During menopause, it’s important to look after yourself. Healthy lifestyle choices will help to improve physical and emotional symptoms at every stage of menopause.
Smoking and other drugs
Sex and relationships
Menopause and work
Many women think weight gain is part of menopause, but it’s more likely due to ageing and associated lifestyle changes.
Women tend to gain weight as they age, whether they are experiencing menopause or not. On average, women between the ages of 45 and 55 years gain about half a kilo per year.
Ageing causes a decrease in muscle mass, which slows down your metabolism. So, if your diet stays the same, you are likely to gain weight.
Weight gain and increased abdominal (belly) fat is common among women at midlife.
Studies show that reduced levels of oestrogen around menopause cause fat to be stored on the waist, rather than the thighs and hips. In fact, belly fat in postmenopausal women accounts for between 15% and 20% of their total body fat. This compares with 5% to 8% in premenopausal women.
It’s not healthy to carry too much weight, but weight around your stomach has significant health risks. Fat stored in this part of your body is also known as 'visceral fat'.
Unlike the other type of fat (that you can pinch with your fingers), visceral fat lies deeper in your body. It can wrap around your vital organs such as your liver, gut and pancreas.
Excess visceral fat is linked to:
Increased belly fat also increases menopausal symptoms such as hot flushes.
A review published by the Mayo Clinic shows women can prevent weight gain at midlife. They can do this by adopting a healthy lifestyle and addressing menopausal symptoms.
Achieving and maintaining a healthy weight during perimenopause is very important. Looking after your health during the perimenopause years can prevent weight gain during menopause. This will also help you reduce the risk of chronic disease.
Menopausal hormone therapy (MHT) may also help to reduce belly fat after menopause , but MHT should not be prescribed specifically for weight management.
What you eat matters. Diet can be especially important to help prevent weight gain during midlife. Making healthy food choices is one of the best ways to achieve and maintain a healthy weight.
A healthy diet will improve your energy levels, keep your blood glucose stable and help you manage your weight.
You can try:
If you are overweight or gaining weight, you can talk to your doctor, dietitian or a nutritionist about the best way to lose weight. They may suggest a low-calorie or low-carb diet, together with physical activity.
Podcast: Jean Hailes naturopath Sandra Villella talks about menopause and nutrition. Listen now
Menopausal symptoms can make it harder to do physical activity, which may contribute to weight gain. If you don’t feel like your normal self during this time, it may be hard to stick to regular exercise and healthy eating.
Physical activity is a vital part of being healthy, especially as we age. It can reduce the risk of chronic disease, falls and osteoporosis. It can also help you manage your weight and your menopausal symptoms. If you want to lose weight, you will need to combine regular physical activity with reduced calorie intake.
It’s recommended that adults aged 18 to 64 years be active on most (preferably all) days of the week. This activity should include:
It’s also recommended you do muscle-strengthening activities at least 2 days per week.
You don’t have to do this in one go. You can accumulate shorter bursts of activity during the day. On days when you feel a bit tired, try a gentle walk.
Other tips to keep active include:
Signing up for a team sport or taking dance classes is also a great way to get active and have fun. Research shows that exercising with others makes it more likely you’ll stick with it. You’re also more likely to spend more time exercising. Exercising in a group can also improve your mental wellbeing and help you manage the emotional aspects of menopause.
Before starting an exercise program, you can talk to your doctor or an exercise physiologist. They can recommend a program to suit your current situation and health goals.
After menopause, lower levels of oestrogen affect women’s bone health, which puts them at greater risk of developing osteoporosis. Women who experience premature or early menopause can start to lose bone density at an earlier age than women who experience menopause in their 50s. This puts them at a greater risk of developing osteoporosis earlier in life.
