Glossary: Simplify It

A category of herbs and plant compounds (think ashwagandha, rhodiola, maca) believed to help your body handle stress more effectively. Popular in the wellness world, though the research is still catching up to the claims, so approach with curiosity rather than certainty, and check with your doctor if you're on any medication.

A hormone made by the small follicles in your ovaries, often used to estimate how many eggs you have left (your ovarian reserve). Levels fall as you approach menopause. It can be useful in fertility conversations, but it can't predict exactly when your last period will be, so it isn't used to diagnose perimenopause.

Hormones that are chemically identical to the ones your body naturally produces, made from plant sources but processed to match your own estrogen, progesterone or testosterone exactly. Not to be confused with "compounded" bioidentical hormones, which are custom-mixed by pharmacies and aren't regulated the same way as licensed HRT. Most standard HRT prescribed today is actually bioidentical. It's the compounded, unregulated versions worth asking more questions about.

Hormones made from plant sources that are chemically identical to the ones your body makes, such as estradiol and micronised progesterone. In the UK this is the preferred term for regulated, licensed HRT products, which are tested for safety and dose. It's different from compounded 'bioidentical' hormones, which are custom-mixed, unregulated and not backed by the same evidence.

A cognitive symptom that brings forgetfulness, difficulty concentrating and an overall mental fuzziness. It can leave you feeling silly, frustrated and worried about your mental health. The good news? It's common, and for most people it's temporary. Now, where are my keys...? If it's affecting your day-to-day life, it's worth mentioning to your doctor.

A general term for conditions that affect the heart and blood vessels. After menopause your risk goes up, partly because estrogen's protective effect fades. Blood vessels lose some elasticity, LDL (the "bad" cholesterol) tends to rise, and HDL (the "good" one) can drop. It's a good time to check in on your heart health, not just to prevent disease but to protect your energy, stamina and strength in the long run.

A structured talking therapy that helps you notice and change unhelpful patterns of thinking and behaviour. In menopause care it is used to ease low mood and anxiety, and it can help reduce how much hot flashes, night sweats and poor sleep bother you. It doesn't change your hormone levels, but it can change how much the symptoms take over your day.

A structural protein that keeps skin, joints, hair and bones strong, and one your body produces less of as estrogen declines. It's become a popular supplement in midlife for this reason, usually taken as a powder or capsule. Worth knowing: supplement quality and evidence vary a lot, so not all collagen products are created equal.

Your main stress hormone. It helps you handle busy days and sudden chaos, but when stress is constant and cortisol stays high, it can disrupt sleep, appetite and where your body stores fat. Midlife often stacks up extra pressure (work, family, caring), and poor sleep can push cortisol up too, so it can become a loop. Stress management, sleep and movement all help break it.

A compound your body makes naturally and stores in your muscles (and brain) as a quick energy source. It's best known as a sports supplement, but it's now being talked about in midlife because muscle mass, strength and bone health all take a hit as estrogen declines. Early research suggests it may support strength when combined with resistance training, though the evidence in menopausal women is still developing. It's not a shortcut, more a possible add-on to lifting weights. Worth checking with your doctor first if you have any kidney concerns.

When your periods stop before the age of 45. It can happen naturally (genetics and autoimmune conditions are among the causes) or after treatment such as surgery, chemotherapy or radiotherapy. Because you're without estrogen for longer, it matters for bone and heart health, and HRT is often recommended until at least the average age of menopause, so it's important to get checked.

The strongest and most active of the three types of estrogen, and the main one your ovaries produce during your reproductive years. It's the estrogen doing most of the heavy lifting for your brain, bones, heart, skin and mood. During perimenopause, estradiol doesn't glide downwards, it swings up and down unpredictably, which is why symptoms can feel so erratic. It's also the type of estrogen used in most modern HRT, in patches, gels and sprays.

The collection of gut bacteria that help process estrogen after your liver has dealt with it. Some of them can release estrogen back into circulation, which is why researchers are curious about the gut's role in hormone balance. The idea is still emerging and most of the evidence so far is observational, so treat any claim that you can 'fix' your hormones through your gut with caution.

