Lifestyle Medicine and Menopause: Six Pillars for Midlife Health

Every October, World Menopause Day shines a spotlight on an important aspect of menopause. In 2025, the International Menopause Society (IMS) chose lifestyle medicine as its theme, highlighting how everyday habits can support health and wellbeing during menopause and beyond.

The IMS also published a White Paper, The Role of Lifestyle Medicine in Menopausal Health: A Review of Non-Pharmacologic Interventions, alongside six factsheets exploring practical ways to support health through midlife.

It's a subject worth returning to long after October has passed.

Lifestyle medicine might sound rather clinical, as though you need a lab coat and a clipboard to get involved. In reality, it includes familiar things: what you eat, how you move, how well you sleep, how you look after your mental wellbeing, the substances you consume and the relationships that help you feel connected to other people.

When you're navigating perimenopause or postmenopause, these areas can play an important role in your overall health. They aren't a magic solution, and they won't remove every menopause symptom. But they can be valuable parts of a broader approach to looking after yourself.

And no, that doesn't mean you have to become a morning person, take up marathon running or start making elaborate green smoothies before sunrise.

It means understanding what may help, deciding what matters to you and finding realistic ways to put it into practice.

Why Does Lifestyle Medicine Matter During Menopause?

Menopause is a natural stage of life, but the hormonal changes associated with it can coincide with changes in symptoms, body composition, sleep, mood and longer-term health risks.

You might notice that your sleep isn't what it used to be. Your waistline may change, your mood might feel less predictable, or the exercise routine that worked for you ten years ago no longer feels quite right.

There isn't one explanation for every change, and not every symptom is caused by menopause. Nevertheless, midlife can be a useful opportunity to review the habits and support that help you feel well.

Lifestyle medicine offers a framework for doing that across six interconnected areas.

Importantly, lifestyle approaches complement appropriate medical care; they don't replace it. Menopause hormone therapy (MHT), other medical treatments and psychological support may be appropriate, depending on your symptoms, health history and preferences. You deserve access to reliable information and the opportunity to make informed decisions with the right healthcare professionals.

If you'd like a broader introduction to how different aspects of health fit together, read my guide to a holistic approach to menopause.

Let's look at the six pillars highlighted by the IMS.

1. Healthy Eating: Nourishment Without the Diet Rules

You've probably seen enough headlines about the best menopause diet to fill a small library.

One day you're told to avoid carbohydrates. The next, you need more protein. Then somebody announces that a single ingredient will supposedly solve all your problems.

It's exhausting.

Healthy eating doesn't need to involve following every new trend or labelling foods as good or bad. A balanced eating pattern can help you meet your nutritional needs and support general health through midlife and beyond.

Depending on your circumstances, useful areas to consider include:

• Eating a varied range of vegetables, fruit, wholegrains and other fibre-rich foods.

• Including suitable sources of protein throughout the day.

• Choosing sources of unsaturated fats, such as olive oil, nuts and seeds.

• Paying attention to calcium and vitamin D, which are relevant to bone health.

• Finding meals and routines that fit your preferences, budget and everyday life.

These are general principles, not a prescription for what every woman should eat. Your nutritional needs may differ depending on your health, medications, preferences and other circumstances.

And please remember: eating well doesn't require perfection. A satisfying, practical meal you can make on a busy Tuesday is often more useful than an elaborate plan you abandon by Thursday.

The useful question isn't, "What's the perfect menopause diet?" It's, "What changes would help me eat in a way that works for my life?"

If you'd like some practical inspiration, you can explore my free menopause-friendly recipe collection.

2. Physical Activity: Supporting Strength, Bones and Everyday Life

Movement can become particularly important as we get older, including for maintaining muscle strength, supporting bone health, cardiovascular health and everyday physical function.

Yet when someone says you should exercise more, it's easy to picture a gym membership, complicated equipment and a personal trainer shouting encouragement while you question all your life choices.

That's not the only way to begin.

Physical activity can include walking, dancing, cycling, swimming, gardening, strength exercises or activities you genuinely enjoy. Muscle-strengthening and weight-bearing activities can be particularly relevant to maintaining strength and supporting bone health, although the most suitable approach depends on your circumstances.

If you're new to exercise, returning after a break or managing a health condition, start at a level that feels appropriate and seek professional guidance when needed.

A few useful questions to ask yourself are:

• What kind of movement do I enjoy, or at least dislike the least?

