Thriving Through Midlife with Lifestyle Medicine: World Menopause Day Special

Menopause is a major life milestone that brings significant physical, psychological, and hormonal changes. As estrogen, progesterone, and testosterone decline, many women experience hot flushes, night sweats, mood swings, fatigue, sleep disruption, and changes in libido. There is a gradual increase in the risk of cardiometabolic diseases like blood pressure, cholesterol and heart disease, and bone loss.

Yet this stage can also be the time to pivot - to pause, realign, and prioritise your health. Small, consistent lifestyle choices in how you eat, move, rest, and connect can transform your menopause experience and long-term health.

This year, the theme of World Menopause Day is Lifestyle Medicine, the key to a smoother, more empowered transition through midlife. Let’s look at some of the key aspects of lifestyle changes.

Nutrition

As women move through perimenopause, their nutritional needs shift dramatically. Hormonal changes alter body composition. There’s often a gradual rise in body fat (especially around the waist) and a decline in muscle mass. Since muscle is the body’s metabolic engine, less lean muscle means burning less calories. This also leads to insulin resistance and an increase in blood sugar.

Ageing also brings anabolic resistance, a reduced muscle-building response to protein and exercise. Prioritising high-quality protein and resistance training helps counter this.

Menopause is associated with low-grade inflammation. Foods that reduce inflammatory stress, such as olive oil, fatty fish, nuts, colourful vegetables, and herbs, play an important role.

There is also a significant shift in gut microbiome with menopause. Research suggests that postmenopausal women have lesser microbiome diversity and altered overall composition compared to pre-menopausal women. Their microbiome looked more similar to that of men. This change in the microbiome may be associated with increased cardiovascular risk. Another point is the Estrobolome – a specific group of gut bacteria that metabolise and regulate estrogen. A healthy estrobolome helps maintain estrogen balance in the body, while dysbiosis may worsen menopausal symptoms.

A growing trend called “fibremaxxing” - intentionally boosting fibre intake - supports hormone health, balances blood sugar, reduces inflammation, and nourishes the microbiome.

Tips:

1.    Include protein in every meal (20–30 g per meal). Mix animal and plant sources.

2.    Boost fibre, fill at least half your plate with non-starchy vegetables.

3.    Add fermented foods like yogurt, kefir, kimchi, or sauerkraut.

4.    Cut back on ultra-processed foods, sugar, and alcohol.

5.    Stay well-hydrated, aim for around 3 litres of water daily.

A Mediterranean-style diet rich in vegetables, fish, legumes, and olive oil has the strongest evidence for longevity and reduced menopause symptoms.

Movement and Exercise

As the body and mind changes with the hormonal shift, the need to change our exercise habits becomes paramount. What worked in your 30s may not be sufficient now.

Exercise is not just about fitness; it’s one of the most powerful forms of medicine during perimenopause. A sedentary lifestyle in midlife not only accelerates muscle loss and weight gain, but it also significantly increases the risk of cardiometabolic disease and reduces longevity.

Exercise physiologist Dr. Stacy Sims describes perimenopause as a “power window” - a strategic time to shift your training to protect your metabolism and muscle.

Lifting heavy weights (what you can lift safely) and adding HIIT training helps counteract the natural decline in muscle mass, bone density, and metabolism that accompany lower estrogen levels.

Gentler forms of movement still have their place too. Yoga, Pilates, and tai chi help maintain flexibility, calm the nervous system, and help reduce cortisol — all valuable during the hormonal transition.

Tips:                                      

• Strength training three times a week for bone and muscle health.

• Cardio walking, cycling, or dancing for heart and brain vitality.

• Yoga or tai chi for balance, flexibility, and calm.

Restorative Sleep

Sleep deprivation is one of the most challenging menopause symptoms, often with the greatest impact on a woman’s quality of life, mood, and health. It tends to creep in slowly, and many accept it as an inevitable part of ageing - but it doesn’t have to be. Night sweats, life’s constant stressors, and hormonal changes can all play a part, yet sleep is when your body repairs and your mind resets.

Tips:

• Keep a consistent sleep routine.

• Avoid screens and blue light at least 2 hours before bedtime.

• Keep your bedroom cool & airy.

• Techniques like slow breathing exercises, meditation or Yoga Nidra before bed can calm the nervous system and help you sleep better.

Stress Management & Cortisol

Midlife often brings a perfect storm of stressors - career demands, relationships, children, aging parents, and health concerns, putting huge demands on a woman. Constant stress has become almost normal in modern life, but it takes a real toll.

When cortisol, our main stress hormone, stays high for too long, it can exacerbate weight gain, brain fog, sleep disturbances, low sexual desire and fatigue. High cortisol creates a state of chronic inflammation, increasing the risk of long-term health conditions like heart disease. It affects immunity, gut function and cognitive function.

It creates “cortisol steal,” which diverts essential resources from hormone production to cortisol production, which worsens the menopausal symptoms.

Mindful stress management isn’t optional - it’s essential for long-term health and longevity.

Tips:

• Practice mind-body techniques like meditation, breathwork, or a mindful walk in nature.

• Nurture joy and connection through laughter with friends and supportive relationships.

• Make space for creative or relaxing hobbies that bring genuine pleasure and balance.

Supplements

While nutrition and movement are the foundation, adding some key supplements such as vitamin D, magnesium, omega-3s, and B vitamins helps with energy, mood, sleep, and bone strength.

A New Chapter

Menopause is not the beginning of the end, but it’s the time to realign and focus on yourself. With proactive personalised lifestyle changes, you can optimise your health, relieve menopausal symptoms and improve your longevity!