The star of the hormonal show! Estrogen is actually a family of hormones (estradiol, estrone and estriol), and it supports your brain, bones, heart, skin, mood and more. It rises and falls throughout your cycle, but during perimenopause those swings get bigger and more unpredictable. Eventually estrogen levels decline, which is what brings on many of the symptoms we associate with menopause, from hot flashes to vaginal dryness to mood shifts.

One of the three types of estrogen (alongside estradiol and estriol). It's the weaker form that takes over after menopause, made mostly in body fat instead of the ovaries. While not as powerful as estradiol, estrone still helps keep your hormonal balance ticking along in postmenopause.

A hormone your brain produces to encourage your ovaries to release an egg each month. As your ovarian reserve declines during perimenopause, your brain has to shout louder, so FSH levels rise. Doctors sometimes test it to help understand where you are in the transition, though it's not always a clean answer. FSH can fluctuate wildly during perimenopause, so one test on one day doesn't always tell the full story.

Short for glucagon-like peptide-1, a hormone your gut naturally produces that affects blood sugar and appetite. It's also the name behind a class of medications (like semaglutide) originally developed for diabetes, now widely used for weight management. Increasingly part of the menopause conversation given the metabolic shifts many women experience, though it's a decision to make with your doctor, not a menopause-specific treatment.

The umbrella term for the vaginal and urinary changes that come with falling estrogen. That includes dryness, irritation, discomfort during sex, needing to pee more often, and recurrent UTIs. Unlike hot flashes, GSM doesn't tend to settle on its own and often gets worse without treatment. The good news is that it's very treatable, including with low-dose vaginal estrogen, which most women can use safely. If this one sounds familiar, you're far from alone, and it's absolutely worth raising with your doctor.

The trillions of bacteria and other microbes living in your digestive system. They help with digestion and immunity, and they play a part in how your body processes estrogen. Research into how the gut changes through perimenopause and menopause is still emerging, so be wary of products that promise to fix your hormones through your gut.

Treatment that replaces some of the estrogen your body makes less of, usually alongside a progestogen if you still have a womb, to ease symptoms like hot flashes, sleep problems and low mood. It also helps protect your bones. It comes as patches, gels, sprays and tablets, and the type matters: estrogen through the skin carries a lower clot risk than tablets, for example. Timing matters too, with the best balance generally seen when it's started within 10 years of menopause or before 60. Guidance has moved on a lot from the early 2000s scares, and the FDA has begun removing the broadest warnings from HRT labels. Your own history shapes the decision, so it's best made with a doctor who really understands menopause.

That sudden whoosh of heat out of nowhere. Your face, neck and chest heat up, often followed by sweating or chills, and sometimes a racing heart. They're linked to shifting estrogen levels affecting your brain's temperature control, and can last seconds or minutes, day or night. Common triggers include hot environments, heavy clothing, alcohol, caffeine, spicy food and stress. They're the best-known menopause symptom, and they're treatable, with both hormonal and non-hormonal options.

Surgery to remove the uterus. Your periods stop afterwards, but if your ovaries are left in place, you're not in menopause, because your ovaries still produce hormones. The catch is that without periods to track, it's much harder to tell where you are in the transition, and some women reach menopause a little earlier after a hysterectomy. If your ovaries are removed at the same time (an oophorectomy), that's surgical menopause, which happens suddenly.

Your body's ability to manage blood sugar becomes less efficient as estrogen declines. It's like your cells stop opening the door for insulin, so sugar stays in your bloodstream longer and your body stores more of it as fat, often around your middle. You may not notice it at first, but it can affect energy, cravings, weight and long-term health. Small daily tweaks in food, movement and stress can make a big difference.

A drop in interest in sex, which is common in perimenopause and menopause and often has more than one cause. Falling estrogen and testosterone, vaginal dryness, poor sleep, low mood, stress and relationship factors can all play a part. It's worth raising with your doctor, because there are treatments, from vaginal estrogen to, in some cases, testosterone.

