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5 ways to manage the menopause

Registered nutritional therapist Michaella Mazzoni suggests some strategies for coping with common symptoms of the menopause

Hot flushes

Around 75 per cent of women going through menopause will experience hot flushes. Hot flushes happen due to the changing levels of oestrogen. In addition or sometimes separate from changes in oestrogen levels, hot flushes can be triggered by anxiety or stress. Keeping a log in your phone or a small diary referencing when you had a hot flush can be helpful with identifying triggers. For example, some women I have worked with found that their daily coffee was a big trigger. As far as supplement support, sage is my go-to supplement for supporting hot flushes. It is important to stay hydrated if you are having regular hot flushes. Drinking two to three litres of water throughout the day is sufficient. In cases of extreme sweating, adding some sports electrolyte drops to your water can help replenish minerals lost during sweating.

Vaginal dryness

During menopause, the change in sex hormone levels can cause vaginal dryness. This is due to the vagina shortening and losing some of its elasticity. If you find you are becoming more prone to urinary tract infections, using a good quality probiotic pessary can be helpful at both lubricating and supporting the immune/microbiome system in the vagina. Adequate daily hydration and omega-3 are key for supporting vaginal dryness. Again, aim for two to three litres of water throughout the day. Food sources of omega-3 include oily fish (two to three servings per week) like salmon, anchovies and mackerel. Other great sources of omega-3 are flaxseeds, chia seeds and walnuts. If you are vegetarian or vegan, consider a high quality plant-based omega-3 supplement.

Reduced libido

Changing levels of sex hormones, hot flushes, vaginal dryness and increased anxiety can often result in sex being the last thing on your mind when you’re going through menopause. Outside of working on those areas individually, there are changes you can make to support your sex drive during menopause. Keeping an adequate amount of protein in your diet (around 1g of protein per kilo of body weight), exercising regularly and relaxing with your partner can help to support your libido. A plant-based phytoestrogen supplement and including freshly ground flaxseeds daily in your diet are great ways to support the reducing levels of oestrogen. Try blending two tablespoons of freshly ground flaxseeds into your smoothie. Do note that women with a history of hormone-dependent cancers should consult with their GP before starting flaxseeds or phytoestrogen supplementation.


Anxiety during menopause is fairly common yet not often spoken about. Due to the decreasing levels of oestrogen, many women can feel their resilience to stress reduces or that they can become anxious or overwhelmed. Reducing caffeine intake can be very helpful in this instance. Lifestyle changes like yoga, mindfulness or gentle exercise like swimming or walking can also help to soothe the mind. A magnesium and methylated B complex supplement can also be helpful in helping support the nervous system. Food sources of magnesium include nuts and seeds, dark leafy greens and whole grains like brown rice.

Issues with sleep

Issues with sleep are very common in both perimenopause and menopause. Some women may find it very difficult to fall asleep due to a busy mind (see anxiety) or waking often during the night, typically around 2am or 3am. If anxiety or a racing mind is keeping you up, a good quality theanine and magnesium supplement may go a long way to help your nervous system create the hormones we need for a good night’s sleep.

If you are waking throughout the night, it can be helpful to consider liver health. During menopause our body is working through lots of hormonal changes which means our liver is working extra hard. Supporting your liver with a cysteine complex and bitter foods like rocket, radish, cress and lemon is a good place to start. In both instances, when it comes to issues with sleep, assessing your night time routine can be a great starting point. How much time is there between your screen time and when you get into bed? When is the last time you have a coffee in the day?

Michaella Mazzoni, Registered NT, DipCNM mBANT CNHC reg, offers private nutrition consultations as well as video consultations to help support all areas of health. To book an appointment, email Michaella at or call 07786 841 333.

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