• What could fit into my existing routine?

• Would I find it easier to exercise with a friend or a group?

• Could I start with something small and build gradually?

Consistency matters, but it doesn't mean following a rigid routine every day. Life happens. The aim is to find a way of moving that you can adapt as your needs and circumstances change.

For more on this topic, read my guide to strength training for menopause.

3. Mental Wellbeing: Making Space for Your Emotional Health

Perimenopause and menopause can coincide with changes in mood, confidence, stress levels and emotional wellbeing. Sleep disruption, life pressures, physical symptoms and other circumstances can also influence how you feel.

If you're more irritable than usual, feel overwhelmed by things you previously managed easily, or find yourself running on empty, you don't have to dismiss it as something you should simply put up with.

Looking after mental wellbeing can involve several approaches, depending on what you need.

You might find it helpful to build short periods of rest into your day, practise relaxation techniques, spend time outdoors, reduce avoidable pressures or make space for activities that help you feel like yourself.

Sometimes, though, self-care isn't enough on its own. If anxiety, low mood or other emotional difficulties are persistent or affecting your everyday life, consider speaking to your GP or an appropriate mental health professional.

Lifestyle changes may form part of the picture, but they aren't a substitute for treatment when treatment is needed.

It's also worth remembering that you don't need to wait until you're completely overwhelmed before asking for support.

4. Avoiding Risky Substances: Small Choices, Wider Health

The IMS includes the avoidance of risky substances as one of its six lifestyle medicine pillars.

This includes considering smoking, alcohol and other substances that may affect health. The aim isn't to judge anyone's choices or pretend that changing an established habit is easy. It's to understand potential risks and make informed decisions.

For example, smoking is associated with significant health risks, and stopping can benefit health at any age. Alcohol can also affect sleep and general health, so reviewing how much you drink may be worthwhile.

That doesn't mean every woman will notice the same effects, or that reducing a particular substance will resolve her menopause symptoms.

If you're considering changing a habit, start by understanding what role it plays in your life. Is it connected to stress, socialising, sleep or the need for a break? Recognising the pattern may help you identify an alternative that feels realistic.

If you drink heavily or are concerned about dependence on alcohol or another substance, seek appropriate professional advice before making significant changes. Stopping some substances suddenly can be dangerous without medical support.

The goal is informed, sustainable choices rather than another set of rules to feel guilty about.

5. Restorative Sleep: More Than an Early Bedtime

If you've ever woken at 3am and found yourself mentally reorganising your entire life, you'll know how frustrating disrupted sleep can be.

Sleep difficulties are common around the menopause transition, although there can be several contributing factors. Night sweats and hot flushes may play a role for some women, while stress, changes in routine, sleep disorders and other health conditions can also affect sleep.

Improving sleep isn't always as simple as going to bed earlier. Nevertheless, some practical habits may help support a more consistent routine:

• Keep your waking time reasonably consistent where possible.

• Create a bedroom environment that feels comfortable for sleeping.

• Allow yourself time to wind down before bed.

• Consider whether caffeine, alcohol or late-evening activities affect your sleep.

• Look at how stress and daytime routines may be influencing your nights.

These steps won't resolve every sleep problem, and persistent insomnia or significant daytime tiredness deserves appropriate assessment. Menopause-related symptoms may also benefit from medical treatment.

You don't have to accept months of poor sleep as an inevitable part of midlife.

If night waking is your particular struggle, my free 3AM Wake-Up Guide offers a practical place to start.

6. Healthy Relationships and Community: You Don't Have to Do Everything Alone

This sixth pillar deserves more attention than it sometimes gets.

When we think about health, we often focus on food, exercise and sleep. But our relationships and sense of connection matter too.

Having people you can talk to, spending time with others and feeling part of a community can contribute to emotional wellbeing. Social connection can also make healthy habits easier to maintain: it's often more enjoyable to walk with a friend, try a new activity with a group or share a meal than to do everything alone.

Of course, not everyone has a ready-made support network. Work, caring responsibilities, living circumstances, mobility, money and other barriers can make it harder to connect with people.

And social connection doesn't have to mean a packed calendar or becoming the chairperson of every local committee.

It might mean:

• Arranging a regular walk or coffee with a friend.

• Joining a group connected to an interest you enjoy.

• Attending a local activity or community event.

