Are you experiencing changes in your body that you can’t quite explain? Feeling like you’re on an emotional rollercoaster? It might be perimenopause, the transitional phase leading up to menopause. Understanding the signs and symptoms can help you navigate this natural and inevitable part of your life.

During perimenopause, which typically starts in our 40s but can happen as early as the 30s, the ovaries gradually produce less oestrogen. This hormonal shift can cause a range of physical and emotional changes. Common symptoms include irregular periods, hot flashes, night sweats, mood swings, fatigue, and a decreased sex drive. The average duration is three to five years, although it can last just a few months or extend as long as a decade. 

Through my clinical work I have defined 4 stages in the menopausal transition, but first let’s go through a quick overview of the menstrual cycle. 

The roles of oestrogen and progesterone in our menstrual cycle

During our peak reproductive years, the amount of oestrogen and progesterone in circulation rises and falls fairly predictably throughout the menstrual cycle. Oestrogen thickens the uterine lining – this becomes the blood flow of your period, and it stimulates ovulation. After ovulation (14 days before your period) the empty follicle from which the egg was released forms a structure called the corpus luteum. The corpus luteum produces progesterone during the luteal phase, the second half of your cycle. Progesterone keeps the lining stable and prepares it for implantation during the second half of your cycle. A drop in progesterone at the end of your cycle signals to your body that it’s time for your period to begin. 

4 stages in the menopausal transition

The transition to menopause via perimenopause is a natural phase in our lives, characterised by hormonal fluctuations which can lead to a variety of symptoms that may affect your physical and emotional well-being.

1. Early perimenopause: oestrogen dominance

As our egg supply is slowly decreasing, we start skipping ovulation. This means oestrogen is still produced which thickens the uterine lining, but because ovulation doesn’t happen, we don’t get the progesterone we need to balance oestrogen. This means that 

  • periods come closer together 
  • periods get heavier, some women experience flooding.

Unbalanced oestrogen can also lead to 

  • breast pain, 
  • fibroids, 
  • anxiety, 
  • bloating, 
  • headaches 
  • worsening of endometriosis and PCOS 

In the meantime low progesterone can cause 

  • anxiety,
  • low moods and mood swings.
  • depressive feelings
  • insomnia or other sleep problems, because progesterone acts as a sedative

2. Late perimenopause: oestrogen decline

As oestrogen is falling, 

  • periods are coming further apart
  • bleeds are lighter
  • common menopausal symptoms start: hot flushes, night sweats, weight gain, brain fog, memory problems, fatigue as well as joint pain, dry eyes (read more about it here and here).

3. Menopause

This last just 1 day, the anniversary of the last period you had 12 months ago.

4. Post-menopause

The time after menopause is post-menopause. Many women ask when menopause ends – officially menopause only lasts one day, but being post-menopausal doesn’t end as that is the stage we are in forever after menopause. What they are really asking is when will this nightmare end? The typical symptoms that started in late perimenopause are getting worse and can continue for another 10 – 15 years or longer. Vaginal dryness is common as are urinary tract infections (read more about it here and here).

How to tell if you’re perimenopausal

Ask yourself these questions,

Am I still having periods?

  • yes and your last period was within the last 12 months, you are perimenopausal
  • No and your last period was more than 12 months ago, you are post menopausal

If you’re still having periods, and they are:

  • heavier? This means you are coming up to early perimenopause
  • coming closer together and are heavier? This means you are in early perimenopause
  • coming further apart and are lighter? This means you are in late perimenopause

Of course we all different, and we can respond differently to our hormonal fluctuations, but the answers to these questions can give you a general idea of where you are in the transition.

Functional medicine approaches to smooth the transition and beyond.

The transition to menopause can be a bumpy ride and it can get bumpier still post-menopause. My approach in early perimenopause is to support oestrogen detoxification as efficiently as possible, to reduce oestrogen dominance as much as possible. Many of us have problems with oestrogen detoxification because it is a metabolically complex system involving the liver, blood sugar, cortisol, optimal vitamins and minerals, and the gut microbiome to name just a few players. Do get in touch if you’d like to have a chat about a personalised health plan to support your early transition, especially because this process can last for 5 years or more.

For late perimenopause and post-menopause I have developed a nutritional solution that is tailored to each woman and reverses all the symptoms over 5 weeks. This approach is based on the fact that oestrogen and insulin work together to extract energy from sugar and carbohydrates, so when oestrogen declines insulin becomes dominant, and without it’s partner it converts sugar and carbs to fat, and stops fat burning. When you can’t burn sugar or fat, starvation sets into the body and the brain. This leads to hot flushes, night sweats, brain fog, anxiety, low moods, fatigue, weight gain. My Menopause Core Nutrition Solution addresses these metabolic imbalances directly with food alone and also allows for food personalisation so that you know what you should be eating now and in the future to prevent these symptoms from returning. The course is on special offer until November 10th, have a look and see if it’s right for you

The International Menopause Society is marking the day by publishing a report encouraging women to “have a health audit – and take action at the time of the menopause to avoid chronic diseases in later life.” Actions taken at the time of the menopause can avoid chronic diseases in later life, according to a report on women’s health marking International Menopause Day.

Their advice is to give up cigarettes, move your body more, practice mindful eating, maintain or achieve a healthy weight and develop good sleep habits. This is great advice for general health but it won’t do much for reversing the debilitating symptoms of menopause.

What will reverse them permanently in 6 weeks is my online expert nutrition course, the Menopause Core Nutrition Solution. This course is designed to eliminate 100% of the core menopausal symptoms: hot flushes, night sweats, anxiety, low moods, brain fog, fatigue and weight gain, just by changing what you eat.

Yes, that’s right – in 6 weeks you can:

  • reverse all your symptoms,
  • learn how to personalise your nutrition for your menopause, and
  • feel your absolute very best. 

And if you join by 10th November, you’ll be feeling like yourself by Christmas.

To celebrate World Menopause Day I am offering you 20% OFF THE COURSE and the offer is valid til November 10th. I can only have 30 women on the course, so JOIN NOW and use this code: WMD23-20%OFF

I came into this program optimistic but, to be honest, skeptical that it would make a huge difference to me. I can’t take HRT and wanted to take control of my menopause naturally.

This has surpassed my greatest hopes – by day 4 I had no more hot flushes or night sweats, my mood has lifted, my anxiety gone. My hair has stopped falling out and I feel brilliant. I feel able to listen to my body and understand the changes to make to bring the best outcomes for myself. I don’t feel I’m going without – it’s incredible.

The program is well structured, supportive and, frankly, life changing. If your journey is anything like mine you won’t regret it.

~ Caron Bradshaw / CEO, Charity Finance Group

Wow. What can I say. I have just completed the Menopause Core Nutrition Solution Course and I am so happy that I found it. I was confident that it would be the kick start my transformation and I certainly wasn’t wrong.

I have dropped 10Kgs, my appetite is stable and I have no crashes in my mood and energy (apart from normal life energy drains).

I have no more sugar cravings and this is for me one of the main positive outcomes, I am able to leave cakes and puddings and sweets where they are!

Its been life changing for me.

~ Danielle Bridge / Interim CEO, Black Minds Matter UK

Apart from the 7 core symptoms that include hot flushes, night sweats, anxiety, low moods, brain fog, fatigue and weight gain, menopause can come with another 30+ symptoms. It’s really intense right? But I can help you with all of those.

Why are there so many symptoms?

Oestrogen is the ultimate multitasker: apart from managing energy it boosts collagen and omega 3 production, it’s an anti-inflammatory, an antioxidant, and maintains vaginal health, just to name a few of it’s jobs! So as it declines in menopause, it can cause over 30 symptoms including loose skin, joint pain, dry eyes, vaginal dryness.

No need to suffer through your best years

I have spent almost a decade investigating what oestrogen is up to in our bodies and I’ve compiled a cheatsheet that you can use to identify which supplements can take over oestrogen’s jobs. For example you can use an inexpensive antioxidant to relieve joint pain in about a week, or firm up hair, skin and and nails with a protein powder within a month.

The Menopause Supplement Cheatsheet is included as a bonus with the Menopause Core Nutrition Solution, but you can get it as a stand alone.

No need to suffer through your best years – take advantage of the cheatsheet and get the know-how to bust through all your symptoms.

Menopause Supplement Cheatsheet »

Coming across Louann Brizendine’s book about menopause was a moment of sheer joy.

The Upgrade – which is exactly how I see menopause – links the physical metabolic changes that declining oestrogen brings, to the emotional changes that we can experience, and explains why the mature brain is so much better than what came before.

I highly recommend this uplifting and illuminating perspective on menopause.


Ms Magazine – helping women to seize the power we have and to use it, to act collectively, to realise that together we can make change happen -is 50 this year, menopausal and still empowering. It helped — and continues to help — ignite a revolution for women’s rights.

