Medical disclaimer: All content on M Pause is for informational purposes only and does not constitute medical advice. Always consult your GP or healthcare provider before making treatment decisions.
Perimenopause
Menopause
Post-menopause

Your body,
understood.

Evidence-based information for every stage of the menopause journey. No fear. No myths. Just science — clearly explained.

51average age of menopause (UK)
13Mwomen in menopause in UK
80%experience symptoms
ðŸŒļ
Stage 1
Perimenopause
Late 30s – early 50s · Cycles still present
  • Irregular or heavier periods
  • Sleep disruption & insomnia
  • Mood changes & anxiety
  • Brain fog & memory gaps
  • Libido changes
  • Joint aches
ðŸŒŋ
Stage 2
Menopause
Defined as 12 months with no period
  • Hot flushes & night sweats
  • Vaginal dryness (GSM)
  • Bone density begins to fall
  • Cardiovascular risk increases
  • Weight redistribution
  • Skin & hair changes
ðŸ”Ū
Stage 3
Post-menopause
1+ year after final period
  • Osteoporosis risk rises
  • Heart health becomes key
  • Cognitive protection matters
  • Genitourinary syndrome ongoing
  • Long-term HRT review
  • Thriving in midlife
Symptom checker

What are you experiencing?

Click any symptom to understand the science behind it, which stage it most commonly occurs, and what the evidence says about management.

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Brain fog
Perimenopause
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Hot flushes
Menopause
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Sleep disruption
Perimenopause
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Vaginal dryness
Menopause · Post
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Mood & anxiety
All stages
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Bone density loss
Post-menopause
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Low libido
Perimenopause
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Heart health
Post-menopause

Evidence-based management

HRT information

Hormone Replacement Therapy

The most effective treatment for menopausal symptoms. Modern HRT is safe for most women. Here's what the evidence actually says.

NICE Guideline NG23 · BMS Position Statement 2020

The 2002 WHI study caused widespread HRT fear. Subsequent research has clarified that modern transdermal HRT carries a very different risk profile. For most women under 60 or within 10 years of menopause, benefits outweigh risks.

Get evidence summaries →
Oestrogen-only HRT
For women who have had a hysterectomy. Patches, gels, or sprays deliver oestradiol transdermally — avoiding first-pass liver metabolism and associated clot risk.
Strong evidence
Combined HRT (E + P)
Oestrogen plus progesterone for women with a uterus. Micronised progesterone (Utrogestan) carries lower breast cancer and clot risk than older synthetic progestogens.
NICE recommended
Testosterone therapy
Evidence supports testosterone for low libido in menopause. Also improves energy, mood and cognitive function. Increasingly recognised in NICE and BMS guidelines.
Growing evidence
Local oestrogen (vaginal)
Treats genitourinary syndrome of menopause (GSM). Minimal systemic absorption. Safe for long-term use and does not carry the same considerations as systemic HRT.
Safe long-term
Nutrition & recipes

Food as medicine

Evidence-based nutrition for every stage. Each recipe is designed around the science of what your hormones need.

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Hormone balance
Phytoestrogen power bowl
Edamame, flaxseed, tofu, and pomegranate. Phytoestrogens may modestly reduce hot flush frequency.
Perimenopause ⏱ 15 min ðŸŒą Vegan
Messina M. Menopause 2014
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Bone health
Omega-3 salmon with kale
Wild salmon, cavolo nero, and sesame. Vitamin D, calcium and omega-3 protect bone density and reduce inflammation.
Menopause ⏱ 20 min 🐟 Pescatarian
Eastell R. NEJM 2009
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Brain health
Mediterranean brain bowl
Blueberries, walnuts, olive oil, and dark leafy greens. The MIND diet reduces cognitive decline risk post-menopause.
Post-menopause ⏱ 10 min ðŸŒŋ Vegetarian
Morris MC. Alzheimers Dement. 2015
ðŸŒū
Gut health
Fermented oat & seed breakfast
Overnight oats with kefir, chia, and pumpkin seeds. Supports the oestrobolome — gut bacteria that metabolise oestrogen.
All stages ⏱ 5 min ðŸĨ› Vegetarian
Baker JM. Maturitas 2017
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Heart health
Black bean & turmeric stew
Legumes, turmeric, and tomatoes. Soluble fibre lowers LDL cholesterol; curcumin has anti-inflammatory properties.
Menopause ⏱ 30 min ðŸŒą Vegan
Muka T. JAMA Intern Med 2016
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Anti-inflammatory
Cruciferous calcium plate
Broccoli, almonds, sesame tahini, and fortified tofu. Calcium and magnesium to support bone remodelling post-menopause.
Post-menopause ⏱ 20 min ðŸŒą Vegan
Kanis JA. Osteoporos Int 2008
Movement & exercise

Move with purpose

Exercise is one of the most evidence-backed interventions for menopause symptoms. Here's what the science says — by type.