You can reduce your risk of osteoporosis by eating the right amount of calcium per day. Women over 50, or women who have reached menopause before 50, should eat 1300mg of calcium per day, which is equal to 3 to 4 serves of dairy per day. Other good sources of calcium include:
You can also:
It’s important to have regular bone health checks which includes checking your medical history and risk factors for osteoporosis. Bone density tests are recommended for women with particular risk factors or those over 70 years of age.
Read the Healthy Bones Australia guide on Exercise and bone health and Exercise and bone density.
Sleep is important for everyone, but it’s very important during menopause. Lack of sleep can contribute to menopausal symptoms and make them worse. This in turn can make it hard for you to exercise regularly.
Research also shows that poor sleep (one of the symptoms of menopause) is associated with a greater intake of food and poorer food choices.
If you develop good sleep habits and seek help for any sleep problems, you might find it easier to manage your weight and menopausal symptoms.
Learn more about managing sleep disturbance.
Drinking too much alcohol can impact menopause by:
In the long term, heavy drinking can also lead to an increased risk for developing some cancers, depression, cardiovascular disease, diabetes and poor bone health.
Australian Alcohol Guidelines recommend that you:
If you have a problem with alcohol, talk to your doctor.
Read the Australian alcohol guidelines.
There is no safe level of smoking or drug use. Smoking is one of the worst things you can do for your health. It can reduce your life expectancy and quality of life. It can also increase your risk of developing other health conditions and dying early.
Women who smoke generally reach menopause earlier than non-smokers. They are also more likely to experience early menopause.
Women who smoke also have more severe and frequent hot flushes and night sweats, and difficulty sleeping.
If you smoke or use illicit drugs, speak to your doctor about ways you can stop.
For health advice about smoking visit Quit.org.au
There are many practical things you can do look after your emotional wellbeing.
Learn more about managing mood and emotional health.
If you are experiencing strong emotions, anxiety or depression, see your doctor.
Sexuality is an important part of our human experience, but hormonal changes at menopause can lead to reduced libido (sexual desire). While this is normal, it can be frustrating and may affect your relationships.
Many factors can influence how you feel about changes to your sexual desire.
The National Ageing Research Institute and the University of Melbourne conducted a large study of women called the 'Women's Healthy Ageing Project'. This study found that as women go through menopause, they may have a significant decline in sexual function. The study also found that reduced sexual function is associated with reduced levels of oestradiol (the main oestrogen hormone), but not testosterone.
Sexual problems may be worse for women who have early or premature menopause, due to a sudden change in hormones.
It’s common for different menopausal symptoms to affect sexual desire. For example, hot flushes, moodiness, sleeplessness and fatigue.
If you are in a relationship, it’s important to discuss your thoughts and problems openly with your partner.
Your partner may not know about menopausal symptoms or what you are going through.
You can ask them to read current information about menopause so they can support you through this time.
If you think these conversations may be difficult, you can:
If you are experiencing menopausal symptoms or health issues that affect your daily life (including your sex life), it can have an impact on your relationship. It’s important to ask your partner for their understanding and support during this time.
At this stage of your life, you may have added pressures that affect your sex life. For example, children moving out of home, caring for elderly parents or work pressures.
You may also feel differently about your body at this age and may not want to be intimate with your partner as often as you used to.
The loss of oestrogen at menopause causes changes in the tissues of your vagina and vulva. This means your vagina becomes drier and less elastic, which can lead to vaginal irritation, vaginal atrophy and pain during sex.
The Study of Women Across the Nation (SWAN) tracked more than 2,400 women over 17 years. It found that more than 50% of women don’t report vaginal dryness and less than 4% use any of the proven therapies to treat this condition.
Learn more about treatment options for dry vagina and pain during sex.
If you are concerned about having low libido, it’s important to discuss this with your doctor. They might suggest different options to improve the way you feel about sex. For example, a trial of menopausal hormone therapy (MHT), or vaginal moisturisers, lubricants or oestrogen to improve vaginal dryness.
