Dr Zoe Williams on how to prepare for menopause in your 30s and 40s

Zoe Williams, the resident TV doctor on ITV's This Morning, is proactively preparing for menopause at 45, despite not experiencing symptoms yet.

"As a woman in my mid-40s myself, the time to start preparing for menopause is before it happens," Dr Williams says.

Her oestrogen levels are lower than before, she says, and she is likely in perimenopause.

To mitigate potential symptoms, the NHS physician and former Gladiator is focusing on building muscle and adjusting her diet.

Menopause, which marks the end of a woman's periods, can bring about various unpleasant symptoms, including mood changes, hot flushes, sleep disturbance, hair loss, vaginal dryness, and joint pain.

However, Dr Williams says that "menopause isn’t all doom and gloom".

She advises women to start preparing from their 30s onwards to offset some of the negative consequences.

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“I’ve already started to make some lifestyle changes, and actually, it’s given me some motivation to stick with certain lifestyle changes that I know are going to help me when I do reach menopause,” she says.

Her focus now is “definitely on building strength and maintaining flexibility”, whereas before, “I used to really love to go spinning and get those endorphins hits, but now I’ve shifted because I know what’s better for me.

“I know as a 45-year-old, gaining muscle in the gym will never be easier than it is right now. I’m lifting weights because I know that if I can lay down muscle now, that’s going to help me when it becomes more difficult to lay down muscle later on.”

Oestrogen plays an important role in maintaining strength and one of the effects of menopause is a loss of muscle mass and bone density, due to the drop in oestrogen levels during this time – “unless we do something about it”, Dr Williams notes.

As they age, women need muscle strength and bone strength to stabilise joints and prevent injury, helping to stay mobile and independent for years to come. There is a lot of research that links higher muscle mass to disease prevention and longer living, too.

Dr Williams, an ambassador for menopause brand Issviva, still does cardio though. “I love walking up a hill and getting a bit sweaty, I do a dance class once a week, I will occasionally do a spin class if I feel that’s what I need but if I’m limited on time and I’ve only got 45 minutes, then I’ll prioritise what my body needs – and that’s building muscle.

“I’ve already started to lose muscle, partly because I’ve had a back injury and there was a period of time that I couldn’t work out. And I can see my muscles are not as strong as they used to be. So I’m working really hard to regain whatever strength I can, because I know that it’s only going to get harder as I get older.”

Muscle loss and bone loss often go hand in hand during menopause and strength training can help bone health too.

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Protein has been key for Dr Williams. “Because I’m trying to regain muscle, I started having protein shakes, which was something I very much did around the Gladiator times. I just find it a really accessible way of getting a good bit of protein into my body – I have a shake immediately after I’ve done my workout in the morning so I know that’s taken care of.”

And for the rest of her diet, “I’ve shifted from trying to eat healthily and trying to minimise foods that are not so good for me to focusing on nutrient-dense foods that I really love.”

She’s also “switched from habitual drinking to mindful drinking”.

“As we’re approaching menopause, it’s really important to make sure we’re getting enough calcium,” she adds. “I try and eat fish more often, I usually have a salad during the week for lunch and chuck mixed seeds and mixed sprouts and a few nuts. It doesn’t cost a lot of money but all the stuff I chuck in there, there’s probably about 20 different plants.

“If you’re entering your 40s and you find that you do have a bit more expendable cash than you had before, consider spending that on nourishing your body with good quality food, before anything else.”

A nutritious diet, that helps to curb blood sugar fluctuation, is understood to help manage common menopause symptoms, like hot flashes and weight gain, while also protecting your heart health.

“The number one killer of women is heart disease,” notes Dr Williams.

“It’s really important that women understand the link between menopause and heart health as women. Women tend to get heart attacks about 10 years later than men, and one of the reasons for that is that the oestrogen that we have in our bodies prior to menopause actually protects the heart. Once we lose that at menopause, our heart starts to become susceptible.”

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For women who don’t take HRT (hormone replacement therapy), there will be an “uptick” in the inflammatory state of the body – “Which we know is not good for our health, it increases heart disease and type 2 diabetes,” Williams says.

“We can think of oestrogen as an anti-inflammatory chemical. Oestrogen is in every cell of our body, it’s in every system of our body and whilst we have oestrogen circulating, it’s providing an anti-inflammatory effect. So therefore, once we lose that oestrogen, the inflammatory state of our body is likely to turn in the direction of a pro-inflammatory, especially if we have lives where we’re really under stress. One of the other major things that increases the inflammatory state of our body is chronic stress, poor diets, physical inactivity, too much alcohol and smoking.

Although, she says, if women do take HRT there’s still an added benefit to lifestyle changes.

“Oestrogen is also really important to maintain the health of the tissues in the urogenital tract – the vagina, the urethra and the vulva – so it’s very common that women experience vaginal dryness [during menopause]…. as well as losing laxity and sexual pleasure.

“I’ve gone through a stage of, even as a doctor, not having enough knowledge, being a bit oblivious, being like ‘I’ll deal with that when I get to it’, to almost dreading it and having too much knowledge and [hearing] all the horror stories, to now very much in a place of acceptance that this is going to happen and it’s not all doom and gloom.

“I think approaching menopause has definitely given me motivation. I feel informed, I feel empowered. But I do also feel that women, many women, are more fearful than they need to be.”