Sunday, August 14, 2022

Midlife toolkit all women need to handle perimenopause, menopause and beyond

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The menopause can still be seen as something of a taboo.

Indeed, until recently, it was often only whispered about in hushed tones – or ignored completely.

Thankfully the tide is turning and the conversation is opening up.

As the producer of Davina McCall’s Channel 4 documentary Sex, Myths and the Menopause, I know just how important this conversation can be.

Indeed there has been a sea change in how visible menopause now is, making a huge difference to the lives of millions of women.

The menopause is a transition women go through in midlife when their periods stop.

The hormones oestrogen, progesterone and testosterone fluctuate then deplete, leading to menopausal symptoms such as brain fog, hot flushes and anxiety.

Symptoms typically begin in your 40s, during what is known as perimenopause.

Kate Muir reveals the midlife toolkit all women need to feel their best during perimenopause, menopause and beyond

This is a relatively new term used to describe approximately 10 years prior to the menopause.

Each of us will have a different experience with menopause.

For instance, while 60% of women report brain fog, 10% may never have a single hot flush.

Lesser-known symptoms include heart palpitations, itchy skin, migraines, joint pain, stress, anxiety and lack of sleep.

So how do we deal with such an unknown?

In part one of my exclusive menopause guide, I’ll share my ultimate survival kit – everything you need to feel your very best in perimenopause, menopause and beyond.


HRT is more than just part of your survival kit – it’s the whole suitcase, into which your other survival tactics (diet, exercise etc) can fit.

For the majority of women, HRT is the best solution for menopause symptoms, and replacing the hormones that deplete during menopause (oestrogen and progesterone) helps future-proof their health.

The best kind of HRT recommended by menopause experts is “body identical” HRT.

This is different to the HRT pills that used to be the norm, which contained synthetic hormones (such as progestin, a man-made form of progesterone) and were found via a Women’s Health Initiative study 20 years ago to be associated with a small increased risk of breast cancer.

My advice is to ask your GP for the gold standard body-identical transdermal (meaning absorbed through the skin) HRT, which is available for free on the NHS.

First, you need transdermal oestrogen, in the form of a patch, gel or spray.

Then, you need natural body-identical progesterone, which comes in the form of a pill.

HRT is the best solution for menopause symptoms


Getty Images/Collection Mix: Subjects RF)

It’s micronised progesterone, which is extracted from yams and is a direct copy of your body’s hormones.

Both of these hormones are plant-based and studies over five years have shown no increased risk of breast cancer.

What’s more, we absorb them much better as they are a copy of our own hormones.

If you don’t tolerate progesterone, which a small number of people don’t, you can opt for a Mirena coil (hormonal IUD).

Also available on the NHS, this is placed in the womb and releases progesterone.


Broken nights and poor sleep are common during the menopause, due to night sweats, sore joints, headaches and anxiety.

This in turn affects mental and physical health.

It’s a vicious cycle – we’re tired, so we don’t perform well during the day, which then keeps us up at night.

Don’t take your phone to bed, or if you do, leave it on the other side of the room so you’re not tempted to scroll instead of switching off.

Make sure your bedroom has a window open at night to cool you down.

Layers can really help. Instead of one thick duvet, have several blankets you can remove as and when.

Practice mindfulness, meditate and write in a journal for half an hour before bed to calm down the brain.


Vitamin D plays an important role in menopause.

It helps the body absorb calcium, which keeps bones strong, preventing osteoporosis that can come as a result of hormone deficiency.

Go outside – in the morning is best – for a walk every day.

Even in the depths of winter you absorb vitamin D, and also reap the mental health benefits of being in the fresh air.

Take a supplement daily to top up your levels.

This is especially important in winter, and if you are mostly inside.


Most women report increased levels of stress, tension and anxiety during menopause.

This can affect everything from work to relationships.

Doing just a little bit of meditation and mindfulness each day can work to bring down stress levels.

The best bit? It’s free and can be done anywhere.

Breathe in for three counts and out for five. Pause, repeat several times.

You will find you physically relax doing this.

Doing something that focuses your attention on just one thing will quieten your mind.

Before bed, write down the thoughts that are whirring around your head. Leave them on paper and deal with them in the morning.


A lot of women find that when they hit the menopause, they can’t drink like they used to.

If alcohol tends to make you feel rubbish rather than raring to go, try cutting back.

Stop before you pour yourself a glass and think “do I actually want this?”

There are so many great alcohol-free options available now, from prosecco dupes to gin.

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Exercise is something of a wonder drug, boosting mental and physical health, preventing weight gain, and strengthening the body.

This is especially important during the menopause. The key is to find something you enjoy doing.

There’s no point signing up to fitness classes you’ll never attend.

Choose something to put a smile on your face, be it running, a team sport, an at-home dance workout or wild swimming.


It can be hard to predict when a hot flush will hit, so prepare by wearing layers.

This means you can whip off your jumper when you need to.

Work out what your bottom layer should be – be it a vest top or T-shirt – and avoid any items you can’t remove or undo easily.


Women telling other women their stories is key, as everybody’s story is different.

We may not all have hot flushes or brain fog, but we will all have something to share.

And the more we can talk, the more solutions we have.

Why not go to the pub, and make the menopause a talking point for you and your friends?

Or start a book club. Choose a book about the menopause, and talk about it, and what helps you and what hasn’t.

Women experience the menopause differently with 10% never having a single hot flush


Getty Images)


There is lots of support out there.

You can track up to 50 different symptoms using the Balance menopause app (, helping you keep tabs on what is going on.

Elsewhere, The Menopause Cafe movement ( sees groups chat about the menopause over tea and cake. It’s a safe space to discuss any questions you have, regardless of your age or gender.

Then, on social media, Dr Louise Newson (@menopause_doctor) and menopause activist Diane Danzebrink (@dianedanzebrink) provide support, advice and a community.


Starting the conversation about menopause in the workplace is important as it takes away any embarrassment over the subject.

If you can, talk to your manager about it, and also to occupational health if you’re in a big organisation.

Find out if your workplace has a menopause policy.

There is a platform called Talking Menopause ( that provides workshops and webinars for support. Henpicked ( also has lots of advice for getting through the menopause at work.

Everything You Need To Know About The Menopause (But Were Too Afraid To Ask) by Kate Muir (£16.99, Simon & Schuster) is out now. Follow Kate on Twitter and Instagram at @menoscandal

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