Last month the founders and leaders of Ms. for all these years — Gloria Steinem, Katherine Spillar, Eleanor Smeal, were celebrating the anniversary and the publication of a new book, “50 Years of Ms”, an anthology of our revolution. And rather than bemoaning the fact that we are fighting the old fights — again — the spirit of determination and commitment was palpable

Here Gloria Steinem reflects on the origin and impact of Ms Magazine and a reader is quoted – “My husband says I used to be a bitch once a month, but sinceI subscribed to Ms Magazine I’m a bitch twice a month!” Just twice??

Happy birthday Ms Magazine, welcome to the club 🙂


On my 40th birthday my best friend ordered a birthday cake for my party, from a du jour artisan London bakery. It turned up on the morning of the party day looking very plain, so she took it to a local Polish bakery, and asked them if they could decorate it with some fancy icing, saying “Naughty Forty”. Dressed up and ready for the party, she picked the cake up on the way to mine, only to find it had been fully white iced over, in hard royal icing, making it look more like a funeral wake fruitcake. And in bright turquoise icing on the flattened top, it said “1940”. It was one of the funniest things I’d ever seen.

Naughty 40s lived up their name, but what I wasn’t expecting was the Fuck You 50s, where I realised that a major part of transitioning to post menopause was shedding my old self by figuring out how to speak my truth, look my truth and live my truth. It was a bit of a bumpy ride, but oh so worth it.

Bring on the Sex Bomb 60s and 70s – it’s incredible to see the glorious Helen Mirren and silver fox Andie MacDowell killing it on the runway at this years Paris fashion week, along with a make up free Pamela Anderson. Change is afoot, at last.

And check out my heroine Iris Apfel, here celebrating her 100th birthday in 2021. Legend.

Fuck you fifties (and beyond) – no more rules!

Chronic insomnia disorder is one of the most common problems in postmenopausal women, exacerbated by underdiagnosis and improper treatment.

This double-blinded, randomized, placebo-controlled trial was conducted to evaluate the potential of vitamin E to treat chronic insomnia as an alternative to sedative drugs and hormonal therapy.

The study enrolled 160 postmenopausal women with chronic insomnia disorder, divided randomly into two groups. The vitamin E group received 400 units of mixed tocopherol daily, while the placebo group received an identical oral capsule.

The primary outcome of this study was sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI), a self-evaluated and standardized questionnaire. The secondary outcome was the percentage of participants using sedative drugs. There were no significant differences in baseline characteristics between the study groups.
However, the median PSQI score at baseline was slightly higher in the vitamin E group compared with the placebo. After one month of intervention, the PSQI score was significantly lower (indicating better sleep quality) in the vitamin E group compared with the placebo.

Moreover, the improvement score was significantly higher in the vitamin E group compared with the placebo. In addition, there was a significant reduction in the percentage of patients using sedative drugs in the vitamin E group (15%), while this reduction was not statistically significant in the placebo group (7.5%).

This study demonstrates vitamin E’s potential as an excellent alternative treatment for chronic insomnia disorder that improves sleep quality and reduces sedative drug use.

Reduced levels of oestrogen and progesterone seem to be what makes post-menopausal women more likely to have symptoms of sleep apnoea, including snoring, irregular breathing or gasping at night.

Middle-aged women who have lower levels of oestrogen and progesterone are more likely to snore, breathe irregularly and gasp while sleeping, which are all symptoms of sleep apnoea.

The involvement of these chemicals means targeted hormone therapy might prove useful for post-menopausal women, says Kai Triebner at the University of Bergen in Norway.

“Women live, on average, longer than men, but during later years, the quality of women’s life is comparatively low, which is inherently associated with their [low-oestrogen] hormone profile,” says Triebner. “Snoring and sleep-related breathing problems add to the burden.”

His team interviewed 774 women aged between 40 and 67 years old, mostly white, living in seven European countries about their respiratory health and lifestyles. The team also carried out clinical exams and took blood samples. The women, some of whom hadn’t yet reached menopause, completed questionnaires about their sleep habits and health. The study didn’t include pre or post-menopausal trans men.

Nearly half the women reported that they had a “disturbing snore”, says Triebner. In addition, 14 per cent had irregular breathing and 13 per cent gasped while sleeping.

Blood analyses revealed that the participants’ oestrogen and progesterone levels varied widely, ranging from just a few units per litre in some women to tens of thousands of units per litre in others. Those variations had clear associations with sleep apnoea, he says. As the levels of oestrone – a kind of oestrogen – doubled, women were 19 per cent less likely to snore. And as progesterone levels doubled, women were 9 per cent less likely to snore.

Within the group of women who snored, there was a 20 per cent drop in the chances of having irregular breathing as oestrogen levels doubled. And a doubling in progesterone levels was linked to a 12 per cent lower likelihood of waking up feeling like they are choking.

PLoS One DOI: 10.1371/journal.pone.0269569

People who have been pregnant or have breastfed a baby are less likely to experience an early menopause. This may be because ovulation is temporarily stopped during pregnancy and slowed down during breastfeeding, maintaining a reserve of eggs for longer.

The team found that people who had experienced pregnancies that lasted at least six months had a lower risk of experiencing an early menopause – defined as menopause before the age of 45 – than those who hadn’t.

“We observed a linear trend,” says Langton. “Women who had one pregnancy had an 8 per cent lower risk, those who had two pregnancies had a 16 per cent lower risk, and those that had three pregnancies had a 22 per cent lower risk.”

The link isn’t explained by infertility, says Langton. Her team accounted for this by removing people who had reported that they were trying to conceive but hadn’t become pregnant from the study sample. “There was no difference in the results,” says Langton.

Breastfeeding also lowered the risk of early menopause. People who breastfed for a total of seven to 12 months over their lifetime who had any number of infants were 28 per cent less likely to experience menopause before the age of 45 than those who had breastfed for less than a month. Those who exclusively breastfed for a total of seven to 12 months over their lifetime and who had three pregnancies had a 32 per cent lower risk of early menopause.

JAMA Network Open DOI: 10.1001/jamanetworkopen.2019.19615

Social stress may release hormones that affect bone loss, a finding that might be linked to the higher incidence of bone fractures after the menopause.

In a study of more than 8000 women aged 50 to 79, researchers found that those who reported higher levels of social stress – defined as strained relationships or stress related to social ties – were also at higher risk of bone fractures.

Women who reported high social strain and poorer quality relationships – and therefore, higher levels of stress – were found to have a larger decline in their bone density measurements over these years.

After adjusting for age, race, education, and other life style effects such as smoking and hormone therapy use, the team found that for each point of higher social strain as measured by the questionnaires, there was an associated increase of about 0.08 per cent loss of bone mineral density at the femoral neck – a portion of the hip. They also saw about 0.1 per cent greater loss across the whole hip, and about 0.7 per cent greater loss at the lower spine.

Previous research found that higher levels of stress hormones such as cortisol were associated with lower bone mineral density in the spine, and the team suggests that social stress may increase fracture risk by altering bone-regulating hormones.

Postmenopausal women may be more likely to experience social stress than their male peers. “There is research showing that social stress is higher in aging women than in men and this may be attributed to women being more likely to be caregivers in older age,” says Follis.

The team found that women with low social strain tended to be more educated and more physically active than those with high social strain. Black, Latina, and Native American women were more likely to report high social strain than White and Asian women.

What kind of hot flasher are you?

The hot flash — that sudden feeling of warmth that can leave a woman flushed and drenched in sweat — has long been considered the defining symptom of menopause. But new research shows that the timing and duration of hot flashes can vary significantly from woman to woman, and that women appear to fall evenly into four hot-flash categories.

Some women, called “early onset” hot flashers, begin to experience hot flashes long before menopause. Symptoms can begin five to 10 years before a woman’s last period, but the symptoms stop around the time of the final menstrual cycle.

Then there are women who don’t experience their first hot flash until after their final menstrual period, the “late onset” hot flasher. And some women fall into a group the researchers called the “lucky few.” Some of these women never experience a single hot flash, whereas others briefly suffer only a few flashes near the end of the menopausal transition.

And then there are the “super flashers.” This unlucky group includes one in four midlife women. The super flasher begins to experience hot flashes relatively early in life, similar to the early onset group. But her symptoms continue well past menopause, like those in the late onset group. Her symptoms can last 15 years or more.

For some women, reaching the menopause can be one of life’s milestones, but when it will happen is a big unknown. Now a blood test can help predict when a woman’s last menstrual period is likely to be.

The test, called MenoCheck, can’t give a firm date, but it can tell women who are over 47 if they are likely to stop having periods within the next year. It would be most useful for those considering being sterilised or having surgery for painful or heavy periods, says Nanette Santoro at the University of Colorado Medical School in Aurora. “They may be wondering how much longer they have to put up with this.”

The average age at which menopause occurs is 51, but in most cases, it can happen any time from a person’s forties to early sixties. Periods usually become more infrequent before stopping for good. They stop because the ovaries run out of functioning eggs, which leads to lower levels of anti-Mullerian hormone – a chemical made by eggs – in blood.

