There are countless biological and chemical changes that occur throughout the arc of a woman’s life. However, three significant stages stand out as major life events: puberty, childbirth, and menopause. During these moments, the female body undergoes more drastic and immediately felt transformations that affect every aspect of her health and quality of life: physical, mental, emotional, and even spiritual.
Up until now, the pervasive state for women navigating these moments is one of confusion and fear. Women find themselves questioning everything they're feeling and overwhelmed by the lack of reliable, research-backed guidance they need to navigate essential health decisions, like hormones, reproductive health, nutrition, and exercise.
When it comes to menopause, the information age is opening up our collective conversation, but the confusion for most women persists. So, this week, let's take a deep dive into the science of menopause, examine how it affects your body, and build a toolkit of knowledge to navigate the three stages of menopause with confidence, empowerment, and a clear understanding of the best choices for your personal health needs.
These are the three stages of menopause, what they are, what you can expect to feel in each stage, and the lifestyle changes that can help you manage your symptoms and build your health and longevity.
What Are The Three Stages?
While many think of menopause as just one stage in life, it can be broken down into three phases: perimenopause, menopause, and post-menopause.
Perimenopause is a gradual process of change leading up to menopause. During perimenopause, progesterone and estrogen levels begin to fluctuate frequently. Some months, they can spike, while others, they plummet. This can present several physiological changes, like irregular periods, temperature fluctuations, fatigue, changes to sleep patterns, and emotional swings.
Menopause is the stage that marks the end of your menstrual cycle. For an entire year, you may experience spotting at the beginning, but your period essentially stops. This is caused by the depletion of your sex hormones (progesterone, estrogen, and testosterone) and marks the end of your body's reproductive years. Menopause is often marked by symptoms like hot flashes, night sweats, insomnia, emotional swings, chronic fatigue, brain fog, weight fluctuations, and muscle mass loss.
Postmenopause is the term used to describe life after the first year of not experiencing a period. This phase lasts the longest of the three. In postmenopause, women often experience symptoms associated with the absence of estrogen and other sex hormones, like bone density loss, fatigue, hair loss, brittle nails, changes to immune health, and muscle health.
Perimenopause: Defining The Beginning
Perimenopause is a gradual transition in the body and usually begins in a woman's 40s; however, it can start as early as the 30s or as late as the 50s. While the symptoms listed above may sound scary, take a breath and read on - knowledge is power. Understanding what is happening and learning tools to implement when needed is powerful agency over your health and vitality.
Symptom 1: Emotional Swings
This is the most commonly cited symptom among perimenopausal women. Emotional swings during a normal period can frustrate the best of us, but emotional swings during a period when you're perimenopausal can feel nuclear.
You're not crazy. This is chemical. During perimenopause, your hormones don't decline in a straight line; they rise and fall, spiking and tanking. If your hormones were shown on a graph, it would be a wavy curve, going up and down over and over again until it finally reaches a point where it begins to decrease steadily.
These constant peaks and drops in your hormones impact your brain and make it harder to regulate the release of dopamine, serotonin, cortisol, endorphins, and other mood-influencing neurochemicals. So, that feeling of being out of control, reactive, and even crazy is real. You're not imagining it, and it's not your fault.
Symptom 2: Irregular Periods
Remember how irregular your periods were during your first years of puberty? Well, perimenopause is a lot like a second puberty. Irregular periods during perimenopause can feel a little scary. Some women report only experiencing spotting for five days, while some women experience 17 days of bleeding, ranging from medium to heavy. With so much variability, it's hard to discern the severity of your symptoms from one period to the next, or know what you'll need to manage each cycle. Some months may feel like nothing, while others may knock you down for days.
Symptom 3: Sleep Changes
On top of emotional swings and sometimes constant bleeding, another symptom you can expect to experience in perimenopause is fatigue from sleep changes like insomnia and disrupted sleep. Estrogen plays a vital role in regulating the production and release of sleep hormones. As it decreases in perimenopause, your brain has a harder time creating those hormones and regulating your sleep.
The result is that your sleep quality gets disrupted, and it takes longer to fall asleep. It's harder to stay asleep, and you don't achieve as much quality REM sleep. This is one of the harder symptoms to manage because sleep deprivation amplifies other symptoms like emotional self-regulation, brain focus, and memory.
There are two key lifestyle habits that will set you on the path to thriving at every stage of menopause.
Movement is medicine
That means you need to move your body intentionally, focusing on strength, mobility, and an elevated heart rate (meaning cardio) every day. The target is 30 minutes of consistent exercise that cross-trains your strength, cardio, and mobility, while keeping your mind-muscle connections agile and responsive. Cardio in particular is an excellent tool in peri-menopause as it improves blood circulation, which in turn helps your body release and regulate your hormone levels. Also, a benefit of cardio is that with improved circulation, your much-needed estrogen cells have a better chance of attaching themselves to open estrogen receptors, especially in the brain.
