Menopause is a normal biological process, yet the way we’ve talked about it hasn’t always been particularly natural. Dr Holly Vaughan, GP and menopause specialist, has spent years seeing women misled by poor information. Her approach focuses on whole health, not just symptoms. Here, she explains what menopause actually does to the body, why it affects so much more than your periods, and how food, movement and rest can support you through it.
Why this matters to women
The word menopause comes from the Greek men (month) and pausis (cessation), essentially the end of your periods. But menopause is much more than the day your periods stop. It’s a major physiological transition that affects our whole body and mind: hormones, metabolism, bones, muscles, heart and brain.
Historically, menopause received little attention from medicine or society. But we now live much longer, and many of us will spend a third or more of our lives after menopause.
So rather than simply “putting up with it”, let’s look at what’s actually happening.
What is menopause?
Menopause itself is defined as 12 consecutive months without a period. In the UK, the average age is around 51, although this varies considerably.
Menopause happens because the ovaries gradually become less responsive, until they eventually stop releasing eggs and producing significant amounts of oestrogen and progesterone.
This begins with perimenopause, when hormone levels fluctuate considerably. Periods may become irregular, and symptoms can appear, disappear and reappear with absolutely no respect for your diary.
Oestrogen isn’t just a “reproductive hormone”
Oestrogen is used throughout the body, including the brain, bones, muscles and blood vessels. So when levels change, it’s hardly surprising that women notice changes well beyond their periods.
What the science says about menopause
The brain, mood and sleep
While the body’s hormones work together in a finely tuned system, oestrogen tends to get most of the airtime, often overshadowing the equally important roles of progesterone, testosterone and others.
Oestrogen influences brain signalling for mood, sleep, cognition and temperature, so falling levels can contribute to hot flushes, night sweats, disrupted sleep, anxiety, mood changes and difficulty concentrating.
It can quickly become a vicious circle. A hot flush wakes you up. A poor night leaves you exhausted. You’re less able to cope with stress. You forget why you walked into the kitchen. Then you wonder whether you’re losing your mind.
You aren’t. But there’s a lot going on.
Menopause doesn’t happen in a vacuum
For many of us, this transition arrives when life is already demanding: work, children, ageing parents and the constant mental load of keeping everyone moving.
Stress doesn’t cause menopause, but it adds to the overall load and can make symptoms harder to manage. Hormonal changes affect sleep, poor sleep increases stress, and suddenly making dinner feels like an Olympic event.
Looking after ourselves at this stage isn’t self-indulgent; it’s part of looking after our health. Women are remarkably good at putting themselves at the bottom of the list. Menopause may be the point where our bodies ask us to reconsider.
Metabolism and body composition
Menopause doesn’t automatically cause weight gain, but it happens alongside ageing, which naturally reduces muscle mass and can shift fat towards the abdomen. Oestrogen also plays a role in insulin sensitivity and energy metabolism.
This isn’t about chasing a particular body shape. It’s about protecting your metabolic health, strength and independence for the years ahead.
Bones and heart
Oestrogen helps regulate the constant breakdown and rebuilding of bone. When levels fall, bone loss can accelerate, increasing the risk of osteoporosis. Your bones may not be something you think about often, but they’re rather useful to have in good working order.
Changes in cholesterol, blood pressure and vascular health can also raise cardiovascular risk, making midlife an important moment to look at the bigger picture.
Food: can diet help?
There’s no magical “menopause diet” and, sadly, no single food that will take away menopause symptoms. But what we eat can support the areas of health that matter most in midlife:
- Protein helps maintain muscle and recovery. Eggs, yoghurt, oily fish, lentils and beans all count.
- Fibre supports digestion and fullness, and can contribute to healthier blood sugar regulation. Think chickpeas, beans, wholegrains, nuts and seeds such as chia and hemp.
- Calcium, vitamin D and protein all contribute to bone health. Yoghurt, oily fish, eggs and leafy greens are good places to start.
- Vegetables, wholegrains, legumes, unsaturated fats and omega-3s support heart health. Oily fish, nuts, seeds and olive oil do a lot of the work here.
A Mediterranean-style eating pattern is a useful model. That’s not because it’s a “menopause diet”, but because it supports healthy ageing generally. Think patterns rather than perfection.
Exercise: one of the best tools we have
If exercise came in a tablet, we’d probably all be queuing up for it. It supports muscle, bones, heart health, metabolism, mood, sleep, balance and independence.
Which type? Both.
- Resistance training helps maintain muscle strength and supports bone density and metabolic health.
- Cardiovascular exercise, from walking and cycling to swimming and dancing, supports heart and lung fitness.
- Balance, mobility and flexibility matter too.
UK guidelines recommend at least 150 minutes of moderate activity a week, plus strengthening activities on at least two days. The best exercise is the one you enjoy enough to keep doing.
How menopause can affect you
Menopause isn’t a disease or a failure of the body. It’s a significant biological transition, and a useful opportunity to think about your health for the decades ahead.
Beyond symptoms, that means maintaining muscle, protecting bones, supporting your heart, eating well, staying active, sleeping well and looking after your mental wellbeing.
When to speak to your GP
- If your symptoms are affecting your quality of life or disturbing your sleep.
- If your periods become significantly heavier, change substantially, or you bleed between periods.
- If you’ve gone 12 months without a period and then have any bleeding, even spotting.
- If you have menopause symptoms before 45.
There’s no perfect menopause. But understanding the science gives us choices, and good information, healthcare and habits can make a real difference.
Menopause is biological. Our experience of it is also shaped by the world around us.