The newer clinical term for HRT. Same treatment, with a name that better reflects that it's hormone therapy for menopause rather than a blanket "replacement" of everything your body used to produce. You'll see both terms used, and they mean the same thing.

The grand finale of your menstrual journey! Strictly speaking, menopause is a single day, confirmed in hindsight once you've gone 12 consecutive months without a period (provided there's no other cause). The average age is around 51, and most women reach it between 45 and 55.

A body-identical form of progesterone made from plants, used in HRT to protect the womb lining when you take estrogen. It appears to carry a lower risk of blood clots and breast cancer than some synthetic progestogens. It can cause drowsiness, so it is usually taken at bedtime, and in the UK it is licensed as Utrogestan.

Hormone shifts can leave you swinging from not caring about anything to white-hot rage, sometimes in one afternoon. Are we laughing or crying? Sometimes, who knows. Perimenopause is also a time when anxiety and low mood become more common, and that's not something to simply push through. If your mood stays low for more than a couple of weeks, or you're struggling to cope, speak to your doctor. Support is available and it really can help.

A molecule found in every cell in your body, essential for turning food into energy. NAD+ levels naturally decline with age, and interest has grown in whether supplementing it (via pills, patches or IV drips) can support energy, metabolism or cellular repair during midlife. The science is still developing, so think promising but not yet proven, rather than a guaranteed fix.

Hot flashes that crash your sleep party. Another vasomotor symptom: repeated nights of suddenly feeling very hot and sweating heavily, leaving you, your nightclothes and your bedding soaked. Managing room temperature and stress can help keep these nighttime disruptions at bay.

A newer type of medication for hot flashes and night sweats that works without hormones. Instead of replacing estrogen, these drugs (fezolinetant, sold as Veoza or Veozah, and elinzanetant, sold as Lynkuet) block a brain pathway involved in your body's temperature control, the same pathway that goes haywire when estrogen drops. They're an option for women who can't take HRT or would rather not. Fezolinetant needs liver blood tests before and during treatment, and availability and cost vary depending on where you live. This is a conversation to have with a doctor who knows menopause.

A condition where bones lose density and become fragile, raising the risk of fractures, most commonly in the hips, spine and wrists. Estrogen helps protect bone, so bone loss speeds up in the years around menopause. There are usually no symptoms until a break happens, which is why it's called a silent disease. Strength training, enough protein, calcium and vitamin D, and not smoking all help, and your doctor can advise on bone density scans and treatment if you're at higher risk.

This covers various conditions with bladder and bowel symptoms: incontinence, constipation, and leaking when you cough, jump, sneeze or LAUGH! It happens when you're unable to fully relax and coordinate your pelvic floor muscles. It also includes pelvic organ prolapse and pelvic pain. A pelvic floor physiotherapist can help.

The transition leading up to menopause, when your ovaries gradually change how they make hormones. Estrogen and progesterone don't decline in a straight line, they swing up and down unpredictably, which is why it feels more like a rollercoaster than a gentle slope. It often begins in your 40s (sometimes earlier) and commonly lasts around 4 to 8 years, though for some it's shorter or longer. You can have symptoms while your periods still seem fairly regular.

There are approximately 34 recognised symptoms of perimenopause, which can be physical, emotional and cognitive. They vary widely and can show up in different combinations and intensities. Up to 80% of women experience symptoms during this time, with common ones including hot flashes, mood swings, sleep disturbances and fatigue.

Plant-based compounds in foods like soy and flaxseed that have a mild estrogen-like effect in the body. Some women find them helpful, but the evidence is mixed, so think of them as a food choice rather than a treatment.

Everything after menopause, where periods are HERstory! Some symptoms can stick around, and lower estrogen starts to matter more for your bones, heart and pelvic health, so it's a good time to focus on long-term health. Many women also find a new kind of freedom here.