Create a Bedtime Ritual
It can feel difficult to establish routines and schedules in our homes when our devices are all clamoring for our constant attention. But, for those of us who remember life before social media and smartphones - all of 10 years ago - you have the benefit of experience on your side when it comes to disciplining your screen time in favor of nervous system care and unplugged, quiet time. And, when we're working with the conditions of perimenopause, an intentional bedtime ritual can make all the difference.
Here's a great sleep schedule to start implementing to help signal your brain that it's time to wind down for the evening.
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Drink a non-caffeinated herbal tea about an hour before official 'lights out' or after dinner.
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Journal - old school - pen, paper, your day's mind and emotions. Just empty it all on the page.
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Release your feet: try this video to open up the fascia tissue in your feet and feel how it unlocks your spine to your occiput. Grounding and calming the nervous system, while also improving circulation in the lower body, which may have become stagnant during the day.
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The phone is turned off and stored in a drawer on the other side of the house. Need an alarm? Get an alarm clock. Truly remove the temptation to scroll.
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Lights out by 10:00 PM - since fluctuating hormone levels can interrupt our circadian rhythm, it can be difficult to feel the need for sleep at the right times, but studies show that sleep achieved earlier in the night is of a better quality and more restorative for the next day.
Pro Tip: Track Your Symptoms
Knowing your body, having a record of what you're feeling, when, and a timeline, will give you an enormously strong platform to advocate for your medical needs as you navigate the medical resources available to you. Menopause is a fairly recent conversation, and while it is blowing up in the media, the reality you'll face when seeking care can be more sparse. Keep track of your symptoms in a journal or a trusted tracking app. Log the dates and length of each period, associated symptoms, sleep changes, moods, stress levels, and anything else you feel is worth writing down.
Menopause: The Heat is On
On average, women hit menopause between the ages of 51 and 55. Once those first few periods are missed, you can be pretty confident that you've entered menopause. This is when the symptoms we've been discussing may begin to intensify - not for everyone and not all at once. Your personal experience will be just that - personal. Know the landscape you're entering, and you'll feel less surprised and more prepared when your cocktail of symptoms shows up.
Symptom 1: Hot Flashes & Night Sweats
Hot flashes, a common symptom of menopause, occur when the body's temperature regulation system, the hypothalamus, misinterprets slight increases in body temperature due to fluctuating estrogen levels. This misinterpretation leads to a cascade of physiological responses aimed at cooling the body down, including vasodilation, sweating, and increased heart rate.
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Estrogen plays a crucial role in regulating the hypothalamus, the brain's thermostat.
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As estrogen levels decline during perimenopause and menopause, the hypothalamus becomes more sensitive to even minor increases in body temperature.
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This sensitivity leads the hypothalamus to perceive the body as overheated, triggering the hot flash response.
Symptom 2: Brain Fog
Brain fog during menopause, also known as meno-fog, is a real phenomenon characterized by cognitive difficulties like memory lapses, trouble concentrating, and impaired executive function. It's primarily linked to hormonal fluctuations, with estrogen playing a key role.
Estrogen receptors are found throughout the brain, and their fluctuations can affect neuronal activity, neurotransmitter levels (like serotonin and dopamine), and even blood flow to the brain.
While brain fog can be concerning, it's generally a temporary symptom of menopause. Studies show that cognitive performance often improves after the menopausal transition.
Symptom 3: Metabolic Shifts
Another key indicator of menopause is weight fluctuations. Depending on your innate metabolism, your body weight will fluctuate and change in ways you may have never experienced.
The combination of lower estrogen levels, decreased muscle mass, and reduced physical activity can generate a cycle of weight gain, especially around the abdomen.
Estrogen and progesterone, both of which decline significantly during menopause, are responsible for metabolic regulation and fat distribution in the body. During this time, you may feel your abdomen filling out as your core, back, and glute fascial tissue begin to slacken and lose some of their collagen/elasticity. These circumstances combined often result in low back pain, increased abdominal weakness/fat retention in the abdominal wall, and tight/immobile pelvis and hips.
Metabolic Slowdown:
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As women age, their BMR naturally decreases, meaning they burn fewer calories at rest. This can make it easier to gain weight even with the same calorie intake as before menopause.
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Muscle mass tends to decrease with age, and muscle burns more calories than fat. This shift in body composition also contributes to a slower metabolism and weight gain.
Lifestyle Factors:
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Many women become less active during menopause due to fatigue, sleep disturbances, or other factors. This reduction in physical activity further slows metabolism and increases weight gain.
