoms.”

Your GP should be able to point you in the direction of a local anger management classes. These may take place over a single day or weekend, or provide longer-term support. If you opt for a private course of therapy, make sure the therapist is registered with theBritish Association for Counselling and Psychotherapy.

Whether or not you choose to seek professional help, making physical exercise part of your regular routine will help you to keep your anger under control. Try yoga, running, swimming or simply taking a daily walk as part of your anger management approach.

You can also try ‘rehearsing’ your response to difficult situations. Replay an experience which made you angry, and to which you reacted in an unhelpful manner, in your mind. Now play it again, but this time, ‘pause’ it before you respond. Imagine yourself responding in a more constructive way. With regular practise, you’ll begin to ‘train’ your brain to respond to anger in new ways.

Why can the menopause make you angry?

Hormone fluctuations and the menopause can cause anger but anger management techiniques can still help. “The main factor is the persistent decline in oestrogen levels which occur in most women from age 45 onwards,” says Dr Henderson. “Oestrogen has an uplifting and anti-depressant effect. This explains why women tend to feel brighter, happier, more positive and less irritable around mid-cycle when they ovulate, as the oestrogen levels peak at this point. When oestrogen levels drop during the peri-menopause, other hormones, including progesterone and testosterone, become more dominant, and this upsets the typical female hormone balance.”

Always felt angry? “Some women may have an underlying predisposition to mood and anger issues, such as chronic depression, anxiety and other psychological issues,” says Dr Henderson. “Unfortunately, these are likely to be exacerbated during the menopause.”

Lack of sleep, which is a common feature of this stage of life, is also bad for anger. “It can lead to more low grade snappiness and irritability,” adds Dr Henderson.

What is peri-menopausal rage?

The symptoms of peri-menopausal rage are very similar to menopausal rage. “It really blend seamlessly into problems women experience during the menopause,” says Dr Henderson. “The condition is more of a continuum, rather than a specific entity.”

Not sure if you will experience peri-menopausal rage of if anger management if worth trying? “There is a common link between those women who experience significant PMS throughout their fertile years and who are more likely to go on to develop peri-menopausal/menopausal mood-related symptoms,” says Dr Henderson. “This is likely to be due to heightened sensitivity in hormone fluctuations.”

That means, if your mother had peri-menopausal rage, you are likely to experience it, too. “Quite why some women experience more significant symptoms than others is not fully understood. However, there is usually a clear genetic pattern with other female family members experiencing similar problems,” says Dr Henderson. “The issue is likely to be at receptor level within the central nervous system.”

How long do mood swings last?

How long your mood swings, and menopausal mood swings, last can vary greatly.When it comes to the menopause, symptoms can be forever.

“It is a myth that menopausal mood swings last for just 18 months or so,” says Dr Henderson. “While this is true in a minority of women, there is increasing scientific evidence that many women will experience menopausal symptoms for at least five years after their periods cease. In many cases, these symptoms can be permanent, although they may reduce in severity with time.”

Want to know how long yours will last for to get a sense of whether anger managment is going to be a long-term game for you? Ask your female relatives. “There is usually a strong genetic link determining duration of symptoms,” adds Dr Henderson.

Mood swings not caused by the menopause? Then the duration can also vary.

“It depends on the underlying cause of the mood swings and how significant the change in mood is,” says Neil. “They can last anything from a few seconds to weeks. Imagine you could draw a graph.The horizontal axis is time, in days.The vertical axis shows your mood; from +10 (Incredibly happy) through 0 (OK) to -10 (Incredibly unhappy). Plot the line showing your mood for the last week. This will help you understand the pattern of your moods and what needs to change.”

The best readsto help anger issues at home

Why we rate it: This book is perfect for someone who knows they have anger issues and wants to help curb any outbursts in the future. The author uses Christian guidance with many personal anecdotes to help others. COST: £12.99

Why we rate it: Not sure you want to see a therapist to deal with your anger issues? This book provides the first step to getting professional help. It includes worksheets, and includes advice for issues which contribute to anger and rage, such as depression, OCD, anxiety and grief.COST: £19.99

Why we rate it: Mindfulness is a great way of overcoming anger and taking control of negative emotions. This book explains how anger manifests and offers mindful solutions to help deal with it. You’ll soon learn to recognise patterns of negative behaviour so you can stop the cycle.COST: £13.17

Why we rate it: This book really shifts the perspective about seeing anger and rage as negative emotions. A must-read for women, it helps you understand how holding anger in can lead to depression when instead it can be used constructively for the better.COST: £16.99

Why we rate it: Whatever life stage you are at, hormonal changes can disrupt your emotions and cause anger. This practical book offers and insight on how to balance your hormones with practical tips and meal plans. It explains in easy language how your body and mind are linked. The best part is you won’t feel like you are going through anger issues alone after reading it.COST: £16.99