Sex DOESN’T have to hurt: Doctor reveals 10 tips for menopause

Sex DOESN’T have to hurt: Doctor reveals the 10 tips women need to know to get through menopause, from diet tweaks to therapy techniques

  • One in four women will experience debilitating side-effects that can last up to 15 years
  • Dr Sarah Brewer, a physician and medical nutritionist in the UK, lays out her top tips to making it through

It’s the one thing that every woman will experience – but that doesn’t make it any less daunting.

Each year, millions of women go through the menopause, some suffering crippling symptoms in the process.

Indeed, recent British research revealed that a quarter of women aged over 50 find their menopause symptoms so debilitating they are considering reducing their office hours.

Hot flushes, memory loss, joint aches and anxiety are some of the side-effects costing 14 million working days every year, researchers found.

The average age for a woman to go through ‘the change’ is 51 – but symptoms can start many years before – and one in four will experience debilitating side-effects that can last up to 15 years.

The good news is there are many steps you can take to manage and reduce your symptoms.

Here, I reveal the things every woman needs to know about the menopause – including how to handle some of the most common complaints…

Millions of women go through the menopause, some suffering crippling symptoms in the process (file image)


If you are willing and able to take hormone replacement therapy (HRT), this will quickly resolve your symptoms.

While studies published in the early 2000s suggested that HRT might increase a women’s risk of heart problems and breast cancer, these results were later questioned.

Guidance from the UK drug watchdog NICE, the National Institute for Health and Care Excellence, states that for that for every 1,000 women taking combined HRT (estrogen and progesterone) for 7.5 years after the age of 50, there may be around five extra cases of breast cancer.

Overall, taking HRT does not appear to increase the risk of dying from breast cancer due to the availability of screening and early treatment with effective therapies.

Together you and your doctor may decide that HRT will suit you but it is a very personal choice.

Some women have contraindications for HRT, while others prefer a more natural approach.


Painful sex is a real issue for many women of this age.

It can be due to vaginal dryness and also due to the skin becoming thinner and less stretchy due to a woman’s level of the hormone estrogen dropping after the menopause.

HRT may also restore vaginal health. However, if the main menopausal symptom is vaginal dryness, the use of vaginal estrogen can be more effective and indeed, may be needed even if HRT is being taken for symptoms such as flushes. Vaginal estrogen is available as a pessary (a ‘pill’ inserted into the vagina), cream or an internal ring and can be prescribed by your GP.

Sex can become painful in many ways during menopause, often caused by dryness (file image)

Anyone wary of taking estrogen – such as those with a family history of breast cancer, for example – may prefer this, as a smaller amount reaches your bloodstream and it can be more effective than oral hormonal regimens at getting to the place that needs it.

Natural moisturizers are also available. The most effective vaginal moisturizers are those that contain an ingredient called hyaluronate, such as Healthspan Silk Intimate Gel, which also includes aloe vera.

Research has also shown that a supplement called sea buckthorn oil is also be very effective. This is because it’s unusually rich in omega-7 – an important building block for healthy skin and mucous membranes.

Indeed, sea buckthorn oil has been used for centuries to relieve conditions associated with dryness, especially dry eyes, dry hair and female intimate dryness – all of which can occur during and after menopause. 


Anxiety is often one of the first symptoms of an approaching menopause, although it is often not recognised as such.

Again, HRT will help, but other options include magnesium tablets or CBD (cannabidiol) oil, which mimics natural chemicals we produce called endorphins to have a relaxing effect and boost general feelings of wellbeing.

Another option is St John’s Wort – a traditional herbal medicine that is as effective as prescribed antidepressants for mild to moderate depression.

NOTE: If you are taking any prescribed medicines, always check for interactions before taking any supplements.

CBT (cognitive behavioral therapy) – which alters how you perceive symptoms – is also beneficial in learning to deal with anxiety and menopause symptoms.

Researchers have found that, after just four sessions of CBT, 65 per cent of women experienced a significant reduction in the number and severity of their flushes and night sweats — compared with 12 per cent in a group given no treatment. Six months later, the women who’d had the CBT also continued to experience fewer symptoms.

Exercises like yoga and CBT are good ways to ease your worries which can exacerbate your physical symptoms (file image)

Yoga is another good, natural way to relieve anxiety during the menopause.

The results from five studies that compared yoga to another type of exercise or no treatment, in 582 women, found yoga helped improve psychological symptoms such as depression and anxiety.

Therefore, regular yoga practice is worth considering if you experience anxiety during the menopause.

In fact, most forms of exercise will help, because being physically active raises endorphins and lifts your mood.


When it comes to the menopause, overhauling your diet can make a real difference to symptoms.

For example, Japanese women experience few, if any, troublesome menopausal symptoms.

This is not a genetic effect, as when Japanese women switch from their traditional diet and adopt a more Western style of diet, their hot flushes increase.

The lack of symptoms is due to a high intake of plant hormones which have an estrogen-like action.

Researchers believe the reason Japanese women have fewer menopause symptoms is because they ingest high amounts of isoflavones and lignans in their diets. These can be found in foods like sweet potatoes

Known as isoflavones and lignans, these plant hormones are found in soy products (e.g. edamame, soy beans, soy meal, tofu), chickpeas, lentils, sweet potatoes, and members of the cabbage and turnip family such as broccoli, pak choy and kohlrabi.

