Menopause and Hormone Balance

About menopause and hormone balance

What it is, why it happens and what helps. Contents:

• What is menopause?
• Perimenopause, menopause and postmenopause
• Common symptoms
• Hormone changes
• Medical treatment options
• CBT for menopause
• Clinical hypnosis
• Everyday tips for hot flushes
• Sleep
• Mood, anxiety and brain fog
• Yoga
• Exercise, bones and heart
• Food and nutrition
• Relaxation and mindfulness
• Menopause at work
• Talking about it
• A gentle 30-day plan
• How self-help methods fit in
• FAQs

What is menopause?

Menopause is when periods stop for good, because the ovaries make fewer hormones. It’s confirmed when you haven’t had a period for 12 months in a row. For most women, it happens between the ages of 45 and 55, with an average age of about 51 in the UK and the US. It can happen earlier, either naturally or because of surgery or medical treatments. Menopause is a natural transition, and with the right support many women feel well and confident through it. You can explore related topics in our Health hub, including sleep, healthy eating and energy and fatigue.

Perimenopause, menopause and postmenopause

Perimenopause is the time leading up to menopause, when hormone levels start to change and symptoms often begin. It can last several years, and periods may become irregular. Menopause is the point 12 months after your last period. Postmenopause is the time after that. Some symptoms ease in the years after menopause, while others, such as vaginal dryness, may continue and can be treated.

Common symptoms

• Hot flushes and night sweats.
• Trouble sleeping.
• Low mood, anxiety or irritability.
• Brain fog and trouble concentrating.
• Tiredness.
• Joint aches.
• Changes to periods.
• Vaginal dryness and lower sex drive.
• Headaches.

Every woman’s experience is different. Some have few symptoms, while others find them hard to live with. Whatever your experience, support is available.

Hormone changes

During perimenopause, levels of oestrogen and progesterone rise and fall unevenly before settling at lower levels after menopause. Oestrogen has roles throughout the body, including in temperature control, bones, the heart, skin, mood and the brain, which is why symptoms can show up in so many ways. Lisa Mosconi’s TED talk on menopause and the brain, in Videos, explains this beautifully.

Medical treatment options

It’s worth talking to your doctor about the options. Hormone replacement therapy (HRT), also called menopausal hormone therapy, is the most effective treatment for hot flushes and night sweats, [4] and your doctor can talk through its benefits and risks for you. There are also non-hormonal medicines, and vaginal oestrogen for local symptoms. The UK’s National Institute for Health and Care Excellence (NICE) has a guideline on menopause that explains the options, listed in our citations. [5] Your doctor can help you decide what is right for you.

CBT for menopause

Cognitive behavioural therapy (CBT) helps you understand how thoughts, feelings, behaviour and body sensations connect, and teaches practical skills to cope with symptoms. In the MENOS 2 trial with 140 women, both group CBT and self-help CBT with a book reduced how much hot flushes and night sweats bothered women at six weeks and six months, and also improved mood and quality of life. [1] The Menopause Society’s 2023 position statement recommends CBT as a non-hormonal option for hot flushes. [4] CBT for menopause often includes slow breathing as a flush begins, calming self-talk and changing habits that make symptoms worse. Professor Myra Hunter, who helped develop this approach, explains it in Videos.

Clinical hypnosis

Clinical hypnosis uses deep relaxation and mental imagery, such as picturing a cool place, together with suggestions for comfort. In a randomised trial with 187 postmenopausal women, those who had five weekly hypnosis sessions and practised self-hypnosis at home reported 74% fewer hot flashes by the end of the study, compared with 17% in the comparison group. Measured hot flashes fell by 57%, and sleep improved too. [2] The Menopause Society also recommends clinical hypnosis for hot flushes. [4] Dr Gary Elkins, who led this research, explains self-hypnosis in Videos.

Everyday tips for hot flushes

• Wear light layers you can remove easily.
• Keep your bedroom cool and use a fan.
• Keep a cold drink nearby.
• Notice personal triggers, such as hot drinks, spicy food, alcohol or stress.
• When a flush starts, slow your breathing and remind yourself it will pass.

Sleep

Night sweats, anxiety and hormone changes can all disturb sleep. A cool, dark, quiet bedroom, regular sleep and wake times, and a calming wind-down routine can help. CBT for insomnia is also a helpful approach. In the hypnosis trial above, women’s sleep quality improved as well. [2] Our sleep guide has more tips.

Mood, anxiety and brain fog

Many women notice low mood, anxiety, irritability or brain fog during perimenopause. These are common and usually improve. Talking to others, getting enough sleep, regular exercise and relaxation practices can help, and CBT can improve mood as well as hot flushes. [1] If low mood is persistent, talk to your doctor. Our anxiety guide and stress management guide have more ideas.

Yoga

Yoga combines movement, breathing and relaxation. A review of 13 trials with 1,306 women found that yoga reduced overall menopausal symptoms, including psychological, physical and vasomotor symptoms, compared with no treatment, and worked as well as other forms of exercise. [3] Gentle yoga is also a lovely way to stay flexible, strong and calm. A 10-minute menopause yoga session is in Videos.

