from the studio

MENOPAUSE IS ONE DAY:The rest is a lot more complicated.

Trainer Articles

Ally Taylor

23/10/2026

AN ARTICLE BY ALLY TAYLOR

What menopause actually is:

Here’s a fact that surprises people: menopause is one day. It’s the day you reach 12 months without a period. Everything before is perimenopause, and everything after is postmenopause, a rather unglamorous way of saying “the rest of your life”.

The NHS describes menopause as the point your periods stop because of lower hormone levels, usually between 45 and 55, though surgery, cancer treatment or genetics can bring it earlier. Symptoms can start years before and carry on afterwards. “Years” isn’t a figure of speech. In SWAN, a long-running US study, women with frequent hot flushes and night sweats had them for a median of 7.4 years, and nearly 12 years or more when symptoms began early in the transition.

It isn’t just hot flushes:

Hot flushes get all the airtime, but the list is long: brain fog, anxiety, low mood, fatigue, joint aches, itching, vaginal dryness, broken sleep. Then there are the ones you can’t feel: falling bone density, rising cardiovascular risk and weight shifting to the middle. Heart disease is the leading cause of death in postmenopausal women, and women overtake men for cardiovascular deaths only after menopause.

Yet the NHS is clear that you may have many symptoms or none. Some women sail through; others are flattened for years. A menopause that follows surgery or cancer treatment often arrives far more abruptly than a natural one. No two menopauses are the same, so any single answer offered to everyone, whether it’s a pill, a cream or a class, deserves a raised eyebrow.

A neglected field:

Why are so many of us finding this out the hard way? Because women’s health has been underfunded, under-researched and under-represented for decades.

Take clinical trials. In 1977, after the thalidomide tragedy, the US Food and Drug Administration advised keeping women who could become pregnant out of early-phase drug trials. The result was a shortage of data on how drugs affect women, and the restriction wasn’t rescinded until 1993. To be blunt, fluctuating hormones also make data messier, which made leaving us out the easier option.

The UK has a gap of its own. When the MHRA and the University of Liverpool analysed 4,616 UK trials submitted between 2019 and 2023, male-only trials were nearly twice as common as female-only ones. According to one legal analysis, there was no legal requirement to include women or to report results by sex. England’s first ever Women’s Health Strategy only arrived in 2022, and the government’s renewed strategy now says the health system is failing women.

When the research is thin, the questions go unanswered. And unanswered questions are very good for business.

How the gap gets filled:

A gap in knowledge never stays empty for long. Menopause deserves the attention it’s finally getting, but attention is also where the charlatans arrive, because worry sells.

Menopause creams, menopause supplements, menopause workouts, menopause everything. Often it’s an ordinary product with a new label and a bigger price. I recently compared a “menopause” night cream with a very dry skin moisturiser. The menopause one cost five times as much, and the main differences were a few extra ceramides and peptides with negligible effect. Strong retinol anti-ageing creams cost about the same as the menopause one and contained more ingredients known to work.

Collagen shows how this plays out. It’s sold for skin, hair, joints and more, and the evidence differs for each. For skin, a 2025 meta-analysis found modest gains disappeared when only independent or high-quality studies were counted, and a more recent review found no robust effect on wrinkles. The hair evidence is thin (pun intended), resting on short, often industry-funded studies. Knee osteoarthritis has small trials suggesting modest pain relief, Cochrane says it probably helps pressure ulcers heal (based on one study of 74 people), and the bone data is a single trial part-funded by the manufacturer. Some promise in a few places, a lot of marketing everywhere else.

Much of this marketing treats menopause and ageing as a disease to be feared and fixed. It isn’t. It’s natural, and for plenty of us it’s hard, which is exactly why we deserve better than a sales funnel.

It’s not only the shelf. A 2025 BMJ Open study of 180 claims about HRT across six major social media platforms found that 67% fell outside NICE and BNF guidance, and fewer than a quarter of the sources had no commercial conflict. That’s diabolical.