Previous tests haven’t been able to measure the very low levels of anti-Mullerian hormone present in the year or two before menopause. But MenoCheck, which has been on sale for about a year, is more sensitive. To see how well it does, Santoro’s team used it on blood samples taken at yearly intervals from about 1500 women taking part in a different menopause study. Santoro is a consultant for MenoCheck’s manufacturer Ansh Labs.

The team found that those over 47 whose anti-Mullerian hormone level was below a certain cut-off had a 67 per cent chance of having their last period within the next year, and an 82 per cent chance of having it within two.

Most women wouldn’t need to take the test to know that they are nearing the menopause, says Esther Eisenberg at the US’s National Institutes of Health.

Yet without it, women can only be advised that if their periods have started to become irregular, they are likely to stop completely within four years, says Santoro.

Menopause is associated with increased risks for cardiovascular disease, osteoporosis, and cancer. Many women experience declining energy, mood, cognitive function and memory during

Rhodiola rosea extracts have been shown to enhance mood, cognitive function, and memory. Moreover, these extracts possess anti-stress, neuroprotective, cardiovascular-protective, and anticarcinogenic properties, which are particularly valuable to counteract some of the common health risks seen in women as they age. R. rosea is low in side effects compared to synthetic selective estrogen receptor modulators (SERMS).

Preclinical and clinical studies suggest that R. rosea extracts provide a combination of effects that could counteract the adverse consequences of estrogen decline by improving neurological, endothelial, and cardiovascular functions.

As a natural SERM, R. rosea could alleviate menopause-related symptoms while conferring additional neuro-protective, cardio-protective, anti-stress, anti-fatigue, osteoprotective, and other health benefits.

Unlike HRT, preliminary evidence indicates that orally ingested R. rosea extracts are unlikely to cause estrogenic effects or increased the risk of cancer in hormone sensitive tissues. R. rosea extracts and salidroside do not significantly stimulate, but rather inhibit growth of human breast cancer in vitro and in vivo in some studies. Human studies are needed to verify the safety of R. rosea in postmenopausal women who are at increased risk or who are being treated for breast cancer.

Further research on the use of R. rosea alone and in combination with other adaptogens during menopause would enable development of this promising alternative SERM.

Underlying causes:

» carbohydrate overload
» low metabolic flexibility

First things first – what is menopause?

Most women become aware of the menopause from the stories told about the debilitating symptoms that it brings – hot flushes, night sweats, insomnia, depression – the list goes on and on and at least 30 different symptoms have been recorded. It seems that future health becomes uncertain, with little understanding or explanation of what is to come.

There is also a confusion with the wording, with various terms used interchangeably so that no-one really knows how to talk about it. There’s peri-menopause, menopause and post-menopause, to the point that “The word “menopause” tends to be used as shorthand for “all the crap that goes on while your ovaries gradually crinkle into useless raisins.”

The medical definition of the menopause is when a woman stops having her monthly period for 1 year. It typically occurs in a woman’s late 40s to early 50s as a normal part of ageing and marks the end of reproductive years. The process is gradual and is usually described in 3 stages:

Peri-menopause or the menopausal transition:

Peri-menopause can begin 8 to 10 years before menopause, when the ovaries gradually produce less oestrogen. It usually starts in a woman’s 40s, but can start in the 30s as well. Peri-menopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last 1-2 years of peri-menopause, the drop in oestrogen accelerates. At this stage, many women can experience menopause symptoms. Women are still having menstrual cycles during this time, and can get pregnant.


Menopause is the point when a woman no longer has menstrual periods. At this stage, the ovaries have stopped releasing eggs and producing most of their oestrogen. Menopause is diagnosed when a woman has gone without a period for 12 consecutive months.


These are the years after menopause. During this stage, menopausal symptoms, such as hot flashes, can ease for many women. But, as a result of a lower level of oestrogen, postmenopausal women are at increased risk for a number of health conditions, such as osteoporosis and heart disease.

This sounds like it should be an orderly transition from the hormonal storms of periods to the calm seas of… but many women are suffering with symptoms of sexual dysfunction, insomnia, hot flashes, night sweats, a lack of overall well-being, anxiety and brain fog to name just a few.

In some women these symptoms are mild; others have symptoms that are mild but go on for a long time; other women go through a couple years of difficulty; and then there are women who have symptoms well into post-menopause; and some who just sail through the whole thing.

I can’t think of any other health condition where the range of symptoms is so vast and the response is so varied. Oestrogen affects every part of the body and so when it starts declining, all hell breaks loose. The effects of oestrogen withdrawal have been studied in virtually every body system, including the heart, bones and skin, but none of these investigations have explained the origin of the symptoms that women suffer with the most – the hot flushes, the night sweats, the anxiety – what is it about oestrogen declining that causes those symptoms?

It’s not an oestrogen problem – it’s an energy problem

It’s a little known fact that oestrogen is a sugar-burning hormone – it allows us to use carbohydrates as sugar energy. By the time we are post-menopausal, the low level of oestrogen allows us to only derive about 20% of energy from sugar and carbohydrates, compared to 100% pre-menopause.

As oestrogen levels start to decline in peri-menopause, the use of carbohydrate for energy becomes more and more impossible. This means that your brain and the body are starving, while excess sugar is quickly converted to fat. This means:

  • You start feeling tired, all the time;
  • You’re getting fatter – high levels of blood sugar causes weight gain as unused sugar is converted to fat;
  • Your brain is deprived of energy which leads to brain fog, depression, memory loss and possibly eventually dementia;
  • Your starving brain activates the fight or flight response causing an adrenaline rush to release high amounts of glucose from the liver into the blood stream – this causes hot flushes in the daytime and night sweats at night, and leads to more weight gain;
  • Adrenaline rushes at night mean that going to sleep and staying asleep becomes difficult;
  • Adrenaline rushes create anxiety which can lead to panic attacks;
  • High adrenaline destabilises potassium balance which means the heart can’t function properly and this leads to heart palpitations.

The menopausal energy switch: sugar burning is switching off and fat burning is ramping up

It is now well established that menopausal symptoms are directly related to sugar metabolism that is mediated by oestrogen. If you continue eating a high carbohydrate diet – e.g. oats, rice, pasta, bread, potatoes – you will end up with high blood sugar, high cholesterol, fatty liver, inflammation, weight gain and experience debilitating fatigue, brain fog, anxiety, heart palpitations and a myriad of other problems. 

To get rid of all these symptoms, you need to switch to burning fat for energy. Fat burning does not require oestrogen, and is freely available in your body. When sugar intake is low, your body converts fat to ketones, which are an alternative clean energy source. A low sugar – or low carbohydrate – diet encourages your body to switch from using glucose as a primary fuel source to burning body fat and using ketones for fuel.

This metabolic switch is the process that underpins the whole menopausal transition. This is what prevents the brain and body from starving as your oestrogen level is declining. The metabolic switch is a mechanism that compensates for energy that oestrogen has stopped providing. This is what you need to harness to reach optimum health in middle age and beyond.

Get your life back: at least 75% menopausal symptoms can be reversed in 6 weeks just by making different food choices

Once you become a fat burner, the results are stunning. In my clinic, I have reversed at least 75 of symptoms in just 6 weeks through a specialised nutrition plan, resulting in:

  • zero hot flushes
  • zero night sweats
  • clear, pin sharp, sustained focus and memory
  • easy solid sleep
  • solid weight loss til you achieve your target weight
  • feeling calm and relaxed
  • feeling energised from the moment you wake up
  • pain-free joints
  • normal heart beat

Do we need HRT?

Women are suffering in menopause and the treatment for that suffering, HRT, is stuck in the 1960s. Feminine Forever, a book promoting HRT published in 1966 by Robert A Wilson, proclaims that it is “a fully documented discussion of one of medicine’s most revolutionary breakthroughs – the discovery that the menopause is a hormone deficiency disease, curable and totally preventable and that every woman, no matter what her age, can safely live a fully sexed life for her entire life”. He went on to say that because the oestrogen level in a woman’s body dropped after menopause, postmenopausal women who didn’t receive treatment were no longer truly female. Or feminine. Panicked women took up HRT in their thousands.

But just consider the fact that oestrogen dropping is normal. That is our natural programming. And our natural programming does not include suffering, as evidenced by millions of women worldwide who are sailing through menopause without a single problem, or HRT.

HRT may be useful for women who have gone through premature ovarian insufficiency early on in life, but if you are making the transition in your late 30s or early 40s, you only need to change what you are eating.

Change what you eat and flip the energy switch!

You can flip the menopausal energy switch, but doing it on your own is hard. Choosing the right foods can be a difficult process of trial and error. Yes low carbohydrate is the way to go, but which carbohydrates, and how low? Supplements can help but which ones are right for you?

I have spent the last 6 years developing and refining this approach to menopause. It is based on scientific evidence and the experiences of hundreds of women. It is always available in clinic, and periodically available as an 6 week group course named Menopause Rehab.

My approach provides the right combination of alkaline foods, appropriate carbohydrates, protein and fats to make the menopausal metabolic switch easy and fast, which means that symptoms reverse quickly and you can get on with your life. Additionally you will be given solutions to take care of heart health, bone health and vaginal issues.

