What Actually Happens During Menopause, And What You Can Do About It

Let's be clear from the start... I'm not a Doctor, in fact I'm not even a woman, so will never experience Menopause personally... however as an experienced Personal Trainer of 25+ years this topic comes up constantly with my clients, and after recording this week's episode of The Voice of Fitness Reason Podcast, I feel like I've had a proper education.

We were joined by Dr. Vic - a GP from Sunderland with a specialist interest in women's health and additional qualifications in menopause. She is, as my co-host Katie put it, "one of the loveliest people I know." And she knows her stuff.

This blog is my attempt to share the key takeaways from that conversation as plain and simply as I can, without any 'mansplaining' (I promise 😝)

So... what actually IS menopause?

Here's the thing that surprised me. Menopause is technically just one single day.

It's the point 12 months after your last period. That's it. One moment in time, like a birthday. Everything before that is called perimenopause (the transition phase, which can last several years). Everything after is post-menopause.

So when people say "I'm going through the menopause" what they're usually describing is perimenopause, and that's where most of the action happens.

Dr. Vic described the ovaries as a hormone factory. For most of a woman's adult life, that factory runs smoothly, producing oestrogen (which affects your mood, brain, bones, skin, heart, and temperature control) and progesterone (which regulates periods and has a calming effect).

As you get older, the factory starts having good days and bad days. Hormones become unpredictable. And that unpredictability? That's what causes the symptoms.

What are the symptoms to look out for?

Dr. Vic was clear: it's different for everyone. But some of the most common signs include:

• Irregular periods — closer together, further apart, lighter, heavier, or skipped altogether

• Hot flushes — a sudden feeling of heat in the face, neck, or chest

• Night sweats — which mess with your sleep, which then messes with everything else

• Mood changes — anxiety, irritability, low mood, feeling overwhelmed

• Brain fog — difficulty concentrating, forgetting words, losing your train of thought

• Joint aches and changes in body composition — particularly weight around the middle, which is linked to cortisol shifts during perimenopause

• Vaginal dryness — yes, we're talking about it, because it matters

She also made the point that women at this stage of life are often juggling careers, teenage kids, elderly parents, and more. So when an "off day" isn't an option, these symptoms hit harder.

What can you do about it?

1. Move — and move smart

This is where I get to chip in. Dr. Vic put weight training at the top of the list, and I nearly fell off my chair with joy.

Here's why it matters so much during perimenopause and post-menopause:

• As oestrogen drops, you lose muscle mass (a condition called sarcopenia) and your bones thin. Weight training helps counter both.

• It improves sleep, mood, and self-esteem.

• It builds what Dr. Vic brilliantly called "bone in the bank" — strength and resilience you'll be drawing on for decades to come.

One thing she flagged that I found really interesting: lots of women come to me wanting to do lots of cardio to lose weight. Understandable. But during perimenopause especially, extended cardio sessions can push cortisol levels up — and elevated cortisol is linked to fat storage around the middle. The very thing they're trying to shift.

Her recommendation? Weight training, high-intensity short-burst cardio, or simply getting your steps in. The middle zone — long steady-state cardio — is where you want to be careful.

"It doesn't matter how much exercise you do, it's all in your mouth if you want to fix weight." — Dr. Vic (and also basically every evidence-based professional ever 😄)

2. See your GP

If lifestyle changes aren't cutting it, please make the appointment. There's a lot that can be done.

HRT (Hormone Replacement Therapy) is an option for most women and can make a real difference to flushes, sweats, mood, brain fog, and more. Dr. Vic was reassuring: for the vast majority of women, there's a form of HRT that's safe and suitable.

For those who can't take HRT, there are other options — including certain antidepressants that help with flushes and sweats, and topical oestrogen for vaginal symptoms.

The key message: there is always something that can be done. It just might look different for you than it does for someone else.

3. Don't suffer in silence

Dr. Vic put it best: "You're not alone if you are experiencing these symptoms. This is real, and it's really happening to you."

What about PMDD?

We also covered PMDD (Premenstrual Dysphoric Disorder) — which came up because Katie had been experiencing symptoms she thought were perimenopause, but turned out to be PMDD.

The short version: PMDD is like PMS turned up to 11. Severe low mood, anxiety, irritability, and relationship difficulties — but in a very predictable, cyclical pattern tied to the menstrual cycle. Symptoms usually appear in the one to two weeks before a period, then lift when the period arrives.

If you suspect PMDD, it's worth tracking your cycle carefully and speaking to your GP. There are effective treatments available.

Listen to the full episode

Dr. Vic explains all of this far better than I can: including some brilliant analogies involving hormone factories, foremen, and workers on strike. Honestly, it's worth a listen.

Want to start building strength?

If this episode has nudged you to do something about it — brilliant. That's exactly the point. I've put together a free 5 Day Strength Kickstart Video Series designed for people who want to build strength without it feeling complicated or intimidating.

Hope it helps

FRANK

your Personal Trainer / Menopause Appreciator