Which hormones play a role during menopause? We explain.

The sex hormones testosterone, oestrogen, and progesterone work closely together to ensure various processes in the body function properly. A good balance between these hormones is essential.

• Oestrogen is responsible for regulating the menstrual cycle and promotes bone health.
• Progesterone prepares the uterus for a potential pregnancy and has a calming effect on the nervous system.
• Testosterone helps maintain muscle mass and plays a role in how energetic you feel.

These are just a few examples, as these hormones perform numerous other important functions in the female body. During menopause, these hormones decrease (at varying speeds and to different extents). Due to these hormonal fluctuations, 80% of women experience menopausal symptoms, such as hot flushes or joint pain.

Read more about the role of the key hormones: oestrogen, progesterone, and testosterone.

In addition to the aforementioned sex hormones, other hormones also affect your well-being during menopause. First, there are LH (luteinising hormone) and FSH (follicle-stimulating hormone), which are responsible for the maturation of eggs and ovulation.

As the final menstrual period approaches (on average, women experience this at age 51), fewer eggs are produced. This leads to a lower production of oestrogen and progesterone. However, your brain continues to try to stimulate the ovaries by increasing LH and FSH levels. An increase in these two hormones can indicate that your final menstrual period (menopause) is approaching. You may notice this as your periods become more irregular.

Although the decline in egg cells and, consequently, sex hormones is a natural process, it can be accompanied by symptoms. This makes it especially important to take good care of your health during this phase of life; a healthy lifestyle can reduce menopausal symptoms. What can you do?

• Choose foods rich in proteins, healthy fats, and slow carbohydrates.
• Consider supplements as an addition.
• Are you experiencing severe menopausal symptoms? Hormone therapy might be an option.

Cortisol and adrenaline, also known as stress hormones, help the body cope with stress. Both hormones are produced in the adrenal glands.

• Cortisol helps your body manage chronic stress.
• Adrenaline triggers a "fight-or-flight" response during acute stress.

Your body produces the most cortisol in the morning. This helps you wake up and start your day alert. Later in the day, cortisol levels decrease, allowing melatonin to take over and help you fall asleep more easily in the evening.

During menopause, fluctuations in oestrogen can disrupt this stress response, leading to elevated cortisol levels. This can worsen existing symptoms or trigger new ones. For example, it can further disrupt your sleep (making it harder to fall asleep or causing you to wake up frequently at night), affect your mood, and even impact your weight.

After menopause, the adrenal glands take over the production of small amounts of oestrogen and progesterone. However, if you experience prolonged stress, the adrenal glands produce cortisol to help your body cope. This, in turn, affects the production of progesterone and oestrogen. This can disrupt the hormonal balance during postmenopause.

To maintain balanced cortisol levels, managing stress is crucial. What steps can you take?

• Make getting a good night’s sleep a priority.
• Engage in at least 30 minutes of exercise daily, ideally outdoors.
• Practise mindfulness, meditation, or other relaxation techniques.
• Cut down on caffeine and sugar consumption, as both can elevate cortisol levels.
• Stick to a consistent daily routine by waking up and going to bed at the same times, even on weekends whenever possible.

Read more: How stress affects your menopause (and how to manage it)

Melatonin is often referred to as the sleep hormone. It is produced in the brain and regulates the sleep-wake cycle. When your body produces melatonin, you feel tired. During menopause, many women experience sleep disturbances. You may struggle to fall asleep or wake up frequently during the night. One reason for this is a reduced production of melatonin.

Melatonin is synthesised from serotonin, but during menopause, the drop in oestrogen levels also leads to a decrease in serotonin. The result? A reduced production of melatonin. Additionally, you are more sensitive to stress during this phase (see the explanation above), and high cortisol levels in the evening can inhibit melatonin production.

