Menopause: Finding Balance Through Change

For some women, menopause symptoms are mild and manageable. For others, hormonal changes can significantly affect sleep, energy, mood, concentration, body composition and quality of life. The good news is that women have options.

A natural approach may include nutrition, exercise, stress management, sleep support, acupuncture and carefully selected herbal medicines. For some women, menopausal hormone therapy (MHT) may also be an appropriate and effective option. The important thing is understanding your choices and deciding what is right for you.

Menopause can be a time to reconnect with your body and pay closer attention to what it needs.

Hormonal changes during perimenopause and menopause can influence far more than the menstrual cycle. Oestrogen receptors are found throughout the body, which helps explain why declining oestrogen can affect the brain, bones, heart, skin, vaginal and urinary tissues and temperature regulation.

This is also a time when healthy lifestyle habits become increasingly important. Regular movement, nourishing food, adequate protein, quality sleep, stress management and maintaining meaningful social connections can all contribute to healthy ageing.

Rather than simply trying to manage individual symptoms, menopause provides an opportunity to take a broader view of your health and establish habits that support you well beyond menopause.

Menopause is officially reached when a woman has gone 12 consecutive months without a menstrual period, provided there is no other medical explanation. It most commonly occurs between the ages of 45 and 55, although the timing varies between women.

The years leading up to menopause are known as perimenopause. During this stage, ovarian hormone production becomes increasingly variable, followed by a decline in oestrogen and progesterone. Testosterone also gradually declines across the lifespan.

Periods may become irregular, heavier or lighter, and the time between cycles may change. Symptoms can begin during perimenopause and may continue for several years after the final menstrual period.

Although fertility declines during this time, pregnancy is still possible during perimenopause. If pregnancy is not desired, discuss contraception with your healthcare professional.

Every woman's experience of menopause is different. Some women experience very few symptoms, while others find that changes significantly affect their everyday life.

Common symptoms include:

• Hot flushes and night sweats – Sudden feelings of heat, flushing and sweating can occur during the day or night. Night sweats can disrupt sleep and contribute to tiredness and reduced energy the following day.

• Sleep disturbance – Difficulty falling asleep, waking during the night or early morning waking can become more common during perimenopause and menopause.

• Mood changes – Anxiety, irritability, low mood and increased emotional sensitivity can occur. Hormonal changes, poor sleep and life stress can all contribute.

• Brain fog and cognitive changes – Forgetfulness, difficulty concentrating and feeling mentally less sharp are commonly reported.

• Changes in libido – Sexual desire can change due to hormonal changes, fatigue, stress, sleep disturbance and other physical or emotional factors.

• Vaginal and urinary changes – Declining oestrogen can contribute to vaginal dryness, discomfort during sex and urinary symptoms.

• Changes in body composition – Maintaining muscle and managing body composition can become more challenging as we age and hormones change.

• Headaches and palpitations – Some women notice changes in headaches or episodes of awareness of their heartbeat.

There are many practical ways to support your wellbeing throughout the menopause transition.

Move Your Body
Exercise is one of the most valuable tools during midlife. A combination of resistance training, weight-bearing exercise and aerobic activity can help maintain muscle strength, support bone density, cardiovascular health and healthy body composition.Maintaining muscle becomes particularly important as we age. Strength training can also support balance, physical confidence and independence later in life.

Prioritise Protein and Nourishing Food
Menopause is an excellent time to pay greater attention to nutrition. Adequate protein helps support muscle maintenance, while vegetables, fruit, legumes, wholegrains, nuts, seeds and other minimally processed foods provide a broad range of nutrients. Calcium and vitamin D are particularly important for bone health, while fibre and healthy fats can form part of a heart-healthy eating pattern. Rather than focusing on restrictive diets, aim for nutrient-dense, satisfying meals that support energy, muscle and metabolic health.

Manage Stress
Stress and menopause can create an unpleasant feedback loop. Hormonal changes can make some women feel more sensitive to stress, while ongoing stress can contribute to poor sleep, anxiety and increased awareness of hot flushes. Regular exercise, meditation, deep breathing, yoga, time outdoors and counselling can all help support stress management.

Social connection matters too.

Maintaining friendships, family relationships, community involvement and meaningful activities can support emotional wellbeing and resilience during this period of change.

Support Better Sleep
Good sleep is fundamental to health, yet it can become more difficult during perimenopause and menopause. Night sweats, hormonal changes, stress and anxiety can all contribute. A consistent bedtime routine, a cool bedroom, regular daytime exercise and reducing alcohol and caffeine when they interfere with sleep may help.
If persistent insomnia is affecting your daily life, don't simply accept poor sleep as an inevitable part of menopause. Discuss it with your healthcare professional.

Dress for Comfort and Know Your Triggers
Breathable clothing and removable layers can make hot flushes easier to manage.
Some women find that alcohol, caffeine, spicy foods, hot drinks, stress or warm environments trigger or worsen symptoms. Triggers vary, so keeping a simple symptom diary can help you identify your own patterns.

Acupuncture

Acupuncture may be considered as part of an integrative approach to managing some menopausal symptoms. Research suggests it may provide benefit for some women experiencing symptoms such as hot flushes and sleep disturbance. If you are interested in acupuncture, choose a suitably qualified and registered practitioner who can assess your individual circumstances.

Herbal medicines have traditionally been used to support women through hormonal transitions. However, natural does not automatically mean safe or suitable for everyone. Herbs can have pharmacological effects and may interact with prescription medicines.

A qualified naturopath or appropriately trained healthcare professional can assess your individual symptoms, health history and medications before recommending herbal support.

Herbs traditionally used in menopause support include:

• Sage (Salvia officinalis) – Traditionally used for excessive sweating and may be considered when hot flushes and night sweats are prominent.

• Ziziphus (Ziziphus jujuba var. spinosa) – Traditionally used in Chinese medicine to support relaxation and sleep and to calm the mind.

• Vitex (Vitex agnus-castus) – Traditionally used to support menstrual and premenstrual symptoms and may be considered during the perimenopausal years when cycle-related symptoms are present.

• Bupleurum (Bupleurum species) – Used traditionally in Chinese medicine in formulas addressing patterns associated with hormonal and emotional changes.

•  

Herbal medicine should be personalised rather than selected simply because a herb is associated with a particular symptom.

Menopause Is a Transition, Not the End of Wellbeing

Menopause is a significant transition, but it doesn't have to define how you feel for the next stage of your life.

This can be an opportunity to become stronger, prioritise your health, address areas that may have been overlooked and build habits that support healthy ageing for years to come.

With the right information and personalised support, menopause can be less about simply managing symptoms and more about investing in your health, vitality and future wellbeing.

Australian Menopause Society
Jean Hailes for Women’s Health