#026 - The importance of understanding Menopause

It is astounding how we can go most of our lives hearing very little about menopause. I was surprised at how my own perimenopause really blindsided- even me as a gynaecologist! The reality is, that very little time and resources have been invested into menopause care, so even healthcare providers are largely clueless about it. Yet it’s a transition that half the population will go through—and it profoundly impacts health for decades. For women in their 40s, 50s, and beyond, understanding this life stage isn’t just about managing hot flushes—it’s about setting up the body and mind for healthy, active, and fulfilling years ahead. For men, understanding menopause matters too: it helps you support the women in your life—partners, mothers, sisters, friends—and it helps us all build communities where staying strong and healthy in midlife is possible.

What Happens in perimenopause and menopause?

• Perimenopause usually begins in the 40s, sometimes earlier and last up to a DECADE. Hormone levels—especially estrogen and progesterone—start to fluctuate wildly, leading to changes in periods, sleep, energy, and mood. Some people like to call it, ‘reverse puberty.’

• Menopause is reached when a woman has gone 12 months without a period. After this point, estrogen and progesterone remain low, while testosterone slowly declines with age.

• Postmenopause is the state that women remain in for the rest of their life after menopause sets in. At this point, hormone levels are a small fraction of what they once were but at least are stable.

These hormonal changes affect much more than fertility. They touch every system in the body: muscles, bones, brain, heart, and metabolism.

Why It Matters for fitness and longevity

1. Muscle & strength
   Estrogen and testosterone supports muscle repair and recovery. With their decline, women lose muscle more quickly. Without intervention, this accelerates sarcopenia—the age-related loss of strength that affects independence later in life. Resistance training and targeted nutrition (like protein and creatine) can counteract this.

2. Bone health
   Low estrogen speeds up bone loss, raising the risk of osteopenia and osteoporosis. Fractures due to osteoporosis are a leading cause of mortality in elderly women. Weight-bearing and strength exercise along with hormone replacement therapy are powerful ways to protect bone density.

3. Metabolism & weight
   Many women notice weight gain in their 40s and 50s, especially around the middle-this is also related to the drop in estrogen during the menopause transition. It isn’t just a cosmetic concern—increased abdominal girth is tied to insulin resistance, cardiovascular disease, and diabetes risk. Fitness and diet strategies are key to maintaining metabolic health.

4. Brain & mood
   Fluctuating hormones can affect sleep, memory, and emotional health. Exercise consistently improves mood, reduces anxiety, and protects brain health. Studies show that regular physical activity helps reduce common menopause symptoms such as hot flushes, night sweats, fatigue, and low mood.

5. Heart health
   After menopause, thanks to the lack of cardioprotective estrogen, women’s risk of heart disease rises and eventually matches men’s. Regular fitness and a healthy diet are among the best preventive tools.

The role of HRT

It is not all doom and gloom though! One of the most powerful tools available is hormone replacement therapy (HRT). HRT includes estrogen, sometimes progesterone, and often testosterone.

Research shows that, when started near the time of menopause, HRT can:

• Significantly reduce symptoms such as hot flushes and sleep disturbance

• Protect bone density and reduce fracture risk

• Improve muscle and connective tissue health

• Lower the risk of cardiovascular disease and possibly dementia when started early in the menopausal transition

For many women, HRT—combined with exercise, nutrition, and lifestyle changes—offers a foundation for thriving well into later life.

Why men should care

Menopause isn’t just a women’s issue. It affects families, workplaces, and communities. Partners who understand what’s happening can provide better support and empathy. Sons and daughters can help their mothers age with dignity and health. Employers who are aware of menopause can create healthier, more inclusive environments.

Just as important: the lessons of menopause—around fitness, muscle, nutrition, sleep, and community—apply to everyone who wants to age well. Even men are using testosterone replacement therapy more and more as they age

The Future Proof opportunity

Menopause is a turning point. Yes, it brings challenges—but it’s also an invitation. With the right approach to fitness, nutrition, recovery, HRT, and lifestyle, women can not only manage symptoms but also build a foundation for strength, vitality, and longevity. For men, understanding menopause helps you stay connected, supportive, and engaged with the other half of the population.

At Future Proof, we see menopause as part of the bigger story of thriving in midlife. By putting health and fitness at the center, we’re not just adding years to life—we’re adding life to years.

 Thank you

Dr Kate Whitehouse