Approaches

Acupuncture

A traditional Chinese medicine practice involving the insertion of fine needles at specific points on the body. Some clinical trials show modest benefit for menopausal vasomotor symptoms, although NICE notes the evidence is not conclusive enough to recommend it routinely. Used by many women as a complementary approach for hot flushes, sleep, anxiety, and pain.

CBT for Insomnia

A structured psychological therapy for chronic insomnia, consisting of cognitive techniques (addressing unhelpful beliefs about sleep) and behavioural techniques (sleep restriction, stimulus control, sleep hygiene). Recommended by NICE as the first-line treatment for chronic insomnia in adults, including menopausal women.

Cold Water Therapy

Deliberate exposure to cold water — via cold showers, outdoor swimming, or ice baths — to improve stress resilience, mood, and energy. Popular among perimenopausal women for managing fatigue, hot flushes, and mood changes. Evidence base is early-stage; most data comes from athletic recovery and mood studies.

Intermittent Fasting

A dietary pattern alternating between periods of eating and fasting. Common protocols include 16:8 (16 hours fasting, 8-hour eating window) and 5:2 (two days per week at 500–600 calories). Used for weight management, metabolic health, and insulin sensitivity. Evidence in perimenopausal women is mixed; some practitioners advise caution regarding cortisol and HPA axis effects.

Low-Carb Diet

A dietary approach reducing carbohydrate intake, typically to below 130g/day (moderate low-carb) or below 50g/day (ketogenic). Used for weight management, blood glucose control, and reduction of menopausal weight gain and insulin resistance. Some evidence for benefit in PCOS and type 2 diabetes.

Low-FODMAP Diet

A structured dietary approach developed at Monash University for managing irritable bowel syndrome (IBS). Involves eliminating then systematically reintroducing fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. Relevant to perimenopausal women because gut symptoms often worsen during hormonal transitions.

Mediterranean Diet

A dietary pattern emphasising vegetables, fruit, legumes, whole grains, fish, olive oil, and moderate red wine. Associated with reduced cardiovascular disease risk, improved cognitive function, and lower rates of depression. Particularly relevant for postmenopausal women given increased cardiovascular risk and metabolic changes after menopause.

Mindfulness Meditation

A formal practice of directing attention to present-moment experience with non-judgmental awareness. Mindfulness-Based Stress Reduction (MBSR) is an 8-week programme with strong evidence for reducing anxiety, depression, and stress. NICE recommends mindfulness for recurrent depression. Used by menopausal women to manage anxiety, sleep disturbance, and perceived hot flush severity.

Pelvic Floor Exercises

Exercises to strengthen the muscles of the pelvic floor. Recommended as first-line treatment for stress urinary incontinence and urge incontinence, which affect many peri- and postmenopausal women. Also supports sexual function and pelvic organ prolapse management.

Pelvic Floor Physiotherapy

Specialist physiotherapy focused on assessment and rehabilitation of pelvic floor muscles. Treats urinary incontinence, pelvic organ prolapse, pelvic pain, and sexual dysfunction. Involves internal and external assessment, individualised exercise programmes, biofeedback, and education. Available on the NHS via GP or self-referral in many areas.

Seed Cycling

A practice involving the consumption of specific seeds during the follicular and luteal phases of the menstrual cycle. Flaxseeds and pumpkin seeds are eaten in the follicular phase; sesame seeds and sunflower seeds in the luteal phase. Claimed to support hormonal balance via lignans and fatty acids. Evidence is anecdotal; no clinical trials exist to date.

Sleep Hygiene Protocol

A set of behavioural and environmental recommendations to improve sleep quality. Typically includes consistent sleep and wake times, reducing caffeine and alcohol, minimising screen light before bed, optimising bedroom temperature, and limiting daytime napping. Often the starting point before CBT-I for menopausal insomnia.

Strength Training

Structured exercise using resistance (bodyweight, free weights, or machines) to build and maintain muscle mass and bone density. Particularly beneficial during perimenopause and post-menopause when oestrogen decline accelerates muscle loss (sarcopenia) and bone density reduction. Also supports metabolic health, insulin sensitivity, and mood.

TENS Machine

A portable device that delivers low-voltage electrical impulses through electrode pads placed on the skin. Used for pain management including dysmenorrhoea, pelvic pain, musculoskeletal pain, and endometriosis-related pain. Available over the counter in the UK without a prescription.

Yoga

A mind-body practice combining physical postures, breathing exercises (pranayama), and meditation. Used to manage menopausal symptoms including stress, anxiety, sleep disturbance, and musculoskeletal pain. Evidence from RCTs supports modest benefit for hot flush frequency, mood, and quality of life.