By making a few simple modifications to your diet, you can completely change your experience of menopause and transition through this life phase healthier than ever. This new way of eating burns fat instead of storing it, reduces inflammation and nourishes your body to restore energy, vitality and health for years to come

Reversal of severe brain fog in a 59 year old woman who’s ambition was to climb a mountain.


The most well known symptoms in menopause are hot flushes and night sweats, but the most common are fatigue, anxiety, brain fog and weight gain.

In women following an inappropriate diet, oestrogen declining leads to a severe energy deficiency in the brain and body, leading to ALL these symptoms.

I have developed a protocol that can reverse this energy deficit – and reduce symptoms by 75% – with nutrition alone in 8 weeks.


LM was 59 years old when she came to see me asking for help with severe menopausal symptoms. Her most significant concerns were severe brain fog, low energy and wanting to get fit to do a trek.

She said:

“I have always had a busy, active life and enjoyed walking and cycling holidays. Now when I have an active day at work I get home exhausted and sleep most of the evening. I find I have a ‘fog’ in my brain which makes it difficult to work especially as I have several ongoing responsibilities at any one time. This year I am transitioning to retirement and I want my energy back in order to enjoy it.”

LM had gone up a dress size in the last year and although she had cut down on eating biscuits and cakes, this didn’t make any difference to her weight. She was still having some hot flushes and night sweats. She regularly fell asleep straight after dinner and was tired in the daytime. She wanted to do regular exercise to prepare for the trek that she planning, but she just didn’t have the energy to do it. 

Health history

  • LM had been on the pill for 20 years 
  • Peri-menopause started when she was about 50 and she had her last period at 53 
  • She started noticing menopausal symptoms around 4 years previously

Nutrition history

  • LM’s diet was high in sugar and carbohydrates: typically cereal with fruit, or porridge with sugar for breakfast, bread and soup for lunch, and frequent rice or pasta dishes for dinner. 
  • She always had a desert such as cake or ice cream or biscuits after lunch and dinner. 
  • She frequently snacked on fruit, dried fruit or biscuits. 
  • She drank little water and 5-7 cups of tea with milk every day

Menopause type analysis

  • 64% of symptoms were associated with oestrogen metabolism 
  • Progesterone was fine 
  • Testosterone was possibly low

Significant test results

Vitamin DSevere deficiencyLow immune function, skeletal concerns
Liver enzymesHighImpaired liver function

Root cause analysis

During the menopausal transition and post-menopause, a woman’s body is switching from using sugar as an energy source, to using fat. Hence menopausal symptoms are not really an oestrogen deficiency problem, they are an energy deficiency problem. 

LM’s diet was too high in sugar for this phase in her life. Her body was converting her dietary carbohydrates to fat, and at the same time it she was not able to burn fat for energy. This meant that her brain and body were starving for energy, leading to severe brain fog, weight gain, hot flushes, night sweats and feelings of severe exhaustion. 

Her high sugar intake was affecting her liver, possibly leading to a fatty liver, and at the same time her vitamin D deficiency was lowering her brain function and preventing restful sleep.



  • I recommended MenoKeto, a nutrition formula that I have developed through my clinical practice that is ideal for women in peri-menopause and menopause;
  • LM was provided with a range of suitable recipes and meal plan suggestions. 
  • LM was asked to follow my 7 food rules as closely as possible. 


  • Vitamin D: calibrated dose of emulsified vitamin D drops



  • 0 – none
  • 1 – mild
  • 2 – moderate
  • 3 – severe
SymptomsWeek 1
Hot flushes2
Night sweats2
Vaginal dryness2
Pain with intercourse2
Poor memory2
Foggy thinking3
Mood swings1
Sleep disturbance2
Hair loss1
Weight gain2
Decreased sexual desire2
Decreased sexual arousal2
Decreased sexual response2
Total score34

Results: follow-up 2 (+8 weeks)

  • LM reported that she was feeling much better and the brain fog had completely lifted. She was able to multi-task with ease, and she happily started and finished writing work proposals on time and with pleasure. 
  • Her energy was back and she had started going to pilates classes, as well aiming to go swimming 2-3 times a week, and starting Tai Chi. 
  • She found the nutrition recommendations easy to follow and had upgraded her meals. 
  • She was now only eating 2-3 meals a day without any cravings or energy dips in the daytime. 
  • LM’s nutrition and supplements were further adjusted for the next 3 months to ensure complete remission of symptoms.



  • 0 – none
  • 1 – mild
  • 2 – moderate
  • 3 – severe
SymptomsWeek 1Week 8
Hot flushes20
Night sweats20
Vaginal dryness21
Pain with intercourse20
Poor memory20
Foggy thinking30
Mood swings10
Sleep disturbance20
Hair loss10
Weight gain20
Decreased sexual desire21
Decreased sexual arousal21
Decreased sexual response21
Total score346
Symptoms reduced by 82%

My specialist menopause plan concentrated on my nutrition and had supplements personalised to me to support me – it has seen my whole health and mindset change.


My review

I was delighted for LM, she cognitive function was excellent and she had more than enough energy in day, enough to start training for her mountain trek.

No woman should be suffering through menopause and the main change that needs to made is nutrition.

I am sick to death of hearing women should focus on cardio exercise and leave strength training to men, says Dr Bernadine Jones.

Rose George writes about women’s exercise plummeting (Pandemic knocked you off your stride? An active woman’s tips for getting fit again, 26 July). The NHS wants us to vigorously run and moderately mow the lawn,, and then also strength train twice a week. Those of us who do all the housework and all the career-aspiring thinking work and then all the childcare would like to know where this time could be retrieved from? Often, we are pointed to spin classes and 2kg dumbbells and told “you can fit in a run in the morning”.

Here’s another solution: three times a week, after you deal with the kids and before work, lift a barbell loaded with two 25kg plates (or whatever you can manage) for 30-45 minutes, and then down a protein shake. Do the same thing every week, just a wee bit heavier. Ignore the “fitfluencers” doing donkey kicks while jumping with 50kg dumbbells. It doesn’t need to be fancy. You don’t need to be bathed in sweat. You don’t need to spend an hour hating yourself on a treadmill. You don’t even need to get that tired.

I am sick to death of hearing how women should focus on cardio and leave the weight room to the men. We end up intimidated and unsure of ourselves, sticking to the step class when our bones are crying out for heavy resistance. There is increasing evidence that women need resistance and strength training to stave off osteoporosis post-menopause. It certainly doesn’t need to be an either/or situation, but if you’re short on time, consider the barbell and lift slightly heavier weights each week. Your joints, your children and your 80-year-old self will thank you.

Dr Bernadine Jones

Steroid hormones regulate metabolic flexibility at the level of the mitochondria. Estradiol, the most frequently studied among the steroid hormones, plays a pivotal role in determining how food fuel is converted into cellular fuel or ATP. 

When we eliminate estradiol with medications such Lupron and other GnRH agonists or antagonists, or when we remove a woman’s ovaries, depleting her primary source for estrogen synthesis, metabolic flexibility diminishes significantly.*  

With the lack of metabolic flexibility comes a number of health issues, some noticeable, like weight gain, and others less noticeable, at least initially, like cardiac and neurodegenerative diseases.


Supplementation with myo-inositol may be considered a reliable option in the treatment of metabolic syndrome in postmenopausal women.

The aim of this study was to evaluate whether myo-inositol, an insulin-sensitizing substance, may improve some features of metabolic syndrome in postmenopausal women.


Eighty postmenopausal women affected by the metabolic syndrome were enrolled prospectively in the study and treated with diet plus supplementation of myo-inositol (2 g BID plus diet: intervention group) or with diet plus placebo (control group) for 6 months. They were evaluated at baseline and after 6 months for insulin resistance (homeostasis model assessment ratio [HOMA] insulin resistance), lipid profile, and blood pressure.


Myo-inositol plus diet improved systolic and diastolic blood pressure, HOMA index, cholesterol, and triglyceride serum levels with highly significant differences, compared with the groups treated only with diet and placebo. In the group treated with myo-inositol, a decrease in diastolic blood pressure (−11%), HOMA index (−75%), and serum triglycerides (−20%) and an improvement in high-density lipoprotein cholesterol (22%) were shown.


Supplementation with myo-inositol may be considered a reliable option in the treatment of metabolic syndrome in postmenopausal women.

‘I look at the clock… it’s 3am’: Why can’t women sleep?

…A new book from the US … appears at first glance to be more of a feminist manifesto for Generation Xers than a self-help manual for insomniacs. On closer inspection, though, a picture starts to form that’s recognisable to any woman who is knee-deep in the mothering, marriage and career years. Disregarding the generational focus of the book’s premise, it offers, not a cure, but insight and some unpalatable news about the lives of women today. Every right we’ve earned, every advance we’ve made, every career we are now free to embark on continues to co-exist with our near full-time engagement in the oldest job in the world: keeping hearth and home.

