Menopause is reached when periods have stopped for 12 months because ovarian hormone production has declined. Perimenopause is the preceding transition, when cycles may become irregular and symptoms begin. It most often occurs between 45 and 55, although earlier menopause requires particular medical attention because of bone and cardiovascular implications.
Hot flushes, night sweats, sleep disruption, anxiety, low mood, memory or concentration difficulty, vaginal dryness, urinary symptoms, joint aches and reduced libido are common. Experiences vary greatly. Any vaginal bleeding after 12 months without a period must be checked, even if it happens only once.
Treatment choices
Hormone replacement therapy is the most effective treatment for most symptoms and helps prevent osteoporosis. Current evidence does not support describing HRT as broadly dangerous: for many symptomatic people under 60 without a high risk of breast cancer or blood clots, benefits are likely to outweigh risks.
Risk depends on the hormones, route, age, duration and personal history. Tablets slightly increase blood-clot and stroke risk, whereas transdermal patches, gels and sprays do not increase clot risk. Vaginal oestrogen treats local dryness and urinary symptoms with very low systemic absorption. Anyone with a womb who uses systemic oestrogen usually also needs progestogen to protect the womb lining.
Food, bones and daily life
Regular weight-bearing and resistance exercise supports bone and muscle strength. A balanced diet should include calcium-rich foods, adequate protein, vegetables, fruit, whole grains and unsaturated fats. Vitamin D is important for bone health, while smoking cessation and moderate alcohol reduce longer-term risk.
Caffeine and alcohol can trigger flushes in some people but do not require universal exclusion. Soya foods, flaxseed and pulses can be part of a healthy diet; their phytoestrogens are much weaker than human oestrogen and effects on symptoms vary.
Useful supplements
Supplements should be selected for the individual rather than used automatically. Product directions and advice from an appropriately qualified professional should take precedence over general information.
| Supplement | Effects |
|---|---|
| Multivitamin and mineral formula | Provides nutrients involved in hormone metabolism, mood, energy production, bone health and fatty-acid conversion. |
| Soya isoflavones | Provides phytoestrogens described as supporting bone health and oestrogen balance. |
| Krill oil | Provides EPA and DHA, which support normal inflammatory regulation and joint health. |
| Vitamin E | Provides antioxidant protection and is described as helping reduce hot flushes. |
| Magnesium citrate | Supports bone mineralisation, muscle function and normal glucose regulation. |
| Calcium citrate | Provides calcium for bone mineralisation when dietary intake is insufficient. |
| Vitamin D3 | Supports bone, immune, mood and inflammatory regulation. |
| Multi-strain probiotic | Intended to support bowel function and normal microbial metabolism. |
| Lecithin powder | Supplies phospholipids described as supporting liver function and cholesterol balance. |
| Coenzyme Q10 in ubiquinol form | Supports cellular energy production; statins can reduce circulating CoQ10 levels. |
Calcium, vitamin D and other nutrients should be considered alongside dietary intake and medical history. Soya isoflavone supplements may be unsuitable for some hormone-sensitive conditions. Vitamin E, krill oil and CoQ10 can interact with anticoagulant medicines. Herbal or complementary products should be disclosed when discussing HRT.
Menopause is natural, but suffering in silence is unnecessary. A personalised discussion can cover HRT, non-hormonal medicines, vaginal treatment, sleep, mood, sexual wellbeing, bones and cardiovascular health.
Looking for personalised nutrition and lifestyle support? An FNTP member may be able to help you explore an approach suited to your individual needs. Find an FNTP practitioner.
This article is for general education and does not replace individual medical advice, diagnosis or treatment.