Exercise, bones and heart

After menopause, lower oestrogen levels mean bones can become thinner and heart health becomes even more important. Regular exercise helps protect both. Weight-bearing activities such as brisk walking, dancing and stair climbing, plus strength training two or more days a week, help keep bones and muscles strong. Exercise also lifts mood and supports sleep. Our building muscle guide has ideas to get started.

Food and nutrition

A balanced diet with plenty of vegetables, fruit, whole grains, beans, nuts, oily fish and calcium-rich foods supports bone and heart health. Many health services, including the NHS, suggest considering a vitamin D supplement, especially in autumn and winter. Some women find that cutting back on caffeine, alcohol and spicy food helps with flushes. The Menopause Society notes that weight loss can help hot flushes for some women. [4] Our guides to healthy eating and weight loss have practical ideas.

Relaxation and mindfulness

Relaxation, meditation and mindfulness can help you feel calmer, cope better with stress and sleep more easily. Many women find that a few minutes of quiet practice each day helps them feel more in control. Slow breathing is also a key part of the CBT approach to hot flushes.

Menopause at work

Many women go through menopause while working. Helpful adjustments can include a desk fan, access to cool drinking water, flexible hours, breaks when needed and light uniforms. In the UK, Australia and a growing number of other countries, employers increasingly have menopause policies. Talking to your manager or HR team about what would help is a positive step.

Talking about it

Menopause is becoming much more openly discussed, which is a wonderful change. Sharing your experience with friends, family, a partner or a support group can bring comfort and practical tips. Women’s Health Concern, the Australasian Menopause Society and The Menopause Society in North America all offer free information, listed in Free resources.

A gentle 30-day plan

Week 1: Notice. Keep a symptom diary, including flushes, sleep and mood, and possible triggers.

Week 2: Talk. Book a chat with your doctor about your options, and share how you feel with someone you trust.

Week 3: Learn new skills. Try a CBT or self-hypnosis practice each day.

Week 4: Move and calm. Add yoga, walking or strength exercise, plus ten minutes of relaxation each day.

How self-help methods fit in

CBT and clinical hypnosis are recommended self-help options for hot flushes. Yoga supports overall wellbeing during menopause, and relaxation and meditation help with calm and sleep. These work well alongside any medical treatment your doctor recommends. You can see every method we cover in the full list above.

Frequently asked questions

What are the first signs of perimenopause?

Common early signs include changes to periods, hot flushes, trouble sleeping, mood changes and brain fog.

Does CBT help hot flushes?

Yes. Group and self-help CBT reduced how much hot flushes and night sweats bothered women, and improved mood. [1]

Can hypnosis help menopause symptoms?

Clinical hypnosis reduced hot flashes and improved sleep in a randomised trial, and is recommended by The Menopause Society. [2]

Does yoga help menopause?

A review of 13 trials found yoga reduced overall menopausal symptoms compared with no treatment. [3]

What is the most effective treatment for hot flushes?

Hormone therapy is the most effective treatment, and CBT and clinical hypnosis are recommended non-hormonal options. [4]

How long does menopause last?

Perimenopause can last several years. Symptoms such as hot flushes often ease over time, and treatments can help in the meantime.

How can I protect my bones after menopause?

Weight-bearing and strength exercise, a calcium-rich diet and enough vitamin D all help keep bones strong.

The best videos on menopause and hormone balance

Hand-picked and checked one by one: the British Menopause Society, TED, TEDx, Henpicked, EMAS, Contemporary OBGYN and Yourself Yoga.

Understanding menopause

CBT and hypnosis for symptoms

Lifestyle and yoga

Books on menopause and hormone balance

Free resources

Experts to follow

Get help

For bleeding after menopause or symptoms that worry you, please see your doctor.

Find a therapist or counsellor

• US and Canada: Psychology Today (US) and (Canada) directories.
• UK: BACP therapist directory.
• Australia: APS Find a Psychologist, and Relationships Australia for couple and family services.
• Elsewhere, including Europe and India: ask your doctor or local health service for a referral, and check that anyone you see is registered or accredited where you live.

This hub is for information, not a substitute for medical or psychological care.

Sources

1. Ayers et al. (2012), Effectiveness of group and self-help cognitive behavior therapy in reducing problematic menopausal hot flushes and night sweats (MENOS 2), Menopause 19(7):749-759
2. Elkins et al. (2013), Clinical hypnosis in the treatment of postmenopausal hot flashes: a randomized controlled trial, Menopause 20(3):291-298
3. Cramer, Peng and Lauche (2018), Yoga for menopausal symptoms: a systematic review and meta-analysis, Maturitas 109:13-25
4. The North American Menopause Society (2023), The 2023 nonhormone therapy position statement, Menopause 30(6):573-590
5. NICE (2015, updated 2024), Menopause: identification and management, guideline NG23

Written by Saj Ali. Last updated 3 November 2026. Spotted an error? Tell us and we will fix it.