How to Thrive in Menopause

Published on 5 August 2025 at 15:48

By Dr. Natalie Barriball

Defining “Menopause” 

  • Menopause is a broad term most people use to describe the point in a woman’s life when periods and fertility stop. But there is a lot more to know about this stage that constitutes over a third of a woman’s life.
  • Stages: 
    • Premenopause: This term refers to reproductive-age females starting at the onset of menstruation and ending with the transition to menopause. 
    • Perimenopause: Starting as early as late 30s in some women, perimenopause is the transition phase leading up to menopause. Hormones begin fluctuating and changes such as irregular periods, hot flashes, and trouble sleeping may occur. 
    • Menopause: Menopause is only officially diagnosed after 12 consecutive months without a period. This marks the end of reproductive abilities, but does not necessarily mark the end of menopausal symptoms. 
    • Postmenopause: This term describes the period after menopause is completed and beyond. Even though menopause is over, symptoms may persist including hot flashes, vaginal dryness, and vaginal atrophy; and conditions such as osteoporosis, cardiovascular disease, and metabolic disease increase in incidence. 

Symptoms of Menopause (there may be more than you thought):

  • Hot flashes
  • Night sweats 
  • Chills
  • Mood swings
  • Irritability
  • Anxiety
  • Depression
  • Brain fog
  • Attention deficits
  • Difficulty falling or staying asleep
  • Poor sleep quality
  • Weight gain
  • Thinning hair or hair loss
  • Dry skin
  • Breast tenderness
  • Fatigue
  • Joint or muscle pain
  • Frequent UTIs
  • Urinary incontinence
  • Tinnitus
  • Neuropathy (tingling or numbness in extremities)
  • Headaches/ migraines
  • Heart palpitations
  • Dizziness or lightheadedness
  • Bloating
  • Change in bowel habits
  • Nausea or indigestion
  • Itchy skin
  • Increased facial hair 

Approach to Thriving 

The most important thing I want women to know is that menopause does not have to be suffered through, nor do the conditions that can arise after have to be certainties. There are SO many options to support this shift and change it from a dreaded season to a new and exciting one!

Diet 

  • A healthy, whole-foods diet is important to follow at all stages of life; however, as we age, our bodies are less able to keep up with the demands of life without proper fuel. 
  • General Guidelines:
    • Aim for 0.8-2.0 grams of protein per kilogram (kg) of body weight (kg is calculated as weight in pounds divided by 2.2). Protein is important for muscle, bone, tissue, and metabolic health. 
    • Aim for 28-35g of fiber daily. Fiber promotes gut, heart, and metabolic health. It also decreases colon cancer risk. 
    • Don’t forget your vegetables! Aim to eat one at every meal and vary the type throughout the week. Getting a variety of vegetables ensures a diverse vitamin and mineral profile. 
    • Include healthy fats such as avocado, nuts, seeds, and olive oil. These helps with hormone production and are important for heart, metabolic, brain, and joint health. 
    • Timing matters! Whether you eat 3 meals or enjoy intermittent fasting, for optimal metabolic function, it is important not to eat too close to bedtime. Give yourself at least 2-3 hours to properly digest and absorb food before bed. This supports healthy sleep, metabolic control, and weight. 

Exercise

  • The best thing you can do to improve longevity and quality of life after menopause is resistance training! 
  • While a mix of resistance training and aerobic exercise is important, resistance training has multiplied benefits, especially for menopausal females. 
  • Resistance training: 1
    • Lowers the risk of osteopenia and osteoporosis, and can treat it. 
    • Improves cardiovascular health. 
    • Improves metabolic health. 
    • Supports cognitive function and mental health. 
    • Reduces menopausal symptoms. 
    • And, in my opinion, makes you feel strong inside and out! 

Herbs

  • There are a variety of herbs that have been used for generations to support the menopause transition. I will often use synergistic combinations, but one of my favorites is Lepidium meyenii, also known as Maca. 
  • This herb is native to Peru and has many wonderful benefits. 2
    • Boosts mood and energy as an adaptogen. 
    • Balances female hormones to reduce symptoms like hot flashes, vaginal dryness, and night sweats. 
    • Increases libido (in men and women). 
    • Improves bone density. 
    • Reduces blood pressure in those with hypertension. 
    • Improves glucose control. 

Nutrients

  • There are many important nutrients necessary for each stage of life. A lot of them can be found in a balanced diet, but creatine and vitamin D have specific benefits for menopause and aren’t as easily sourced from food. 
  • Creatine 3
    • Creatine is a naturally occurring amino acid compound found primarily in muscles and the brain. It is used for making energy in the body. 
    • It can be found in red meat and seafood or taken as a nutritional supplement. 
    • It is commonly used by athletes and bodybuilders, but is helpful for menopausal women too, showing benefits including: 
      • Enhanced muscle strength and endurance. 
      • Improved bone health. 
      • Increased cognitive function. 
      • Mood support. 
      • Pairs great with resistance training ;)
  • Vitamin D 4
    • Despite the availability of vitamin D in sunshine and food, many Americans are deficient. 
    • Vitamin D is critical for 
      • Maintaining or increasing bone health and strength. 
      • Supporting immune health. 
      • Regulating mood. 
      • Supporting heart health. 
      • Supporting brain health. 
    • A deficiency in Vitamin D is linked to 
      • Osteopenia/ osteoporosis. 
      • Cardiovascular disease. 
      • Cancer. 
      • Autoimmune disease. 
    • Vitamin D is found largely in fatty fish, egg yolks, and from sun exposure. 
    • Getting 15 minutes of direct sunshine per day is a great way to get your daily dose of Vitamin D. 
    • If supplementation seems more attainable, it is important to get a lab test run first to see where your levels are, as vitamin D can be overdosed and cause calcium imbalances. 

