How HRT, your GP and lifestyle habits could keep you healthy in menopause, according to a doctor
Posted by Claire Hewitt, on June 25, 2025. Tags: Health benefits, Menopause, Wellbeing
Estimated reading time: 6 minute(s)
From lesser-known symptoms of perimenopause to all the HRT options, women’s health expert Dr Mayoni Gooneratne talks us through managing your menopause with lifestyle changes and healthcare support, in the second of our ‘meno wellness’ expert series.
If you’re in perimenopause, you’re probably primed to look out for the most common symptoms – hot flushes, brain fog, insomnia and anxiety. But, according to functional medicine doctor and women’s health expert Dr Mayoni Gooneratne, many women may experience a veritable shopping list of other symptoms including burning mouth or gum discomfort, itchy skin, heart palpitations, vaginal dryness, low libido, bladder issues, tinnitus, electric shock sensations, and a loss of confidence.
“These symptoms arise because of the fluctuation and eventual decline in oestrogen and progesterone, hormones that play key roles throughout the body,” she explains. “Their influence spans the brain, skin, muscles, joints, bladder, cardiovascular system and more, which is why symptoms can feel so wide-ranging and unpredictable.”
When should you seek help from your GP?
With so many potential symptoms to consider, it can be difficult to know exactly when and how to reach out for professional help. Dr Mayoni recommends, “If you’re in your mid-to-late 30s or 40s and start noticing any physical, emotional or cognitive changes that persist and don’t have another clear cause, it’s worth starting a conversation with your GP.” It can help to speak to a specialist, but not all GPs are specialists in menopause – ask your local surgery if any of their GPs are trained in menopause care and are familiar with the NICE guidelines.
Before making an appointment, Dr Mayoni suggests tracking your symptoms for a few months, especially any changes in your menstrual cycle, mood, sleep patterns, energy levels, skin, libido or weight. At your appointment, share this with your GP and mention if you have any family history of early menopause or hormone-sensitive conditions.
“Be clear about how your symptoms are impacting your quality of life,” she says. “You can then discuss HRT or non-hormonal support depending on your needs.”
What treatment options are available – and is HRT suitable for everyone?
Before considering any medical intervention, Dr Mayoni recommends ensuring you are as healthy as you can be through nutrition, sleep and stress management, as well as introducing joyful movement and nurturing the relationships in your life. If your symptoms are causing concern and you believe additional treatments could help, you can explore the options with your doctor.
“Hormone Replacement Therapy – commonly referred to as HRT – is the most effective treatment for many menopause symptoms, with different types tailored to individual needs,” says Dr Mayoni. “[These are] oestrogen-only HRT, for women who have had a hysterectomy; combined HRT, which is oestrogen and progesterone for those with a uterus; and body-identical hormones, derived from plants and structurally identical to your body’s own hormones.” These treatments come as patches, gels, sprays, tablets and vaginal forms, such as creams or pessaries.
She advises that while the NHS offers a range of HRT some formulations, such as testosterone or compounded hormones, may only be accessible through private clinics.
A few years ago, scare stories hit the press linking HRT to a higher risk of breast cancer. Dr Mayoni points out that it’s a common concern that still causes confusion, however: “For most women, the benefits of HRT outweigh the risks – especially when started before the age of 60 or within 10 years of menopause. Combined HRT has a small increased risk of breast cancer, particularly with longer use, while body-identical progesterone appears to carry a lower risk. Oestrogen-only HRT does not increase breast cancer risk and may even reduce it slightly,” she adds.
How to protect your health post-menopause
Once you’ve navigated perimenopause, it’s important to maintain healthy habits to protect your post-menopausal body. Dr Mayoni says, “Menopause is officially diagnosed 12 months after your last period. Some symptoms settle quickly, but others – like vaginal dryness, urinary issues or joint pain – can persist for years or reappear later. Start preparing as soon as you can – it’s never too early!”
She identifies these areas as key concerns post-menopause:
Bone health: “Oestrogen helps maintain bone density, so [to counteract its decline] resistance training, and calcium plus vitamin D are essential.”
Heart health: “The risk of cardiovascular disease rises so, where appropriate, HRT and healthy lifestyle choices are protective.”
Cognitive health: “Keep your brain stimulated, your sleep consistent, and your blood sugar stable.”
Pelvic floor support: “Consider pelvic physio or regular pelvic floor exercises to prevent incontinence and prolapse.”
Mobility: “Pilates, yoga and other gentle activity will keep you mobile and flexible enough to keep putting on your own bra for as long as you need!”
Community and connection: A wealth of research, including a major Harvard study, concludes that socialising regularly and maintaining close relationships has the biggest impact on lengthening your lifespan. Dr Mayoni believes it’s important to nurture those friendships, adding, “Friends at 50 years old are your friends at 80 years old!”
5 top lifestyle habits for a smoother menopause
Approaching menopause holistically, in a way that supports your overall metabolic and hormonal health, can make a profound difference to your experience, according to Dr Mayoni. Here are her top health tips for a smoother menopause:
Nutrition: “Eat whole, anti-inflammatory foods, and prioritise protein and phytoestrogens (such as flaxseeds, soy and lentils), and omega-3s.” (Have a read of our menopause nutrition advice for more)
Movement: “Include resistance training, weight-bearing exercise, and activities that reduce stress such as yoga or walking.”
Sleep hygiene: “Keep a consistent routine, avoid late-night screens, and support your nervous system with magnesium or adaptogens if needed.” (Adaptogens are natural substances derived from plants or mushrooms, e.g. ashwagandha which some women find helps reduce stress.)
Alcohol and sugar reduction: “These can worsen hot flushes, mood swings and gut health.”
Stress management: “Cortisol dysregulation can worsen symptoms, so prioritise mindfulness, exposure to nature, and rest.”
About Dr Mayoni Gooneratne
Dr Mayoni Gooneratne, a former NHS colorectal and pelvic floor surgeon turned pioneering lifestyle and functional medicine doctor, is founder and medical director of Human Health, SkinFit and Human Health Professionals. With over two decades of clinical experience, Dr Mayoni combines surgical precision with a deep understanding of systems biology. She is a TEDx speaker, Vice Chair of the British College of Functional Medicine, and curator at the annual Medical Longevity Summit at CCR.
A mother of three navigating her own perimenopausal journey, she is passionate about demystifying midlife health for women. For more on how Dr Mayoni could help you, and to book an appointment, visit www.drmhumanhealth.co.uk. space for describing your block.
Does HRT work for you? What advice did your GP give you? Share your experiences or ask other women for their tips on our socials using hashtag #MenoWithRoyce.
Want more? Discover a nutritionist’s tips on diet and supplements during menopause, and find out more about why we’re focusing on The Unapologetic Menopause this summer.