The area of wellbeing and libido is very complex, and research tells us these are likely to be influenced by psychological factors more than testosterone. But testosterone therapy may be a suitable treatment for postmenopausal women who feel distressed by their loss of sexual desire. This condition is known as hypoactive sexual desire disorder (HSDD).
Testosterone therapy is only recommended for women diagnosed with HSDD. There is no evidence to support using testosterone in premenopausal women for low libido or any other condition such as low mood or depression.
Professor Susan Davis is a leading researcher and endocrinologist. In this podcast she discusses testosterone therapy as a treatment option for low libido in postmenopausal women.
A testosterone 1% cream (specifically for women) is now available and approved for use in Australia.
The cream is applied every night to the lower abdomen or outer thigh. Your doctor will usually test your testosterone level after three weeks to make sure it is not too high, and again after 12 weeks. Your doctor should then see you every six months for a check-up and to monitor blood testosterone levels.
If testosterone therapy is going to improve your libido, you will start to notice this after about four weeks. If there is no improvement after six months, you should stop testosterone treatment.
You may experience some side effects when you use testosterone therapy, although these are rare if you use the right dose of testosterone.
Side effects from excessive use of testosterone may include:
If you experience any of the above, see your doctor.
Testosterone therapy is not suitable for:
Your fertility will decline as you age, but while you still ovulate it is possible to get pregnant. In the lead-up to menopause, you can ovulate twice during one cycle. And you can still ovulate up to three months before your final period.
The possibility of pregnancy in women aged 45–49 years is estimated to be 2–3% per year. After the age of 50, it’s less than 1%.
If you’re younger than 50 and you don’t want to fall pregnant, you should use contraception for at least two years after your final period.
If you’re 50 or older and you don’t want to fall pregnant, you should use contraception for at least one year after your final period. Keep in mind, MHT is not a contraceptive.
Talk to your doctor about the best contraception for you.
Menopause is a normal part of life for most women. Symptoms can affect women at home and at work. The transition into menopause is now recognised as an important workplace issue, but not all workplaces support women going through menopause.
Many employers don’t fully understand the symptoms of menopause. And women may also feel uncomfortable talking about their experience in case they’re seen as ‘too old’ or unable to do their job. It’s estimated that around 10% of women stop working due to severe menopausal symptoms.
The good news is that more employers are developing policies that acknowledge and include menopausal health as an important part of employee wellbeing.
Menopause can impact work in many ways. Physical symptoms like hot flushes, fatigue, poor concentration and poor memory can all impact the quality of your work. They can also reduce your ability to function normally. Symptoms such as loss of self-confidence, low self-esteem, anxiety and depression can make things worse.
Studies show that menopausal symptoms can impact work attendance and performance. Sometimes symptoms are interpreted as poor performance or lack of commitment. Other women may be misjudged as having a mental illness or other health conditions.
Symptoms can also stop women from applying for promotions or cause them to retire early.
You can let your employer know about your situation and how you can be supported in the workplace.
Talk to your employer or manager if you have symptoms that make work difficult. Explain what your symptoms are and how they impact your work. You might also like to share some of the information from our website with your employer.
Ask your employer to make reasonable adjustments if needed. This may be flexible working hours, or the ability to work from home if you need to manage fatigue. It may also include changing the temperature of your office or using a fan to help keep you cool if hot flushes are a problem.
Women make great advocates for one another in the workplace. If you feel up to it, offer to help develop policies that support menopause at work. Take part in training or induction programs that include information about menopause. Offer formal or informal support for others in your workplace who are going through menopause.
Looking after your own health can help you manage symptoms and help you cope better at work. You can try:
If menopausal symptoms are impacting you, talk to your doctor about treatment options. Managing your symptoms can help you cope better at work.
If you feel your manager is not supporting you through menopause, seek other support. You can talk to your organisation’s human resources staff or discuss the issue with advocacy bodies, such as trade unions or professional associations.
Menopause at work provides information and resources to help workplaces support women during the menopause transition.
This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at August 2022.