Bioidentical Hormones 

  • The most popular hormone talked about with menopause is estrogen, but this is just one piece of the puzzle. All sex hormones decline with age, and it is important to support them all for the best health outcomes. 
    • Estradiol: The stronger form of estrogen, estradiol support bone, brain, and heart health, and alleviates symptoms such as hot flashes, night sweats, and vaginal dryness. 
      • Estradiol should ALWAYS be taken with progesterone as progesterone balances the estradiol and protects the uterus from a thickened lining and endometrial cancer. 
    • Estriol: Estriol is a lesser-known estrogen, as it is much weaker compared to estradiol. But despite being weaker, it can still support systems and alleviate symptoms similar to estradiol. It can be used alone, or when used in combination with estradiol, it may have protective effects from estrogen-related cancers and adverse symptoms. 5
    • Progesterone: Progesterone helps brain function and sleep, two areas commonly affected in menopause. It also protects the uterus in estrogen use. 6
    • Testosterone: While typically known as a male hormone, females possess testosterone too, and it is critical for bone and muscle health/ strength, energy, libido, and cardiometabolic health. Some research shows it may be protective against breast cancer. 7
    • DHEA: A hormone not commonly known, DHEA is made primarily by the adrenal glands and converts to testosterone and estrogen in the body. It helps with energy, inflammation, mood, bone health, libido, and cognitive function. 8
  • As menopause progresses, these hormones can fluctuate and play different roles in overall health and symptom picture. I find that they work best in synergy, working together to support optimal health in the menopause transition and beyond. 

Mind-Body

  • Acupuncture 
    • Acupuncture can help with nearly all symptoms of menopause, and makes a great adjunctive treatment. 
    • In addition to therapeutic benefit, it’s an opportunity to relax from a busy schedule, and can even be combined with facial aesthetic points helpful in reducing the aging process. 
  • Meditation/ Prayer 
    • Taking time to slow the body and shift focus is incredibly important for overall health and supporting an easy transition, as is true for any transition in life. 
  • Maintaining Good Relationships and Friendships 
    • Community is a major part of life and can add fun, enjoyment, and support to every season of life. 
  • Taking Time for Yourself 
    • This is often the hardest task of all for women. Taking time means valuing yourself; it means knowing that you have to feel supported and happy before you can do it for anyone else. With all the changes that can happen in the menopause era, give yourself a break and give your body what it needs to get the most out of this time.

 

Menopause is not a diagnosis—it’s a transition. And you don’t need to go it alone, find ways to support your system, providers to listen to you, and treatments that make life not only bearable but worth living! 



References: 

  1. Capel-Alcaraz AM, García-López H, Castro-Sánchez AM, Fernández-Sánchez M, Lara-Palomo IC. The Efficacy of Strength Exercises for Reducing the Symptoms of Menopause: A Systematic Review. J Clin Med. 2023 Jan 9;12(2):548. doi: 10.3390/jcm12020548. PMID: 36675477; PMCID: PMC9864448. 

  2. Gonzales GF, Villaorduña L, Gasco M, Rubio J, Gonzales C. Maca (Lepidium meyenii Walp), una revisión sobre sus propiedades biológicas [Maca (Lepidium meyenii Walp), a review of its biological properties]. Rev Peru Med Exp Salud Publica. 2014;31(1):100-10. Spanish. PMID: 24718534. 

  3. Smith-Ryan AE, Cabre HE, Eckerson JM, Candow DG. Creatine Supplementation in Women's Health: A Lifespan Perspective. Nutrients. 2021 Mar 8;13(3):877. doi: 10.3390/nu13030877. PMID: 33800439; PMCID: PMC7998865.

  4. Anagnostis, Livadas, Goulis, Bretz, Ceausu, Durmusoglu, Erkkola, Fistonic, Gambacciani, Geukes, Hamoda, Hartley, Hirschberg, Meczekalski, Mendoza, Mueck, Smetnik, Stute, Trotsenburg, Rees, Lambrinoudaki. EMAS position statement: Vitamin D and menopausal health. ISSN 0378-5122. https://doi.org/10.1016/j.maturitas.2022.12.006. 

  5. https://www.lifeextension.com/magazine/2008/8/estriol-its-weakness-is-its-strength#:~:text=Estriol%2C%20once%20thought%20of%20as,menopausal/%20postmenopausal%20women%20with%20osteoporosis. 

  6. https://my.clevelandclinic.org/health/treatments/15245-hormone-therapy-for-menopause-symptoms 

  7. Donovitz G, Cotten M. Breast Cancer Incidence Reduction in Women Treated with Subcutaneous Testosterone: Testosterone Therapy and Breast Cancer Incidence Study. Eur J Breast Health. 2021 Mar 31;17(2):150-156. doi: 10.4274/ejbh.galenos.2021.6213. PMID: 33870115; PMCID: PMC8025725. 

  8. https://www.health.harvard.edu/staying-healthy/dhea-supplements-are-they-safe-or-effective#:~:text=Dehydroepiandrosterone%20(DHEA)%20is%20a%20hormone,what%20does%20the%20research%20show

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