7 things you didn't realise could
affect the menopause

The menopause is a natural stage in life that all females will go through. However it's associated symptoms can be an unpleasant experience for many. From night sweats, headaches and mood swings to vaginal dryness, UTIs, and increased risk of bone fractures, many women suffer from an array of emotional and physical symptoms during both the peri-menopausal and post-menopausal periods. Interestingly, women in other cultures often don’t experience unpleasant side effects to the extent that women in the West do, indicating that various diet and lifestyle factors may play an important role. Below are 7 things that could affect your menopause:


The amount of oestrogen and progesterone produced by the ovaries declines during the peri-menopausal period and instead the adrenal glands, which also produce stress hormones such as cortisol and adrenaline (which control our fight or flight response), take over to start producing these hormones in smaller amounts. However, the adrenal glands cannot produce female hormones efficiently when they are constantly pumping our stress hormones. The body will always choose survival over fertility! Reducing stress levels through yoga, meditation, mindfulness, spending time outdoors and taking time for yourself is recommended. 


Female sex hormone levels influence the composition of the microbiome (the community of microorganisms e.g. bacteria) that reside in many sites of the body, including the gut and vagina. The reduction in oestrogen in menopause may therefore alter the microbiome balance in these areas, contributing to digestive issues, genitourinary infections and reduced nutrient absorption. Maintaining a healthy balance of bacteria is especially important to help transition through the menopause, and to alleviate the on-going effects of low oestrogen levels in the post-menopausal years. 


Western women appear to suffer with menopausal symptoms more than women from other cultures, potentially due to the western diet, which is high in sugar, refined carbohydrates and processed foods and low in fibre. This way of eating can lead to blood sugar imbalances and nutrient deficiencies, which are thought to contribute to menopausal symptoms. During the menopause there is also an increase in free-radicals, which can cause damage to cells and exacerbate symptoms such as hot flushes. There is therefore an increased need for antioxidants. Eating a balanced diet of unprocessed whole foods with lots of antioxidant rich fruits and vegetables, nuts and seeds, good quality protein and healthy fats such as oily fish, avocado and olive oil is recommended.


Use of tobacco and alcohol has been shown to potentially affect the age of on-set of menopause.1 For example, it has been observed that women who smoke 14 or more cigarettes a day enter menopause on average 2.8 years earlier than women who do not smoke.2 This is another good reason to quit if you are a smoker, and to keep alcohol consumption below the Government’s recommended 14 units a week (approximately 1.5 bottles of wine). 


Heavy physical activity seems to bring menopause onset forward, whereas light physical activity appears to delay it.4 This is a good reason for women to take regular gentle to moderate exercise in the years leading up to the menopause. Exercise can also be extremely beneficial for counter-acting some of the symptoms and risk factors of menopause. For example, improving bone heath, reducing the risk of cardiovascular disease, weight-management, helping with sleep and improving mood. Weight-bearing exercises are particularly beneficial for bone-health. These types of exercise include activities that make you move against gravity whilst bearing your own (and sometimes additional) weight. For example, lifting weights at the gym, running, tennis, hiking (especially with a backpack) or aerobics. Yoga, pilates and tai-chi are lower impact examples and are especially good for improving co-ordination and balance, which is particular important as we age, as the risk of falls and fractures increases.


Being overweight has also been shown to increase the frequency of menopausal symptoms and the risk of hot flushes,5 so taking steps to manage weight may be good preparation for menopause, especially as many women naturally put on some weight around this time. A holistic approach looking at diet, activity and psychological factors that can contribute to weight-gain is likely to be most effective. 


Research indicates that women with a more negative attitude towards menopause are associated with more frequently reported symptoms compared to women with a positive attitude.12 Unfortunately in recent years menopause has been viewed with negativity, and treated almost akin to an illness, which is unhelpful. Instead the transition to menopause can be a time of reflection and inspiration. Although transitions of any kind can be inherently difficult, many women experience a newfound sense of freedom and personal growth in their menopausal years. Engaging in a daily gratitude practice, whereby each day you think of three things you are grateful for, (including your health and body) has been shown to have a positive impact on mental health and out-look.


1. Ceylan B, Özerdo?an N. Factors affecting age of onset of menopause and determination of quality of life in menopause. Turkish J Obstet Gynecol 2015; 12: 43–9.

2. Kinney A, Kline J, Levin B. Alcohol, caffeine and smoking in relation to age at menopause. Maturitas 2006; 54: 27–38.

3. Sapre S, Thakur R. Lifestyle and dietary factors determine age at natural menopause. J Midlife Health 2014; 5: 3.

4. Gudmundsdottir SL, Flanders WD, Augestad LB. Physical activity and age at menopause: the Nord-Trøndelag population-based health study. Climacteric 2012; 16: 78–87.

5. Thurston RC, Sowers MR, Sutton-Tyrrell K, et al. Abdominal adiposity and hot flashes among midlife women. Menopause 2008; 15: 429–34.