Exercise has been shown to be beneficial, and there’s evidence to show that women who regularly exercise have fewer symptoms. Some forms of exercise are better than others. Sustained aerobic exercise (think jogging, spinning and brisk walking) is ideal, rather than HIIT (high-intensity interval training) which may increase hot flushes post-exercise, because of the increase in cortisol that it generates. So, moderate-intensity workouts are a better idea if you’re struggling with hot flushes or sleeping at night.

Resistance training (i.e. strength training), is important to help reduce the risk of bone mineral density loss and muscle mass loss during menopause. Good muscle strength helps support joints that may be feeling achy during menopause and will help to increase our resting metabolic rate (and thus keep the pounds off).

Some women report feeling better with open water swimming, and many women find Pilates helps with their core strength and pelvic floor, whilst others find that yoga is a great way to reduce stress and anxiety.

There’s no ‘one size fits all’ when it comes to exercise, so find something you enjoy doing, and ring-fence time in your busy week to ensure it happens.

During menopause, the drop in oestrogen causes a slowing in our metabolism and our bone mineral density declines. A study has shown that women who eat more dairy and protein post-menopause will have higher bone mineral density levels than those who have dairy-free or low-protein diets: https://www.sciencedirect.com/science/article/pii/S0002916522047839?via%3Dihub

Tryptophan, which is an amino acid found in milk can also aid restful sleep – particularly staying asleep.

Foods that are high in omega-3 fatty acids (such as salmon, mackerel, walnuts, flax seeds and chia seeds) help to reduce the risk of coronary artery disease (which increases as we go through menopause).

Whole grains and foods high in fibre and B vitamins (such as whole wheat bread, quinoa and rye-based foods) have been shown to reduce severe menopausal symptoms, and women who eat more fruits and vegetables also have fewer menopausal symptoms.

It’s helpful to reduce your intake of caffeine if you’re experiencing hot flushes and sleep disturbance, and reducing alcohol can also aid sleep and reduce the emotional impact of menopause.

There is a small amount of medical evidence that some herbal treatments can help relieve hot flushes. The best evidence is for Red Clover and Black Cohosh, however, the products which are available to buy vary in their effectiveness and potency. We also don’t know how they interact with other medications and they are not normally safe for women with breast cancer to take.

Cognitive behavioural therapy (CBT) can help some women cope with mood swings and anger, as well as low mood and sleep problems. Mindfulness training has also been shown to reduce anxiety and irritability for women going through menopause and help lessen the impact of hot flushes.

There are some women for whom HRT is unsuitable, e.g. women who have had oestrogen-dependent cancer such as breast cancer, and some types of gynaecological cancers.

Medications which can help treat menopausal symptoms and which do not involve HRT include some antidepressant medications, e.g. Venlafaxine, Paroxetine, Fluoxetine, Sertraline, Escitalopram or Citalopram.

Other medications such as Gabapentin, Pregabalin, Clonidine and Oxybutynin can also be used.