Thriving Through Menopause: Evidence-Based Strategies for Health and Well-Being

Menopause is not just a biological milestone—it’s a new phase of life that can bring both challenges and opportunities for growth. While symptoms like hot flashes, mood changes, and sleep disruption are common, this transition also offers a powerful moment to reassess priorities and invest in long-term health.

This post provides evidence-informed strategies for managing menopausal symptoms and enhancing overall well-being, helping you move through this phase with confidence, clarity, and control.

Understanding What’s Happening in Your Body

Menopause is defined as the permanent cessation of menstruation for 12 consecutive months due to a decline in ovarian hormone production—primarily estrogen and progesterone. The average age of menopause in the U.S. is 51, though the transition can begin several years earlier in a stage known as perimenopause. Hormonal fluctuations during this time can lead to a wide range of symptoms. Hot flashes affect approximately 75% of women, while others experience disrupted sleep, mood swings, decreased libido, brain fog, and changes in metabolism. Understanding these changes is the first step in managing them.

Nutrition as a Foundation for Health

Diet can play a significant role in how your body responds to menopause. Research supports several dietary patterns and nutrients that may help mitigate symptoms and protect long-term health.

A balanced diet rich in whole foods—fruits, vegetables, whole grains, lean proteins, and healthy fats—helps stabilize energy, support cardiovascular health, and maintain muscle mass and bone integrity. Calcium and vitamin D are especially critical during this time, as the risk of osteoporosis increases with declining estrogen levels.

Some research suggests that soy-based foods or plant-derived phytoestrogens—such as those found in flaxseeds, legumes, and tofu—may offer modest relief for hot flashes in certain women. However, study results are mixed, and benefits are not universal. If you choose to include these foods, they are generally safe and nutritious, even if symptom relief is not guaranteed.

A menopause-trained clinician or registered dietitian can help you personalize your approach, especially if you're navigating weight changes, cholesterol, or blood sugar concerns.

A nutritious meal showcasing vibrant vegetables.

Movement for Body and Mind

Physical activity is one of the most powerful tools for managing the changes that occur during menopause. In addition to improving cardiovascular and musculoskeletal health, regular exercise has been shown to stabilize mood, improve sleep quality, reduce anxiety, and help counteract the changes in body composition that often accompany hormonal shifts.

Emerging research has clarified what types of exercise are most effective at this stage of life:

• Heavy resistance training plays a critical role in preserving and rebuilding muscle mass, which naturally declines with age and becomes more pronounced after menopause. Resistance training also stimulates bone remodeling, which helps reduce the risk of osteoporosis. Whether using free weights, machines, or body weight, exercises like squats, deadlifts, lunges, and presses should be included 2 to 3 times per week to support strength, function, and metabolic health.

• High-intensity interval training (HIIT) has also gained strong support for midlife women. HIIT involves short bursts of intense effort followed by recovery periods and has been shown to improve cardiovascular fitness, insulin sensitivity, and fat metabolism without placing excessive stress on the body. This “just enough stress” approach can help women make measurable progress while respecting the body’s capacity for recovery, which can become more limited during midlife due to changing hormonal and stress-response systems.

• Flexibility and balance become increasingly important during midlife and beyond. Incorporating yoga, Pilates, or simple stretching routines can support joint health and mobility, while balance exercises can reduce fall risk and support long-term independence.

• Current guidelines recommend at least 150 minutes of moderate-intensity aerobic exercise per week—such as brisk walking, swimming, or cycling. This level of activity supports cardiovascular health and metabolic function while reducing the risk of chronic disease.

  
  

It’s important to remember that the best workout is the one you’ll actually do. Any consistent movement will improve blood flow, support mobility, and enhance mental health. The key is finding forms of activity that you enjoy and can sustain long-term. Activity during menopause isn’t just about symptom management: it’s a powerful investment in your future health, autonomy, and resilience.

Emotional Well-Being Deserves Equal Attention

The emotional and cognitive shifts during menopause can be just as impactful as the physical ones. Changes in estrogen levels can influence mood, memory, and concentration, and many women report feeling more anxious, irritable, or emotionally vulnerable during this time.

