Sailing through the Menopause: How practitioners can help menopausal women webinar

This webinar focuses on supporting menopause care, covering:

• Menopause physiology
• The latest research on symptom phenotyping and clusters
• Clinically important red flags that need referral
• Evidence-based lifestyle and dietary interventions
• Practical guidance on boundaries for non-medical care

Hosted by Ella (Practitioner Lead, Registered Nutritionist and Nutritional Therapy Practitioner) with guest speaker Sue Potgieter, RN, rANP, rGNC.

Key Points Discussed

Why menopause symptoms vary widely

Menopause is a whole-body, systems-level transition driven by hormonal shifts, especially oestrogen decline and the earlier decline in progesterone. These shifts influence thermoregulation, neurotransmitters, metabolism and urogenital/pelvic tissues.

What menopause is biologically

Menopause occurs when the ovaries no longer naturally produce oestrogen and progesterone, or through medical intervention (e.g., hysterectomy/oophorectomy). It is clinically defined as no periods for 12 consecutive months. The average age is around 51, but it can occur earlier or later.

Hormonal shift mechanisms and symptom relevance

1. Oestrogen decline affects thermoregulation (hot flushes), neurotransmitters (mood and cognition), bone turnover, the vaginal microbiome, collagen synthesis and more.
2. Progesterone drops earlier in perimenopause, contributing to anxiety, poor sleep and stress reactivity.
3. Androgens decline gradually, contributing to libido changes and muscle loss/sarcopenia.

Latest research (symptom phenotyping and clusters)

Large cohorts show that menopause symptoms cluster predictably rather than occurring randomly. These include SWAN, UK Biobank and the Australian Longitudinal Study on Women's Health.

Symptom clusters

• Vasomotor instability (hot flushes, night sweats, temperature swings)
• Neurocognitive and mood symptoms (memory lapses, anxiety, irritability)
• GSM (genitourinary syndrome of menopause: vaginal dryness, painful intercourse, recurrent UTIs)
• Musculoskeletal changes (joint aches, reduced collagen, sarcopenia)
• Metabolic changes (increasing visceral fat, reduced insulin sensitivity)

Timing matters clinically

Early or premature menopause (before around 45, and especially before 40) is linked to higher long-term cardiometabolic risk, including type 2 diabetes and cardiovascular risk markers. Later menopause (55+) is described as comparatively protective.

Lifestyle and nutrition as evidence-informed interventions

Diet: Mediterranean-style eating, phytoestrogen-rich foods, protein optimisation, stable glycaemic patterns, and limiting alcohol and ultra-processed foods.

Lifestyle: resistance training, moderate cardio, sleep hygiene, support for stress physiology, and pelvic floor health.

Updated guidelines and clinical importance

Guidelines published in 2025 and endorsed by major European and international societies stress comprehensive evaluation, staging, symptom clusters and individualised therapy. Phenotyping improves recognition, especially in perimenopause when symptoms may be less 'classic'.

Key Takeaways

• Use symptom phenotyping: menopause symptoms cluster by stage and trajectory. Pattern recognition helps with assessment, validation and tailored intervention.
• Watch for red flags and refer. The following need medical evaluation:
• • Abnormal bleeding
  • Severe cardiopulmonary or neurological symptoms
  • Severe mood disturbance
  • Recurrent systemic UTIs
  • Rapid unexplained weight loss
  • Suspected thyroid or pituitary issues
• Prioritise early lifestyle interventions. These can meaningfully reduce symptoms and support long-term health:
• • Mediterranean-style nutrition
  • Sufficient protein (especially with resistance training)
  • Stable glycaemic patterns
  • Alcohol reduction
  • Sleep hygiene
  • Stress support
  • Pelvic floor work

Conclusion

This webinar delivers a practitioner-ready framework for menopause care grounded in physiology and the newest symptom phenotyping research. It emphasises:

• Validating women's experiences
• Using predictable symptom clusters to guide individualised nutrition and lifestyle strategies
• Referring promptly when red flags arise
• Communicating boundaries clearly around medication and herbal advice

This webinar is fully approved by BANT® and accredited for CPD hours.