Menopause is something that will affect half the population, and yet is only just getting the attention that it truly deserves.

It can be a time in a woman’s life of extreme change, which impacts their mood, skin, sleep, libido and energy.

In medical terms, menopause occurs when a woman has not had a period for 12 months.

However, many women experience symptoms for several years leading up to menopause, known as perimenopause.

Although there is no change to menstruation, perimenopause is a time when levels of female hormones start to change.

Progesterone levels begin to fall, while oestrogen is initially high before also falling as menopause approaches.

It is this change in hormone levels that can cause some of the symptoms experienced by many women, including anxiety, depression, heavy periods, poor sleep, night sweats, painful breasts, low libido and headaches or migraines.

Many of these symptoms are temporary and will gradually disappear with the onset of menopause.

However living with them for a decade or more can be a cause of distress, for both the women experiencing them and their loved ones.

Fortunately there are nutritional and lifestyle interventions that can minimise unwanted symptoms and support women as they transition to life after menopause.

The three key areas to address in perimenopause and menopause are reducing stress, lowering inflammation and improving gut health.

Focusing on these will gradually, and gently help bring the body back into balance and make many of the symptoms more manageable.

Reducing stress

Stress during perimenopause and menopause can often be a vicious circle.

Long-term chronic stress can make overall symptoms worse, while anxiety (and the stress that goes with it) is a recognised symptom of perimenopause. This in turn increases levels of stress in the body - and so it goes on.

The aim is to address all sources of stress and have a number of coping strategies for times when it gets too much.

Not all techniques will work for everyone, and some need to be built into a daily habit rather than being used when stress levels rise.

Try them out to see which are the ones that work best for you:

· Dedicate 15-20 minutes to ‘me-time’ every day

·Get together with friends regularly for support and laughter

· Spend time outside each day - garden, go for a dog walk, sit in the garden

· Start a meditation/yoga/mindfulness practice

· Take gentle exercise

· Practise breathing techniques during moments of stress

Lowering inflammation

Inflammation within the body can increase many of the menopausal symptoms, and may be caused by a number of different reasons. It occurs when our immune system is overstimulated, and results in our body being constantly ready to fight.

Heavy periods, hot flushes, poor sleep and mood swings can all be made worse by chronic inflammation.

There are a number of reasons why we may have increased inflammation - an ongoing illness; eating a typically Western diet; drinking alcohol regularly; poor sleep; smoking; carrying excess weight.

Increased inflammation is also a direct result of the menopause, as oestrogen itself is a potent anti-inflammatory.

In terms of diet, ways to lower inflammation include adding brightly-coloured fruits, vegetables and spices to your meals; aiming for two to three portions of oily fish each week, and limiting alcohol and sugar consumption as much as possible.

Lifestyle approaches could include cutting down or quitting smoking, and trying to optimise your sleep - although this can be easier said than done when hot flushes wake you in the early hours!

Improving gut health

While this doesn’t sound like an obvious area to target, good gut health is key to many symptoms in perimenopause and menopause.

We have a two-way communication between the gut and the brain, known as the gut-brain axis, which can impact symptoms of anxiety and depression.

In addition, constipation may exacerbate heavy periods and painful breasts.

When clearance from the body slows down, used oestrogen can remain in the body longer than desired, and may be reabsorbed into the blood, leading to even higher levels.

And if you need a further reason to support gut health, 70% of our immune system is thought to reside in our colon, which is linked to levels of inflammation throughout the body.

Ways to support gut health, and therefore perimenopause and menopause, include:

· Eating a variety of plant foods each day - vegetables, fruit, nuts, seeds, pulses and wholegrains

· Reducing alcohol, sugar and caffeine

· Minimising processed foods and takeaways

· Identifying and reducing any food sensitivities or intolerances

· Introducing fermented foods to the diet

· Supplementing with key nutrients and a good quality probiotic

Some women also find that unwanted weight gain is a symptom of perimenopause and menopause.

Once again, the key to addressing this is to go gently.

Crash diets and HIIT classes that might have served you well a few years ago are likely to add to your stress levels.

Instead, try intermittent fasting (going at least 12 hours overnight without food), reducing your sugar and refined carbohydrate intake and including strength training into your weekly routine.

It may take longer, but this approach will work with your body as it goes through this new phase in your life.

The good news is that symptoms will pass. By supporting these areas of health, it may be possible to minimise the unwanted effects of hormonal changes, and enjoy perimenopause and menopause feeling well and full of energy.

Please note that if your symptoms are interfering with your daily life, then you should book an appointment with your GP to discuss your options, including HRT.

Emma Jamieson is a registered nutritional therapist and health coach specialising in digestive health. Find more health advice on her website, emmajamieson.co.uk or follow her on Instagram for tips, recipes and more @emmajamieson_nutrition.