What is the menopause?
Perimenopause vs Menopause vs Postmenopause - What's the difference?
Perimenopause is the transition leading up to the time before your periods stop, when you may have symptoms. There's a variation how long this can take, but the average is 4 years. Normally, your GP can confirm a diagnosis of perimenopause based on your symptoms, but sometimes a blood test may be used, particularly if you are under 45 years.
Sometimes, women may experience early menopause. This is when your periods stop before the age of 45. If this happens before age 40 then this is known as 'primary ovarian insufficiency' (POI). Often the cause is unknown, but it can be related to genetic or autoimmune conditions, some cancer treatments (chemotherapy or radiotherapy) or surgical removal of the ovaries. It is more common in women who have a strong family history of POI.
Menopause refers to the day after which you haven't had a period for 12 consecutive months. This is due to a reduction in hormone levels (oestrogen and progesterone) as your ovaries stop producing eggs. The average age is 51 in the UK, but it can start much earlier, or much later than this.
Postmenopause is the time after your periods have stopped for 12 months.
What are some common symptoms of the menopause?
Reduced levels of oestrogen in the body can cause most menopausal symptoms.
Every woman's experience of perimenopause and menopause is different, but some common symptoms include:
- Change in the normal pattern of your periods, for example they become irregular, during perimenopause
- Mood swings - such as low mood or irritability
- Odd taste in the mouth or the feeling of zaps under their skin.
- Mood swings - such as low mood or irritability
- Weight gain and changes in body shape
- Difficulty sleeping - which may be a result of night sweats and make you feel tired and irritable during the day
- Brain fog - problems with memory or concentration
- Hot flushes - when you have sudden feelings of hot or cold in your face, neck and chest which can make you dizzy
- Joint pain, including stiffness and aches
- Perimenopause present as irregular menstruation while the menopause features a total absence of menstruation
- Low sex drive
- Vaginal dryness
- Headaches and migraines that are worse than usual
- Palpitations, when your heartbeats suddenly become more noticeable
- Increased risk of heart attack and high blood pressure during menopause due yo the decline in oestrogen.
Is heart disease linked to menopause?
Oestrogen offers some protection against coronary heart disease therefore reducing the risk of a heart attack. It helps to control your cholesterol levels and so reduces the risk of fatty plaques building up inside the artery walls.
During and after the menopause, a woman's body gradually produces less oestrogen than it used to. This increases your risk of developing heart disease or stroke due to increased cholesterol levels and blood pressure.
Regular physical activity of any type can offset some of these changes (1).
How does menopause affect my bone health?
The decline in oestrogen production can affect the amount of calcium in your bones. This can decrease your bone density, leading to a condition known as osteoporosis. It can also make you more susceptible to hip, spine, and other bone fractures. Many women experience accelerated bone loss the first few years after their last menstrual period.
Regular physical activity, particularly weight bearing, resistance exercise and low impact physical activity e.g. jogging can maintain bone density, preventing osteoporosis and the risk of fractures (2).
Will I gain weight when I experience menopause?
Changes in your hormone levels may cause you to gain weight. However, aging can also contribute to weight gain.
Physical activity, particularly weight bearing, and resistance exercise maintains muscle mass (3), which is important for strength and metabolism. As well as preserving muscle mass, regular physical activity can limit weight gain during the menopause (6).
Menopause and physical activity
With symptoms ranging from hot flushes to anxiety – it can be hard to feel your best. But evidence shows that physical activity can help women manage and cope better with their symptoms.
Menopause is a significant opportunity to re-engage with physical activity. We've pulled together a list of top tips to get started below:
Physical activity tips and tricks:
- Wear layers so that you can regulate your temperature.
- If you get hot flushes, avoid exercising in the heat of the day in the warmer months.
- Menopausal joint pain can be worse in the morning – try gentle stretching or yoga to combat this or do your physical activity in the afternoon instead.
- If you suffer from urinary leakage, make sure you empty your bladder before exercising and avoid caffeine until after you have finished.