A solution starts with your problem. A sale starts with your fear. So before you buy, ask three things:

Who is selling this?
Where does the evidence come from, and is it independent?
Would it make sense without the word “menopause” on the label?

Bad information is worse than none, because it arrives with confidence and often an intent to profit.

“Natural” isn’t a safety standard:

More worryingly, the same trick shows up with menopause hormone therapy. “Natural” and “bioidentical” sound reassuring, and they’re used to frighten women off ordinary HRT while selling them something else.

Bioidentical only means the molecule matches the one your body makes. That already describes regulated body-identical HRT: the patches, gels and micronised progesterone available on the NHS, much of it derived from plants such as yams. The “compounded” versions from private clinics aren’t regulated by the MHRA, so there’s no rigorous safety testing or batch standardisation, and NICE advises telling women their safety and efficacy are unknown. The Endocrine Society found no evidence that custom-compounded hormones carry fewer risks than approved ones.

The dose is the real worry. The British Menopause Society points out that compounded products haven’t been tested against placebo or licensed HRT in randomised trials, and in 2017 the Advertising Standards Authority ruled against a UK clinic for misleadingly promoting them. When US compounded products were measured, hormone levels varied between pharmacies and even within one, so you might not get the dose on the label. Too little leaves symptoms untreated, too much risks the effects of excess hormone, and unpredictably absorbed progesterone creams may leave the womb lining under-protected. The irony? They come from the same source ingredients as NHS body-identical HRT and are made in a lab too. Dr Jen Gunter’s book The Menopause Manifesto devotes a whole chapter to this if you’d like to know more. And if you know someone on bioidentical HRT, maybe send them this article and save them some money!

HRT isn’t right for everyone, and that’s a conversation to have with a GP who listens and follows British Menopause Society and NHS guidance, not a sales pitch.

There’s no such thing as a menopause workout, sorry Joe Wicks!

There’s a person, with her own training history, goals, injuries and things she enjoys, going through menopause in her own way. I’m not aware of any good evidence that a “menopause workout” beats well-coached, individual training. It reminds me of the 50+ classes health clubs ran when I started in the industry 26 years ago: little pink dumbbells, light resistance bands and a lot of sitting. That was reductionist then, and it’s offensive now to the many women in their 50’s+ whose workouts match or exceed those of plenty of 20-year-olds. Women don’t need pigeonholing because they got older. They need instructors educated on all facets of menopause who can adapt whatever workout they choose to their unique symptoms. Period.

That means understanding what they might need to adapt:

Hot flushes: a spot near a window or fan, light layers, water to hand.
Bone health: keep the strength work. If someone has osteoporosis, take care with loaded spinal flexion and rotation.
Pelvic floor: mind the impact and intra-abdominal pressure, refer to a pelvic floor physio when needed, and know your scope of practice.

And on it goes, because the list changes with the person. Good coaching listens first, then adapts. That’s not a category, it’s just coaching.

What we actually need:

Good information. A GP who listens. Evidence-based treatment, whether that’s for a season or for life. And a healthy scepticism for anyone whose first move is to make you afraid or sell you a product.

If you’re in the thick of it, be kind to yourself, ask plenty of questions, and ask who’s selling. And if you’d like somewhere to ask them without a sales pitch, you know where we are. The kettle’s on.

Sources:

Checked October 2026.

König et al. 2018, collagen peptides and bone density in postmenopausal women, Nutrients

NHS: Menopause

SWAN: duration of menopausal vasomotor symptoms, JAMA Internal Medicine

HHS Office on Women’s Health: women in clinical trials (US)

MHRA and University of Liverpool: analysis of UK clinical trial submissions, 2019 to 2023

Report on the MHRA data: male-only and female-only UK trials

Bristows: the women’s health gap in clinical trials (UK legal analysis)

UK Parliament: Women’s Health Strategy for England (2022)

Renewed Women’s Health Strategy for England, written statement

McCartney et al. 2025, online information about HRT in UK media, BMJ Open