The Menopause Roadmap!

Menopause is made up of three transitions, or let’s call them stages. 

All three have a name because all three exist and each specific ‘pause’ is different.  


Perimenopause is the precursor to menopause and marks the beginning of hormonal decline (which will continue to do throughout menopause, and your lifetime), leaving your body in a state of hormonal imbalance. It is the ‘pause’ in which you start feeling change and symptoms arrive.

Levels of female sex hormones, oestrogen and progesterone, fluctuate daily, causing inconsistent surges. It is these surges and imbalances that cause symptoms such as unexplained weight gain, mood swings, hair loss, crying fits, low energy, hot flushes, lack of sex drive, sleepless nights, fatigue, joint pains, dry skin, recurrent urinary tract infections (UTIs), foggy moments, and many more life-disrupting symptoms. 

This is the time when your cycles will become irregular but hasn’t completely stopped. 

This is the stage at which your immune system is weakening (and will continue to do with age) due to the decline in hormones production. We are, therefore, left more vulnerable and more likely to catch more colds, flu and infections. Your immune system is the protector of your health. When your immune system is weak you are less able to handle stress and are more susceptible to illness in general. This is why it is so important to keep your body strong, vital and healthy.    

Perimenopause usually begins 8 to 10 years prior to menopause, the standard age for menopause being 51 years. However, many women today are entering perimenopause earlier due to high-stress levels and toxicity (from the foods we eat, the waters we drink and the air we breathe). For the majority of women perimenopause usually begins in the early 40s, but it can start as early as your early to mid-30s. 

The average duration of perimenopause is about 5 to 10 years, but this can vary from one woman to another.  


Menopause is when a woman ceases to menstruate for a duration of 12 months. 

Menopause is a natural life transition which marks the end of your reproductive years and is considered a natural part of the ageing process. It is something every woman will have to go through…something you cannot avoid, but certain lifestyle changes can help keep your body strong and ease symptoms. 

In menopause your ovaries slow and eventually stop the production of female hormones, although some postmenopausal women, up to the age of 80 do still manage to make small amounts of oestrogen, specifically oestradiol (E2), a type of oestrogen. 

With the continual decline of oestrogen the reproductive system gradually shuts down. 

How it Works… From Birth to Menopause

When we are born, we are born with 1 to 2 million undeveloped eggs in our ovaries and, by the time we reach puberty and start menstruating, approximately only 300,000 immature egg cells (follicles) remain. Following this, an average of 600 follicles die per month, which are not replaced. By the time we reach menopause, there are no eggs left. And as eggs are the main producer of female hormones, we slowly become deficient (in female hormones).

So, when our eggs are finished there will be no oestrogen production, and consequently, with no oestrogen production, there will be no more progesterone production either.   

Basically, we can’t make babies anymore. We are in full-blown menopause! Then comes postmenopause.


Postmenopause is the name used to describe a period of time after a woman has not bled for an entire year (and will never bleed again after going through menopause). But there is so much more to ‘after menopause’ than just that.

When you reach postmenopause, symptoms have usually subsided because the body has now adapted to the new environment of low hormone production, specifically oestrogen and progesterone. 

So… what does this mean?

Does it mean that when symptoms of perimenopause have subsided and we no longer have a period that menopause has ended, that everything goes back to normal and life just starts all over again? Was the perimenopause just a hiccup? Was menopause just a message telling us we could no longer reproduce? Not exactly.

Yes, it is true we can no longer reproduce and it is true that the majority of menopausal women find that symptoms such as hot flushes, night sweats, sleeping difficulties, mood swings, palpitations, crying fits, etc are transitory, and last only as long as it takes the body to adapt. But don’t kid yourself, the menopause is not over. There are other menopausal health issues that are lurking in the background.

In fact, more important and permanent changes such as drying and thinning skin and vaginal membranes, dry eyes, senior moments, a deceased urinary tract tone, diabetes, heart disease, osteoporosis, and other age-related illness are the next step in this body-change movement.   

This is what happens to the body postmenopause. You don’t feel it like you feel the initial symptoms of perimenopause because it’s moving so slowly now, but the body is giving us other indicators. It’s not happy, it’s talking to us telling us that we should be taking more care of it. We should listen to these telltale signs.  

