Your menopause. It’s never too early to start thinking about it

I’ve been working for 7 years now as the BiG TOE reflexology and through working with a broad spectrum of clients have realised my passion is in women’s health. Although having said that I still love treating all the different clients I see particularly the little ones helping them poo and my wonderful, regular clients who love it for their health and wellbeing.

“I’m still too young to start thinking about that. I want to keep my head in the sand for as long as possible.”

Since turning 44 I’ve been reading, researching and going on specific reflexology menopause courses to try and get my head around it all. I’ve realised it’s NEVER TOO EARLY to start thinking about the menopause. I asked one of my friends, who is in her early 40’s if she wanted to come on a menopause yoga retreat and her response was, “I’m still too young to start thinking about that. I want to keep my head in the sand for as long as possible.” This is exactly what I thought, until about a year ago. I’ve now realised if I start making gradual adjustments to my lifestyle early on, I might just have an UNEVENTFUL menopause. Far more importantly, I want to be aware of what happens after the menopause and protect my mind and body from the aftermath of progesterone, oestrogen and testosterone decrease, as well as the havoc cortisol can cause when it’s unbalanced and unruly.

I want my reflexology sessions to empower and educate women as to what the menopause is, what happens during it, how they can look after themselves and what they need to think about afterwards.

The main thing is the menopause is a journey and you will get through it. You don’t have to just make do and put up with it. I want to help my clients understand there are ways they can make a difference to their menopause before, during and afterwards.


The menopause marks the end of our periods and natural reproductive years. Perimenopause is the first sign of the menopause and can last around 4 years. It can have all the trademark symptoms of the menopause. The only difference is that you are officially in the menopause once you have stopped having a period for 12 whole months.

The first signs of the perimenopause can be irregular periods, hot flushes and night sweats, dry skin, eyes or mouth. There are also about 40 different symptoms associated with the perimenopause and menopause. These can include:

Hot flushes, night sweats, heart palpitations, irritability, mood swings, insomnia, low libido, increased facial hair, gum disease, tinnitus, fatigue, anxiety, depression, poor memory, incontinence, itchy skin, weight gain, hair loss, muscle aches and pains, bad breath, allergies. I even heard one husband complaining his wife’s smell had changed…

You also need to be aware that Hypothyroid has similar symptoms: fatigue, depression, mood swings, weight gain, irregular periods and insomnia.  

As your hormones decrease this can also lead to insulin resistance and drive Type 2 Diabetes. Symptoms of this can include: lethargy, hunger, brain fog, weight gain, high blood pressure and high cholesterol. Risk factors for this happening include: being overweight, living in a chronic level of stress, eating a high sugar and calorie diet. Therefore if you’re starting to feel “just not yourself,” it’s always helpful to get a blood test at your doctors to eliminate Hypothyroid and Type 2 Diabetes and find out what’s going on.

GP tests you can ask for:

Thyroid test: This shows problems with your thyroid gland, which can affect your period and can cause symptoms that seem like the menopause.

Follicle-stimulating hormone (FSH) test: FSH goes up as you near menopause. However this is usually a test for the under 45s. After 45 the results can be too erratic to know if this is the menopause or not.

Estradiol test: This tells your doctor how much oestrogen your ovaries are making. Once you start perimenopause your oestrogen levels will start decreasing.

Anti-Mullerian hormone (AMH): Your body makes AMH in its reproductive tissues. It can help your doctor learn about the reserve of eggs you still have in your ovaries.


Women are born with all of their eggs stored in their ovaries. Their ovaries also make the hormones oestrogen and progesterone which control  periods and the release of eggs. Menopause happens when the ovaries no longer release an egg every month and your periods stop. The menopause can last about 4 years but it can be shorter and longer…

Hormones in nutshell:


When it’s balanced: it has a calming influence, builds uterine lining, helps blood flow, breast growth and protects our bones.

When there is too little: you become lethargic, depressed, have mood swings, hot flushes, dry skin, headaches. It can also affect blood vessels and lymphs. Your liver can become fatty, inflamed and increase cholesterol production.

