Menopause: Forewarned is Forearmed!

by | Sep 7, 2022 | Articles, Pilates for Menopause, Uncategorized

If only I had understood more about the experience of Menopause I would have realised that from the age of around 45 I was in a state of hormonal fluctuation called Peri-menopause.

But I didn’t! I returned to live in the UK after 6.5 years of living abroad in 2012 and if I’m honest I wasn’t thrilled about it! My children were 9 and 12 and I hadn’t worked full time since before I had them and so with some trepidation I started my return to work as a Physiotherapist. After about 6 months of retraining I was back in the saddle. I had always had some difficulty sleeping and I thought the stress of an international move and returning to work was causing this problem to rear its head again. But other things were going on too….

Menopause Symptoms Crept up on me!

Gradually I noticed that my already dry skin got dryer! I had awful digestive difficulties, bloating and wind. Night sweats and palpitations added to my sleep disruption (waking 5-6 times a night) Hot flushes during the day only appeared much later. My periods became more frequent; every 21 days without fail and heavy. Embarrassing leaks became a monthly occurrence as I struggled to keep up with the flow on some days.

I ended up with iron deficiency anaemia, I was totally shattered and felt like nodding off most afternoons. My memory began to let me down; I had difficulty recalling names and I had a couple of near misses in the car. This made me worry about doing my job well.

All if a sudden I was anxious and didn’t feel like going out to socialise. My moods were fluctuating (putting it mildly) and I felt as though I was dragging myself through most days and spending my weekends recovering.

Finally I decided to go to my GP. My best recollection is that I was told I couldn’t have HRT until my periods stopped and that I could take antidepressants and Iron supplements. I said yes to iron but I didn’t want to take antidepressants. And so began a journey to discover as much as I could to help myself using lifestyle approaches to manage my symptoms.

Menopause Bingo

I now know that the symptoms I was experiencing were largely as a result of fluctuating levels of sex hormones. I was working part time temporary jobs during this time and this made me feel vulnerable so I didn’t seek help from my employers. Worse still I was of the mindset that I had to deal with this on my own and hardly ever voiced my difficulties to friends and family. My life could have been better if only I had realised earlier what was happening and asked for help.

If we were playing a game of bingo how many of the following Menopause Symptoms would you be able to check off on your card?

Mood Swings Bloating Dry Mouth Digestive Problems Tender Breast
Dizziness/Vertigo Night Sweats Headaches Hair Thinning Fatigue
Hot Flashes Depression Free! Urinary Pain Muscle Pains
Insomnia Decreased Confidence Anxiety Acne Skin Dryness
Vaginal Dryness Weight Gain Loss of Libido Joint Stiffness Brain Fog

What is Menopause

Menopause is a natural part of ageing that usually occurs somewhere between 45 and 55 years of age. But it can also occur earlier for a variety of reasons. Menopause is the end of the reproductive cycle; it happens when your ovaries stop producing as much of the hormone oestrogen and no longer release an egg each month. There is also a decrease in progesterone levels.

Definition: Menopause is reached when a year passes without having had a menstrual period. In the UK, the average age for a woman to reach menopause is 51.


The term Peri-menopause is used to describe the time approaching menopause before periods have stopped but when the balance of the sex hormones begins to change. Most women will experience some symptoms around the peri-menopause but the age of onset, duration and severity varies greatly from woman to woman.

I was one of the 25% of women to suffer severe symptoms in the peri-menopausal period that can begin months or as in my case years before your periods stop. Physical symptoms can reduce around the onset of menopause; lasting on average around 4 years after Menopause but some women will experience them for longer.

Premature or early Menopause

This can occur at any age, and in many cases there is no clear cause. Sometimes it’s caused by a treatment such as surgery to remove the ovaries (oophorectomy) or breast cancer treatments (chemotherapy or radiotherapy). Premature ovarian failure can sometimes run in families. This might be the case if any of your relatives went through the menopause at a very young age (20s or early 30s).

  • With menopause induced by drug treatments, there may be a short transition as the damaged ovaries shut down production of hormones over a period of time.
  • Following surgery, menopause occurs abruptly, on the day of surgery. This abrupt loss of ovarian hormones usually causes more drastic symptoms than those seen with natural menopause.
  • Menopause at an earlier age carries an increased risk for some diseases due to the loss of protection from oestrogen. For example an increased risk for osteoporosis and fragility fractures.

It is really important that these women are supported to ensure they receive adequate symptom relief and appropriate disease prevention treatment.

What are the long term health effects of Menopause?

Loss of oestrogen has effects throughout the body and there are some conditions which can be linked to declining oestrogen levels including:

  • Osteoporosis or thinning of the bone leads to increased risk of fractures of the wrist, hips and spine.
  • Loss of muscle mass and strength or Sarcopenia and can lead to functional decline, disability and falls
  • Menopause found to be a causative factor in Dementia and Alzheimer’s Disease in particular
  • Increased instances of Heart attack and Stroke
  • Pelvic floor Dysfunction and Pelvic Organ Prolapse more prevalent post menopause

Get Your Head Together

You could enjoy a more positive Menopause experience! Did you know Everything that we think, our body feels? So rehashing stressful situations, focussing on our worries and anxieties can all cause our body to feel what we think every time we think it. Focussing on the symptoms of menopause can send us into negative thought spirals that reinforce how those symptoms affect us. But if we can be more aware of when we are thinking these thoughts, catching the thoughts and replacing them with an alternative thought it can really create a powerful shift in how we feel.

There is lots we can do to help ourselves.

My approach to my own health and menopause management has evolved over that time. I incorporate lifestyle medicine into everyday using good nutrition, appropriate exercise, adequate rest and stress management techniques. I also use a low dose of body identical oestrogen in a patch and progesterone tablets prescribed by my GP.

My Menopause DIY Top Tips

There is a lot of evidence that lifestyle management strategies make a huge contribution to managing symptoms; both in the short and long term.

  1. Reducing processed foods especially high salt and sugar.
  2. Reducing Alcohol and smoking
  3. Exposure to natural daylight and fresh air every day.
  4. Stress reduction – Try meditation or relaxation techniques, a bath scented with aromatherapy oils
  5. Turn off technology at least 1 hour before bed
  6. Reduce caffeine; Try decaf after 12.00 noon
  7. Natural fibres and layers!
  8. Increase daily activity levels
  9. Pilates has been shown to Reduce Menopause symptoms and is a great way to introduce exercise safely in midlife and beyond.
  10. Yoga and meditation really helped me manage stress and anxiety and get a good night’s sleep.
  11. Regular weight bearing exercise can help reduce the risk of fracture, help to maintain independence and manage pain.

Why not join me to try Pilates or Yoga or BOTH!

Movement Really is Medicine

precizion pilates online for menopause womens health physiotherapist yoga class

There is pretty much NOT ONE symptom of Menopause that being more Physically active will not help!

  • Exercise can help reduce the risk of fracture, help to maintain independence and manage pain.
  • Studies have found that both resistance and aerobic exercise training increase muscle mass and improve function irrespective of age.
  • Only 10 minutes of light activity increases electrical activity in the hippocampus. This is the centre for learning, memory, mood and emotion in the brain. We see increases in the volume of the hippocampus in response to activity and it’s never too late to make positive changes.
  • When we Increase heart rate, we increase endogenous cannabinoids and endogenous opioids or the feel good chemicals!
  • Strength training increases physical endurance and decreases risk of injury.
  • Being more active benefits the heart, blood vessels and brain.

Try this Pilates Video to experience the power of Movement for Menopause


A Word about Pelvic health

Bladder, Bowel and/or sexual dysfunction is very common amongst peri and post Menopausal women and has a significant impact on sexual functioning, emotional wellbeing and activities of daily living. Somewhere in the region of 50% of women will suffer symptoms, but only around 25% seek out help.

The pelvic floor is a group of muscles and responds to specific muscle training exercises. Do not suffer in silence and seek help! Your Doctor can refer you to a women’s health Physiotherapist for a detailed evaluation and treatment plan.

The Role of Medication

The British Menopause Society recommends that hormone therapy has an important role in managing symptoms for healthy women during the menopause transition and in early menopause. This is great news for women but there are instances where medical conditions prevent women from receiving hormonal therapy and the side effects can prevent some women. It is definitely the case that even if you are taking medication it is not a cure all.

What can workplaces do to help?

Consider whether you have the following:

  • Easy access to sanitary, private washing and changing facilities and free sanitary products.
  • Uniforms and PPE that reflect the needs of menopausal women. Flexible, spacious and natural fibres
  • Manual handling assessments that take menopausal issues into account; such as joint and muscle aches
  • Opportunities for flexible working.
  • Health promotion resources and advice made available to women highlighting the importance of lifestyle choices before, during and after the menopause and the benefits of lifestyle modification.

Menopause is Normal but Struggling to Cope is NOT!

Menopause is a normal part of life and we can sail through it with no symptoms at all. But not everyone will be as lucky and there is no rhyme or reason why this may be the case. Even your mothers experience may not be yours. The most important message of all is to keep talking as we pick our way through the maze that is Menopause and seek assistance sooner rather than later.

Checkout my Moving through Menopause Podcast and sign up to receive my monthly newsletter packed full of top tips.

I help women to get the most out of life! so do Connect with me on social media and join my Moving through Menopause facebook group.


Phillipa Butler

Pilates for Menopause for Massage Therapists and Manual Therapists  - NAT Diploma Course with Precizion 10 CEUs

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Interested to learn Pilates or Yoga?

Join Precizion for regular online Pilates and Yoga classes.  All led by Phillipa Butler, a Chartered Physiotherapist, Clinical Pilates and Women’s Health Expert. One-on-one consultations also available.

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