All types
Strength
Cardio
Mind-body
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Resistance training
Bone density · Muscle mass · Metabolism
Weightbearing exercise stimulates osteoblast activity, protecting against the rapid bone loss of the first 5 post-menopausal years.
2–3× per week All stages Level: beginner+
Chilibeck PD et al. Br J Sports Med 2021
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Brisk walking
Cardiovascular · Mood · Hot flushes
150 mins per week of moderate aerobic activity reduces cardiovascular risk and has modest evidence for reducing vasomotor symptom frequency.
30 min daily All stages Level: any
Daley A et al. Maturitas 2015
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Yoga & mindfulness
Sleep · Anxiety · Hot flushes
RCT evidence shows yoga reduces perceived hot flush severity and improves sleep quality. The MENOS trial found CBT-based mindfulness effective for symptom distress.
3–5× per week All stages Level: any
Ayers B et al. Menopause 2012
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Pelvic floor training
Bladder control · Sexual function · GSM
Kegel exercises improve urinary continence and pelvic organ support. Cochrane review confirms significant improvement with supervised pelvic floor training.
Daily Menopause · Post Level: any
Dumoulin C et al. Cochrane 2018
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Swimming
Joint pain · Cardiovascular · Mood
Low-impact aerobic exercise ideal for joint pain (common in perimenopause). Improves cardiovascular fitness without stress fracture risk from high-impact activity.
2–3× per week All stages Level: any
Watt FE. Maturitas 2018
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Nature walking (green exercise)
Cortisol · Anxiety · Mood
Combines aerobic benefit with cortisol reduction. HPA axis dysregulation — worsened at menopause — responds particularly well to time in natural environments.
3× per week All stages Level: any
Genazzani AR. Gynecol Endocrinol 2006
Mental health & wellbeing

Your mind matters

Mood, anxiety, and depression are not just "emotional" — they have a hormonal and neurological basis. Here's the evidence.

2×
Women are twice as likely to experience depression during perimenopause than at other life stages.
Cohen LS et al. Arch Gen Psychiatry 2006
68%
of women with moderate-severe symptoms report significant impact on their work performance and daily life.
Hardy C et al. Maturitas 2018
62%
reduction in anxiety symptoms seen with HRT in women with hormonal anxiety during perimenopause.
Freeman EW. Menopause 2010
CBT for menopause
Cognitive behavioural therapy is NICE-recommended for menopausal symptoms where HRT is not wanted or suitable. The MENOS trial showed significant reduction in hot flush distress and improved sleep.
NICE recommended · MENOS Trial 2012
Mindfulness-based stress reduction
MBSR programmes reduce perceived stress, anxiety, and sleep disturbance in menopausal women. Cortisol regulation improves, supporting the HPA axis that is disrupted by oestrogen decline.
RCT evidence · Carmody JF 2011
Antidepressants & non-hormonal options
SSRIs and SNRIs (particularly venlafaxine and escitalopram) have moderate evidence for reducing hot flushes and treating co-occurring depression. Fezolinetant — a new NKB antagonist — is now licensed for vasomotor symptoms.
NICE NG23 · NICE 2023
Social connection & community
Isolation amplifies symptom distress. Peer support groups and online communities provide validated psychological benefit for menopausal women, independent of medical treatment.
Qualitative evidence · Hunter MS 2016
Research library

The evidence base

Every claim on M Pause is backed by peer-reviewed research. Here is our curated citation library — searchable by topic and stage.

All topics
Hormones & HRT
Bone health
Cardiovascular
Mental health
Nutrition
Exercise
Study Journal Year Topic Impact
Resource library

Tools to empower you

Evidence-based guides, trackers, and tools — free and paid. Everything designed to help you navigate menopause with knowledge and confidence.

Free downloads
Most popular
Free
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GP Appointment Prep Guide

What to say to your doctor about menopause symptoms. Includes symptom tracker, word-for-word scripts, 12 questions to ask, HRT options, your patient rights, and a post-appointment action plan.

8 pages PDF All stages Evidence-based
Download free →
NICE NG23 · BMS 2020 · peer-reviewed
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Free · Coming soon
Symptom Diary Template

4-week daily symptom log. Track patterns, triggers, and severity to share with your doctor.

4 weeks Printable PDF
Notify me →
Coming soon — paid guides
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Understanding HRT Guide
Complete guide to every type of HRT — benefits, risks, and how to choose.
ÂĢ9.99 · PDF · 20 pages
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Menopause Meal Plan
4-week evidence-based meal plan with 28 recipes and a shopping list.
ÂĢ14.99 · PDF · 40 pages
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Brain Fog Action Plan
Science-backed strategies for cognitive symptoms — diet, sleep, exercise, and treatment.
ÂĢ9.99 · PDF · 16 pages
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Move Through Menopause
12-week exercise programme designed specifically for perimenopausal and menopausal women.
ÂĢ19.99 · PDF · 48 pages
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