Menopause is a biological transition that marks a change in hormone balance. In the UK, it’s estimated that around 13 million women are peri- or postmenopausal, that’s roughly one-third of the female population.¹
While hot flushes and night sweats are the most recognised symptoms, menopause has in fact got over 100 unique symptoms that can accompany it. It can impact everything from your sleep quality, mood, memory, gut health, skin integrity, energy metabolism, and more.² ³
Despite this, over 90% of women aged 45+ say they weren’t educated about menopause until they experienced it firsthand.⁴ Many still struggle to find clear, science-backed answers to their questions or feel unsupported when navigating their symptoms.
That’s why we’re sharing insight from Lola Biggs, our in-house registered dietitian. Lola supports hundreds of women in her private practice and plays a key role in shaping Together Health’s formulations to reflect nutritional needs across life stages, including perimenopause and menopause.
In this Q&A, we’ll explore:
- What’s actually happening in the body during perimenopause and menopause
- Why symptoms are so varied and how they connect to hormone and nutrient shifts
- The evidence behind specific nutrients that help
- Her go-to strategies for supporting mood, energy, sleep, and skin
- A complete nutrition and lifestyle protocol designed to boost your vitality
Whether you're in your 40s and starting to notice changes, already navigating postmenopause, or simply want to understand how to support your body through this phase, this is a science-backed, practical guide designed to help you do just that.
Can you explain the process of the menopause in the body, and why it results in such a range of symptoms?
Let’s break down the term 'meno' and 'pause' to paint a picture of its meaning.
‘Meno’ refers to menstruation, and ‘pause’ simply means stop. So menopause literally means the end of menstrual cycles.
It begins with the gradual change in our menstrual cycle length and frequency led by a shift in hormone production, predominantly reduced oestrogen and progesterone. This stage is often given the term 'peri' menopause. Over time this leads to a prolonged pause, and for some this can be the stage where they feel the most changes and increased symptoms.
Driven by the continued downward production of sex hormones and the reduction in ovary mass and function, we reach our final stage, where our cycle ceases to return. This is the menopause.
The duration of both these stages and when they initiate varies, and an individual's experience of this transition, the range of their symptoms and the severity, can also differ. But what is agreed is that these changes and their influence on the body are profound, affecting all of our key physiological systems.
Our hormone cycles influence every part of our body, so when there are changes, shifts, ups and downs, our bodily functions respond. The key organs and systems that are affected by these changes in turn affect: our moods, brain health, body temperature, sleep-wake cycle, bone density, cardiovascular fitness and experience of sex.
Naturally, due to the vast amount of bodily functions relying on these hormones, it is no wonder that women can experience up to 100 different symptoms.
How debilitating can the menopause be, and what are the most common symptoms experienced?
Several factors can influence the experience an individual goes through during the transition into menopause, and for some sadly it can be highly debilitating.
For many, it brings a complex mix of physical, cognitive and emotional symptoms that can impact quality of life on a daily basis. According to NICE guidelines, around 80% of women experience noticeable symptoms during menopause, with 25% describing them as severe or debilitating.5
While vasomotor symptoms like hot flushes and night sweats are the most commonly reported, menopause can also affect systems you might not expect including mood, sleep, skin, digestion, memory, and more. This is due to the wide-ranging role that oestrogen, progesterone, and other hormones play in the body. The severity of the drop in these hormones has been linked to the severity of symptoms you might experience.
Overall, the time frame for symptoms and their severity can be linked to a person's lifestyle, genetics, stress levels, environmental factors, the amount they move and their diet. However, pot luck and unknown factors can also play a big role. There is no one size fits all.
Finally, what makes menopause particularly challenging is that these symptoms can be interconnected. For example, poor sleep may worsen mood and memory, while fluctuating oestrogen can disrupt both gut health and skin barrier function.
What health issues can women be more at risk of post-menopause, and why?
Post-menopause, your body enters a new hormonal landscape, one where oestrogen and progesterone remain consistently low. Many women find relief in the subsidence of some of the symptoms, with many reporting feeling more balanced as they become accustomed to their new baseline. However, this new baseline can result in long-term modifications to important internal systems, which does increase health risks. Maintaining the density of bone tissue is one of them.
Oestrogen plays a crucial role in maintaining bone density and after menopause, bone resorption (breakdown) begins to outpace bone formation, leading to a greater risk of osteopenia and osteoporosis. Women can lose up to 10% of bone mass in the first 5 years post-menopause6, so dietary and lifestyle changes are essential here.
