By Heléne Herholdt
Before diving in, let’s take a step back and look at the bigger picture of what’s happening in the body during menopause. Menopause is defined as the day when a woman hasn’t had a menstrual period for 12 consecutive months. The time leading up to that milestone is known as perimenopause, while the years that follow are considered postmenopause. That said, most women commonly refer to this entire transition—from the first hormonal shifts to life well beyond
the final period—as menopause. It’s helpful to understand that this journey unfolds in three key phases: premenopause, perimenopause, and postmenopause, as illustrated in the graph below.
During the first stage of menopause (premenopause), you’re considered in the late reproductive years of your life. You’ll likely still get your period. It’s usually pretty regular, but your ovarian reserves are declining. During this stage, you probably won’t even realise that your hormones are beginning to shift. During perimenopause, sometimes also referred to as the menopausal transition, your period may become irregular and your ovaries start to produce less estrogen, progesterone and testosterone. This is the stage identified with wild hormonal fluctuations and the classic symptoms of “menopause” including: hot flashes, night sweats, brain fog, fatigue, weight gain especially around the abdomen, joint pain, mood swings, headaches, palpitations, struggling to sleep, dry and thinning vaginal tissues. Symptoms are so vast due to our estrogen receptors being located right through the body, affecting various organs.
You officially reach menopause when you haven’t had a period for an entire year. In the final phase of menopause, you’re now considered postmenopausal. The beginning of this stage is called early postmenopause. For some women, their vasomotor symptoms (hot flashes and night sweats) begin to subside. But for others, they battle symptoms for a full decade into postmenopause. During this time, you may see menopausal symptoms begin to lessen, but low estrogen levels also put you at greater risk for things like osteoporosis and heart disease. Think of the menopause transition as a dynamic interplay between shifting hormone levels and your brain’s existing chemistry. These hormones are highly responsive to your environment, daily habits, and how you experience stress. The question becomes: How can we support our bodies to move through this transition with greater ease and age with vitality and grace?
There are 5 main areas to focus on that form a part of the menopause toolkit, these include:
- Nutrition
- Movement
- Stress
- Sleep
- Libido (sex life)
Nutrition
Estrogen is protective against chronic inflammation (it’s a powerful anti-inflammatory hormone), and when our levels start to decline naturally in midlife during perimenopause, chronic inflammation increases. When inflammation is present, even those with the most disciplined nutrition and fitness routines can struggle to maintain or lose weight. Therefore, during menopause, it becomes even more important to focus on a low-inflammatory diet. Reduce foods that can cause inflammation, such as sugar, refined carbohydrates, dairy, alcohol, fatty meats (lamb and pork) and fried foods. Include a variety of colourful foods, aim to eat the rainbow, and incorporate raw, crunchy vegetables with each meal. Choose options rich in polyphenols; the more vibrant the colour, the better. Rotate your choices weekly to ensure variety. These antioxidant-rich foods also help reduce inflammation.
Liver detoxification is not only important to reduce external toxin exposure and accumulation, but it is also a very important process to help with hormone balance, especially estrogen. If detoxification is sluggish, toxins, harmful end products, and hormones can accumulate, leading to fatigue, mood swings, and weight gain. Support optimal detoxification by adding more cruciferous alkaline vegetables daily, especially dark leafy vegetables (such as spinach, kale), broccoli, cauliflower, cabbage, bok choy, daikon radish, onions, garlic, and scallions. These alkaline vegetables help the liver detoxify.
We have to change the way we look at weight gain in menopause. It’s not your metabolism that is slowing down, but rather the amount of muscle mass that declines by 3-8% after the age of 30 if you are not doing anything to maintain it. Muscles are the “organ” of longevity; they drive metabolic rate and insulin sensitivity. When you lose muscle mass, you become more insulin resistant. This means that your body is not listening to the insulin produced by your pancreas, leading to increased glucose levels, which may result in declined metabolic function, blood sugar imbalances, fatigue (late afternoon dips), increased hunger, cravings and weight gain, especially around the belly. Therefore, one needs to focus on balancing blood sugar and making the body more insulin sensitive.