So Why Am I Telling You This?

Why am I telling you this? Because I truly want to help you. Menopause, its symptoms, and ageing are something we can’t get away from but there are some very important lifestyle changes that you can implement that will help you battle the waves of hormonal disruption. 

  • Eat For Menopausal Health.

Nourish your body with quality foods to help improve your hormonal health. Many of the side effects of menopause, such as hot flushes, weight gain, and fatigue can be compounded by the foods we eat. A diet high in sugars, processed carbohydrates/foods, and unhealthy fats is a no-no!. Instead try to eat a healthy, balanced diet full of fruit and vegetables, leafy greens, nuts, lean meats, whole grains, and healthy fats such as omega-3 fatty acids from fish. These simple changes to your diet may make this natural transition easier for you. You may also want to limit alcohol, caffeine and high-sodium or spicy foods as they may trigger hot flushes.  

  • Exercise for Menopausal Health.

A decrease in oestrogen and progesterone in menopause leaves you at an increased risk of heart disease, type-2 diabetes, and osteoporosis –  your healthier diet is the first step in the right direction to help ease menopause. Another great step is regular exercise – at least 3 times per week. Try a mix of both cardio (great for keeping the heart in shape) and weight-bearing exercise (a must for increasing bone mass).

  • Find ‘ME’ time – Focus More on Yourself.

We know very well that the majority of women in menopause have spent the last few decades thinking about and caring for others. It’s time to start taking care of yourself and focus on YOU. Take time out. Avoid stressful situations as much as you can. Menopausal women are already highly stressed, to begin with, due to the decline in female hormones.

Prolonged stress degrades the immune system. Learning to say ‘NO’ will give you more time for yourself, time to relax and rest more if need be, to do the things you want to do. All these will help you weather the storm of menopause more gracefully! 

  • Update Your Vitamin Supply.   

Menopause is the time in your life when your body, brain, and immune system need extra support. You should think about upgrading your vitamin, nutrient, and mineral intake or, if you have not previously taken supplements then maybe it’s time to start.   

Vitamins and minerals are considered essential nutrients for the body. They all play a specific role and work in synergy with each other. They can help with hormonal activity, bone health, wound healing, bolster your immune system, your energy levels, and help repair cellular damage, to name a few.  Magnesium, calcium, vitamins K2, D, A, C, and B vitamins are a must. And the minerals zinc, chromium, selenium, copper, iodine and others all help to keep you strong in menopause. Don’t forget prebiotics and probiotics, as well as a high-quality omega-3.  

A good supplement plan in menopause may help to protect your overall health and manage any discomfort. 

  • Drink Filtered Water…and Drink Enough.

Drinking sufficient (good) water, preferably filtered water, is one the easiest lifestyle changes you can make. 

As we age, your body can’t retain moisture as well as it once did. In youth, we are 60-70% water; after menopause, women may be only 55% water, quite a difference. Fact is, oestrogen helps your tissues to retain moisture. As the levels of hormones drop so does moisture retention in your body

Drinking more water may improve brain function, help make skin, hair and nails healthier, and even relieve hot flushes. It may even reduce the intensity and frequency of headaches and may ease menopause cramps. 


University of Michigan Health – Normal Ovarian Function

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Nanette Santoro, MD, Professor and E Stewart Taylor Chair of Obstetrics and Gynecology and John F Randolph, Jr,. Dr, Professor of Obsetrics and Gynecology and Director. Reproductive Hormones and the Menopause Transition.

Panagiotis Anagnostis, Stavroula A Paschou , Niki Katsiki , Dimitrios Krikidis , Irene Lambrinoudaki , Dimitrios G Goulis. Transition to menopause is associated with an increase in cardiovascular disease (CVD) risk. Curr Vasc Pharmacol 2019;17(6):564-572

Paweł Milart, Ewa Woźniakowska, and Wojciech Wrona.Selected vitamin and quality of life in menopausal women. Prz Menopauzalny. 2018 Dec; 17(4): 175–179. 

Nina S. Stachenfeld, PhD1,2,3. Hormonal Changes During Menopause and the Impact on Fluid Regulation. Reprod Sci. 2014 May; 21(5): 555–561.

This blog was first published on as part of menopause awareness month

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