Pro-Tip:
Movement is medicine for all of your body's needs and functions. So many of the issues we're describing here are self-fulfilling cycles. Disrupt the cycle with daily movement, and many of these symptoms are not only preventable but also reversible. At any point in your life, you can begin moving your body, breathing, loving yourself, and enjoying the life you have the privilege to live. RM Revive is here to get you started whenever you are ready.
How to Thrive in Menopause
A combination of lifestyle, nutrition, some supplements, daily cross-training + mobility exercises, combined with some light medical support like hormone replacement therapy (HRT)
Movement: It's everything
Daily movement means intentionally tending to your body's needs, regardless of whether you feel motivated to work out. This is about a habit, not a punishment. If you're starting for the first time in your life, let it be a fun exploration of what developing a fitness lifestyle looks and feels like for you…begin by choosing your time of day - try a few different ones and see which times feel the best. Cross train - your tissues are changing through menopause, meaning your body needs a combination of fascial hydration, neuromuscular activation, and then strength/cardio cross training. RM is built on 20+ years of research into women's bodies, muscular function, and what you need to stay active, strong, and healthy for a lifetime. Here is a quick sample sequence:
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Deep core activation - engaging pelvic floor - transversus abdominis with breath alone, then with resistance ( i.e., toe taps with the pilates ball)
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Back body mobility - your back muscles are 50% of your core equation - they need to be mobilized if you want them to work for you.
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10-20 standing squats that engage your feet through your leg, pelvic floor, back, and glute muscles.
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3 rounds of lunging yoga sun-salutes to engage, breathe, move, and strengthen your entire body.
Exercise is important across all stages of life. In menopause it can be a key factor in helping reduce the severity of symptoms like hot flashes, weight fluctuations, and fatigue. During menopause, it's especially important to approach exercise holistically: cardio, strength training, and joint flexibility are all key areas you need to focus on when creating a new exercise regimen.
Hot Flash Triggers
Certain foods can trigger hot flashes and night sweats. The biggest contributors to your body's thermoregulation rollercoaster ride are caffeine, alcohol, spicy foods, and high-sugar/processed foods. These foods fall into two types of hot flash triggers: vasoconstrictors and vasodilators.
Vasoconstrictors are substances that cause blood vessels to constrict and become smaller. This causes blood pressure to increase, which can result in an increase in body temperature and lead to a hot flash. Common dietary vasoconstrictors are coffee, refined sugars, and some peppers (others can be vasodilators).
Vasodilators are foods or other substances that cause blood vessels to expand. While they lower blood pressure, they also increase blood flow velocity. This rush of blood can cause your body to increase its internal temperature as a result. Some common dietary vasodilators are alcohol, certain types of peppers, and dark chocolate.
Treat your body like a nutritional temple during menopause. This doesn't mean you can't enjoy your coffee or a glass of wine, but pay attention. If during the height of menopause, those substances are triggering huge reactions in your body, you may be motivated to abstain and replace with herbal tea, lemon water, and other relaxation techniques like soft foam rolling and breath meditations. Also, check with your doctor if certain medications are listed as vasoconstrictors or vasodilators, as certain medications may worsen hot flashes.
Supplements and Hormone Replacement Therapy:
While diet and exercise are the core foundation for maintaining health through the menopausal journey, sometimes we need additional help to ensure that maintenance. Nutritional supplementation can support overall health and energy levels, helping our bodies self-regulate through transitions. This means our brain functions better, muscle quality improves, and our emotional ebbs and flows are more balanced.
Probiotic supplements can help your body absorb nutrients more effectively, regulate your circulatory and immune systems, and directly contribute to managing menopause symptoms.
Essential vitamins and minerals like Vitamin D, Calcium, Magnesium, Vitamin E, and Omega-3 Fatty Acids. These can all help support better blood circulation, immune health, and cardiac health, and contribute to easier management of hot flashes and other symptoms.
Low-dose estrogen supplements and creams can be extremely effective at mitigating many of the menopause related symptoms. Hormone Replacement Therapy is a well-documented treatment, is very effective, and has very low side effects and health risks. You want to develop a relationship with a doctor trained in HRT and who specializes in women's health.
Postmenopause
After the first complete year of having no period, you have officially entered postmenopause. After completing menopause, this chapter of life can feel truly liberating. You've hit a stride physically and emotionally. With the lifestyle habits discussed above in place, you're ready to thrive through every decade ahead - mobile, independent, strong, and living life's adventures to the fullest.
Aging is a Privilege: Here's How to Love Your Body and Thrive
Bone Density: Keep it strong
Hormone levels stabilized (through HRT and lifestyle), you still will experience the natural aging process of bone density loss.
There are estrogen receptors attached to our bone cells, and when not enough estrogen reaches those receptors, our bodies produce fewer bone cells at a fast enough rate to maintain their strength. As a result, our bones become porous and more fragile, making the risk of fractures increase every year we get older.
