The Menopause Conversations Every Woman Deserves to Have | Insights From a Menopause Health Coach
Beyond Hot Flushes: Advice from Health Coach, Ailsa Hichens
Table of Contents:
Menopause is a completely normal life stage that affects every woman, yet it's still too often misunderstood, minimised or quietly endured. We are talking more openly about it than ever before. But despite the growing conversation, millions of women still feel uninformed, unheard or unsure where to turn. And some topics, particularly those relating to vaginal and urinary health, remain shrouded in silence and shame.
This World Menopause Day, we're opening up that conversation.
The numbers show why this conversation matters. According to GOV.UK (2025) 75% of women experience menopause symptoms, which can last an average of seven years. However, fewer than 1 in 10 women feel they have adequate information to deal with it.
That gap between experience and understanding won't close overnight, but every honest conversation moves things forward. When women feel informed, supported and heard, they can take meaningful steps to look after their health, and that's where real change begins. It's also where a skilled Health Coach can make a real difference, helping women understand what's happening in their bodies, build sustainable habits and feel truly supported at every stage.
That’s why we sat down with Ailsa Hichens, Health Coach, Nutritional Therapist and Health Coaches Academy Mentor to ask her 5 questions about menopause. Ailsa brings a wealth of knowledge and lived understanding to the conversation around women's health. She is passionate about helping women truly understand what is happening in their bodies and feel their very best through menopause and beyond.
1. What Is Something You Wish More Women Knew About Menopause?
Many women picture menopause as a single moment, often marked by the first hot flush. In reality, the journey usually begins much earlier, and it can look very different from one woman to the next.
“I wish more women knew that they don't have to wait for hot flushes and night sweats before considering that they might be in perimenopause.
Hormonal changes can begin earlier than women realise, and by their early to mid-forties, many are already noticing shifts in how they feel.
But instead of recognising that something is changing, they think they're failing. That they need to try harder, do more, push through. And sadly, that's often the message they're getting from the people around them, sometimes even from healthcare professionals.
It's astonishing how hard some women still have to fight to be taken seriously.
Perimenopause can last for years, symptoms can start long before periods stop, and some women never experience a single hot flush.
I want women to recognise the signs sooner, understand what's happening in their bodies and know that they don't simply have to put up with feeling rubbish.”
The research supports Ailsa's point. The Office on Women's Health says perimenopause can last between two and eight years before periods stop for good. During that time, hormone levels can rise and fall unpredictably.
Symptoms can also be far broader than hot flushes. As many as two-thirds of women going through perimenopause report problems with memory or focus, according to the Office on Women's Health. When brain fog arrives in the middle of a busy career, it's easy to blame yourself rather than your hormones.
Some of the less obvious early signs include:
Changes to your periods, such as heavier, lighter, longer or shorter cycles
Trouble sleeping or waking during the night
Brain fog, forgetfulness or difficulty concentrating
Mood changes, irritability or anxiety
Low energy and fatigue
Joint aches and pains
Changes in weight, particularly around the middle
Knowing these signs gives you power. It means you can stop asking "What's wrong with me?" and start asking "What does my body need right now?"
2. What Menopause Topics Do We Still Struggle to Discuss?
“I would love to break the stigma around talking about what happens 'downstairs' during menopause.
We talk much more openly about hot flushes, brain fog and weight gain these days, but vaginal health is still something so many women feel uncomfortable discussing.
Yet the changes can be absolutely devastating, not just physically, but for women's confidence, their intimate relationships and their quality of life.
As oestrogen levels decline, women can experience vaginal dryness, irritation, recurrent urinary tract infections and changes to the vaginal tissues, including thinning, narrowing and shortening. This can make sex deeply uncomfortable or painful, sometimes even causing bleeding.
And because women don't necessarily understand what's happening, or feel comfortable talking about it, they suffer in silence. Some simply stop having sex because it's too painful.
What I really want women to know is that there are effective treatments. Vaginal oestrogen, for example, can make an enormous difference, and it's something worth discussing with your GP.
I completely understand why these conversations can feel embarrassing or difficult. But knowing that what you're experiencing is common, that it has a name and, most importantly, that you can do something about it, could be life-changing.
We need to stop treating vaginal health as something women should be embarrassed about. It's a fundamental part of their health and wellbeing.”
These symptoms are common, they are real, and help is available. The Office on Women's Health notes that vaginal dryness can start or get worse around menopause. It also points to a range of options, from over-the-counter moisturisers and lubricants to prescription treatments.
Urinary symptoms, such as needing to get up in the night or leaking when you laugh or cough, are also common. They are not simply "part of getting older", and they can be treated.
If something doesn't feel right, you deserve to talk about it without shame.
3. A Word of Encouragement From a Menopause Health Coach
If you're in the thick of it right now, this is for you.
“You have more control over your menopause symptoms than you might think.
There is so much you can do to improve how you feel, and you don't have to accept feeling rubbish as an inevitable part of getting older.
You might not be able to control your hormones, but you can take steps to support your body through the changes. And you don't have to do it all at once.
Small changes can make a big difference. You deserve to feel good at this stage of your life, not simply get through it.”
If you’re experiencing symptoms that are affecting your daily life, it can help to go into your doctor's appointment feeling prepared and clear about what you want to discuss. A few simple steps can make those conversations feel easier and more productive.