- If you are struggling to sleep due to menopausal symptoms, exercising 2-3 hours before bed is best to give you enough time to wind down.
What physical activity should I be doing?
The Chief Medical Officers' (CMO) guidelines for physical activity in adults is at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity per week.
You can view our Physical Activity Guidelines for women during menopause and perimenopause here.
Find the rest of our Guidelines, including guidance for adults and disability adults here.
The table below summarises the types of physical activity which have been shown to help specific menopausal symptoms, plus how strong the evidence is for this recommendation.
Use this to help you decide what activity is best for you, but remember, every movement counts, and you should always do something you enjoy.
Your Guide to an Active Menopause
Your Guide to an Active Menopause
Whilst 'menopause' itself refers to the day after which you haven't had a period for 12 consecutive months, 'Your Guide to an Active Menopause' is a resource for women at all stages of their menopause journey, including those experiencing symptoms of early menopause, perimenopause, and postmenopause.
This guide will help you to get started and find what works for you. It will cover the three main types of physical activity for managing menopausal symptoms: aerobic activity, strength and resistance activity, and pelvic health exercises, taking you through the key information, top tips and instructional 'how-tos'.
You can download the guide for free.
What are some other treatment options?
Similar to physical activity, having a healthy, balanced diet can help with menopausal symptoms, as well as keep you healthy during and after the menopause transition.
Why is a healthy diet important in managing my symptoms?
- To protect bone health
- Try to get 2-3 portions of food rich in calcium per day e.g. milk or yoghurt
- Get some sunlight on your skin as this helps to produce vitamin D. It is recommended to expose your skin to direct sunlight for around 10 minutes, once or twice per day, but avoid burning. Use at least factor 30 suncream and spend time in the shade between 11am and 3pm.
- Consider taking a daily supplement containing at least 10 micrograms of vitamin D, particularly during autumn and winter. Consider taking it all year round if you are over 65 years, have dark skin from African, African-Caribbean or South Asian background or if you have low sunlight exposure.
2. To protect heart health:
- Try to maintain a healthy weight. Being mindful of portion sizes can help to control the amount you eat.
- Reduce your intake of refined sugar and carbohydrate e.g. cakes and soft drinks
- Reduce salt by limiting ready meals and salted snacks
- Eat at least 5 portions of fruit and vegetables which can be fresh, frozen, canned, juiced or dried.
- Reduce foods high in saturated fat e.g. red meat, fried foods. Healthy fats include oily fish and nuts.
- Eat high fibre foods e.g. wholegrain breads, brown rice and pulses.
3. To maintain muscle
- Ensure you have good quality protein (either plant or animal based) as part of your meals e.g. fish, lean meats such as chicken, eggs and legumes (beans, chickpeas, lentils).
4. To help menopausal symptoms
- Limit the amount of caffeine, spicy foods and alcohol you have which can increase hot flushes
- Oestrogen falls sharply in menopause, causing a host of symptoms, such as hot flushes, mood swings and fatigue. Food high in phytoestrogens are thought to have a balancing effect on hormones, combating low oestrogen, and supporting your health during this time. Some examples include: soyabeans and edamame, flaxseeds, legumes, dried fruit (particularly prunes apricots and dates), garlic, grains, sesame seeds, and cruciferous vegetables.
- Start small if it feels overwhelming, such as a handful of flaxseeds on your porridge, some dried fruits in a smoothie, or throw some edamame and garlic in with your stir fry!
Prescribed treatments include hormone-based therapy and non-hormonal treatment.
- Hormone replacement therapy (HRT) aims to treat the symptoms of menopause and replaces the hormones which are low including oestrogen +/- progesterone replacement. Testosterone can also be used for improving cognition, concentration and fatigue, as well as improved libido.
- There are different types of HRT, and some people may not be suitable for HRT due to health problems.
- Non-hormonal medical treatments which have been shown to help with hot flushes include clonidine (a blood pressure medicine), gabapentin (an epilepsy medicine) and some antidepressants (9).