So, consider calcium, magnesium, strength training with weights and body resistance, whole/nutritionally dense foods, and incorporating lots of joy and playfulness to keep your joints mobile and muscles flexing/releasing functionally in your daily life.
Hair and Nail Nourishment
While hair thinning and becoming a silver fox are often expected with age, brittle nails and sensitive skin can come as a surprise.
Like your bones, your hair and nails require essential nutrients to maintain their health, including calcium, keratin, and a few essential amino acids. Your body has a harder time producing these naturally. Avoid dyes and nail polish as much as possible on your hair and nails if you're feeling that they are becoming dry and brittle. You can also use organic sesame or coconut oil drops on your nails, cuticles, and hair tips to help condition and stay nourished.
Healthy Joints:
Joint pain is one of the most common reported conditions women struggle with post menopause.
As bones become more porous, muscles begin to lose their mass and elasticity, and the tendons and ligaments surrounding joints become weaker as well. This causes your joints to become more inflamed due to the amount of stress being placed on them without proper support from the surrounding tissue. The RM Soft Foam roller immediately reduces stress on joints, enhances synovial fluid circulation and production, and helps the muscles that support your joints activate and function properly.
Your Roadmap to Postmenopausal Thriving
Like with all other stages in life, there are three central Pillars to healthy living: daily nourishing exercise, nutritionally dense, delicious foods (shared with friends and family), and high-quality rest and sleep.
Exercise: Listen to your body and keep trying new moves
This is where your lifelong movement habits pay off. If you love lifting, running, yoga, and pilates, keep doing them. But keep trying new workouts as well. Listen to your body, focus on the magic trio of: fascial hydration, neuro-muscular activation, and intelligent cross-training. The pace may need to slow a little so that you can maintain good muscle activation throughout your workouts, but the key is to keep challenging your body to move dynamically, 3-dimensionally, and playfully.
Some excellent exercises to help women focus on mobility and overall strength are:
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Pilates roll-ups - sitting with legs outstretched, breathe to touch your toes, exhale to slowly roll down to your back with arms overhead, then roll back up and touch your toes - using back, core, chest, and side waist muscles. Repeat 5-10 times and notice how each one feels a little freer and how your abs begin to light up.
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Shoulder blade glides with a resistance band - standing tall, holding the band between your hands, slowly rotate your straight arms all the way overhead and down towards your back, and then return overhead until your arms are hanging by your sides. Repeat 5-10 times to open your chest, lungs, lats, side waist, and mid back muscles.
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Bird Dog - once your body is feeling open, come to hands and knees and alternate extending your right arm and left leg, touching them together under your chest and re-extending. 5 times, and then switch to left arm and right leg. Excellent for cross-body integrated strength, crossing the mid-brain barrier, and keeping your back, core, chest, and abs actively integrated and functionally strong
Bone & Heart Healthy Foods
Listen to your body and care for your body health. As you age, your digestive system slows, and the tissues lining your intestines and stomach need more TLC to remain strong and be able to absorb nutrients efficiently. You may find that you're eating less or craving less of the foods you once enjoyed, like spicy, rich meats or sugary sweets. Food that is cooked is easier to digest, and lean protein is easier for your liver to process and enrich your blood. Highly acidic substances like alcohol, caffeine, refined sugar, and white starches are rough on the stomach lining, so keep these to a minimum, and if you do enjoy them, make sure you balance them out with plenty of water, whole warm foods, and smaller meal sizes to give your digestive system a chance to process fully.
What essential nutrients do you need to maintain healthy bones and a healthy heart?
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Calcium
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Vitamin D
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Vitamin K
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Magnesium
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Phosphorus
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Potassium
You can get these nutrients from foods like whole, farmed milk, artisanal cheese, leafy greens, fish, nuts, and legumes/whole grains. Consult with your health care professional to ensure that there are no existing complications with medications or pre-existing conditions.
The Change of Life Is Your Next Chapter of Freedom
Aging has historically been cast as a negative aspect of life, most especially for women. It certainly puts us right up against the truth of mortality and the inevitability that one day, this body will no longer be alive.
That's a hard one to sit with. There is so much to love about this life, our families, and so much to live for!
So, your challenge is to look at those old narratives and rewrite a brand new script of living and aging with adventure, vitality, and thriving hearts and bodies, right up until your final breath. Now is the time. Take the reins on your health and happiness. Dive in and embrace your golden years with the joy, love, wisdom, and self-knowledge that only comes with having really lived.
Ready to start taking your first steps towards menopausal health mastery? Check out the RM Revive Program today for research-backed fitness routines, access to in-depth knowledge, and a community of friends who know just what you're going through in the RM Inner Circle!