Further to this, the proficiency to repair and protect the cardiovascular system can be hindered and can increase the risk of cardiovascular disease. Studies show that hypertension, stroke, and heart disease increase significantly in the decade following menopause7 for this reason.
Along with these changes, lower oestrogen levels can cause the vaginal tissue to become thinner and less elastic, while also changing the local pH and microbiome. This can make intimacy less enjoyable and increase susceptibility to urinary tract infections.
Can you recommend a healthy menopause plan in terms of dietary and lifestyle changes that can help a woman through the process? Both in what to add in, but also elements that could be making symptoms worse?
As a dietitian working with women, I often get asked about what foods can support the transition into menopause. My answer is always to aim to include an abundance of foods that offer the most nutrients per serving, which, simply put, is a whole food diet skipping the processed options. Make sure your diet is rich in fruits and veggies, eat enough good quality protein and include heart-healthy fats like avocado and Omega-3s.
Finding moments to include movements that help lift mood and support bone health is also key. Studies have shown that walking and doing weight-bearing exercise like yoga and resistance exercises are effective lifestyle habits.
Stress is a key antagonist, so trying to support the body's relaxation and repair is essential to long-term health and wellness, and being aware of what is triggering stress responses in the body. It is well documented that burdening the liver with ultra-processed foods, high levels of refined sugar, alcohol and other foods low in nutrients can increase the impacts of the change.
We cannot always remove all sources of stress from our lives, and not everyone can reach instant zen with meditation or having a cup of herbal tea, so it is important to try different ways to manage stress until you find something that feels good for you.
I recommend giving the body a helping hand with a well-thought-out natural supplement. Look for those containing a blend of adaptogens to support stress management, such as ashwagandha, herbs like sage to ease flushing, and vitamins and minerals that can support the body in adapting and building resilience.
Are women at an increased risk of nutrient deficiencies, both during the process but also post-menopause?
As hormones can influence the body's ability to store, use and absorb nutrients, the drop and change in oestrogen and progesterone can have an impact on nutrient stores. As a result, many peri- and postmenopausal women can be at risk of increased deficiency in or low levels of vitamin D and magnesium, iron, calcium, folate, riboflavin, vitamin B12, and vitamin K2.
Also, changes to mood and energy levels can impact the types and frequency of foods being included in the diet, with a tendency to increase comfort-giving foods. These are often rich in carbohydrates, refined sugars and more inflammatory fats, which offer fewer nutrients overall and compound the issue.
Are supplements important for women at this time? What would you recommend and why?
A targeted supplementation routine can certainly help with symptoms and support health throughout the process, but it all depends on what symptoms are being experienced and why the supplements are needed.
Studies have shown that there may be benefits from taking additional bone health nutrients to protect against osteoporosis. These should include Calcium, and vitamin D3 and K2. Calcium helps maintain bone mineral density, where D3 and K2 allow the calcium to be absorbed and pushed towards the bone 7.
Stress can trigger several different pathways that can exacerbate symptoms, so some women may find support in taking some calming herbs and minerals like marine magnesium, adaptogens like ashwagandha and calming functional mushrooms like Reishi.
B vitamins are employed for supporting hormone synthesis and balancing our energy levels, so taking a B complex including all essential B's can be helpful.
Giving our liver a helping hand with greens and plants like milk thistle is also a good idea. This crucial organ is involved in ensuring we metabolise new and remove old non-helpful circulating hormones. It is also involved in assisting in grabbing essential nutrients from the food we eat and getting rid of substances and metabolites that can cause inflammation in the body, which can hinder our overall wellness.
Do women need to be careful of any supplements if they are also taking medication, such as HRT?
The evidence base for the short and long-term influence of supplements with HRT is not conclusive, especially surrounding herbal varieties. So it is important to talk to your health practitioner who has prescribed hormone replacement therapy for the best course of action.
I would, however, recommend taking natural vitamin and mineral complexes, especially those supporting bone health, as there is no evidence of any contraindications with the menopause medication, and the benefits are well established.
Your Complete Menopause Protocol
A daily rhythm of nutrients, movement, and mindset support for midlife vitality.
MORNING: Balance your energy and protect your bones
- Menopause (for symptom support and foundational nutrients), Bone Aid (for bone strength), B Complex (for energy and mood), and CoQ10 (for cellular power)
- Stabilise blood sugar and fuel focus. Think eggs, oats and berries for added antioxidants, or a smoothie with flax and nut butter
- Step outside into daylight within 30 minutes of waking. Morning light supports your circadian rhythm and energy regulation
- Move your body: walk, stretch, or do mobility work to boost circulation, reduce stiffness, and energise your nervous system for the day ahead
- Do a weight-bearing activity: ideally 2–3 sessions per week of bodyweight exercises, resistance bands, or light strength training can make a measurable difference to bone and muscle mass plus helps you feel good
- Drink plenty of water as dehydration can worsen symptoms like hot flushes.