Movement
Prioritising daily movement is important! It doesn’t have to be big, just move your body. You also want to prioritise resistance training (strength training) to increase lean muscle mass which will help with blood sugar balance and metabolism.
Mood
Cortisol often increases due to fluctuating estrogen and progesterone levels. While progesterone (which has a calming effect) declines, making the body more sensitive to stress and impacting sleep. Sleep disturbances, mood swings, and increased belly fat can be signs of elevated cortisol. Focus on reducing cortisol levels by enjoying your morning coffee with or after breakfast, rather than on an empty stomach, to help avoid unnecessary cortisol spikes. If possible, get outside and soak up some natural morning light. Exposure to sunlight early in the day helps boost serotonin production in the brain, a key neurotransmitter that supports mood and emotional well-being. Incorporate daily practices that help you unwind and stay grounded. This might include yoga, meditation, journaling, breathwork, gentle exercise, setting healthy boundaries, walking in nature, or even a warm bath. Do something every day that gets you out of your head and into your body.
Sleep
Along with melatonin and other hormones, estrogen and progesterone tell the brain it’s bedtime. So when your ovaries stop making estrogen and progesterone, and melatonin declines with age, it’s no surprise that insomnia is a common complaint. Sleep affects stress and cortisol levels. Without 7-8 hours of sleep a night, cortisol levels increase and cause inflammation in the body, potentially leading to lowered defences in the immune system and an increased risk of developing many chronic conditions.
Libido
There is a 50% sexual dysfunction rate amongst women going through menopause. You may experience extreme dryness, pain and discomfort during intercourse and/or suddenly become more prone to urinary tract infections. This is actually normal due to declining hormones, especially estrogen. Testosterone (which is not only a male hormone) is also to blame. It is produced in two places in the body: the adrenal glands and the ovaries. When ovaries come to the end of their lifespan, their production of testosterone, together with estrogen and progesterone, decreases. Some women may experience symptoms of low testosterone, such as low libido, fewer intense orgasms, decreased sense of well-being and fatigue. To support libido during menopause, incorporate foods rich in phytoestrogens, such as flaxseeds, sesame seeds, edamame, and legumes. These plant compounds have gentle estrogen-like effects that may help ease common symptoms, including vaginal dryness. Maca, a powerful adrenal adaptogen, can also help to restore balance, whether your system is running on overdrive or feeling depleted. It’s known for its ability to support hormonal equilibrium, enhance mood, and boost libido.
Prioritise a food-first approach to nourish your body naturally, turning to supplements only when necessary. Begin with testing, understanding your current nutritional status and hormonal health is key to making informed choices. Genetic testing can also offer valuable insight into which metabolic pathways need support and how your body processes and utilises essential nutrients, helping you target areas that may need extra attention. While menopause brings change, women are inherently equipped to navigate this transition. By taking proactive steps and creating balance in our lives, we can help our hormones find their natural rhythm. Empowerment begins with knowledge and care from the inside out.
Heléne is an integrative and functional board-certified nutritionist with an honours degree in Biochemistry and a master’s degree in Psychiatric Genetics.
Passionate and dedicated, Heléne is driven by a purpose to empower individuals to take control of their health and unlock their full potential. Her approach is grounded in three key pillars: genetic testing, personalised nutrition strategies, and holistic lifestyle adjustments. Genetic testing is at the heart of Heléne’s practice, allowing her to tailor her recommendations to each individual’s unique genetic makeup. By understanding your genetic predispositions, she can create personalised nutrition plans and lifestyle interventions that are precisely tailored to your needs. She believes in addressing the root causes of these issues rather than merely treating the symptoms, ensuring a comprehensive and lasting approach to health and wellness.