Despite a century of emancipation, women still do most of the backstage work that keeps the show on the road. Scratch the surface of this national insomnia pandemic and you discover that inequality is at the heart of the malaise. Aside from sexual politics and headline grabbers, such as #MeToo, most women’s lives aren’t improving quantifiably, they’re just different from 50 years ago.

“It’s great that men and women are equals in the workplace, but what this means in reality is that women are effectively taking on twice the load,” says Dr Elle Boag, associate professor in social psychology at Birmingham City University. “Only too often we do the work, the domestic labour and the childcare (to be fair, sometimes these chores are shared). We’ve adopted this multitasking role and it’s become normative.” So, it’s no surprise that when we go to bed we find we can’t switch off.

…Sometimes my own perimenopausal moods are more rage than anxiety. I woke up the other day and noticed that my husband had placed a couple of champagne corks on top of a picture frame. It made me want to start breaking things. What is this, a goddamned student house? In this state, I noticed things I had missed before: bags spilling out of cupboards, stacks of receipts and change on a table, my son’s stuff everywhere. “It’s like living in Hoarders!” I ranted. If I’d had a pack of matches I could have burned the place down.

When I open the book How to Face the Change of Life with Confidence, published in 1955, I see a question from a woman, 37, who has wild mood swings before she gets her period. The expert male gynaecologist author tells her: “Man reaches physical maturity at 25, and emotional maturity at 35. Unfortunately, you seem to have missed the boat somewhere along the line, and you are still in your childish stage of emotional reactions.”

Decades of that sort of condescension have kept women from asking certain questions twice.

“Almost every woman I know of my age is feeling confused and in a state of transition even as most of us are at the top of our game in our careers, financially stable and pretty comfortable with being parents,” said Yvette, 43, a Californian who is the COO of a video game company. “I spend a lot of time with other friends of my age. We talk about the fact that we are widening and softening where we don’t want to and don’t know if it makes us shallow or not feminists to do something about it; the fear that we don’t know how to monitor our children’s screen time; the fact that we don’t really like or need sex very often; our worry that we are losing time to try our ‘dream’ job.”

Experts in gynaecology maintain that hormone replacement therapy (HRT) remains the most effective scientifically proven treatment for the symptoms of menopause. And yet, fearing the increased risk of cancer, stroke and blood clots that we’ve long heard comes with a hormone therapy regimen, we’ve gone rogue. That, perhaps, is why Gwyneth Paltrow’s online community Goop can get away with selling us expensive jade eggs to stick up our yonis.

Women who have sex more than once a month go into menopause later.

Having regular sex during the perimenopausal and menopausal period can also help make sex less painful with time because it helps keep the vagina open, she points out — so sex sessions on the regular certainly can’t hurt.

A number of things can be going on with your body if you’ve started bleeding after menopause, Julian Peskin, MD, an ob-gyn at Cleveland Clinic, tells Health.

But let’s be clear about one thing: It’s not your period. “If a patient’s postmenopausal, there should be no reason for them to bleed,” says Dr. Peskin. Once you’ve hit menopause, there’s no going back. So don’t try to convince yourself it’s probably just one more period to avoid another doctor’s visit.

In fact, you should definitely get to the doctor as soon as you notice postmenopausal bleeding, says Dr. Peskin. This is because, while some causes of postmenopausal bleeding are relatively harmless, others are more serious. The two that could be more complicated to treat, and potentially fatal, are endometrial cancer and fibroids that have become cancerous. In fact, “one in 10 women who present with postmenopausal bleeding will have endometrial cancer,” says Dr. Peskin. Therefore, you need to immediately get checked out if you’re bleeding down there after you’ve already hit menopause.

That said, the source of postmenopausal bleeding could be something pretty easy to deal with. Examples include benign polyps in the uterus, a vaginal infection, or even certain medications. Dr. Peskin points out that doctors evaluating patients for postmenopausal bleeding should always ask their patients about their medication history because taking hormones can cause irregular bleeding after menopause.

Menopause, despite the fact that it has happened or will happen to every single person with a vagina, is still a pretty confusing milestone—especially for those who experience it.

For the most part, it’s common knowledge that, once a woman stops having her period, then she also stops having the ability to have children. Or at least it was, until news reports highlight that women past childbearing age—like Omaha native Cecile Edge, at 61 years old—are able to give birth to their own grandchildren in some instances.

So what gives? Can you give birth after menopause? Health asked ob-gyns about any misconceptions that may be had around if (and how) someone can give birth after hitting menopause—and what to know about giving birth past childbearing age.


One of the more pervasive, and frankly, annoying myths about menopausal women is that they cannot build muscle after a certain age. The argument goes that as certain hormones decline, so too does the ability to build muscle. On the surface, that seems like a reasonable argument. Indeed, there have been an endless number of studies that suggest hormone decline, in both males and females, negatively influences muscle mass and strength. Ditto for the opposite – increasing certain hormones increases muscle development for both males and females. Why else would we have entire industries devoted to the development of hormones for use in competitive sports and sub-industries whose sole purpose is to find ways to circumvent the detection of those products? Yes, all else being equal, certain hormones impact muscle development more positively in higher concentrations and more negatively in lower concentrations. Does that mean however that hormones are the sole contributors to muscle development, or as the menopausal research always seems to conclude, that the state of diminishing hormone concentrations as we age and move through menopause is enough to hamper or prevent muscle development in women? No. Absolutely not.

Like so many aspects of women’s health research, the connection between declining hormones and declining muscle is spurious at best. It relies on equal parts latent (and no so latent) biases towards women and surrogate markers that may or may not equate directly with muscle and strength. The bias holds that women in general have difficulty building muscle compared to men based upon their unique hormonal makeup e.g. lower androgens and higher estrogens, a difference that is magnified with aging. This bias leads to research questions that essentially presume the answer in the framing of the question. That is, the research asks ‘why women have difficulty building muscle’ across menopause or compared to men and not ‘do women have difficulty building muscle.’ The research assumes that women have this issue, and thus, proceeds show us why. It then uses surrogate markers of this supposed muscle building difficulty, neither defining clearly what constitutes muscle development nor measuring actual muscle development in women who train to build muscle. When the associations between these surrogate markers and the hormone in question is found, usually estradiol, are found, as they so often are, causation is inferred and PR campaigns begin.

This bugs me to no end for a number of reasons, not the least of which, because it is an asinine way to conduct research, but mostly, because it is logically fallacious. We have made the assumption that women have difficulty building muscle and proceed to demonstrate why. Of course, we are going to find some reasons. We can do that with any research design that assumes the answer in the question. It would be no different than assuming all men idiots and designing research to find out why. It is offensive and it is wrong, and yet, this is the standard course of most research. What is that saying – assumptions make asses out of you and me? Well, research like this makes asses out of us all.

These are very real physical changes and conditions. Some symptoms alarm a woman that she may be suffering from a serious disease. Perhaps you know the more common ones related to menopausal symptoms in this list. But many of these may surprise you, as they have not been typically associated with this normal physiological transformation. 

