How to take control of your menopause journey

Sarah Wasser
Sep 2
4 min read

Peri-menopause can feel like your body’s suddenly running a software update you never asked for. One day things work the way they always have, the next — sleep is illusive, hot flushes keep cropping up at inopportune moments, and you’re wondering why you’ve walked into the kitchen for the third time in ten minutes.

Sound familiar? Let’s break down what’s really happening, and more importantly, what you can do about it.

Menopause 101: what’s actually going on

Menopause is technically just one day — the point where you’ve gone 12 months without a period. Peri-menopause is the long lead-up to that point (can potentially be 8 years), and for many women, that’s where the symptoms begin.

What’s happening is that oestrogen and progesterone — two key hormones — start to fluctuate and eventually decline. Oestrogen, in particular, has been quietly running the show for years: it supports your brain, bones, heart, skin, sleep, and even your mood. So, when levels drop, you feel it.

Research shows around 80% of women experience symptoms, and about 25% have symptoms classed as severe (NICE guidelines, 2019). But, every woman is different so it’s almost pot luck what you get!

Six actions to take back control

1. Exercise: strength and movement

Bone density and muscle loss start from age 30 and dropping oestrogen doesn’t help this. Women can lose up to 20% of their bone density in the 5–7 years after menopause (NHS, 2023). And, drops in muscle density will affect your metabolism.

What helps? Strength training. You don’t need to live in the gym, but 2–3 sessions a week with weights, resistance bands, or even just bodyweight exercises will protect your bones, muscle, and metabolism.

Also add in mobility and balance training — Pilates, yoga, or simple daily stretches. The word mobility certainly doesn’t sound glamorous, but this and balance training helps prevent falls later in life. Nobody wants their grand finale to be tripping over a paving stone.

2. Nutrition: fuel, not restriction

Your body doesn’t need punishment diets or the same approach you had in your 20s. It needs smart fuelling. Here are key nutrients you need to add to your diet:

protein: aim for 20–30g per meal to maintain muscle and keep you fuller for longer.
fibre: supports digestion, hormone balance, and cholesterol. Think whole grains, fruit, veg, beans, lentils.
calcium & vitamin D: crucial for bone health. Find them in dairy, fortified plant milks, leafy greens, and oily fish.
healthy fats: omega-3s (from oily fish, chia, flax) support brain health.
hydration: if hot flushes are common, you’ll be losing more fluids. Sip water, herbal teas — not six glasses of Sauvignon (sorry).

We need to work on the mindset shift of nourish, not punish. Treat your body like you actually want it to work well for the next 30/40 years. Equally depriving yourself of your favourite foods/drink won’t help. Work on the 80/20 rule!

3. Sleep and stress: your hidden levers

Peri-menopause often makes sleep feel impossible: night sweats, racing mind, anxiety at 3am. Add your day-to-day stress into the mix and symptoms can spiral.

You can’t control every symptom, but you can set yourself up for better odds:

create a bedtime routine — low lights, screens off, reading or doing a calming activity
limit caffeine after lunch. It lingers in your system far longer than you think.
manage stress with small daily habits — 10 minutes of walking outdoors, journalling, or even simple breathwork.

Why bother? Because high stress raises cortisol, which worsens weight gain and hot flushes. Sleep and stress aren’t luxuries — they’re foundations.

4. Hormone replacement therapy (HRT)

HRT is probably the most talked-about option. Replacing oestrogen can be life-changing for hot flushes, night sweats, mood swings, bone density, and even heart protection.

But: it’s not a miracle cure, and not for everyone. Some women can’t take it due to medical history, and others don’t get the relief they hoped for.

What matters is an informed chat with your GP. NICE guidelines (2019) say benefits outweigh risks for most women under 60 or within 10 years of menopause. Take with you a journal of your symptoms so you can show what you’ve been experiencing.

And remember - it’s about what’s right for you, not copying your friend’s prescription.

5. Stop comparing

Your friend might breeze through menopause, while you feel like you’re living in a sauna with mood swings as your plus one. What good is it going to do you getting jealous of her?

And forget comparing yourself to your 20-year-old self. In your 20s, you could probably live on 3 hours’ sleep and a kebab. Now, your body asks for care. That’s not weakness — that’s wisdom.

6. Mindset shift: aesthetics aren’t the goal

Menopause often shines a harsh light on body image. Weight shifts, fat distribution changes, hair and skin play by new rules.

But always chasing aesthetics — the flat stomach, the “pre-baby jeans” — is exhausting. Instead, shift focus to function and health.

Strong bones to stay active into your 70s. Energy to enjoy your life. Resilience to manage stress. Focus on those, and you’ll actually see results that last — and funnily enough, the aesthetics part often follow anyway.

The takeaway

Taking control of menopause isn’t about doing everything, it’s about building habits that work with your body now.

Exercise for strength and mobility.
Eat to nourish.
Protect your sleep and manage stress.
Consider hrt if it’s right for you.
Stop comparing yourself to your friends or your younger self.

Yes, menopause can be a bumpy ride — but with the right tools, you can not just survive it, but thrive in it.

And remember: hot flushes may be rubbish, but at least you’ll never need to rummage through every handbag pocket looking for a tampon again!!

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