• Reconnecting with someone you've lost touch with.

• Finding a supportive menopause community where you can share experiences.

• Asking someone you trust for help when life feels particularly demanding.

Quality matters more than the number of people you know. A small number of supportive relationships can be just as meaningful as a wide social circle.

Not every relationship is supportive, of course. If a relationship is a source of significant distress, the right next step may be boundaries, professional support or help with your safety rather than trying harder to maintain it.

The important point is that looking after yourself doesn't have to be a solo project. Connection, practical help and shared experiences can all be part of how you support your wellbeing.

Turning the Six Pillars Into Everyday Life

Reading about healthy habits is one thing. Making them work around deadlines, family responsibilities, unpredictable sleep and everything else in your life is another.

You don't need to overhaul all six areas at once. In fact, trying to change everything simultaneously can leave you feeling overwhelmed before you've really begun.

Instead, consider these questions:

• Nutrition: Is there one meal or eating habit I'd like to make easier?

• Movement: What kind of activity could I realistically fit into my week?

• Mental wellbeing: What helps me feel calmer, more supported or more like myself?

• Risky substances: Is there a habit I'd like to understand or reconsider?

• Sleep: What is one thing I could change to support my sleep routine?

• Relationships and community: Who could I spend more time with, reconnect with or ask for support?

Choose one area that matters to you. Make the first step small enough to be manageable, and consider what might get in the way.

If it doesn't work the first time, that isn't proof that you've failed. It may simply mean the plan needs adjusting.

This is where behaviour change becomes important. Understanding what might support your health is useful; developing routines that fit your actual circumstances is a different challenge.

My article on behaviour change in menopause explores why making changes can be harder than knowing what to do.

Where Does Menopause Coaching Fit In?

As a nutrition and health coach, I help women explore what matters to them, identify practical goals and work towards habits that fit their lives.

That doesn't mean I diagnose medical conditions, prescribe treatment or replace a doctor, menopause specialist, therapist or other healthcare professional. Nor does coaching guarantee that particular symptoms will improve.

Instead, coaching can provide a structured space to think through your priorities, recognise obstacles, build confidence and review what is and isn't working.

For example, you might already understand the value of regular movement but struggle to fit it around work and caring responsibilities. Perhaps you want to improve your everyday routines but feel overwhelmed by conflicting information. Or you may simply want help turning broad intentions into manageable steps.

The approach starts with your circumstances rather than assuming that the same plan will suit everyone.

Lifestyle medicine isn't about achieving perfect habits. It's about understanding the options available to you and making informed, realistic choices that support your health and wellbeing.

If you're interested in learning more, you can read what a health coach can do for you.

Explore Your Options

If you're still deciding what kind of support would be most useful, these articles may help:

• Menopause coach, therapist or GP: which support is right for you? Explore the different roles these professionals can play and when their support may be appropriate.

• Is menopause coaching worth it? Understand what coaching can realistically offer, what working together involves and how to consider the investment.

Each type of support has a different role, and you may benefit from more than one.

Your Next Step: Start With the Menopause Blueprint

You don't need to change six areas of your life this week. You don't need a perfect routine, an expensive gym membership or a fridge full of carefully labelled containers.

You need a starting point that makes sense for you.

My free Menopause Blueprint is designed to help you take a step back, make sense of the bigger picture and consider where to focus your attention.

Rather than trying to do everything at once, use it as an opportunity to identify what matters most to you and what a manageable next step might look like.

Get your free Menopause Blueprint

Because looking after your health through menopause isn't about doing everything perfectly. It's about finding a way forward that works for you, with the right information and support along the way.

References

The International Menopause Society's 2025 World Menopause Day resources provide a useful starting point for exploring the evidence behind lifestyle medicine in menopausal health.

• IMS World Menopause Day 2025: Lifestyle Medicine in Menopausal Health - information about the 2025 theme and its supporting resources.

• The IMS White Paper: The Role of Lifestyle Medicine in Menopausal Health - a review of non-pharmacological approaches to supporting health during menopause.

• IMS World Menopause Day 2025 factsheets and resources - resources covering healthy eating, physical activity, mental wellbeing, avoiding risky substances, restorative sleep and healthy relationships.

Lifestyle approaches can play a valuable role in supporting health, but they are one part of menopause care. If you're experiencing troublesome symptoms or have concerns about your health, speak to an appropriate healthcare professional about your options.