  1. Change in Menstrual Cycle, Cycles may get closer together or farther apart, lighter and shorter in duration or much heavier, lasting longer than one has been accustomed to. Menses may seem to take forever to begin with dark spotting for days until you actually flow, or you might feel like you have your menses every two weeks.
  2. Menstrual Flooding can come on with sudden onset and feel like you may hemorrhage to death. Or it can be a gradual build-up just when you think your menses will end and you start gushing for days. Flooding commonly accompanies the woman with uterine fibroids as she transits into menopause.
  3. Headaches, Migraines, especially before, during or at the end of your menses debilitate and radically interferes with normal functioning.
  4. Decreased Motor Coordination, Clumsiness, almost begins to make the woman who experiences this feel like she is a bit spastic, certainly less than graceful during perhaps an already awkward period in her life. 
  5. Lethargy, a persistent feeling sluggishness physically and mentally, that seems to negate ones ability to do much. 
  6. Physical Exhaustion , and Crushing Crashing Fatigue that can come on so suddenly and grip you into feeling like you will collapse unless you stop this instant.
  7. Exacerbation of any Chronic Illness or Existing Condition transpires as hormones decline or deviate from their normal balance.
  8. Insomnia, this includes a new or unusual pattern of either difficulty falling asleep, or dropping off to sleep for a few hours and then awakening with the inability to return to sleep.
  9. Sleep Disturbances sometimes are from nightmares, night sweats, or just a vague sense of restlessness keeping you up or disrupting your precious revitalizing retreat from this realm of responsibilities.
  10. Night Sweats often begin between a woman?s breasts, initially a night or two before her menses, waking her from sleep, later more profoundly disturbing with up to total body saturation, followed by damp or sweat-drenched chills.
  11. 11. Interference With Dream Recall interrupts the sense of normal sleep, if you are someone accustomed to vivid or at least some detailed memory of your dream time. 
  12. Muscle Cramps can occur anywhere in the body from legs to back to neck, and sometimes reflects the need for more calcium, or simply that your progesterone levels are too low. 
  13. Low Backache often worsens before or during menses, but if your hormones remain at low levels, you can experience it on a regular basis.
  14. Gall Bladder Symptoms of pain, spasms and discomfort felt in the right upper abdominal quadrant under the ribs, which may be accompanied by belching, bloating, and intolerance to certain foods reflect the increased liver load with declining hormones. 
  15. Frequent Urination, or sensations that mimic urinary infections is a disturbing symptom often unrelieved by actual urination. It is often experienced as the sensation of needing to urinate all the time, even immediately afterwards.
  16. Urinary Incontinence, the uncontrollable and spontaneous loss of urine, or the Urge for Incontinence, can occur suddenly or feel continuous, and not only in response to coughing, sneezing, jumping or running. 
  17. Hypoglycemic Reactions happen when suddenly your blood sugar crashes and you must have food now.
  18. Food Cravings, often for sweets or salty foods, but can include sour or pungent foods. 
  19. Increased Appetite, especially at night and after dinner contributes to that unusual and unwanted weight gain.
  20. Dark Circles Under Eyes can also be caused by adrenal exhaustion and thyroid dysfunctions, but no amount of sleep seems to eliminate it. 
  21. Joint and Muscle Pain, Achy, Sore Joints, Muscles and Tendons, which sometimes develop into actual carpal tunnel syndrome, or give rise to the questioning of other disease possibilities.
  22. Increased Tension in Muscles demonstrates itself in those hunched up shoulders as you work or talk about anything uncomfortable, along with promoting lower back pain and a stiff neck.
  23. Increased Hair Loss or Thinning anywhere on body, including your head, armpits, pubic area.
  24. Increase in Facial Hair especially under your chin, or along your jaw line. It may be defined by generalized hair growth, or a specific and coarse single strand of hair that pokes out, even curls. 
  25. Unusual Hair Growth, around Nipples, between Breasts, down your back, places where your hair was finer, less coarse.
  26. Acne, quite disturbing to any woman who dealt with this in adolescence and never thought it would recur. 
  27. Infertility causes grief in the woman who postponed pregnancy in her earlier years and now wishes to conceive, carry to term a healthy baby, and discovers she is unable to do so. 
  28. Loss of Breast Tissue begins with a decrease in progesterone production. Women often feel as though their breast have become empty sacs devoid of their normal fullness, with or without sagging.
  29. Breast Soreness/Tenderness/Pain/ Engorgement and swelling occurs particularly a few days to one week before bleeding actually begins, which usually potentiates complete relief of any pain or swelling.
  30. Painful, or tender nipples have been described as this exquisite localized pain only in the nipples and suggest estrogen excess. 
  31. Cold Extremities feels quite strange especially in the presence of a hot flash, the combination of which is not impossible.
  32. Being Accident Prone, bumping into things, not even realizing it until the bruise reveals itself later and then lacking the ability to recall the causative incident feels perplexing and a little scary at the prospect of something more damaging. 
  33. Hot flashes initially may be described as mild to severe flushes of heat waves, and for some women these evolve into intense outbreaks of sudden heat with sweating and turning bright red all over. 
  34. Loss of Sexual Energy, our Libido, can be marked by a gradual or sudden disinterest in sex, to the development of an actual aversion. 
  35. Painful Sex often described as if one?s vagina would tear open at the point of penetration along with feelings of abrasion during intercourse.
  36. Vaginal Dryness, Irritation, sometimes accompanied by a consistent unusual discharge – typically odor free, negates a woman?s ability to be sexually active, or able to enjoy or be comfortable in her body.
  37. Dizziness, feeling lightheaded and the loss of physical balance, and even a bit wobbling at times, requires pause in movement to prevent falling over or deepening into vertigo or feeling faint.
  38. Ringing in the Ears, Tinnitus, can be experienced as a pulsing sensation, a whooshing sound, an almost musical or buzzing sound with a fuzzy sensation.
  39. Abdominal Bloating comes on suddenly often after eating, or seems to be all the time, and can be visibly evident making you feel that you look like you are pregnant. 
  40. Weight Gain disturbs most women, particularly when it seems to happen over a couple of days, settles in the waist, buttocks and thighs, promoting a visceral thickening from the waist down, the classic middle-aged figure.
  41. Fluid Retention, Edema, commonly with swelling in the legs and ankles, though not limited to this area and it is unrelieved by urination.
  42. Palpitations or Heart Racing usually comes on suddenly, without warning or provocation, and dissipates spontaneously. The experience can be so wild and intense that a woman may become alarmed and wonder if she is having a heart attack. 
  43. Irregularities in your Heart Rate may feel more like your heart has just done a flip-flop or skipped a beat.
  44. Constipation/Diarrhea, intermittent or alternating, results from declining hormone levels, which increase the demands on liver function and alters intestinal motility.
  45. Tendency towards Candidiasis can increase, even if you have no prior known history ? and if you do, it may worsen.
  46. Gastrointestinal Distress, Increased Flatulence, Unrelieved Gas pains, Indigestion, Nausea all can reflect intestinal changes due to hormonal imbalances.
  47. Slow Digestion often goes along with the bloat ? what previously took four to five hours to digest, now seems to take all night. It seems worse in the evenings.
  48. Lack of Appetite may be experienced as more of a lack of interest in food, going to the frig and standing there with the door open and staring blankly. Feeling completely uninspired, you busy yourself with something else and forget that you need to eat.
  49. Changes in Body Odor especially disturbing when it seems to focus in the groin area, but can be anywhere on the body.
  50. Puffy Eyes, not only from sleep disturbances, but also can accompany low progesterone.
  51. Facial Pallor alternating with Facial Flushes is often intermittent with hot flashes.
  52. Flare-up of Arthritis worsens with low progesterone levels and increase sugar intake.
  53. Loss of Bone Density, Osteoporosis, is not only an elderly woman?s disease, though it seems to develop over an extended period and is triggered by the decline of hormone production.
  54. Dry Hair, Change in Skin Tone, Integrity, and Texture, becomes more wrinkled, and may begin the thinning process.
  55. Changes in your Fingernails characterized by easy breakage, bending, cracking and getting softer.
  56. Itchy, Crawly Skin with a strange sensation like insects crawling around under the skin ? quite different than the dry skin feeling.
  57. Muscle tone seems to slack and sag, and lose its previous response to normal exercise.
  58. Pelvic Pain can be random and independent of cycles and may feel continuous for some women.
  59. Dry, Itchy Eyes felt in the deep posterior aspect of the eye socket, as well as superficially.
  60. Teeth Aching or the experience of a strange sensation in one?s teeth or gums, often accompanied by an increase in bleeding gums.
  61. Change in the normal Tongue sensation, which can be accompanied by a feeling of burning in your tongue and roof of mouth, malodorous breath or change in breath odor, and/or a bad taste in your mouth.
  62. Memory Loss or Lapses in time, makes one feel disoriented and less focused, especially when you go into another room to get something specific and seconds later cannot remember what you went to retrieve.
  63. Feeling Faint for no known reason (this does not include standing up too quickly)
  64. Tingling in Extremities not only feels weird and like your hands or feet are falling asleep, but if persistent can be a symptom of diabetes, B12, potassium or calcium deficiency, or a compromise in blood vessel flexibility.
  65. Sensation of Electrical Stimulation, or Shock occurring in the tissue under the skin, and may signal you that a hot flash will begin.
  66. Increase and worsening of Allergies occurs as hormones become imbalanced, so can our immune system.

Metabolic syndrome is a cluster of conditions that occur together, including

  • increased blood pressure
  • high blood sugar
  • excess body fat around the waist, and
  • abnormal cholesterol or triglyceride levels.

Having just one of these conditions doesn’t mean you have metabolic syndrome but as you develop more of these conditions, your risk of complications such as type 2 diabetes and heart disease, rises higher and higher.

Research shows that the more carbohydrates you eat, the more likely you are to have metabolic syndrome:

  • for every 5% intake of energy from carbohydrates, the increase in the risk of metabolic syndrome goes up by 2.6%.


White matter hyperintesities are areas of the brain where damage has occurred to the neurons. These areas are associated with peri/menopausal hot flushes because the brain is starved of energy and is cannibalising itself for energy.

White matter hyperintesities are also associated with dementia and Alzheimer’s but recent research shows that exercise can help to reduce the risks of decreasing brain function:

“…as people age, the presence of Alzheimer’s-related brain changes increases—including the buildup of amyloid, slower breakdown of glucose by brain cells, shrinking of the volume of the hippocampus (central to memory), and declines in cognitive function measured in standard recall and recognition tests.

But they found that in people who reported exercising at moderate intensity at least 150 minutes a week, as public health experts recommend, brain scans showed that these changes were significantly reduced and in some cases non-existent compared to people who were not active. “The association between age and Alzheimer’s brain changes was blunted,” says Okonkwo, “Even if [Alzheimer’s] got worse, it didn’t get worse at the same speed or rate among those who are physically active as in those who are inactive.”


‘They are not mentally ill, antidepressants are not appropriate. Once they have the label, it doesn’t help them,’ says expert.

