Hormonal highs and lows

A practical guide to the menopause

The menopause is a time of transition that can cause upheaval to our sleep, mood, energy and confidence – all while life keeps moving. “Women can often feel overwhelmed,” says Emma Bardwell, a nutritionist with vitamin company Vitabiotics (www.vitabiotics.com).

“Not just with this life stage – but with all the plates they’re spinning, whether that’s career, relationships, elderly parents or children.”

“Perimenopause and menopause often get framed as the ‘end of youth,’ says Dr Nirusha Kumaran, a leading medical expert specialising in women’s longevity and hormonal vitality (www.drkumaran.com). “But, in reality, this phase can be a powerful ‘reset’. With the right knowledge, women can approach it with confidence rather than dread.”

What’s happening with our hormones?
“The perimenopause for many can be a hormonal roller coaster,” says Dr Kumaran. “Oestrogen levels typically fluctuate unpredictably, and progesterone levels often decline. During perimenopause, the ovaries stop producing oestrogen and progesterone in a steady rhythm. Instead, levels rise and fall unpredictably, leading to irregular cycles and perimenopausal symptoms. Menopause is the point when the ride slows down. Once periods stop for 12 consecutive months, oestrogen and progesterone remain consistently low, marking the onset of menopause. Additionally, other crucial hormones decline in menopause including DHEA and testosterone.”

Symptoms: the biology behind the feelings
These hormonal fluctuations affect different systems in the body, causing widespread disruption. “Oestrogen in particular has protective effects on the brain, heart, bones, and even skin,” says Dr Kumaran, “so its decline can bring a wide range of changes.” Here are some examples:

• Brain and mood: memory lapses, anxiety, brain fog.
• Temperature regulation: hot flushes, night sweats.
• Heart and blood vessels: increased risk of high cholesterol and cardiovascular disease.
• Bones and joints: loss of bone density, more aches and stiffness.
• Skin and hair: thinner skin, dryness, hair changes.
• Metabolism: slower metabolism, easier weight gain

Fluctuations in progesterone typically affect the body in this way:

• Mood and sleep: lower progesterone can cause anxiety, irritability, and insomnia.
• Menstrual cycles: irregular bleeding, heavier or lighter periods.
• Nervous system: less of its naturally calming, soothing effect can lead to more tension and restlessness.

And here’s how testosterone can be affected:

• Libido and sexual health – causing a reduced sex drive and lower arousal.
• Energy and motivation – low levels causing more fatigue and less “get up and go.”
• Muscle mass and strength loss – leading to reduced tone and power.
• Confidence and mood – some women notice reduced assertiveness or self-drive.

Managing the rollercoaster
So how can we manage this hormonal rollercoaster ride? “Women can benefit from a variety of nutrients, when going through the perimenopause and menopause,” says Emma Bardwell. She explains: “Calcium-rich options such as dairy, tofu, leafy greens, almonds, figs and fortified plant milks help support bone health. Iron-rich foods like lentils, beans, green leafy veg, fish and lean meats are particularly important if menstrual cycles are still occurring, as iron needs may be higher. Whole grains and legumes provide valuable fibre and B vitamins. Oily fish, such as salmon and mackerel, offer heart-healthy omega-3 fatty acids.”

Emma continues: “Whilst there are several foods and drinks that can provide necessary nutrients during menopause, there are also many foods that people choose to avoid during perimenopause or menopause. Some food and drink you may want to consider avoiding during perimenopause and menopause include alcohol, ultra processed foods (UPFs), sugary foods such as sweets, biscuits and pastries; spicy food, caffeine (if sensitive to it), and foods high in salt, such as crisps and ready meals.”

Practical first steps to try today
“Making dietary changes can feel overwhelming, but small, manageable steps can make a big difference,” says Emma. “Starting with one simple change, like adding an extra portion of vegetables to each meal, can build momentum without feeling daunting. Preparing meals in advance through batch cooking can ease weekday stress and help maintain consistency. Keeping healthy snacks such as nuts or fruit readily available supports better choices throughout the day. Women also get extremely good results in terms of energy, mood and weight management when they start the day with a protein-rich breakfast. It can be as simple as swapping toast or granola for Greek yoghurt or eggs. Staying hydrated is another essential, yet often overlooked, habit that supports overall wellbeing.

As a nation we’re all under-eating fibre. Guidelines suggest we aim for 30 g a day, but most of us are only getting 16-18 g. The benefits include lowering cholesterol, regulating blood sugar, reducing cravings and improving digestion and gut health. There are even links to improved mood, skin and hormone balance. Top tips include keeping the skin on fruits and vegetables, adding nuts and seeds to meals and swapping white pasta for lentil or bean pasta.”

Dr Kumaran adds: “Medical therapies such as HRT can be valuable for many, but lifestyle measures can also make a huge difference. Optimising your lifestyle will enable a swifter transition into menopause. Strength training can help preserve muscle, protect bones and boost our mood. Sleep practices such as cooling the room, reducing screen time, and adding relaxation practices can all help. Manage stress through breathwork, yoga, or mindfulness. Track your cycle and symptoms to help spot patterns and triggers. Seek support or professional advice when lifestyle measures alone aren’t enough.”

Snack suggestions
To maintain steady energy and help keep hormones balanced, Emma Bardwell recommends focusing on snacks combining complex carbohydrates, healthy fats, and protein, such as:

• A small pot of Greek yoghurt + berries + mixed seeds
• A homemade protein smoothie
• Roasted chickpeas
• Fruit + a handful of nuts
• Seaweed thins
• Dark rye crackers + hummus + a boiled egg
• A mini chia pudding

Reframe and plan
Here are some final thoughts from Dr Kumaran on how to approach the perimenopause in a more positive light. “Reframe the narrative,” she says.

“This is not a decline but a transition into a new stage of health, ideal for health optimisation and vitality. Lean into knowledge: understanding your body removes fear and builds confidence. Connect with others: share stories to remind you that you’re not alone. Re-prioritise self-care: nutrition, exercise, and rest can feel more intentional at this stage. Partner with professionals: whether through lifestyle, supplements, or medical therapy, personalised guidance can make the journey smoother.”

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