Common questions and challenges at Perimenopause, Menopause, and Post Menopause

In the broadest terms, how does/can menopause affect my health?

In the lead-up to menopause (referred to as the perimenopause) levels of oestrogen gradually begin to decline. Lower levels of oestrogen and progesterone raise your risk for certain health problems after menopause.

Common symptoms can be broadly classified as public and private. For example, public symptoms are generally what most people are aware of and what individuals do not mind talking about (hot flushes, forgetfulness or brain fog, mood changes, etc.,). Private symptoms are issues that go unseen, or those that individuals do not necessarily talk about openly.

Examples of private health problems in the years after menopause include:

  1. Heart disease and stroke.

Before age 55, women have a lower risk of heart disease than men. Oestrogen helps keep blood vessels relaxed, open, flexible and (simply put). Without oestrogen, cholesterol or inflammation may start to affect arterial walls leading to the heart. By age 70, women have about the same risk for heart disease as men of the same age. A ‘heart healthy’ diet can help mitigate these effects, and an effective supplement regime may help to fill the nutritional gaps (see below).

Having less oestrogen after menopause causes you to lose bone mass much more quickly than you did before, which puts you at risk for osteoporosis. Osteoporosis is a condition that causes your bones to become brittle and weak and break easily. A recent large study found that women who have severe hot flushes and night sweats during the years around menopause usually have more bone loss and are at a higher risk for hip fractures than women who do not have severe symptoms.

  1. Increased risk of UTI.

A decrease in oestrogen levels can cause the vaginal tissue to become thinner and drier. This can make it easier for bacteria to flourish, which could eventually lead to a urinary tract infection (UTI). While a woman’s risk for UTIs depends on individual factors, such as overall health, the occurrence of UTIs generally increase with age. In women over age 65, the rate is approximately double that of women of all ages, according to a review article published in May 2019 in the journal Therapeutic Advances in Urology, which also found that nearly 10 percent of postmenopausal women reported having had a UTI the previous year.

What steps can I take to build my health in the years around menopause?

  1. Quit smoking

Quitting smoking is the most important step you can take to be healthier. Smoking hurts your health in many ways, including damaging your bones, causing heart disease and may also be a precursor to as many as 12 types of cancer in women.

  1. Be active

Getting at least 30 minutes of physical activity on almost every day of the week is one of the most effective ways to be healthier. Physical activity can help your bones, heart, and mood. Exercise doesn’t have to be complicated. Aim for at least 2 hours and 30 minutes a week of moderate aerobic physical activity or 1 hour and 15 minutes of vigorous aerobic activity or, ideally a combination of the two. Exercises that build muscle strength have an amazing long-term benefit on bone density so try incorporating this on two days each week.

  1. The right supplementation

In addition to ‘heart healthy’ diets, look at a broad range multi-vitamin with B-vitamins and consider a good quality fish oil (if you do not incorporate oily fish such as salmon into your diet). Post (and even before) menopause, Calcium needs a boost to maintain bone health. Doctors recommend that women aged 51years and older get 1000 milligrams of Calcium each day and 1000iu of Vitamin D. Promensil Post Menopause tablets with a combination of natural isoflavones/phytoestrogens, Calcium and Vitamin D helps bone health, muscle function and energy, in addition to providing a dietary support for menopause.

However, it is recommended, initially at least, to speak with a healthcare professional regarding supplementation as taking some supplements in isolation may exacerbate existing, underlying issues.

Can I take natural supplements to help mitigate effects of perimenopause and menopause?

Of course, it is an individual choice whether a woman decides to take HRT or allow nature to take its course.  Natural supplements can help if issues around hot flushes and night sweats are mild and moderate and if HRT is contra-indicated (i.e. previous history of cancer).  They may not be suitable if symptoms are severe or if there are several co-morbidities.

While looking for a natural supplement, always choose one that is backed by a good bank of clinical studies. It is also imperative to look for high levels of the active ingredient, as not all supplements contain adequate levels required to help provide a long-term balance from within. E.g., The active ingredient in a Red Clover supplement is called isoflavones/phytoestrogens.

Promensil Double Strength tablets contain 80mg of Red Clover isoflavones, that has scientifically been studied to be the optimal level required to help provide relief from hot flushes and night sweats during perimenopause and throughout menopause.


Becker, R.C. (2005). Heart attack and stroke prevention in women. Circulation; 112: e273–e275.

Crandall, C., Aragaki, A., Cauley, J., Manson, J., LeBlanc, E., Wallace, R., et al. (2015). Associations of Menopausal Vasomotor Symptoms with Fracture Incidence. Journal of Clinical Endocrinology and Metabolism; 100(2): 524–534.

Surgeon General’s Report on Smoking and Health. (2014). Smoking and Cancer.

Jackson, L.W., Cromer, B.A., Panneerselvamm, A. (2010). Association between bone turnover, micronutrient intake, and blood lead levels in pre-and postmenopausal women, NHANES 1999–2002. Environmental Health Perspectives; 118(11): 1590–1596.