With less oestrogen, your body fat is redistributed so your shape can change. It can cause you to eat more, do less and it can lower metabolic rate, effect sleep and make your body less effective in using up carbs.


When it’s balanced: it maintains womb lining, protects our bones and helps breast feeding. It’s a calming hormone that promotes sleep.

When there is too little: it causes irregular periods, heavy periods, longer periods and anxiety.

If cortisol starts to dominate, oestrogen and progesterone are reduced even more.


Cortisol is another hormone that becomes unbalanced during our perimenopause/menopause years. It’s great when its balanced but causes havoc when not. Your body produces it on a daily cycle making more in the morning to kickstart you out of bed and into your day and it naturally declines towards the evening as your melatonin levels rise to help you sleep.

Cortisol is produced alongside adrenaline from your adrenal glands when you’re under stress . It used to give us focus and increased energy in times of stress when our lives were threatened by sabre toothed tigers coming into our caves. Our bodies still release this same level when we’re attacked by modern emotional and physical stresses that are less life threatening. This modern level of stress can still be dangerous for our health and wellbeing if not addressed. When highly stressed, our bodies maintain the same level of cortisol throughout the day rather than declining towards the evening and over a period of time these high levels of cortisol can cause serious problems.

During the menopause and perimenopause your adrenal glands try to support your ovaries by producing small quantities of hormones to help balance the decline. However if your adrenals are too busy, constantly producing cortisol they won’t be able to help balance the other declining oestrogen, progesterone and testosterone hormones.

Normally, oestrogen helps protect us from cortisol but as it starts to decline naturally, this natural buffer from cortisol declines as well. High cortisol can cause insomnia, low energy, frequent colds, cravings for unhealthy foods, weight gain, aches and pains, low sex drive and low mood.


When it’s balanced: it helps our libido, metabolic function, muscle and bone strength, mood and oestrogen production.

From our early 20s it naturally lowers and in some cases can cause acne, facial hair and even baldness.


Oestrogen, progesterone, testosterone and cortisol can also affect our brain, circulation, digestion, liver, kidneys, immune system, nerves and muscles. This is why is why it’s so important to look after ourselves before, during and after the menopause.

After the menopause this hormone deficiency can make women more susceptible to : heart disease, cancers, depression and anxiety, poor concentration, mood swings, osteoporosis, Alzheimer’s, poor muscle power and tone, weaker vision and a lower sex drive. Which is why it’s imperative to start taking action now, looking after our mind and body as much as possible to decrease this list of possible outcomes.

To give a little bit of history as to how we got to where we are today. There seems to be a lot of shame, embarrassment and fear associated with the menopause. Having researched how it’s been talked about since year dot. I can see why…

Ancient Greeks were too interested in youthful virgins and childbearing mothers to focus any attention on the menopause. However, it is documented that the women became colder and drier – in contrast to our hot flushes and night sweats experienced now.

There are some schools of thought that say there isn’t much written about the menopause because women simply didn’t live long enough to have it or go through it. However, I read an interesting article about Professor Susan Mattern, a US based historian who wrote The Slow Moon Climbs exploring the history of the menopause.

She said “Our early female ancestors were likely to have lived for at least two decades after going through menopause.” She argues, “Far from being an accident, menopause evolved to improve our survival as a species. Most animals reproduce until death. Humans don’t. Menopause is an adaptation that’s been vitally important for us to survive and thrive.”

In some traditional societies, where older women are honoured for their wisdom and experience they gain higher status after menopause. It’s likely that our ancestors also shared this view of women in midlife and beyond. It may have been a phase in which women became respected role models and at the very least, the menopause just wasn’t an issue.

The industrial revolution in the Victorian era bought about the women’s function being increasingly defined by their childbearing years and menopause was seen as the start of old age. It’s interesting that menopause really could have been a non-event before industrialisation. There is research that indicates non-industrialised countries have far less menopause symptoms than industrialised ones.

Generally speaking, in non-industrialised countries, the menopause is mostly uneventful.  This could be related to less stressful days, a higher plant-based diet, outside lifestyle surrounded by nature and tight knit communities where the older generations still live with their families and are held in high regard.