Not only can these plant estrogens significantly reduce menopausal symptoms, many are a source of filling fiber, meaning you are less likely to feel hungry. They also have beneficial effects against coronary heart disease and osteoporosis (fragile bones).

Add soy beans to soups, stews, chili, stir fries, risotto, salads and vegetarian dishes. Another good source is flaxseed and pumpkin seeds.

Isoflavone supplements for menopause are also available. Healthspan’s Menoserene contains natural plant estrogens but also essential minerals and vitamins needed to support energy levels, flaxseed and sage extracats.


Are you getting enough vitamin C? This is important as the vitamin has numerous anti-ageing effects. 

As an antioxidant, it neutralizes free radicals – harmful molecular fragments which damage tissues and are linked with premature ageing.

Vitamin C is also needed for energy production and to reduce tiredness and fatigue, but where it really comes into its own is in stimulating the production of collagen in the skin to reduce premature lines and wrinkles.

Berries give you a boost of antioxidants and vitamins that lower blood pressure

To make sure you are getting enough, eat more fruit and veg – those providing the most vitamin C include berries, guava, citrus fruit, kiwi fruit, mango, capsicum peppers and green leaves.

As well as providing vitamin C, fruit and veg are packed full of what’s known as antioxidant polyphenols; these have protective effects against high blood pressure, raised cholesterol levels, type 2 diabetes, heart disease, stroke and cancer.


Diet and lifestyle changes can have a huge impact on a woman’s symptoms – much more than many realize.

Cutting right back on caffeine and alcohol can really help – both cause blood vessels to dilate and make the problem worse.

While coffee has many benefits, it can also worsen symptoms by dilating your blood vessels

Caffeine also mimics the stress response in the body – this reduces the effects of a calming brain chemical, adenosine, therefore increasing anxiety levels.

If you can’t face giving up caffeine and alcohol totally, reduce as much as possible and keep your alcohol intake within recommended levels.

Try herbal teas such as rooibos, calming chamomile or soothing mint instead.


Barely a week goes by without us hearing how important gut bacteria are for overall health – and this goes for our hormone levels, too.

Ensuring a healthy balance of bowel bacteria will help to boost production of oestrogen-like plant hormones from the fruit, vegetables, nuts, seeds and grains you eat.

This can have beneficial effects on hormone balance to help minimize the severity of menopausal symptoms such as hot flushes and night sweats.

A healthy gut bacterial balance can help to improve mood and reduce anxiety, by stimulating the production of the so-called ‘happy chemical’ serotonin.

So what’s the best way to improve your gut health?

A healthy gut bacterial balance can help to improve mood and reduce anxiety, by stimulating the production of the so-called ‘happy chemical’ serotonin. Eating yogurt helps (file image)

  • Eat a Mediterranean-style diet providing plenty of fruit, veg, pulses and some fish (especially oily fish).
  • Increase your intake of soy-based foods rich in isoflavones, plus foods providing lignans such as flaxseed and sweet potatoes (see above).
  • Aim to eat fermented foods such as live bio yogurt, sauerkraut, kimchi, tempeh or kefir on most days. If you find these unappetizing, take a probiotic supplement with your isoflavones to obtain the maximum benefit. These friendly bacteria activate isoflavones to make them effective.
  • Limit your intake of foods containing added sugar and salt.
  • Avoid convenience and processed foods containing artificial additives – eat home-made meals as much as possible
  • NB. If swapping to soy-based yogurt and milk, ensure good intakes of calcium from other dairy products, whole grains and dark green leaves


Magnesium is vital for long-term good health – it helps to overcome tiredness and fatigue, reduce muscle cramps and restless legs, and promotes normal bowel function – especially if menopause leaves you prone to constipation, insomnia or anxiety.

Lack of magnesium is common as food processing removes much of the magnesium naturally present in foods such as grains.

As well as being absorbed via the diet, magnesium is also absorbed across the skin.

A great way to get a good night’s sleep is to put a handful of magnesium salts in a warm bath in which to lie back and relax for half an hour before bed.

Works for me every time!

A great way to get a good night’s sleep is to put a handful of magnesium salts in a warm bath in which to lie back and relax for half an hour before bed (file image)


Menopause is associated with general drying of hair and skin, which often first shows as itchy, dry, flaky shins, and as increased dryness on the face.

Evening primrose oil provides essential fatty acids that rapidly improve skin quality, smoothness and luster while reducing roughness and dry scales.

Taking evening primrose oil 1g to 2g per day also helps skin to look more youthful by improving moisture, smoothness, elasticity and firmness.

It’s one supplement I would not be without.


A survey by the vitamin and supplement company Healthspan found that 46 per cent of women said the menopause impacted on their confidence levels.

And crucially, research has shown that women who feel more satisfied with their appearance report fewer menopausal symptoms.

‘The key here appears to be self-esteem and confidence as the researchers took into account the women’s hormone levels,’ explains Dr Megan Arroll, a psychologist and co-author of ‘The Menopause Maze’.

‘So in this study at least, feeling good about oneself actually made experiencing menopausal symptoms less likely.

‘Therefore, boosting confidence from within is a powerful tool for long term health – on the inside and out.

‘This is why self-care is so important – so do whatever makes you feel good, whether it is using a new shampoo that brings the shine back to your hair or a high-quality moisturizer to refresh the skin.’

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