Keep a note of your symptoms. Write down what you’re experiencing, when it started, how often it happens and how it affects your sleep, mood, energy, work or relationships.
Track patterns. If symptoms seem cyclical or linked to stress, sleep or certain triggers, make a note of that too.
Write your questions in advance. It’s easy to forget things in the moment, especially if you’re feeling emotional or rushed.
Be honest about the impact. You don’t need to minimise what’s happening. If something is painful, disruptive, upsetting or affecting your confidence, say so clearly.
Ask what your options are. That might include lifestyle support, tests if appropriate, symptom management, vaginal oestrogen, hormone replacement therapy (HRT) or referral onward depending on your needs.
Take someone with you if that helps. A partner, friend or family member can offer support and help you remember what was said.
Ask for clarification. If you don’t understand something, it’s absolutely okay to say, “Can you explain that differently?” or “Can you talk me through my options?”
Seek further advice if needed. If you don’t feel heard, or if the support offered doesn’t feel right for you, it is okay to book a follow-up, ask for a second opinion or speak to another qualified professional.
4. Where Would You Start With a Woman Experiencing Menopause Symptoms?
With so many possible symptoms, it can be hard to know where to begin.
“I'd start with two things: breakfast and bedtime. Bookending the day, if you like.
One of the first things I look at with women is their diet, particularly how they're managing their blood sugar. Insulin resistance becomes more common around menopause and can contribute to some of the metabolic challenges women experience, including weight gain and fluctuating energy.
And this is something we can make a real difference to through nutrition.
I'm possibly the world's biggest fan of breakfast! I wasn't always, but during my own menopause, changing what I ate first thing in the morning was transformational.
So I'd encourage women to start with a protein and fibre-rich breakfast. It's a relatively simple change that can help with appetite, blood sugar regulation and energy throughout the day.
Then I'd look at the other end of the day: sleep.
Sleep can become much more challenging during perimenopause, as hormonal fluctuations, including changes in progesterone, can affect how well we sleep.
I encourage women to create boundaries around bedtime. Set an alarm to remind yourself to start winding down, rather than just one to drag yourself out of bed in the morning! Build an evening routine you actually enjoy, so going to bed earlier feels like something you want to do, rather than another chore.
By bookending the day with a nourishing breakfast and a proper wind-down routine, you're creating a framework that supports so many other aspects of your health.
And sometimes, those relatively small changes can make an enormous difference to how you feel.”
The Office on Women's Health also links low progesterone to trouble falling and staying asleep, and recommends regular activity, avoiding alcohol and large meals near bedtime, and keeping regular sleep times.
For more practical tips, read our other blogs:
These are exactly the kind of practical, sustainable changes a Health Coach helps people build. Knowing what to do is one thing. Turning it into a habit that sticks is where coaching shines.
5. What Else Do You Think Is Vital for Women to Thrive Through Menopause?
“I think one of the most important things women can learn to do is speak up for themselves.
So many of the women I work with are incredibly successful in their professional lives. They're capable, accomplished women who are used to looking after everyone else, juggling responsibilities and just getting on with things.
But menopause can be a pivotal moment when they need to start advocating for themselves and putting their own health and wellbeing higher up the priority list.
I want women to understand that asking questions isn't making a fuss. Challenging advice that doesn't feel right isn't [you] being difficult. And asking for a second opinion doesn't make you bossy or demanding.
You know your own body. If something doesn't feel right, you deserve to be heard, taken seriously and given the support you need.
And if you're not getting that support, please don't be afraid to ask again, or ask someone else.
Because advocating for your own health isn't making a fuss. It's taking care of yourself. And you deserve that just as much as everyone else you've spent years looking after.”
Making a Real Difference Through Menopause
Ailsa's insights remind us that menopause isn't something to simply "get through". With the right knowledge, small daily changes and the confidence to speak up, women can truly thrive at this stage of life.
There is a huge need for people who can listen, guide and help women turn advice into lasting change. That's at the heart of what a Health Coach does, working alongside medical care to support nutrition, lifestyle, habits and behaviour change.
Perhaps your own menopause, or health journey, has sparked a desire to help others feel better too. Many of our graduates came to health coaching after experiencing their own health challenges, and now use that understanding to support women through menopause, general health and beyond.
After qualifying as a Health Coach through Health Coaches Academy, Ailsa shared “Health coaching has given me the answer to 'what to do when people don't (or can't) do what you want them to do as a nutritional therapist.’ People are looking to Nutritional Therapists to provide the specific science, testing and supplement recommendations to help them improve their health but it has to actually work in their lives otherwise it might as well just be a handout. Health coaching is what gives people access to the transformation that the science can have.”
At Health Coaches Academy, our Level 5 Diploma in Health & Wellness Coaching gives you the nutrition and lifestyle knowledge, coaching skills and ongoing support to build a career you love, all with flexible learning designed around busy lives. If you’d like to learn more about becoming a professional Health & Wellness Coach, join one of our free introductory webinars.
For already qualified Health Coaches, we have new specialist CPD online health and wellness courses coming in January 2027 to help Health Coaches understand mid-life hormonal health through a whole-person lens. Develop your skills with our Perimenopause, Menopause and Hormonal Health Course.
Comments