In Industrialised countries the menopause symptoms include fatigue, weight gain, mood swings, rapid aging, hot flushes, night sweats  and a possible other 30 symptoms.

In our youth-idolizing Western culture, menopause can seem like an ending. However, in many cultures, especially non industrialised ones, the menopause is a time of new respect and freedom for women. A study reported that Mayan women, although experiencing some uncomfortable symptoms, looked forward to menopause, as it provided newfound freedom and status.

“In societies where age is more revered and the older woman is the wiser and better woman, menopausal symptoms are significantly less bothersome. Where older is not better, many women equate menopause with old age, and symptoms can be much more devastating.”

Dr. Mary Jane Minkin, a professor in obstetrics, gynecology and reproductive health at Yale Medical School said, “In societies where age is more revered and the older woman is the wiser and better woman, menopausal symptoms are significantly less bothersome. Where older is not better, many women equate menopause with old age, and symptoms can be much more devastating.”

This may explain why the Victorian era has far more written about the menopause than before because it had become a ‘thing.’

Doctors locked menopausal women up in asylums for being seen as hysterical and insane. Ovaries and clitorises were removed and women stopped reaching out for help for fear of how they would be treated.

Thankfully in 1929, a decrease in oestrogen was identified as a key component as to why the menopause was having such an effect on women’s health. Gradually, the belief that menopause was a sign of madness was replaced by the theory that hormone treatments could really help women going through this change.

During the 1950 and 60s, information about the menopause began to alter; statements concerning loss of sexuality and loss of youth became more frequent and shame and embarrassment around the menopause became widespread.

HRT (Hormone Replacement Therapy)

After 1960, oestrogen replacement therapy was recommended for an increasing array of symptoms. The first form of HRT was a concoction of shrivelled and pulverized cow ovaries blended with flavoured powder. Next was a treatment manufactured with the urine of pregnant women which was too costly and complicated so they then used pregnant mares urine. This is still used today alongside plant based and synthetic hormones.

HRT supporters believed that, as well as relieving common menopausal symptoms such as hot flushes and night sweats, its benefits extended to protecting the heart and bones and boosting sex drive after the menopause.

That all changed when, in 2002, the Women’s Health Initiative (WHI) concluded HRT was not protective and could actually raise the risk of heart disease and breast cancer. The number of women using HRT dropped dramatically as a result, GPs stopped prescribing it and many women have simply put up with their menopausal symptoms believing there was no alternative.

However this study wasn’t even for menopausal women. It wasn’t even researching how HRT affects menopausal women. It was actually finding out whether older women who hadn’t had HRT for their menopause could start using it afterwards to help protect their hearts and bones from disease.

The main hypothesis was, “You’re never too old to start HRT. You can still enjoy its benefits for heart health and a longer, healthier life after the menopause.” They were also studying a specific type of oestrogen and progesterone no longer used by doctors as there are more effective and safer forms being used today.

Another key factor was the average age of the women in the study was 63. The average age for menopausal women is between 45 and 55 years old. 25% of the women on the WHI experiment were over 70 when they started using HRT. Two thirds of these recipients were between 60 and 79 years old. I’ve also read that half the women in this study were smokers and 70% were overweight.

Therefore the study did show that these women had a 26% increase in the risk of breast cancer. This however was taken from the results that 38 women in 10,000 were at risk of breast cancer compared to 30 women in 10,000 on the placebo. The study also concluded that the risk of getting breast cancer on HRT was only slightly higher than the risk of drinking once glass of wine a night but less than the risk of drinking 2 glasses a night. They also concluded the risk of breast cancer from HRT was similar to the risk reported with obesity and low physical activity.

The same study did show that women between the ages of 50 and 59 had clear benefits of being on HRT. These women had FEWER cancers, fractures and deaths from any cause compared to the women taking the placebo.

Yet the media caused widespread panic because they only highlighted HRT increasing breast cancer and heart disease, not mentioning it was from the older, post-menopausal women in the study. 80% of perimenopausal and menopausal women threw out their HRT prescriptions. Many were too horrified to discover that what had been prescribed by their doctor to keep them healthy was now being reported as deadly. Since then many women have just put up with their symptoms thinking there was no alternative. The belief that HRT was deadly stuck for just under 20 years until Davina McCall’s menopause programme aired in 2021 and she spoke openly about taking HRT and its benefits to her.

