I’ve been wanting to talk about menopause for a while, because suddenly it feels like it’s everywhere. My friends bring it up, the wellness world is buzzing about it, and I’m watching so many women feel confused about what they should be doing. I don’t ever want to tell anyone not to take hormones. Truly — do whatever feels right for your body. But I also want to share something that doesn’t get talked about enough: we don’t automatically need hormones just because we reach a certain age.

I know women who love hormone therapy. I know women who tried it and felt worse. And I know women who are incredibly healthy, grounded, and thriving without ever touching hormones. It seems to me there are as many versions of the menopause journey as there are women on it. And I think this also means we can feel supported, balanced, and well without assuming pharmaceuticals are the first step.

When the emotional waves hit

My own experience didn’t begin with hot flashes. It started with moodiness — feeling out of balance, like I was having full-on PMS even though I wasn’t on my period at that moment. Tight, edgy vibes. The moment those feelings showed up, I went straight to acupuncture. The treatment and the herbs my practitioner gave me shifted everything — and the symptoms? Well, they disappeared completely. It was incredible.

That experience reminded me how responsive our bodies can be when we offer them the right kind of support. I feel most comfortable trying the gentlest option — ones that work in harmony with how our systems naturally want to function — before jumping to the heaviest tools.

Leona West Fox, CN, CH, FMCHC, is someone I’ve turned to a lot on this journey. She has such a grounded understanding of nutrition, herbs, and hormonal balance. “Menopause isn’t a disease to treat, it’s a natural biological transition,” she says, and it shows up very differently from woman to woman. “For many women, the years leading into it, called perimenopause, can feel like a second puberty. Hormones fluctuate more dramatically during this time, which is why things can suddenly feel chaotic. Sleep may become fragile, emotions more unpredictable, and the body may respond very differently to stress, food, alcohol, or caffeine than it once did.”

Understanding What Triggers Symptoms

After my moodiness, hot flashes came next, and they taught me a lot! I could almost track them like weather patterns: if I had sugar, caffeine — especially coffee — or alcohol, the flashes were more frequent and more intense. If I skipped those things, they often went away entirely. And if I indulged here and there, the flashes crept back in.

It was such a clear connection that it changed the way I understood my symptoms. I realized menopause wasn’t happening to me; I was in a relationship with it. My choices mattered. What I ate and drank mattered.

One simple thing Leona taught me: simply turning down the heat to 68 degrees at night made a major difference for my sleep. (It’ll reduce your winter heating bills a ton, too!)

If you’re feeling overwhelmed by symptoms, try checking in with these basics:

Are you eating meat or dairy?
Are sugar and white flour part of your daily rhythm?
Is coffee a non-negotiable morning ritual?
Is alcohol something you enjoy regularly?

For many people, removing meat and dairy is the biggest shift. Then sugar. Then things like white flour and caffeine. Try not to look at these changes as punishment; they’re experiments. They’re invitations to see what your body does when you remove some of the biggest triggers for inflammation, stress, and hormone disruption (whether you’re going through menopause or not).

Herbs, Acupuncture, and Natural Support

Alongside diet, there are beautiful plant-based tools that can help with hot flashes, mood swings, sleep disruptions, and that general sense of feeling out of sync. Acupuncture has been incredible for me. Traditional herbs, adaptogens, and nutrient-rich supplements can also make a meaningful difference.

Leona says that as the body redistributes how hormonal stability is maintained, stress resilience, restorative sleep, and metabolic health become especially influential in how women feel. “In my work, I often incorporate nervous-system-supportive herbs like lion’s mane, ashwagandha, and shatavari, which have long traditions of supporting mood stability, cognitive clarity, and the body’s ability to adapt to hormonal change.”

While perimenopause can sometimes feel random, “even for women who take excellent care of themselves,” Leona says experiencing symptoms doesn’t mean someone has done something wrong. “What I do see clinically, though, is that when foundational systems are supported, stable blood sugar, restorative sleep, regular movement and strength training, and a nutrient-dense diet rich in protein, omega-3 fats, magnesium, fiber, and minerals, the body often navigates this transition much more smoothly.”

One of the simplest but most effective interventions for night sweats and sleep disruption is lowering the bedroom temperature. During perimenopause and early menopause, the hypothalamus, the brain’s temperature regulation center, becomes more sensitive, which is why even small increases in heat can trigger hot flashes.

