Menopause Explained: Real Answers to the Most Common Questions

Watan-Menopause is a natural stage every woman’s body goes through, but it is often accompanied by several uncomfortable changes that may leave women feeling exhausted or even broken.

Dr. Naomi Potter, a 48-year-old menopause specialist, explains that what she loves most about her work is the chance to completely transform someone’s life. “You take a woman who feels utterly broken,” she says, “and help her return to feeling like herself again.”

After 16 years working in the NHS, here are the 10 most common questions she’s asked—and her expert advice:

1. Why is my hair thinning?

Estrogen affects every part of the body—including hair quality and growth. Just as you may notice thicker or shedding hair during pregnancy, these changes are hormone-driven. With menopause, estrogen levels drop. Many women tend to overestimate how severe the hair loss is, which often feels worse than it actually is.

Potter’s Solutions:

• Use moisturizing shampoo if hair becomes dry or brittle.
• Avoid frequent hair dyeing—it can worsen hair damage.
• Rule out other causes like vitamin deficiency, thyroid issues, or anemia.
• If hair loss is severe (e.g., receding hairline or bald patches), consult a doctor.
• Maintain a healthy diet—especially if underweight or cutting calories, as hair growth is not a bodily priority during nutrient shortages.

2. Why do I have brain fog?

“Brain fog” is a common term for symptoms like forgetfulness, difficulty finding words, or getting lost even in familiar areas. It can come and go, and deeply impact confidence.

Potter’s Solutions:

• Consider hormone replacement therapy (HRT).
• Evaluate your lifestyle—is it really hormones, or is it stress, relationships, parenting, or caring for elderly parents?
• Reflect on how you handled stress five years ago to identify if hormones are now playing a bigger role.
• Carve out time daily for yourself: eat healthily, exercise (preferably outdoors), even a walk counts.
• Let go of the need to control everything—sometimes you have to allow others to adapt too.

3. Is weight gain during menopause inevitable?

Hormones affect metabolism and fat storage. During fertility years, fat tends to accumulate on the hips, thighs, breasts, and face. After estrogen drops, fat is stored more around internal organs. Aging naturally leads to increased fat and decreased muscle.

Potter’s Solutions:

• HRT may help reduce fat distribution but won’t change metabolism.
• Don’t just eat less—focus on protein, fiber, fruits, and vegetables.
• Prioritize exercise, especially strength training, to support muscle and metabolism.
• Choose a workout you enjoy and can stick with.
• Be realistic and kind to yourself: weight gain isn’t the worst thing with age.

4. Why am I so tired?

Hormonal changes and estrogen loss can cause fatigue. But not all women experience it, and it can resolve on its own.

Potter’s Solutions:

• If fatigue is due to poor sleep from menopause symptoms (e.g., night sweats, anxiety, or waking to urinate), HRT can help.
• If you sleep 9 hours and still feel exhausted, investigate other causes.
• Estrogen affects urinary function—loss of it may cause more frequent urination or UTIs.
• Don’t “preemptively” urinate—train your bladder to hold more. Only go when truly needed.

5. Why do my joints ache so much?

Joint pain—like knee pain, frozen shoulder, or plantar fasciitis—often increases during menopause. Estrogen loss affects muscles, ligaments, and joints, which need lubrication to function smoothly.

Potter’s Solutions:

• HRT may help (but not always).
• Low-impact exercise like cycling strengthens key muscles and supports joints.
• A steroid injection can relieve a frozen shoulder.
• Remember: joint pain now doesn’t mean it’s permanent—many symptoms improve with time.

6. What are hot flashes, exactly?

A hot flash is a sudden sensation of heat, often from the chest up to the face. Blood vessels dilate, pushing blood to the skin surface, causing sweating. Estrogen fluctuations disrupt the brain’s thermostat, making the body think it’s overheated.

Some women also experience cold flashes—a sudden chill, which is less common but also less disruptive.

Potter’s Solutions:

• HRT is highly effective.
• If you avoid HRT, other medications are available.
• Identify and avoid your triggers: stress, spicy/hot food, alcohol, and smoking.

7. Why am I feeling so anxious?

Anxiety is often the first menopause symptom. Hormones affect brain chemistry. Progesterone has a calming effect, so when it drops, anxiety can increase.

Potter’s Solutions:

• Cut back on stimulants like coffee and alcohol.
• Practice mindfulness, meditation, and exercise regularly.
• Some women find alternative treatments like herbal remedies, acupuncture, or massage helpful.

8. Why can’t I sleep through the night?

Waking up at 4 a.m. may be due to a spike in adrenaline. The causes are complex and hormonal, but the main issue is not falling asleep—it’s staying asleep.

Potter’s Solutions:

• Go to bed only when sleepy.
• If you can’t fall asleep, get up and return when ready.
• Wake up at the same time daily to reset your sleep pattern—even if you didn’t sleep well.