Hormonal Changes During Menopause: What You Need to Know

by Silvia Diaz-Roa

Menopause brings big shifts in how your body feels and functions, largely due to changing hormone levels. These changes can affect your heart, bones, weight, mood, and even your skin and hair. But with the right information, you can take steps to feel strong and healthy through it all.

The Role of Hormones in Women’s Health

Hormones play a crucial role in regulating various bodily functions, including metabolism, mood, bone density, and cardiovascular health. The primary hormones affected by menopause are:

• Estrogen – Responsible for reproductive health, bone strength, and skin elasticity.

• Progesterone – Helps regulate the menstrual cycle and maintains pregnancy.

• Testosterone – Although often associated with men, women also produce small amounts that influence muscle mass, mood, and libido.

As women transition through menopause, the levels of these hormones fluctuate before eventually declining, leading to a range of physical and emotional symptoms.

How Hormonal Changes Affect Health

1. Cardiovascular Health

Estrogen has a protective effect on the heart by keeping blood vessels flexible and regulating cholesterol levels. As estrogen declines, women face an increased risk of heart disease, hypertension, and high cholesterol. According to the American Heart Association, heart disease is the leading cause of death in women, and the risk accelerates after menopause.

2. Bone Health and Osteoporosis

Estrogen is also critical for bone density. Its decline can lead to increased bone loss, making postmenopausal women more susceptible to osteoporosis and fractures. According to Weill Cornell Medicine, women lose up to 25% of their bone density in the five to seven years after menopause.

Management Tip:

• Engage in weight-bearing exercises like walking, hiking, and stair climbing.

• Incorporate strength training to stimulate bone growth. Here’s a strength training routine for women over 50.

• Ensure sufficient intake of calcium (1,200 mg/day) and vitamin D (600–800 IU/day).

• Talk to your doctor about a bone mineral density test (DEXA scan) to assess your risk.

3. Metabolism and Weight Gain

Many women experience weight gain during menopause, particularly around the abdomen. This is partly due to hormonal shifts affecting how the body stores fat, coupled with a natural slowing of metabolism. Menopause is often accompanied by a reduction in lean muscle mass, which lowers basal metabolic rate (BMR), meaning fewer calories are burned at rest.

“It’s not just about calories in, calories out,” said Dr. Stacy Sims. “Hormonal shifts make it harder to maintain muscle mass, which is a key factor in keeping metabolism efficient.”

Tips for Support:

• Prioritize strength training to maintain muscle mass.

• Adjust caloric intake and increase protein consumption to match metabolic needs.

• Incorporate aerobic activities like walking, swimming, or cycling.

4. Cognitive Function and Mood

Estrogen influences neurotransmitters like serotonin and dopamine, which regulate mood and cognition. Declining levels may contribute to brain fog, memory issues, and increased risk of depression and anxiety.

Ways to Support Brain Health:

• Exercise regularly: Improves neuroplasticity and blood flow to the brain.

• Eat a brain-friendly diet: Include omega-3-rich foods (e.g., salmon, walnuts), leafy greens, and berries.

• Prioritize sleep: Sleep disruptions during menopause can impair memory and mood. Aim for 7–9 hours per night.

• Limit alcohol and manage stress: Both can exacerbate cognitive symptoms.

5. Skin and Hair

Estrogen helps maintain collagen levels and skin hydration. As levels decline, skin becomes thinner, less elastic, and more prone to wrinkles. Hair may become finer or shed more easily, and nails may become brittle.

Strategies for Maintaining Skin and Hair Health:

• Use collagen-boosting skincare ingredients like retinoids, peptides, and vitamin C.

• Drink plenty of water to support skin hydration.

• Consider collagen supplements with peptides if approved by your healthcare provider.

Next Steps

Understanding how hormones affect your health is the first step. The good news is there are many ways to support your body during this transition. From food and movement to stress relief and treatment options, small changes can make a big difference.

Read our next post on how to manage hormonal changes →