Blog Science Navigating Menopause: Hormonal Shifts, Symptoms, Health Risks, and Lifestyle Solutions
Navigating Menopause: Hormonal Shifts, Symptoms, Health Risks, and Lifestyle Solutions
Navigating Menopause: Hormonal Shifts, Symptoms, Health Risks, and Lifestyle Solutions

Authors: Therabody Scientists: Tim Roberts, MSc; Rachelle Reed, PhD, MS, ACSM-EP; Kyle Silvey, PhD, CSCS; Michelle Darian, MS, MPH, RD, LDN

Menopause is a natural transition that women experience, signaling the end of their menstrual periods. Despite menopause being a universal experience, there is a lack of credible, science-based information available to help women navigate this change. The changes — both physical and mental — can impact overall quality of life.

In this article, we explore the hormonal shifts underlying menopause and the common symptoms women may face, detail the associated health risks, and provide evidence-based lifestyle solutions to arm women with knowledge and practical solutions for this phase of life.

The Hormonal Shifts of Perimenopause and Menopause

During the reproductive years, women’s hormones fluctuate cyclically. If a woman has a regular period, estrogen and progesterone are higher during the luteal phase, dropping systematically as her period begins.

When fluctuations turn from this predictable pattern to becoming less regular, perimenopause may be beginning. Dr. Pamela Peeke, Therabody® Scientific Advisory Board Member and women‘s health expert, explains, “Perimenopause is the time during which a woman’s sex hormones estrogen and progesterone are naturally decreasing, and this time period extends anywhere from the late 30’s until the onset of menopause around the age of 52. Menopause occurs after 12 consecutive months without a menstrual cycle." [1]

Fluctuations and low levels of estrogen and progesterone are triggers for menopause-related symptoms, including: [2, 3, 4, 5]

  • Night sweats
  • Daytime sweats
  • Hot flashes
  • Anxiety
  • Disturbed sleep
  • Mood changes
  • Weight gain
  • Fatigue
  • Vaginal dryness
  • Reduced sex drive

That said, the symptoms, and the severity of these symptoms, can vary greatly from person to person.

What We Know About Health Risks Postmenopause

Estrogen plays protective roles throughout the body. And as estrogen levels decline with menopause, some of the protection from various health concerns can follow. Here are the health risks associated with menopause.

Loss of Bone Mineral Density

One of the primary risks of diminishing estrogen during menopause is the loss of bone mineral density, which increases susceptibility to osteoporosis. [6] Estrogen plays a vital role in calcium regulation, and calcium is essential to bone rebuilding. When estrogen levels drop during menopause, bones can lose density and strength more rapidly and become brittle. This frailty also heightens the risk of falling and fractures associated with falling. [7]

Decreased Heart Health

As the leading cause of death in women, heart disease and heart health risks are critical to monitor and take action on. Estrogen has a protective effect on the cardiovascular system by helping regulate cholesterol levels and facilitating healthy blood flow. As estrogen levels decline, postmenopausal women are more likely to have higher cholesterol and blood sugar levels than their premenopausal counterparts. Higher cholesterol and blood sugar levels have well-researched links to heart disease, making postmenopausal women more susceptible to this disease without estrogen’s protective properties. [8]

Slower Metabolism and Fat Mass Gain

During menopause, it’s common to gain a few stubborn pounds. A loss of estrogen also negatively impacts metabolism and fat distribution, and can lead to midsection weight gain.  [9] Gaining weight (particularly fat mass) can raise the risk for type 2 diabetes, even in women at a healthy overall weight. [10]

Lifestyle Solutions During Perimenopause and Postmenopause

While this transitional period is accompanied by symptoms and health risks, adopting or maintaining healthy lifestyle habits can provide significant relief and support overall well-being. Science shows that four key pillars — exercise, nutrition, sleep and stress management, and preventive health monitoring — can benefit health during menopause.

1.    Get Regular Exercise

Regular physical activity offers a wealth of benefits for menopausal women. As Dr. Pamela Peeke states, “Routine, regular exercise is absolutely a mainstay of healthy living throughout life, and especially after the age of 50."

