The Hormone Story of Menopause

We’ve been talking about menopause as more than just hormones. Because it is. 

It’s an ecosystem - a network of systems, constantly communicating, adjusting, and trying to keep you in balance.

And hormones?

They’re not the whole ecosystem. But they are the signals that move through it.

And, they are still a powerful part of the story.

Why hormones can feel so powerful

Hormones are your body’s messengers. They don’t act in isolation. They influence, and are influenced by every part of your internal ecosystem. 

Your brain interprets the hormonal signals. Your stress system amplifies or softens the response. Your metabolism determines how those hormones are converted, recycled, and cleared. So when hormones fluctuate during menopause, it’s not just one thing changing. It’s the entire ecosystem responding. That’s why it can feel like everything is “off” at once.

The four hormones most women hear about

Oestrogen — supporting your brain

Oestrogen plays a key role in your brain and nervous system. When it fluctuates, you feel it quickly:

• thoughts feel less clear
• emotions feel closer to the surface
• tolerance feels lower

Progesterone — calming your system

Progesterone helps regulate your nervous system. It brings a sense of calm and safety. When it declines (often earlier than oestrogen):

• you feel more reactive
• sleep becomes lighter
• you find it harder to switch off

Cortisol — your stress response under pressure

During menopause, your system can become more sensitive to stress signals. So even if your life hasn’t changed dramatically, your body may respond differently:

• more alert
• more wired
• less able to relax

Testosterone — your drive and spark

This is the hormone we rarely talk about. But you feel it when it shifts. It’s your:

• motivation
• physical energy
• sense of drive
• sexual desire

When it declines, it can feel like:

“I just don’t have the same spark anymore”

The rhythm your body used to follow

Before menopause, your hormones moved in a rhythm. 

First half of your cycle (follicular phase): oestrogen rise, promoting the growth of the uterine lining.

Second half (luteal phase): progesterone rises (if you ovulate) to prepare the uterus for potential pregnancy; if pregnancy does not occur, hormone levels drop, leading to menstruation. 

But if ovulation doesn’t happen, progesterone doesn’t rise. This is why menopause journey can feel so inconsistent, because inconsistent ovulation is a key feature of the menopause transition. Your body is no longer following the same predictable pattern.

A quiet truth about the pill

If you've been on the hormonal contraceptive pill, you may have been told you're having a period. But it's actually a withdraw bleed. It's triggered by stopping synthetic hormones, not by natural ovulation.

Which means:

• your body may not have been producing progesterone in the same way.
• your natural rhythm may have been paused.

For many women, this only becomes visible when they come off it.

Where does MHT fit into all of this?

Menopausal Hormone Therapy (MHT) is one option to top up the hormones your body is no longer producing in the same way. For some women, it can be life-changing.

It can:

• ease day-to-day symptoms, especially for hot flushes, night sweats and mood changes
• work relatively quickly
  
• can significantly improve the quality of life, particularly those experiencing severe menopausal symptoms

But it’s not the full picture...

Things to consider:

• it’s not suitable for everyone.
• less commonly used in the early phase of the transition, when hormone levels are bouncing up and down and hormone tests are less reliable.
• some women experience side effects, especially at the start or adjusting doses.
• it doesn’t address underlying factors like stress, gut health, or how your body processes hormones.

There is no “right” choice. Only the right choice for you.

A different way of thinking

When symptoms hit, it can feel urgent. Like something needs to be fixed—now. But this phase shouldn't be about reacting. It’s an opportunity to understand your body in a deeper way than you ever have before. And maybe the better question is:

Why do we wait until things feel hard?

What if we prepared our bodies earlier?
Supported our "ecosystem" before they start to struggle?

Because here’s something we don’t talk about enough: Some women move through menopause with very few or mild symptoms.

Which means—

A different experience is possible.

More prepared.
More supported.
More yours.

With thanks to Minal Patel, a naturopath specialising in hormones, for generously sharing her knowledge and insights.

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Frequently asked questions

What hormones change during menopause?

The four most talked about are oestrogen, progesterone, cortisol, and testosterone. Oestrogen affects brain clarity and emotional regulation, progesterone brings calm and supports sleep, cortisol governs your stress response, and testosterone drives motivation and physical energy. Two others are getting more research attention: FSH (follicle-stimulating hormone) and LH (luteinising hormone). Both rise as the ovaries respond less to their signals, and FSH in particular is being studied for possible direct effects on bone and metabolism, not just as a marker of where you are in the transition.

Why does menopause affect so many things at once — mood, sleep, energy?

Because hormones don't work in isolation — they're signals moving through an interconnected system that includes your brain, stress response, and metabolism. When hormone levels shift, the whole system responds together, which is why symptoms can feel like they're hitting from every direction at once.

Is hormonal change in menopause gradual, or does it happen suddenly?

It's rarely a straight line. In early perimenopause, hormones fluctuate dramatically rather than simply declining — which is why this stage can feel like a rollercoaster. Later, the swings settle into a steadier, lower baseline by postmenopause.

If I was on the contraceptive pill, does that affect how I experience menopause?

It can. The monthly "period" on the pill is actually a withdrawal bleed triggered by stopping synthetic hormones, not natural ovulation — so your body's natural progesterone rhythm may have been paused. For some women, this only becomes noticeable once they come off it.

What does testosterone have to do with menopause?

It's the hormone that's talked about least, but it drives motivation, physical energy, and sex drive. When it declines, it often shows up as a loss of "spark" rather than a classic symptom people expect to associate with menopause.

Is hormone therapy (MHT) the right choice for everyone?

No — it can be life-changing for some women, particularly for hot flushes, night sweats, and mood, but it isn't suitable for everyone, is less commonly used in early perimenopause when hormones are still fluctuating, and doesn't address underlying factors like stress or gut health. It's a personal decision, not a default one.

Does menopause have to feel severe?

Not necessarily. Some women move through this transition with very few or mild symptoms — which suggests preparation and ongoing support for the body's systems may shape how this stage is experienced, not just how it's treated after symptoms appear.

Disclaimer - This content is for general informational purposes only and is not intended to imply benefits of any specific product.