New study outlines how lifestyle changes can help menopausal symptoms

Today is World Menopause Day and a new white paper argues that what women do day to day — how they eat, move, sleep, manage stress, avoid risky substances, and maintain relationships — can meaningfully reduce menopause symptoms and lower the risk of future health problems. The paper, “The role of lifestyle medicine in menopausal health: a review of non-pharmacologic interventions,” summarizes research published between 2000 and 2024 and concludes that what is called “lifestyle medicine” should be a foundation of menopause care, alongside other options as needed.

The lead author of the paper is Dr. Chika Anekwe and World Menopause Day was founded by the International Menopause Society in 2009.

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Menopause typically occurs between ages 45 and 55 and is preceded by years of hormonal ups and downs known as perimenopause. While menopause isn’t a disease, the transition can bring hot flashes and night sweats, sleep and mood changes, weight gain around the middle and rising risks for heart disease and bone loss. The study authors conclude that an approach that starts with everyday behaviors can help women feel better now and protect their health later.

Professor Rossella Nappi, President of IMS; photo courtesy of IMS

“Menopause is not a disease, but it can bring symptoms and health risks that need personalised care. This year’s White Paper shows convincing evidence that lifestyle medicine, healthy eating, regular activity, good sleep, emotional wellbeing, and supportive relationships, can make a real difference. Together with other evidence-based treatments when needed, these approaches give women the tools to make informed choices and feel strong and well through this stage of life,” says Professor Rossella Nappi, President of IMS.

How the authors looked at the evidence

The team searched four major databases for human studies of perimenopausal, menopausal, and postmenopausal women. They included randomized trials, cohort and cross-sectional studies, and systematic reviews that examined at least one of six “pillars” of lifestyle medicine: healthy eating, physical activity, mental well-being, avoidance of risky substances, restorative sleep, and healthy relationships. Across these areas, they report consistent links between lifestyle changes and fewer hot flashes, better sleep and mood, healthier weight, and lower risks tied to heart and bone disease. They also highlight that multidisciplinary, tailored programs tend to boost adherence and patient-reported outcomes, and are generally cost-effective and adaptable across diverse populations.

What are the six pillars?

Healthy eating. Diets centered on vegetables, fruits, whole plant foods, and unsaturated oils—such as Mediterranean and DASH patterns—are associated with better blood pressure, cholesterol, insulin sensitivity, and weight regulation. For midlife women, nutrition also matters for bones: the paper reiterates guidance that most women over 50 need 700–1200 mg of calcium daily and adequate vitamin D, which can be harder to get from sun exposure with age. Evidence that diet alone relieves hot flashes is mixed—some studies show modest benefits from produce-rich patterns, while findings on soy foods are inconsistent. Still, the authors emphasize that plant-forward eating supports overall metabolic and cardiovascular health during and after the transition.

Physical activity. Exercise appears to help on several fronts—even when the scale barely moves. Aerobic activity supports vascular health and fitness, while resistance training helps preserve or build lean muscle and bone. Multiple studies link regular activity with fewer or less intense vasomotor symptoms and better quality of life. Combining modalities (for example, strength plus cardio or interval training) may deliver the broadest benefits, including improvements in body composition and inflammatory markers. The paper notes current recommendations that adults aim for roughly 150 minutes of moderate-intensity aerobic activity per week plus strength work on at least two days, and it stresses that consistent routines of 3–4 months can translate into measurable improvements over 6–12 months.

Mental well-being. Midlife often brings stacked stress—from careers to caregiving—which can worsen menopausal symptoms. Programs that teach cognitive and relaxation strategies improve coping and can dial down hot flashes and perceived stress. The review also points to emerging tools—mobile health apps, wearable trackers, and conversational AI—that show promise for stress reduction and behavior change, while noting that menopause-specific trials remain limited. Pairing human coaching or motivational interviewing with self-monitoring technologies may be especially effective.

Avoidance of risky substances. Smoking is tied to earlier menopause and worse symptoms; quitting improves quality of life even if weight rises modestly, which the paper reports does not appear to worsen key cholesterol risk factors. The study authors detail complex, sometimes contradictory findings on alcohol. While low to moderate intake has been linked in some studies to certain metabolic benefits, alcohol can raise estrogen levels and is a known risk factor for conditions such as breast cancer. The review’s bottom line: any potential benefits must be weighed against well-documented risks, and reducing consumption is a good choice for many.

Restorative sleep. “Restorative” sleep, waking refreshed and functional, matters as much as sleep duration. Poor sleep and frequent awakenings are common during the transition and are associated with slower thinking speed, lower bone density, higher insulin levels, and increased cardiovascular risk. Non-drug steps like consistent bedtimes, a cool and dark room, daytime activity, and limiting evening caffeine and alcohol can help. For persistent insomnia, Cognitive Behavioral Therapy for Insomnia is recommended as a first-line approach and is effective with or without concurrent hot flashes.

Healthy relationships. Social connection isn’t just nice to have, it’s linked to better control of chronic conditions, reduced risks of heart disease, diabetes, osteoporosis, and even lower overall mortality. Strong, supportive networks also appear to buffer hot flashes and improve mood and life satisfaction. Conversely, loneliness and social isolation correlate with higher rates of stroke, metabolic syndrome, disability, and fractures. The quality of relationships matters: close, trusted ties appear more protective than large but distant networks, and partner education about menopause can improve relationship quality and well-being.

Why this matters

Taken together, the authors conclude that lifestyle medicine offers an “evidence-based framework for equitable menopause care.” Because these strategies are scalable and adaptable, they could be woven into clinical guidelines and public health policy to improve access and outcomes, particularly for underserved groups. Their message is not “lifestyle instead of medicine,” but “lifestyle as medicine,” a foundation that can stand alone for some women and complement hormonal or non-hormonal therapies and medicine for others, according to the study.

Study citation: Anekwe, C. V., Cano, A., Mulligan, J., Ang, S. B., Johnson, C. N., Panay, N., … Nappi, R. E. (2025). The role of lifestyle medicine in menopausal health: a review of non-pharmacologic interventions. Climacteric, 28(5), 478–496. https://doi.org/10.1080/13697137.2025.2548806