Menopause is talked about more openly than it used to be, but many women still reach perimenopause feeling underprepared for the physical and emotional changes it can bring.
We spoke with nutritional therapist Julie Gough about her own experience, the lifestyle changes that helped her feel more like herself and why she believes food, movement and stress support deserve a place in the wider menopause conversation.
Julie's Own Menopause Story
Julie began studying nutrition at 48, during a period shaped by significant family loss. Not long afterwards she developed symptoms including hot flushes, anxiety, brain fog and disrupted sleep.
Because of her family history, she says she did not feel comfortable starting HRT at that point. She focused instead on changes to her diet, movement, sleep and daily routine, and found that some of her symptoms became easier to manage. That experience eventually shaped the work she now does with other women.
Julie's experience is personal. It should not be read as evidence that lifestyle changes can replace medical treatment for everyone.
Our Conversation with Julie
Why does menopause still feel difficult to talk about?
Julie believes many women have spent years hearing very little about perimenopause until symptoms arrive. That can make common changes feel alarming or isolating. Better education, she says, helps women recognise that they have options and gives them better language for appointments with healthcare professionals.
What role can nutrition play?
Julie's approach centres on regular, balanced meals with enough protein, fibre, vegetables and healthy fats. She encourages women to think about consistency rather than restrictive diets or “hormone-balancing” rules.
A nourishing diet can support general health, bone health and cardiovascular health through midlife. It cannot, however, guarantee relief from hot flushes, anxiety or other menopause symptoms.
What about exercise and stress?
Julie favours a mix of strength work, weight-bearing movement, walking and recovery rather than treating exercise as punishment. The NHS recommends weight-bearing and resistance exercise to help protect bones, alongside regular activity for general health.
Stress management matters too, particularly when sleep is already disrupted. That might mean breathing exercises, time outdoors, social connection or simply reducing the pressure to perform at the same intensity every day.
What emotional changes can happen?
Perimenopause can coincide with anxiety, low mood, irritability, reduced confidence and difficulty concentrating. Julie encourages women not to dismiss those changes as a personal failing. If symptoms are affecting daily life, it is appropriate to seek professional support.
Lifestyle Support and Medical Care Can Coexist
Menopause care does not need to be framed as “natural versus medical”. NICE recommends individualised discussion of symptoms, treatment preferences, benefits and risks. HRT is an evidence-based option for symptoms such as hot flushes and night sweats, and menopause-specific CBT can also help with some symptoms.
If HRT is not suitable for you, or you do not want to use it, a clinician can discuss alternatives. The NHS also advises speaking to a healthcare professional before using herbal remedies or supplements because safety, quality and interactions can vary.
Julie's Starting Points
- Build regular meals around protein, fibre and colourful plant foods rather than chasing a perfect menopause diet.
- Include strength and weight-bearing exercise in a way that is realistic for your body and energy levels.
- Protect sleep where you can and notice whether alcohol, caffeine or late meals make symptoms worse for you.
- Keep a simple symptom record if you are struggling to see patterns.
- Ask for help when symptoms are affecting work, relationships, sleep or quality of life.
For products and resources chosen for this life stage, browse our perimenopause and menopause collection.
About Julie Gough
Julie is a nutritional therapist whose own menopause experience led her to focus on practical, sustainable nutrition and lifestyle support for women in midlife.
Her central message is simple: start with the foundations you can influence, but do not feel you have failed if you also need medical treatment. Good menopause care can include both.
