Making Sense of Menopause – Part 2

The peri and post-menopausal phases are unavoidable times of change in the life of a female. Just like puberty, hormones are doing their thing. It’s important for women to learn what these changes are and work with them for a better outcome, because the symptoms of peri-menopause are  avoidable.

One of the most common complaints in clinic from peri and post-menopausal women is the sense of a complete change in body shape and stagnant body weight. Hot flushes and declining sleep quality aren’t far behind.

Body Shape and Composition

Throughout perimenopause (the years prior to menopause) estrogen levels fluctuate and eventually decline as menopause draws nearer. It’s this change in oestrogen that can lead to a change in fat burning ability and an increase in fat deposition around the middle. “There’s a tire around the middle that I just can’t shift” is often what I hear.

While oestrogen is a female reproductive hormone paramount to fertility, it’s also key to metabolism in that it supports insulin sensitivity. As insulin sensitivity declines it leads to greater insulin requirements creating a vicious cycle of increased fat storage, reduced fat burning and an increase in risk factors for metabolic disease like an increasing waistline and high triglyceride levels.

To regain blood sugar control (insulin sensitivity) a lower carbohydrate approach to nutrition is recommended at this stage of life. First and foremostly this means exchanging processed carbohydrates, such as bread and pasta for lower GI options including quinoa and sweet potato. Secondly, it means deprioritising carbohydrates at mealtimes which creates more space for fibre rich vegetables and berries, quality protein and anti-inflammatory fats.  This Skin Loving Blueberry Smoothie is the perfect example of a lower carbohydrate, higher fat and protein rich meal.

Sleep Quality

Sleep issues are common in perimenopause, with around 50% of women reporting inadequate sleep and 26% stating it negatively impacts their quality of life and daytime functioning. These symptoms are again hormonal in nature.  Progesterone is the ‘cool and calm hormone’, so as levels decline during peri-menopause so too does sleep quality. Oestrogen regulates cortisol which helps to stabilise sleep, so with declining oestrogen comes greater susceptibility to stressors at night time.

Blood sugar control will assist with sleep quality, so the above carbohydrate recommendations are relevant here. To further support sleep quality, consider reducing or removing caffeine and alcohol (especially in the evening) and introducing magnesium in the hour before bed.  Lifestyle strategies such as establishing a regular bedtime, eliminating screens and devices in the hour before bed and sleeping in a well ventilated room may also be helpful.

Hot Flushes

A 9 year longitudinal study done on women in Melbourne (Australia) showed that only  17% of peri-menopausal women didn’t experience hot flushes – so they’re common! It’s declining oestrogen that can lead to women  experiencing hot flushes. These can be described as period of ‘intense heat spreading over the body’ and can be associated with sweat and a sense of panic.

Reviews of 17 double blind studies have quantified the effects of phyto-estrogen & isoflavone rich foods on frequency and severity of hot flushes and found them to be more effective than a placebo. Isoflavones can be found in foods such as chickpeas, lentils, flaxseeds and soybeans (always organic and non-GMO, please). Check out this Lamb and Chickpea Stew for inspiration.

Essential fatty acid supplements containing EPA/DHA and vitamin E have also been researched and shown to reduce incidence of hot flushes in menopausal women.

If you’re a female in your 40’s or 50’s and experiencing these symptoms, please know that you are not alone. Alongside the above you might also be experiencing low mood, anxiety, vaginal dryness, change in strength, reduction in bone mineral density and/or a change in your ability to train. These are all commonplace in peri and post-menopause.

Please leave a note or comment below if you’ve found these foundational guidelines helpful. If you’d like to take a more tailored approach to managing your changing hormones please arrange your 15-minute Complimentary Consultation to discuss what’s next.  


Taku K, Melby MK, Kronenberg F, Kurzer MS, Messina M. Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity: systematic review and meta-analysis of randomized controlled trials. Menopause. 2012;19(7):776-790. doi:10.1097/gme.0b013e3182410159

Campagnoli C, Abbà C, Ambroggio S, Peris C, Perona M, Sanseverino P. Polyunsaturated fatty acids (PUFAs) might reduce hot flushes: an indication from two controlled trials on soy isoflavones alone and with a PUFA supplement. Maturitas. 2005;51(2):127-134. doi:10.1016/j.maturitas.2004.11.002

Baker FC, de Zambotti M, Colrain IM, Bei B. Sleep problems during the menopausal transition: prevalence, impact, and management challenges. Nat Sci Sleep. 2018;10:73-95. Published 2018 Feb 9. doi:10.2147/NSS.S125807

Carr MC. The emergence of the metabolic syndrome with menopause. J Clin Endocrinol Metab. 2003;88(6):2404-2411. doi:10.1210/jc.2003-030242

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