When your ovaries stop working normally before the age of 40, leading to irregular or missing periods and menopause-type symptoms. It affects around 1 in 100 women. Sometimes there's a clear cause, such as genetics, an autoimmune condition or cancer treatment, but often there isn't one. POI is different from early menopause, and it's important to get checked, because the long-term effects on bones and heart health mean treatment is usually recommended.

One of the key sex hormones and estrogen's calming sidekick. Progesterone helps regulate your cycle, supports sleep and keeps your mood steadier. It's often the first hormone to dip in perimenopause, as ovulation becomes less regular, which is why you might notice more anxiety, disrupted sleep or irregular periods. If you take estrogen as HRT and still have a womb, you'll usually need a progestogen alongside it to protect the womb lining.

The gradual loss of muscle mass and strength that comes with age, which can speed up around menopause as estrogen falls. Less muscle means a slower metabolism, weaker bones and a higher risk of falls. Strength training and enough protein are the best-evidenced ways to protect it.

You're exhausted but can't sleep? Welcome to the paradox of perimenopause. Hormones like estrogen, progesterone and melatonin all play a role in your sleep-wake cycle, and when they shift, sleep can feel broken. You might wake up hot, anxious or just wide-eyed at 3 a.m. Add late-night scrolling or revenge bedtime procrastination (staying up to reclaim time for yourself) and it's no wonder sleep feels off.

This is when both of your ovaries are removed during surgery (oophorectomy), leading to a sudden loss of estrogen and progesterone. Menopause begins straight away rather than gradually, which can make symptoms more intense. HRT is often recommended until at least the natural age of menopause, unless there's a reason not to.

Yep, women have it too, and it matters. Testosterone supports your libido, energy, mood, muscle strength, motivation and confidence. Unlike estrogen and progesterone, it doesn't fall off a cliff at menopause. Levels decline gradually from your 30s onwards, though they can drop more sharply after surgical menopause. When they run low, you might feel more tired, flat, or just not quite yourself, with less drive and a lower sex drive. It's one of the lesser-talked-about hormones, but it plays a quiet power role.

A small butterfly-shaped gland at the base of your neck that acts as your body's energy and thermostat controller. Thyroid conditions, like an underactive thyroid or autoimmune Hashimoto's, are common in midlife, and the symptoms overlap heavily with perimenopause: fatigue, brain fog, low mood, weight changes, disrupted sleep. That's why a thyroid check is worth asking for rather than assuming everything is hormones. Perimenopause might be part of the picture without being the whole picture.

Estradiol taken through the skin, as a patch, gel or spray, instead of a tablet. Because it bypasses the liver, it is linked to a lower risk of blood clots and stroke than oral estrogen. UK guidance treats it as the first choice for women with risk factors.

One of the most common and least talked-about symptoms. As estrogen falls, the tissue of the vagina and vulva becomes thinner, drier and less elastic, which can mean dryness, irritation, discomfort during sex and needing to pee more often. It's part of what's now called Genitourinary Syndrome of Menopause (GSM), the modern term that replaces "atrophic vaginitis". It rarely settles on its own, but it's very treatable, so it's worth raising with your doctor.

A low-dose estrogen cream, pessary, tablet or ring placed in the vagina to treat dryness, discomfort and urinary symptoms (GSM). It works locally, with very little absorbed into the bloodstream, and symptoms often return if you stop. Ask your doctor, as it needs a prescription and some situations need specialist advice.

The medical name for hot flashes and night sweats. As estrogen drops, the part of your brain that controls body temperature becomes more sensitive, so small changes can trigger a sudden surge of heat as your blood vessels widen. It's your body's thermostat acting up. Frustrating, yes, but there are ways to manage it.

Belly fat, "meno belly"... it can show up around your middle from your 40s onwards, often without weight gain anywhere else. As estrogen drops, the deeper fat around your organs increases from around 5-8% to 10-15% of total body fat. Add a natural decline in muscle mass, so your body burns fewer calories even at rest, and it's easy to see why. It's not just about looks: visceral fat can also affect heart and metabolic health, and strength training is one of the best-evidenced ways to help.