Cognitive behavioral therapy (CBT) has been shown to be particularly effective in managing emotional symptoms and improving sleep quality. CBT for insomnia (CBT-I), a structured, non-drug approach to sleep, is a first-line treatment for chronic sleep disruption in midlife women. Mindfulness-based strategies, such as meditation or deep breathing, also support emotional resilience and help reduce reactivity to stress.

Staying connected to others can have a significant positive impact as well. Whether through support groups, friends, or therapy, being able to share your experience and feel understood can make a meaningful difference.

A peaceful outdoor setting for relaxation and mindfulness.

Hormonal and Non-Hormonal Treatment Options

When menopausal symptoms become disruptive to daily life there are a number of effective treatment options to consider. Menopause hormone therapy (MHT) remains the gold standard treatment for vasomotor and genitourinary symptoms. MHT is most effective when initiated within 10 years of menopause or before age 60. Systemic estrogen therapy, whether administered orally, through a patch, or as a gel, can significantly reduce hot flashes which may improve sleep and mood. Women who still have a uterus need to use a combination of estrogen and progestin to protect the endometrial lining. Local estrogen therapy, such as vaginal tablets, creams, or rings, can be used to treat genitourinary symptoms like vaginal dryness, irritation, or painful intercourse, with minimal systemic absorption.

Among the newest and most promising non-hormonal treatments for hot flashes is fezolinetant (Veozah®), a neurokinin 3 receptor antagonist approved by the FDA in 2023. It works by acting on the temperature-regulating center of the brain, addressing the root cause of hot flashes without affecting hormone levels. Clinical trials have shown that fezolinetant significantly reduces both the frequency and severity of vasomotor symptoms. Liver function monitoring is recommended due to potential side effects.

Elinzanetant, another neurokinin 1,3 receptor antagonist currently in late-stage clinical trials, holds promise as a future non-hormonal treatment for both hot flashes and sleep disturbances without the liver function concerns. Though not yet FDA-approved, its development signals the expanding landscape of menopause-specific therapies.

Low doses of SSRIs and SNRIs, specifically paroxetine mesylate (Brisdelle®), venlafaxine, and desvenlafaxine, also have been shown to reduce hot flashes. These medications are especially useful when vasomotor symptoms occur alongside mood changes or anxiety.

Gabapentin, a medication originally used for nerve pain and seizures, has also demonstrated efficacy in reducing nighttime hot flashes and improving sleep quality. It can cause drowsiness or dizziness in some individuals, but it’s often well tolerated when taken at night.

When it comes to genitourinary symptoms, oral non-hormonal options such as ospemifene (Osphena®), a selective estrogen receptor modulator (SERM), can improve vaginal tissue integrity and reduce discomfort during sex. For milder symptoms, over-the-counter vaginal moisturizers and lubricants, particularly those that are pH-balanced and free of irritating ingredients, are effective and safe.

Daily Habits That Make a Difference

Even small shifts in daily routines can support better symptom control and overall well-being. Staying well-hydrated supports skin, energy, and temperature regulation. Establishing a consistent sleep routine, using layered bedding, and keeping the bedroom cool can ease nighttime symptoms. Although caffeine and alcohol don’t affect all women equally, some find that they trigger hot flashes or disrupt sleep. Tracking your symptoms can help you identify personal patterns.

A calming bedroom environment for better sleep during menopause.

Empowerment Through Education and Community

Menopause is often under-discussed, leaving many women feeling isolated or uninformed. But there is power in knowledge and connection. Access to trusted resources, qualified clinicians, and supportive communities can transform the experience from one of confusion to one of clarity and empowerment.

Organizations such as the The Menopause Society offer up-to-date, evidence-based information and guidance tailored to women at midlife and beyond.

Reframing the Menopause Narrative

Menopause isn’t something to "get through"—it’s a powerful life phase that deserves attention, support, and respect. With the right tools and mindset, it can also be a time of renewed vitality, personal growth, and redefined priorities.

Invest in yourself. Ask questions. Seek care that centers your values. And most importantly, know that you are not alone in this journey.