AFTERNOON: Sustain and stabilise
- Take Omega-3 with your main meal; it supports cognition, mood balance, and helps manage inflammation
- Eat a balanced lunch with fibre, healthy fats, and lean protein. Your blood sugar (and brain) will thank you
- Try a 5-minute post-meal walk or breathwork session, small habits that regulate digestion and lower cortisol
- Schedule a short reset: read, journal, or simply be quiet. Mental clarity improves when you give your nervous system a break
- Moderate your caffeine. As oestrogen declines, it can affect your sensitivity to caffeine. If you're noticing afternoon crashes, difficulty falling asleep, or more restlessness than usual, it’s worth experimenting with your caffeine timing and intake.
EVENING: Wind down wisely
- Take your marine Magnesium to support deep sleep, muscle relaxation, and nervous system calm
- Eat a warm, light dinner at least 2 hours before bed and avoid heavy meals, spicy food or alcohol late in the evening
- Try adding phytonutrients like tofu or flaxseed. They weakly bind to oestrogen receptors, and while mild in effect, they can reduce vasomotor symptoms (like hot flushes) in some women¹ and are best added to your routine consistently and early
- Dim your lights after 8pm to support melatonin production and quality sleep
- Create a bedtime buffer: no screens for 30 minutes. Try a stretch, a warm bath, or a fiction book instead
What to expect
This protocol isn’t a quick fix. It’s a steady, evidence-based way to support your body through a time of major biological transition and help you feel more like yourself again.
Here’s what you can expect over the coming weeks:
Weeks 1 - 2
You might not experience dramatic changes, but this is when nutrients begin replenishing, blood levels of key vitamins start to rise, and habits (like movement and sleep cues) begin supporting your circadian rhythm. Think better digestion, steadier energy through the day, fewer crashes
Weeks 3 - 6
As nutrient status stabilises, particularly magnesium, B vitamins, and omega-3s, many women begin to notice:
- Improved sleep quality
- Smoother mood patterns
- Less brain fog or mental fatigue
- Milder PMS or perimenopausal symptoms
If you’re tracking symptoms (e.g. hot flushes, irritability, energy dips), you may see early signs of improvement here.
Weeks 7 - 10
This is where consistency pays off. With bone-supportive nutrients like D3, K2, calcium, and omega-3s, you’re now supporting:
- Long-term bone density maintenance
- Cardiovascular health during a higher-risk phase
- Hormonal processing through liver and gut pathways
- More consistent mood and sleep regulation
Some women also report fewer night sweats, improved skin texture, or better recovery from exercise during this phase.
The real magic happens longer-term (3+ months): Protective, cumulative benefits
Nutrients like CoQ10, magnesium, and vitamin D continue building up in tissues and systems. At this stage, the protocol shifts from symptom relief to supporting resilience, protecting bone health, cognitive function, and energy production long-term.
You’ll experience fewer health surprises, improved stability, and more confidence in your routine.
Parting thoughts
Menopause isn’t a problem to be solved. It’s a powerful, complex biological transition that deserves to be understood, supported, and respected.
We’ve covered a lot with the help of our Dietitian Lola; the hormonal shifts that drive common symptoms, the health risks that can emerge post-menopause, and the very real ways nutrition and lifestyle can influence how you feel.
Your front-line support system includes magnesium for sleep and anxiety, Vitamin D3, K2 + Calcium for bone strength, Omega-3 (DHA/EPA) to support cognition and reduce inflammation, and CoQ10 to aid cellular energy.
Combined with real food, consistent movement, quality sleep and stress reduction, these aren’t just wellness hacks. They’re powerful tools that support your biology in ways that are measurable, cumulative, and grounded in evidence.
This protocol isn’t about overhauling your life or following it to the letter. It’s about stacking small, smart decisions that honour what your body needs right now and setting the stage for strength, clarity and wellbeing in the years ahead.
References:
NHS England – Menopause in the Workplace Report, 2022
BMC Women’s Health – Symptom prevalence among postmenopausal women, 2023
NICE – Menopause: diagnosis and management guidelines
University College London – Study on menopause education, 2023
Nice Guidelines- https://www.nice.org.uk/guidance/ng23
International Osteoporosis Foundation
Weaver et al., Osteoporosis International, 2016 – Calcium intake and postmenopausal bone health