Most women sleep best when the bedroom is kept between about 60 and 68 degrees, which allows core body temperature to drop — something the body requires for deep, restorative sleep.

Other practices that support this natural temperature drop include magnesium or glycine in the evening, warm showers or baths before bed, dimming lights after sunset, and reducing late-night screen exposure. These signals help the nervous system shift into repair mode.

Several non-hormonal botanical options can support women through menopause. One example is EstroG, a combination of three traditional Korean herbs that has been studied for helping reduce vasomotor symptoms such as hot flashes and night sweats.

Before You Jump Into Hormones

What concerns me most is how casually hormones are prescribed. I hear from so many women who were told, “You’ve reached this age, it’s time,” without any conversation about what they’re eating, how they’re sleeping, or what their daily stress levels look like. Hormones are not a shortcut to balance if the foundation underneath is depleted or inflamed.

So before reaching for hormone therapy — even the lowest dose, even the bioidentical versions—ask yourself:

Have I explored my diet?
Have I removed the biggest triggers?
Have I tried acupuncture or herbs?
Have I experimented with green tea instead of coffee? Have I supported my nervous system and adrenals through lifestyle shifts?

These questions aren’t about avoiding hormones forever. They’re about understanding your options. About remembering that menopause is not an emergency; it’s a transition. And transitions respond beautifully to patience and care.

“With or without hormone therapy, food is one of the most powerful tools for supporting the body during menopause,” Leona says. “I encourage women to focus on foods that are both deeply nourishing and naturally cooling to the system.” She recommends leafy greens like kale, arugula, and spinach as well as berries, cucumbers, melons, flaxseeds, and lentils.

“Cruciferous vegetables like broccoli, cauliflower, and Brussels sprouts are particularly valuable because they support liver pathways that help metabolize and clear hormones efficiently,” Leona says. “Many women also find seed cycling helpful, rotating flax and pumpkin seeds for two weeks, followed by sesame and sunflower seeds for two weeks to provide nutrients that support estrogen and progesterone pathways and overall hormone metabolism.”

Magnesium can help calm the nervous system and improve sleep quality, omega-3 fatty acids support brain health and mood stability, and evening primrose oil is often used to support skin health, moisture balance, and hormonal comfort.

Leon says that one of the most overlooked interventions during menopause, however, is maintaining muscle mass. “Muscle isn’t only about strength or appearance, it’s a metabolically active tissue that helps regulate blood sugar, support hormone signaling, and protect long-term metabolic health while also helping prevent the body fat redistribution many women notice as muscle declines.” She says that beginning in our 40s, women can lose roughly 3–10 percent of their muscle mass per decade if it isn’t actively maintained. “Strength training is one of the most effective ways to counteract this shift and may even help reduce symptoms like fatigue, insomnia, brain fog, and hot flashes.” A randomized trial published in Maturitas found that women participating in a structured resistance-training program experienced significant reductions in the frequency and severity of hot flashes.”

Lifestyle patterns matter just as much. “Many people assume that if they exercise for an hour they are no longer sedentary, but if the rest of the day is spent sitting the body can still experience many of the metabolic effects of inactivity,” Leona says. She advises regular movement throughout the day, walking, standing, stretching, and taking short movement breaks, helps regulate blood sugar, circulation, and energy levels. Explore your physical hobbies, too, that keep the body moving, such as gardening, dancing, hiking, tennis, swimming, or even active household tasks.

Embracing the Transition

During this phase many women also notice that long-held habits may affect them differently than they once did. Fasting patterns, alcohol intake, caffeine consumption, protein distribution across the day, and even wake and sleep times often benefit from reassessment and adjustment, Leona says.

This stage of life doesn’t have to feel heavy or scary or like a loss of control. There’s actually something empowering about it—something clarifying. When I listen closely, my body tells me exactly what it needs. When I simplify my diet, nourish myself, get acupuncture, and stay off things that inflame me, everything feels smoother. The mood swings quiet down. The heat disappears. The whole process feels more like an unfolding and less like something I have to fight.

“Menopause may initially feel like it’s only about an ending, but I see something very different,” says Leona. “Women today are living longer than ever before, and many will spend as many years, or even more, in the post-menopausal phase as they did in their reproductive years. That’s incredibly powerful when you think about it. It’s most definitely a beginning.”