Here are some tips for talking to your healthcare professional about menopause:
• Some GP practices have healthcare professionals with a specialist interest in menopause (including nurses, pharmacists, paramedics) who you can ask to speak with.
• Discuss your main symptoms and how these are affecting your life.
• A symptoms chart or tracker can be useful to bring along to any appointments (see 'Useful Resources' section at the bottom of this page).
• Check the NICE guidelines to see what is recommended for menopause.
• Research some of the treatment options yourself and think about what treatments you would like before the consultation.
Non-prescribed or 'complementary' treatments could include:
- Herbal remedies such as black cohosh, red clover or isoflavones (soya). Some women find these helpful however there are some considerations before starting (9):
- There is no strong evidence that they work for menopausal symptoms.
- Their quality, purity and ingredients are not regulated and may be unknown
- Some can interact with other medicines and cause side effects. Consult with your pharmacist or GP if you are considering starting any herbal remedy
- Compound bioidentical hormones
- These are unregulated in the UK and their safety is unknown (9)
- Cognitive behavioural therapy (CBT) is a type of talking therapy. It may help with:
- Low mood or anxiety due to menopause
- Dealing with menopausal symptoms (9)
- Alternative therapy e.g. acupuncture (10), mindfulness or meditation
There is some evidence for these therapies in helping with menopausal symptoms.
Here we have listed some simple tips and tricks to help stay and feel healthy during the menopause:
- Wear loose, natural-fibre pyjamas at night
- Ensure you build some "me time" into your weekly schedule to reduce stress
- Prioritise sleep and keep your bedroom cool at night (16-18°C)
- Reduce or stop smoking
- Each time you have a tea break, sit down, lower your shoulders, breathe in gently through your nose, hold to the count of 3 or 4 and then breathe out through your mouth, mentally saying the word 'calm' as you do
- Learn something new that you can fit into to your life as an antidote to stress
- Communicate – reach out to someone to talk if you are struggling
Further physical activity support
A series of 4 physical activity sessions covering aerobic, strength and resistance, pelvic floor and relaxation activity. Find more ways to get active in ways right for you here.
In collaboration with Leicestershire Partnership Trust.
Emma Sylvester – Total Pilates
Learn more about how Pilates can support you with particular emphasis on core strength to improve general fitness and wellbeing.
Leona Knott – Cardio Workout
Leona has devised a workout specially to suit those going through the menopause with stretches and moves which will benefit and support general fitness.
Jo Waller - One Fit Core
Learn specific techniques and gain functional advice to help repair and restore areas of weakness in the pelvic floor, building strength for life.
Jackie Parsons – Relaxation Therapist
The session will take you through progressive muscle relaxation and guided visualisation, and provide an insight into how deep relaxation can support with anxiety and low mood, muscle pain, headaches and insomnia, as well as reduced concentration and ability to think clearly
Further nutrition support
Clare Shepherd, Nutritional Therapist and Health Coach
Clare will introduce you to the greatest contributor to hormonal chaos, and give simple and effective nutrition and lifestyle solutions to help you manage your menopause symptoms and create optimum health through menopause and beyond.
Session 1 – Introduction to the main contributors to experiencing menopausal symptoms
Session 2 – Managing internal stress and anxiety
Session 4 – Taking a look at useful supplements, exercise and how to access further information and support
Session 3 – How to support manage symptoms through better digestive health
For more information please contact:
Assistant Development Officer
I am working flexibly in the office or at home, therefore please contact me via email or phone number provided.
My areas of responsibility are:
When I'm not working - I'm at Loughborough University athletics track, training for the 400m. I've been an athlete for 13 years, and love exploring different parts of the world whilst competing.
Favourite Sporting Moment – Derek Redmond at the 1992 Barcelona Olympics. After tearing his hamstring in the 400m semi-final, Derek's father ran from the stands to help him and they both finished the race together. It always makes me cry!
- 01509 467486
Our Active Menopause webpage has been created by Active Together in collaboration with Dr Natalie Shur, Specialist Registrar in Sport and Exercise Medicine.