Regular exercise can help improve sleep quality, manage hot flashes, boost mood, increase strength, improve metabolism, and even heart health. Weight-bearing exercises are especially important for countering bone loss and maintaining muscle mass as you age. [11] Lifting weights, among other weight-bearing activities like walking, tai chi, yoga, and Pilates, are all science-backed ways to keep your bones healthy. [12]

Dr. Peeke emphasizes, “Exercise definitely helps a woman transition through menopause as it improves her ability to get regenerative sleep while decreasing cardiometabolic and cancer disease risk."

2.    Aim For a Nutrient-Dense Diet

A balanced, nutrient-dense diet becomes even more critical during the hormonal shifts of menopause. Dr. Peeke advises, “Healthy, balanced eating is essential." Focus on incorporating plenty of fruits, vegetables, lean proteins, whole grains, and healthy fats. [13] Proper hydration and adequate calcium and vitamin D intake (through foods like dairy, leafy greens, and fatty fish), or targeted supplementation also support bone health. [10]

3.    Pay Attention to Sleep and Stress Management

The sleep disruptions and anxiety that can arise not only affect your mood but your metabolism. High levels of stress also signal the body to hold onto fat, and poor sleep disrupts your hunger hormones and can make choosing healthy foods to eat less appealing. [4, 14]

It’s especially important to prioritize quality sleep and stress relief techniques during this time. Dr. Peeke confirms, “Technology can play a valuable role here by providing tools to enhance rest and decrease anxiety."

Establish a relaxing pre-bed routine, try meditation or breathwork, and ensure the bedroom environment is conducive to sleep. Managing stress through yoga, journaling, and other calming practices can further promote restfulness.

4.    Engage in Preventative Healthcare

This life stage serves as an important reminder for all women to stay up-to-date on preventive health screenings. “Every woman needs to keep up with her routine preventive checkups (for example, physical exams, mammograms, pap smears)," notes Dr. Peeke. Proactively screening and monitoring markers of bone density, heart health, and cancer risk allows for early detection and management of any issues.

Menopause Research is Increasing, But There Are Still Unknowns

While menopause is a natural process that women experience, there remains a significant disparity in research focused on its symptoms and risks and how treatments affect them. Oftentimes, women’s symptoms are often dismissed, misdiagnosed, or not adequately addressed by healthcare providers. [15]

This lack of research perpetuates an inability to fully understand and address issues that uniquely impact women’s health. Dr. Dan Giordano, Therabody Scientific Advisory Board Member, emphasizes, “Women’s hormones are different and they change throughout a woman’s lifetime (i.e., – menstruation, pregnancy, menopause), which can all have a significant impact on performance and musculoskeletal health."

Dr. Peeke also emphasizes, “Women need more credible, science-based education about how to care for and maintain a fit and healthy mind and body."

By acknowledging and investing in research that accounts for these differences, the medical field can better serve the diverse needs of women and promote positive health outcomes over their lifetime.

It’s Never Too Late to Prioritize Care

“It is absolutely never too late to take care of oneself. I can tell you endless stories of these over 50 athletes who turned their lives around much later in life, sometimes in their 70s and 80s," shares Dr. Peeke. “The body is extraordinarily forgiving and will reward you with stronger, toned muscles and mental fortitude when mental and physical fitness are prioritized."

No matter where a woman may be on her journey through menopause, adopting lifestyle habits can support overall well-being. Using tools that address women’s needs and prioritizing overall lifestyle habits can empower women during the menopausal transition.

Key Takeaways

  • Menopause, defined in large part by hormonal shifts, is a natural transition that women experience.
  • Low estrogen and progesterone contribute to a range of symptoms and health concerns.
  • Common menopause symptoms include hot flashes, night sweats, anxiety, and vaginal dryness.
  • A woman’s risk for osteoporosis (and bone fractures), high cholesterol, heart disease risk, and metabolic concerns also increase after menopause.
  • Certain lifestyle approaches like exercise (especially strength training), eating a nutritious diet, and managing stress can help mitigate symptoms.

*This article provides general information and discussions about health and related subjects. The information provided in this article and any linked materials are not intended for and should not be construed as medical advice, nor is the information a substitute for professional medical advice, diagnosis, or treatment.