I was 44 when I reached menopause. Looking back, my body had been trying to tell me something since my mid-thirties. I just didn’t have the words for it, and neither, it turned out, did the people I asked for help.
This is my story, and the five self-care pillars I wish someone had handed me ten years earlier — a practical guide to self-care for women in midlife.
“There’s nothing wrong with you”
For years I felt run down. My immune system seemed to crash again and again, along with a long list of other symptoms I couldn’t connect. I saw my GP four times. On the last visit I was told, “Look at you, there is nothing wrong with you.”
I pushed for answers anyway. Tests eventually showed very low oestrogen. I had been in perimenopause since around 36, and the late diagnosis left me with low bone density.
I also wish I had understood earlier how much being underweight was affecting my hormones and my bones. But here is what I’ve learned since: it is never too late to start looking after yourself properly.
Why midlife changes everything
Most women reach menopause around 51. When it happens before 45 it’s called early menopause, and before 40 it’s premature menopause. Perimenopause, the transition before your last period, can start years earlier and often goes unrecognised — for more background, the Australasian Menopause Society’s fact sheets are a good place to start.
As oestrogen falls, a lot shifts at once. Your body tends to store more fat around the middle, you lose muscle more easily, your resting energy use drops, and bone loss speeds up. Sleep, mood and stress tolerance can all take a hit too.
That’s why midlife self-care isn’t about bubble baths. It’s about deliberately supporting a body that is changing its rules.
The five pillars of midlife self-care
1. Speak up for yourself
You know your body better than anyone. Keep a simple symptom diary for a few weeks tracking perimenopause symptoms: sleep, hot flushes, mood, cycle changes, energy. Take it to your doctor and ask directly whether perimenopause could be part of the picture.
If you’re over 45, perimenopause is usually diagnosed from your symptoms, because hormone levels swing too much for a single blood test to be reliable. If you’re under 45, testing is more useful, so ask about it. If you don’t feel heard, it’s okay to seek a second opinion or a doctor with a special interest in menopause.
Be open to all the options, including menopausal hormone therapy (MHT, also called HRT). For most healthy women under 60, or within ten years of their last period, it is the most effective treatment for hot flushes and night sweats, according to The Menopause Society’s 2022 Hormone Therapy Position Statement. After all my own research and trials, I’m a fan. It isn’t right for everyone, so it’s a conversation to have with your doctor.
2. Nourish, don’t restrict
This is where my chef’s heart lives. Midlife is the time to eat more of the good things, not less of everything — good menopause nutrition is about addition, not restriction.
- Protein at every meal to help protect muscle: eggs, fish, legumes, Greek yoghurt, tofu, chicken.
- Calcium-rich foods, especially if you’re dairy intolerant like many of us: tinned salmon or sardines with bones, calcium-set tofu, almonds, tahini, leafy greens and fortified plant milks.
- Vitamin D from safe sun exposure, and ask your doctor about checking your levels.
- Fibre and plants for gut health, blood sugar and heart health: wholegrains, beans, lentils, vegetables and fruit.
- Omega-3 fats from oily fish, walnuts, chia and flaxseed.
Many women find that alcohol, caffeine and very spicy food make their hot flushes worse. Track your own triggers rather than cutting everything at once.
3. Move to protect your muscle and bones
Strength training is one of the best things you can do in midlife. Two or more sessions a week of resistance work, plus weight-bearing movement like brisk walking, helps protect both muscle and bone. If you have low bone density, as I do, get advice from a physio or exercise physiologist on what’s safe for you.
4. Guard your sleep and calm your stress
Night sweats, anxiety and broken sleep feed off each other. A cool bedroom, regular sleep and wake times, and less alcohol in the evening all help.
Two non-drug approaches have strong evidence for easing hot flushes themselves: cognitive behavioural therapy (CBT) and clinical hypnosis, both recommended in the UK’s NICE guideline NG23 on menopause. Both are worth asking about.
5. Be careful what you buy
The supplement aisle promises a lot. The evidence is much thinner. The Menopause Society’s 2023 Nonhormone Therapy Position Statement does not recommend soy products, herbal remedies such as black cohosh, dong quai or evening primrose oil, or most supplements for treating hot flushes, because studies haven’t shown they work reliably.
Some herbs can also interact with medications. Real food first, and talk to your doctor or pharmacist before adding anything else. For more trustworthy, plain-English guidance, Jean Hailes for Women’s Health is another excellent resource.
Self-care is a skill you can learn
If there’s one thing my story taught me, it’s that looking after yourself isn’t selfish and it isn’t automatic. It’s a set of skills: knowing your body, cooking food that serves you, moving with purpose, protecting your rest, and asking for what you need. That’s genuinely what menopause self-care looks like in practice.
That’s exactly why I created Self Care for Women, my online self-care course for women. It’s a 12-week, self-paced program in three sections:
- Section 1: how much and what to eat, choosing the right ingredients, equipment, and cookery methods
- Section 2: organisation, knife skills, mise en place, and growing your own food
- Section 3: time-saving tips, wellness factors, self-coaching, and designing your own dishes
Alongside the cooking, you’ll work through 10 self-care factors, including diet, social, spiritual, financial, relationships, security, freedom and community. Each one has its own vision worksheet, so you can focus on what matters most to you. Do as much or as little as you like each week, wherever you are in the world.
Enrol in Self Care for Women here
Not ready yet? Download my free e-book of fast-nutrition recipes and start in your own kitchen today.
Look after yourself, and look after your sisters.
Chef Cass
This post is general information only and isn’t a substitute for advice from your own doctor or health professional.
Frequently Asked Questions
What is the difference between early menopause and perimenopause?
Perimenopause is the transition leading up to your final period, when hormones fluctuate and symptoms begin. Menopause is confirmed 12 months after your last period. Early menopause means reaching that point before 45.
Can a blood test tell me if I’m in perimenopause?
For women over 45 it’s usually diagnosed from symptoms, because hormone levels change from day to day. For women under 45, blood tests are more useful. Your doctor can advise what’s right for you.
What does self-care for women in midlife actually involve?
It’s practical: eating enough protein, calcium and fibre, strength training, protecting your sleep, managing stress, and speaking up about symptoms with your doctor.
Do natural supplements help with hot flushes?
Current clinical guidance does not recommend soy, black cohosh, dong quai or most supplements for hot flushes, because the evidence doesn’t show they work reliably. CBT, clinical hypnosis and prescribed treatments have stronger evidence.
Is your self-care course only for women in menopause?
No. Self Care for Women is designed for women at any stage who want practical skills for looking after their body and mind. The midlife lessons are especially helpful if you’re in perimenopause or menopause.
References: The Menopause Society, 2023 Nonhormone Therapy Position Statement (Menopause, 2023;30(6):573–590); The Menopause Society, 2022 Hormone Therapy Position Statement (Menopause, 2022;29(7):767–794); Australasian Menopause Society information sheets; Jean Hailes for Women’s Health: Menopause; NICE guideline NG23: Menopause.
