The Menopause – Knowledge is Power

By Emily Foster, RD (

In a recent survey of women aged 45-65, it was found that women reported an average of seven menopause symptoms with 42% feeling that their menopause symptoms were much worse than they expected. [British Menopause Society Survey, 2016]

Usually, around the age of 45 (give or take 5 years), women enter perimenopause (the menopause ‘transition’ – used to describe the time ‘around menopause’) – this can be a confusing and often frustrating time for a lot of women. It’s worth knowing that women under the age of 40 can also experience the menopause, although this is less common, premature ovarian insufficiency (POI) occurs in one in 100 women under the age of 40 and one in 1000 under the age of 30.

Around 80% of women will experience at least some symptoms during the menopause, and these symptoms can include:

  • Irregular periods
  • Memory loss
  • Headaches
  • Mood swings
  • Irritability
  • Difficulty concentrating
  • Bladder infections
  • Itching skin
  • Heart palpitations
  • Hot flushes
  • Bloating and stomach discomfort
  • Joint pain
  • Night sweats
  • Vaginal infections
  • Fatigue and sleep disturbance
  • Dry vagina
  • Lack of interest in sex
  • Panic attacks

Let’s be honest, that’s a long list. Symptom bingo anyone? It’s also of particular concern because many women don’t even consider that the symptoms they are having could be a result of the menopause. This is not the fault of the individual but often a combination of factors such as not being able to consistently see the same GP, lack of training healthcare professionals receive about menopause and the additional factor that talking about menopausal symptoms, in general, is still, for a lot of people, considered taboo.

Your Treatment Options: 

As a registered dietitian/nutritionist, it is beyond my scope to go into exact detail on the variety of therapies available to you but I wanted to give you a list below of options and resources so that you can begin to see that there are treatments available for the menopause and you do not need to suffer in silence if you are finding your menopause difficult.

As military spouses, we tend to move around a lot, and bouncing from GP to GP can be frustrating. Knowing your symptoms and being aware of treatment options will allow you to have a more informed and confident conversation with a healthcare professional so that they can better help you. A good practitioner will help to explain to you your options and empower you to find a treatment, or combination of treatments, that feel right for you. At the end of the day, you are the expert of your own body – your body, your choice.

The basics of treatment options: speak to your GP or menopause specialist for more information. 

  • Hormone Replacement Therapy (HRT): estrogen and progestogen given as tablets, creams, sprays, patches, or gels.
    • HRT can improve symptoms and even has potential health benefits (bone health, heart health, and more.). Larger studies headlined in the press in the past often did not follow current menopause treatment guidelines, used different, synthetic preparations and higher doses of HRT – plus the results were poorly managed by the media – unable to be put in context by healthcare professionals. Although HRT is not right for everyone, the media has certainly done a fair bit of damage to the public’s belief in effective and safe menopause care.
  • Testosterone
  • Symptom-specific Medications
  • Cognitive Behavioural Therapy (CBT)
  • Herbal Medicines and Supplements (MHRA – look for Traditional Herbal Registration Mark)* know that this is a largely unregulated area and the scientific evidence behind herbal medicines and supplements varies greatly.
  • Nutrition & Lifestyle

For more personalised information and guidance on treatments, speak to your GP or head to the British Menopause Society – find a Menopause Specialist. [Link in resources section].

From a dietitian/nutritionist perspective, what do you need to know about your health in perimenopause and beyond?

Your Bones:

When estrogen declines, as it does in the menopause, bone loss accelerates. Vitamin D, calcium, and magnesium are all important to consider as well as physical activity to keep your bones strong. In the UK it is recommended that adults Oct-Mar take 10mcg (400iu) of Vitamin D3 – if you have darker skin, you will want to consider taking a Vitamin D supplement throughout the year – not just in Oct-Mar. All women should have between 700mg (19+)-1200mg (after menopause) of calcium daily.

Your Heart:

When in the menopause there does seem to be an increase in LDL (your ‘bad’ cholesterol) as well as total cholesterol. This is partly because estrogen has a slight protective effect onon the arteries and can help to control your cholesterol, it also helps to reduce your risk of a heart attack. Keeping active and focusing on a Mediterranean-type diet can help to keep your risk of heart disease low.

Want more information on nutrition for the menopause? You can follow me on Instagram at @menopausedietitian.

Lifestyle factors to help manage symptoms and reduce your risk of disease: 

Quit Smoking:

Smoking increases your risk of heart-health-related issues, and research shows you are more likely to have an earlier menopause if you do smoke.

Manage your Alcohol & Caffeine:

Caffeine can irritate the bladder and also can play a role in heart palpitations if this is something you seem to be experiencing with your menopause symptoms. Aiming to reduce your caffeine intake and/or switching to decaf versions of your favourite drinks more often could be helpful.

Alcohol can impact hot flashes as well as affect quality of sleep, be mindful of how much you are drinking and stick below, or to, recommended limits.


Physical activity is important across our lives but in particular to menopause it can help to keep our bones strong and our minds healthy.

Although the menopause can feel like a daunting time it is a great opportunity for women to check in with themselves, their habits as well as their mental and physical wellbeing – potentially opening the door to creating a more joyful and healthy 40+ years to come.

Key Resources: