The menopause might feel as though it’s decades away, but if you want to have an easier ride of it when the time comes, you’ve got to start preparing now, argues writer Sophia Akram.

Moving homes, new relationships, career prospects and summer holidays. These are some things you might be thinking about when you’re in your 20s and 30s. What most people in this age range probably aren’t likely to be pondering, however, is ‘the big change’. It may be the furthest thing from your mind, but the reality is that menopause isn’t a sudden condition that hits women once they reach their late 40s. Rather, it’s a gradual transition (called perimenopause) and can start 10 years before menopause itself.

As many as 5% of the UK population will reach menopause earlier than the average age of 45-55, while 1% experience it earlier than 40. In your 20s, the likelihood is 0.1%. And the longitudinal US study SWAN showed that women from Black and other minoritised ethnic groups might experience menopause earlier than the average.

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Early and premature menopause: the signs, symptoms and what to expect

There’s certainly more awareness now of what can be distressing symptoms of menopause: increased anxiety, osteoporosis, insomnia and a slower metabolism. The earlier you start monitoring and recognising those symptoms, the more empowered you will be to seek advice and start a treatment plan to alleviate them and other long-term effects. 

Most of us can usefully integrate diet and fitness tweaks, including more strength training to build muscle mass and bone density, which also helps prevent low hormone-related diseases and symptoms.

What are the symptoms of perimenopause?

“Some women have lots of symptoms; some women might only have one symptom and that symptom is enough to really impact the quality of their life,” says GP and menopause specialist Dr Louise Newson, explaining there is no blueprint of how women experience perimenopause.

Some people may start feeling worse just before their periods – more irritable and tired – other people feel those days last longer. Some experiences will involve symptoms coming on very quickly with a sudden onset of mood, memory and sleep issues. Hot flashes and night sweats are commonly cited problems but not all women will experience these. However, some women will feel bad all of the time.

There are more unusual symptoms too, such as urinary symptoms, vaginal dryness, burning mouth, tinnitus, restless legs and itchy or dry skin. Symptoms may vary throughout the days as well. 

“There’s this misconception that women have to manage the symptoms,” says Dr Newson. “When women have symptoms, it’s a sign that their hormone levels are low.” And that can be easily treated with hormone replacement therapy (HRT), which Dr Newson says “is safe for the majority of women”.

Hot flushes might be one of the most talked about symptoms, but not every women will experience them in the same way.

Poor treatment can affect how difficult the menopause can be

Taking HRT earlier can also reduce the risk of disease, says Dr Newson. But, as well as women empowering themselves with information, there should also be a wider acknowledgement that women’s choice is largely being dismissed. Women have been refused HRT, for example, and given antidepressants instead.

“Women are just being ignored, which has got to stop. It’s 2022,” says Dr Newson.

“Women know their bodies; often, women understand whether their symptoms are due to their hormones or not. And if they think they are, then they absolutely should be taken seriously.”

However, while a 1% chance of experiencing menopause before your 40s may seem like good odds, one in 100 women is actually a significant proportion, says Dr Newson: “A lot of women are told they’re too young to be menopausal or perimenopausal – for which no one is too young.”

That is why it’s so important that women know when to get appropriate guidance from a healthcare professional. You really want to see your GP as early as possible, particularly once symptoms start affecting your quality of life.

But Dr Newson also says that moderating diet and exercise can assist with some of the health-related risks associated with having low hormone levels, as can looking at your sleep and mental wellbeing. Perimenopause is, therefore, a good time to take stock and consider how we live our lives and how it will affect our future selves. 

How to eat in the run up to the menopause

Irina Allport, a personal trainer and nutritional coach, also recognises the benefit of reviewing diet and exercise practices during perimenopause and menopause, something she homed in on after watching her mum have a particularly tough time going through it.

She found that some of the best ways of looking after your health are to incorporate more fish, nuts, veggies, fruit and dairy into your eating plans.

“Eat natural foods and stay clear away from anything that elevates your hormones – coffee, booze or overconsumption of sugar. We want you to have a balanced body to help out with all the changes taking place,” says Allport.

In addition, Allport advocates for eating soy foods, phytoestrogens or plant-based oestrogen that mimics the role of natural oestrogen in the body. Research suggests that eating phytoestrogen-rich foods (soy milk, tempeh, tofu, soy-linseed bread) may ease menopausal symptoms.

Supplements for good hormonal health during the perimenopause

Supplements can form part of any regime. Allport says to consider:

  • flaxseed for easing night sweats
  • calcium to prevent bone loss
  • vitamin D to compensate for low-oestrogen-related vitamin D deficiency
  • ginseng, which helps as a mood booster
  • St. John’s Wort to control mood swings

Exercise tweaks for hormonal support

Then there’s exercise, which many say should include more resistance training and balance – not just cardio.

“Strength train. This is the best thing to do as we get older,” says Allport. “Strength training exercises will help to build bone and muscle strength, and rev up your metabolism. At home, opt for dumbbells and resistance bands.”

Being more attentive to your diet and exercise can improve mood, balance hormones, sleep and energy levels and lower heart disease, diabetes and osteoporosis risks, says Allport, which are linked to low hormone levels. In addition, professionals say the younger you start these exercises, the more beneficial it is.

Irina Allport recommends the following strength-building exercises for menopause and perimenopause:


  1. Stand straight with feet hip-width apart
  2. Tighten your stomach muscles
  3. Lower yourself down, as if sitting in an invisible chair
  4. Straighten your legs to lift yourself back up
  5. Repeat 8-12 reps for 3-5 sets

Shoulder press

Equipment: set of dumbbells/1.5 litre water bottles

  1. Stand with feet shoulder-width apart and hold the dumbbells at shoulder height with your elbows at a 90-degree angle
  2. Slowly lift the dumbbells above your head without fully straightening your arms. Pause at the top.
  3. Slowly return to the start position.
  4. Repeat 8-12 reps for 3-5 sets.


  1. Lie on the floor with your elbows under your shoulders, hands flat on the floor and core engaged
  2. Keeping your forearms and knees on the floor slowly raise yourself upwards until your body is in a straight line from your knees to your head
  3. Hold the position for as long as you can – aim to hold the position for 40-45 seconds 
  4. Repeat 3-5 times.

Images: Getty

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