HRT comes in many different forms. Oestrogen and progesterone are the most common as  a patch, tablet or implant. Oestrogen can also be used as a gel. Progesterone can be taken as a tablet or in the Marina Coil and testosterone can be taken as a gel.

Side effects of HRT can include bloating, indigestion, nausea, breast tenderness, headaches, vaginal bleeding, depression, mood swings, acne and back pain. Research in the 1990s showed that HRT helped reduce hip fractures, Alzheimer’s, colon cancer and heart disease. In 1997 the American Medical Association claimed that HRT could help increase life expectancy for a further 3 years.

HRT is a very personal decision and I would encourage you to do your own research and talk to a women’s health doctor. Keep in mind, as our hormones reduce, they not only cause the menopausal symptoms but can also have a huge impact on how we age as we leave the menopause behind and journey to the next chapter of our lives.


We should also look at places where people seem to know how to live really well. We should try and imitate their lifestyles so we too can age wonderfully well. There is a current study of countries where people are reportedly living happier, healthier and longer lives. The top five are called the Blue Zone Countries and these include:

Okinawa in Japan

Sardinia in Italy

Nicoya in Costa Rica

Ikaria in Greece

Loma Linda in California

What do they all have in common? They eat mostly garden-picked plant-based foods of lentils, soy, beans, wholegrains. They have a reduced amount of fresh meat, fish and dairy and snack on nuts and little sugar. They prefer to drink glasses of red wine in the afternoons with friends and family and also drink plenty of water. They spend lots of time in outside in nature and always put family and loved ones first. They have a sense of belonging, whether it be church and/or community groups. They all share a common purpose.

From these common lifestyle traits, the five pillars for healthy ageing and an uneventful menopause have been born. This is where we can start looking after ourselves long before the menopause starts. A quick overview would be to eat well (ideally eat less sugar and eat more photoestrogens), sleep well (6-8 hours a night to help the body heal and repair), exercise well (find movement you enjoy for 150 mins a week), relax well (reduce life stresses) and enjoy life (find your purpose). When clients come for reflexology sessions we talk about these areas in more depth, personalising what works best for each person.


As part of the reflexology session I give my clients hand reflexology charts to help with their own self care at home. There are some really helpful points on your hands and body you can use before and during symptoms. The chart above shows the points that can help reduce hot flushes and aid sleep. Another tip for a hot flush is to have a cold tea spoon handy. Using circular motions between your eyebrows and chin can really help cool you down. I also email clients a booklet discussing the five pillars of health in more detail, explaining the adjustments they can make to age well.

I’ve treated clients with menopausal symptoms and had some really good results. Reducing hot flushes, helping sleep, reducing anxiety, improving mood, helping relaxation, increasing wellbeing and easing tension can all be felt through reflexology. There is also some excellent research that reflexology can help the perimenopause and menopause:

Reflexology can help vasomotor complaints (hot flashes, night sweats, heart palpitations)  and quality of life

(Gozuyesil E, Baser M. Complementary Therapies in Clinical Practice.t. 2016 Aug, 24:78-85)

Reflexology can help reduce depression during menopause

(F Mahdavipour et al, Complementary Therapies in Medicine, Volume 47, 2019)

Reflexology can help improve sleep for menopausal women

(Maryam Asltoghiri, Zahra Ghodsi. Procedia – Social and Behavioural Sciences, Volume 31, 2012 Pages 242-246)

So that’s my intro. You have some choices to make and those choices will hopefully lead you to having an uneventful menopause which will help you start your magnificent healthy ageing journey.

Reflexology is a wonderfully relaxing treatment that helps release tension, improve sleep, improve mood and can be a great tonic for perimenopause and menopause. If you’re well rested and relaxed your body’s own innate healing is encouraged from within and your general wellbeing will be improved.

To learn more about the BiG TOE reflexology please have a look at:


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