• Relaxing sufficiently in the evening (and throughout the day) helps lower cortisol levels and stimulates melatonin production. How can you do this? Read a book, practise calming yoga, or take an evening walk.
• Melatonin production is influenced by light. Dim the lights in the evening, including bright lamps and screens, to signal to your brain that it’s time to sleep.

The hormone insulin is produced in the pancreas and facilitates the absorption of glucose from the blood to be used as energy.

During menopause, the decline in oestrogen can impact insulin regulation. Cells may become less sensitive to insulin, increasing the risk of insulin resistance (and consequently higher blood sugar levels). This can result in fatigue, weight gain, and a heightened risk of type 2 diabetes.

Stabilising your blood sugar levels may help alleviate symptoms related to insulin regulation. What you can try:

• Opt for a protein-rich diet and limit your intake of (fast) carbohydrates. Consuming more protein and fewer carbohydrates supports muscle building and helps you feel fuller for longer.
• Exercise regularly to enhance glucose absorption in cells and improve insulin sensitivity.

Read more: What are the signs of insulin resistance and what can you do about it?

The thyroid produces hormones such as triiodothyronine (commonly referred to as T3) and thyroxine (commonly referred to as T4). These hormones are essential for metabolism, energy levels, temperature regulation, and hair growth. T4 is inactive and must be converted into the active T3 in the body.

Progesterone plays a key role in this conversion process. When progesterone levels drop during menopause, T3 production may decrease. This can lead to symptoms of an underactive thyroid, such as fatigue, weight gain, hair loss, and dry skin.

Additionally, women in perimenopause are often oestrogen-dominant because progesterone decreases more rapidly than oestrogen. This can further affect thyroid function, as elevated oestrogen levels inhibit the conversion of T4 to T3. As a result, thyroid issues are more common in women during menopause.

First and foremost: do you suspect thyroid problems? These can be identified through a blood test. Speak to your doctor about getting tested. What else can help:

• Consume a diet rich in iodine (found in seaweed and fish), selenium (found in Brazil nuts), and zinc (found in nuts and seeds).
• Reduce stress, as cortisol production can further disrupt thyroid hormones.
• Avoid hormone-disrupting substances, such as xenoestrogens. These artificially raise oestrogen levels, contributing to oestrogen dominance and impaired thyroid function.

Leptin and ghrelin regulate hunger. Leptin is produced in fat cells and signals feelings of fullness. Ghrelin, often referred to as the hunger hormone, stimulates appetite and is primarily secreted by the stomach lining and hypothalamus.

During menopause, hormonal changes can disrupt this balance, making you feel hungrier and less full. Insulin resistance can also contribute to leptin resistance. The result? You may find it easier to gain weight.

Your diet plays a key role:

• Focus on eating unprocessed foods rich in proteins, healthy fats, and fibre. This helps maintain a healthy balance between leptin and ghrelin.
• Ensure you get sufficient sleep. Sleep deprivation increases ghrelin production and lowers leptin levels.
• Maintain a consistent daily and nightly routine. This helps regulate cortisol and melatonin, improving your sleep quality.

Serotonin, produced in neurons in the brain, gut, and blood vessels, influences your mood, sleep, and appetite. Dopamine, produced in the brain, gut, and to a lesser extent in the adrenal glands, is involved in motivation and feelings of reward.

During menopause, the decline in oestrogen can reduce the levels of these neurotransmitters, affecting your mood and energy. You may feel low, experience mood swings, or have reduced energy. Additionally, serotonin is a precursor to melatonin, so lower serotonin levels can also contribute to sleep problems.

What helps to promote the release of serotonin and dopamine?

• Engage in exercise for at least 30 minutes each day (though more is always beneficial!).
• Consume foods rich in tryptophan (such as bananas, turkey, and seeds) and tyrosine (such as nuts, seeds, fish, and eggs), as well as omega-3 fatty acids.
• Prioritise gut health. A varied diet and adequate relaxation contribute to improved digestion and overall gut wellbeing.