Hot flushes and night sweats are the most well-known symptoms in peri/menopause, but the most common ones are anxiety, depression and brain fog. So many women who are looking for help get prescribed anti-depressants, despite the fact that:

“Menopause guidelines are very clear that antidepressants should not be given first-line for low mood associated with the menopause because there is no evidence that they will help.”

Editor’s note:

The reason why anti-depressants don’t help is that these medications target neurotransmitters like serotonin. But the loss of brain function that is associated with peri/menopause is not a neurotransmitter problem, it’s an energy problem.

During peri/menopause the brain becomes less and less able to use carbohydrates for energy and switches to mainly using fat for energy. This means that unless a low carb/high-fat diet is being followed, the brain will become starved of energy, leading to anxiety, depression and brain fog.

Switching to a low carb/high-fat diet can resolve brain issues in just a few weeks.

Breathing is information. The more stressed you feel, the faster you breathe, and your brain will notice this and read it as a signal that things are not going well. That fast, shallow breathing which happens when you’re stressed is effectively telling your brain that you’re running from a lion. But the reverse of this rule is also true: if you breathe slowly, you’re giving your brain a signal that you’re in a place of calm. You will start to feel less stressed. Studies have even shown that the right kind of breathing can reduce our perception of pain. Both the pace at which you breathe and how deeply you breathe change your stress response. If all you do for one minute is slow your breathing down and aim for six breaths (one breath is in and out) in that minute, it will reduce the stress state and stimulate the thrive state.

A daily practice of breathing – Breathing practice is especially worth considering if you’re the kind of person who finds meditation difficult. You don’t have to stick to the same practice each time. Play around. Listen to your body. Experiment. I’m sure that, within a few days, you’ll find a technique that works for you. Aim to do at least one of these practices every day. Even one minute per day of focused, intentional breathing can make a big difference.

Postmenopausal women can fight off hot flashes and night sweats by pumping iron, a new clinical trial shows.

“Resistance training is already recommended for all women always, but now we can see it may be effective also for hot flashes around menopause,” Dr. Emilia Berin of Linkoping University in Sweden, who led the study, told Reuters Health.

Determined to enjoy longer and healthier lives, two women researched the science to find the key. Here, they share what they discovered.

When Susan Saunders was 36, her mother was diagnosed with severe dementia. “I had a toddler, a newborn, a full-time job as a TV producer – and I became a carer as well.” As a teenager, she had watched her mum care for her own mother, who had the same condition. “I became determined to do everything I could to increase my chances of ageing well.”

Annabel Streets’ story is similar. When she was a student, her grandfather died from cancer months after he retired; later, she watched her mother care for her grandmother, who lived with dementia and crippling rheumatoid arthritis for nearly 30 years. “When I developed a chronic autoimmune disease, I knew things had to change. But by then I had four young children and there was precious little time for my own health.”

Together, Saunders and Streets started researching the latest science on how to have a healthier, happier old age and how to apply it to their own lives, and blogged about their findings for five years. Their Age Well Project has now been published as a book, compiling almost 100 shortcuts to health in mid-and later life – and Streets and Saunders, who are both in their 50s, say they have never been in better health.

What did they learn?

We tend to think that a loss of mental acuity is just part of getting older — but age is not the only contributing factor to cognitive decline. Our lifestyle also plays a key role. Failing to follow a nutritious diet, a lack of sleep and exercise, ongoing stress, smoking, drinking alcohol excessively and environmental pollutants can all damage our brain cells.

Fortunately, mental deterioration is not irreversible. In fact, the brain is incredibly dynamic and has the potential and the ability to change at any point throughout our entire life – and you have the power to enhance your brain function, protect your brain from damage and counteract the effects of aging! That is, if you’re willing to fuel the brain and tweak your everyday decisions.

Here are 5 small changes you can make in your life that can mean big differences in your cognitive abilities.

It was once thought that hearing loss in older women might be linked to loss of estrogen and progesterone following menopause and that hormone therapy might reduce that risk. Recent results from the Nurses’ Health Study II indicate just the opposite — that late natural menopause and the use of oral hormone therapy are linked to a higher risk of hearing loss.

…Further studies are needed to determine whether hormone use causes hearing loss. As of now, the results, published online May 10, 2017, by the journal Menopause, indicate that hormone therapy doesn’t help to preserve a woman’s hearing.

Hot flashes, undoubtedly the most common symptom of menopause, are not just uncomfortable and inconvenient, but numerous studies demonstrate they may increase the risk of serious health problems, including heart disease. A new study suggests that hot flashes (especially when accompanied by night sweats) also may increase the risk of developing diabetes.

As reported in “Vasomotor symptom characteristics: are they risk factors for incident diabetes?” data was analyzed from the more than 150,000 postmenopausal women who participated in the Women’s Health Initiative (WHI) to confirm that the occurrence of hot flashes was associated with an elevated diabetes risk. Of the total population studied, 33% of the women had experienced hot flashes. Any incidence of hot flashes was associated with an 18% increased diabetes risk, and this risk continued to climb on the basis of the severity and duration of the hot flashes. Moreover, diabetes risk was the most pronounced for women reporting any type of night sweats but only if the onset of hot flashes occurred late in the menopause transition.

Diabetes is a serious health risk currently affecting 15% of women aged 55 years and older. Its incidence is expected to more than double by 2050. Compared with men with diabetes, women with diabetes have a higher risk of being hospitalized for or dying from diabetes and its complications, which makes the timely identification and management of diabetes through lifestyle intervention or medical management critical.

This study showed that, after adjustment for obesity and race, women with more severe night sweats, with or without hot flashes, still had a higher risk of diabetes,” says Dr. JoAnn Pinkerton, NAMS executive director. “Menopause is a perfect time to encourage behaviour changes that reduce menopause symptoms, as well as the risk of diabetes and heart disease. Suggestions include getting regular exercise and adequate sleep, avoiding excess alcohol, stopping smoking, and eating a heart-healthy diet. For symptomatic women, hormone therapy started near menopause improves menopause symptoms and reduces the risk of diabetes.”

As women start to produce less estrogen and enter perimenopause, they are likely to experience a mix of challenging symptoms. These include hot flashes, insomnia, night sweats, vaginal dryness, and mood swings.

Menstrual periods may get lighter or heavier and less regular, but once a woman has not had a period for 12 months, they are in menopause. Then, the symptoms experienced over the previous years begin to subside.

There is a range of vitamins and supplements available to help women manage the symptoms of perimenopause and menopause.

If you feel as though you can’t do as much physically as you’ve gotten older, there may be a reason. Both aging and menopause are known to affect sarcopenia, which is a loss of muscle mass and strength, which in turn affects balance, gait, and overall ability to perform tasks of daily living. A new study is one of the first to link alcohol consumption with a higher prevalence of sarcopenia in postmenopausal women. The study outcomes are being published online today in Menopause, the journal of The North American Menopause Society (NAMS).

Previous studies of postmenopausal women have suggested the beneficial effect of estrogen therapy on muscle mass and function. Because of this, it is believed that postmenopausal women are more vulnerable to sarcopenia. Although alcohol is known to inhibit skeletal muscle protein synthesis, few studies have examined the relationship between sarcopenia and alcohol-drinking patterns.

…Study results published in the article “Associations between high-risk alcohol consumption and sarcopenia among postmenopausal women” show that the prevalence of sarcopenia was found to be nearly four times greater for the high-risk, alcohol-drinking group than the low-risk group. 

…With this study suggesting that more muscle loss leads to sarcopenia and other studies suggesting that even one drink of alcohol may increase the risk of breast cancer, postmenopausal women should limit their alcohol intake.”

A new study of more than 2,000 perimenopausal and menopausal women showed that moderate-severe vasomotor symptoms (hot flashes or night sweats) were an independent and significant risk factor for moderate-severe depression. Researchers explored the controversial link between hot flashes and depressive symptoms by focusing on more severe forms of both conditions and concluding that there is likely a common underlying cause, as reported in an article published in Journal of Women’s Health, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The article is available free on the Journal of Women’s Health website until May 18, 2017.

Data presented in the article entitled “Moderate-Severe Vasomotor Symptoms Are Associated with Moderate-Severe Depressive Symptoms,” demonstrate that among a group of women ages 40-65, those with moderate-severe hot flashes were significantly more likely to have moderate-severe depression than women with no or mild vasomotor symptoms. Roisin Worsley, MBBS, Robin Bell, PhD, Pragya Gartoulla, Penelope Robinson, and Susan Davis, MBBS, Monash University, Melbourne, Australia, found hot flashes, depressive symptoms, and use of antidepressant medication to be common in the age range of women included in the study. The researchers also examined whether or not moderate-severe depression was associated with a greater likelihood of psychotropic medication use, smoking, or binge drinking at least once a week.

You think the menopause signals the end? For these four women, it was only the beginning. Here they share their stories about how the menopause. was the trigger to improve their lives, careers, relationships and even sex lives…  

Hot flushes, mood swings and a diminished sex drive. The menopause s seen as a pretty miserable time for women – but new research suggests that it can actually trigger bursts of energy, creativity, and even renewed intimacy.

According to a recent survey by the Cleveland Medical Centre in Ohio, women in their 50s and 60s have more satisfying sex lives than younger women, and a report from the small-business support group Enterprise Nation revealed that more than half of new businesses started last year were set up by people over 46….

The menopause is so often regarded as a negative experience, but it can be a new chapter in which many women find themselves with a new lease of life.

The rush of energy and increased confidence that women can experience can be the perfect springboard for pursuing long-held ambitions or new dreams, whether that’s embarking on a new career, taking up a new sport or hobby, or simply taking the time to focus on feeling your best.

Here we speak to women about the greater self-assurance that comes with menopause – and what it inspired them to do.

Clare, 52, Hertfordshire

“For me, this stage in my life has signalled new beginnings and a desire to try new things. Just after I turned 50 I decided to take up a part-time gardening course at a local college. I loved it so much I then took a sabbatical from my retail job to do a year-long course full time, and was awarded horticulture student of the year for my level. As well as learning a new skill I’ve made lots of new friends and it’s really boosted my confidence. It has been a very positive experience and I’m now looking into pursuing gardening full time.”

Almost 4,000 women in the UK undergo operations each year to remove their ovaries. The procedure, which triggers the menopause, is often carried out on younger women to prevent cancer.

But now scientists from Toronto University have linked the surgery with a reduction in memory and thinking skills.

Experts fear this may eventually lead to early-onset dementia for many women, and even to Alzheimer’s.

The therapeutic benefits of omega-3 fatty acids – which are abundant in certain fish oils – have long been known. In the 1950s, upon the discovery that omega-3 improves brain development, cod liver oil was given for free to young children, pregnant women, and nursing mothers. In the 80s, scientists reported that eskimos enjoy better coronary health than their mainland counterparts as a result of their fish rich diets. And in 2009, a study published in the Menopause journal suggested that omega-3 helps reduce the frequency of hot flushes in menopausal women.

 As you can see, the hype that surround omega-3 is warranted, and not something to be shied away from.

 The Truth About Fats

Many women are concerned about fat, and wrongly believe that consuming fat will make them overweight. The truth is, however, that an extremely low-fat diet won’t regulate your weight – and it certainly won’t enhance your health. Fat can be hugely beneficial in the right form, and by consuming fatty acids such as omega-3, you will surely be more healthy.

Research has confirmed that omega-3 fatty acids may have an excellent effect on impacting degenerative diseases, such as heart disease, rheumatoid arthritis, hypertension, Alzheimer’s disease, diabetes, and many more. As for menopause, omega-3 fatty acids contain anti-inflammatory properties shown to have a positive effect on many of the symptoms associated with “the change”.

What can omega-3 help with?

Because of its wonderful properties, omega-3 can greatly help women during menopause. It helps treat a range of menopausal symptoms, such as:

  • Hypertriglyceridemia– Postmenopausal women may have higher triglyceride concentrations than premenopausal women, exposing them to increased risk of coronary heart disease. As  omega-3 offers a triglyceride-lowering effect, many practitioners recommend menopausal women obtain a bare minimum 1g/day as provided by your diet or supplementation.
  • Joint pain/menopause arthritis– Omega-3 fats can reduce inflammation, which may help relieve joint pain and stiffness related to menopause arthritis. Omega-3s work in a similar way as non-steroidal anti-inflammatory drugs (NSAIDs).
  • Menstrual pain – As part of your ovaries’ frustrating grand finale, perimenopausal women often experience strong menstrual pain and cramping. This pain is often caused by substances called prostaglandins, which come in both “good” and “bad” form. Menopause promotes the bad kind, while  omega-3 fatty acids promote the good kind.
  • Depression– Women are twice as likely to suffer depression compared with men, and the risk is even greater following menopause. Irritability and sadness are common emotional symptoms of menopause, but omega-3 may effectively alleviate these symptoms. Omega-3s work to improve mood and restore structural integrity to brain cells that are critical in performing cognitive functions.
  • Osteoporosis– An increased intake of omega-3 acids increases bone mineral content and produces healthier, stronger bones. As menopause can increase a woman’s risk of developing osteoporosis due to a drop in oestrogen levels, omega-3 fatty acids should be an essential part of a menopausal diet.
  • Hot flushes– The frequency of hot flushes in women going through menopause can vary from as little as once a week to every 30 minutes. Some hot flushes last minutes, while others a mere few seconds. Studies have shown that while omega-3 may not affect the intensity of hot flushes, it can halve the frequency of hot flushes with the right dosage.
  • Vaginal dryness– Fatty acids help to lubricate the body in general, therefore helping with dryness of the vagina – a common symptom of menopause.

Postmenopausal women with a more diverse population of gut bacteria may be more efficient at breaking down estrogen, a new study suggests. Because estrogen plays a role in causing breast cancer, researchers speculate a healthy bacterial population may lower the risk for cancer.

“The composition and diversity of the intestinal microbiota were associated with patterns of estrogen metabolism that are predictive of the risk of breast cancer in postmenopausal women,”

Estrogen is metabolized in the liver and in other tissues such as the breast, yielding fragments that are excreted in urine or, through bile, into the gut. Gut microbes can degrade these metabolites, allowing them to be reabsorbed into the bloodstream and further recycled in the liver. Dr. Fuhrman and colleagues suggest that women whose gut bacteria more efficiently process estrogen may have a lowered risk for breast cancer.

Postmenopausal vulvovaginal atrophy is associated with age-related changes in the vaginal microbiome, with a shift from Lactobacillus-dominated strains in premenopause to a predominance of anaerobic organisms, new research shows.

“We have not yet identified specific interventions, but we are interested in pursuing personalized selections of probiotics and prebiotics for a given woman,” said lead investigator Rebecca Brotman, PhD.

“We have been advocating probiotics or prebiotics to improve vaginal health for almost 30 years,” said Gregor Reid, PhD.

“I 100% support the conclusions of this work. It is nice to see confirmation of work we published in 2011, with an aberrant microbiota associated with some cases of vulvovaginal atrophy,” Dr. Reid told Medscape Medical News (PLoS One, 2011;6:e26602).

Brain imaging and gene analyses in twins reveal that white matter integrity is linked to an iron homeostasis gene.

Iron deficiency is a well-known cause of impaired cognitive, language, and motor development, but a report out today (January 9) in Proceedings of the National Academy of Sciences reveals that even in apparently healthy young adults, variations in iron levels correlate with variations in brain structure integrity.

“[The researchers] make a very interesting connection between the issue of iron metabolism and the integrity of white matter, more specifically myelin”—the cellular sheath that enwraps and insulates neuronal axons—said George Bartzokis of the University of California, Los Angeles, who was not involved in the study.  “This would have been predicted by what is known about myelin, because it actually contains a lot of iron, so it is important that [they have] directly demonstrated this in humans with imaging.

Overweight women who experience hot flashes—the uncomfortable flushing and sweating spells that accompany menopause—may be able to cool those symptoms by losing weight, a new study suggests.

“If you’re a woman who is overweight or obese, you can substantially improve your hot flashes by losing weight through diet and exercise,” says Alison Huang, MD, the lead author of the study and a professor of internal medicine at the University of California, San Francisco.

“Weight loss isn’t just something that will benefit your long-term health 10, 20, or 30 years from now,” she adds. “It can make a real difference in your symptoms and quality of life right now.”

Previous research has shown that women with higher body-mass indexes (BMI) tend to experience worse hot flashes. Until now, however, few studies have tried to measure the immediate effect that weight loss has on symptoms.

Psychologists are helping women sidestep the stereotypes associated with menopause and transform this developmental passage into a vital new phase of life.

… In a 2008 qualitative study in the Women’s Studies International Forum (Vol. 31, No. 4), for instance, 21 midlife Australian women reported greater confidence and wisdom, more time for themselves, and greater self-awareness and self-worth, despite some sadness about ageing. Likewise, a 2008 article in Maturitas (Vol. 39, No. 1) by University of Copenhagen physician Lott Hvas, MD, found that about half of the 393 women who answered an open-ended questionnaire about menopause described positive aspects of the experience, including a time of well-being following menopause and relief at no longer having to deal with menstruation. They also recognized the possibility of personal growth and greater freedom to concentrate on their own lives.

…. “Clarity, decisiveness, emotional intelligence, the ability to discern the truthfulness of others — all of that tends to ramp up in your fifties,” says Gearing, who sees many female executives of this age in her practice.

More forgetful? Not thinking as clearly? Simple arithmetic coming more slowly? Worried that mental functions are worsening? Are the processes of ageing catching up? There is much that can be done to prevent worsening mental functioning and memory loss. For some, memory loss heralds the onset of dementia. Regardless of a person’s occupation or social environment, loss of memory is the most feared consequence of ageing…

…Specific nutritional interventions and nutritional supplements can help to detox and protect individual cells of the brain and nervous system.

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Connecting women, science and spirit, the Gynelogic Sunday Supplement delivers a bi-monthly dose of  news, views and reviews, as seen through my lady lens.