Burning when you urinate, repeated toilet trips and bladder pressure can leave you feeling miserable during a urinary tract infection (UTI). Women can experience UTIs at any age and understanding the triggers, recognising symptoms and choosing appropriate treatment options can help protect your urinary health.

Leaking urine when you cough, sneeze, exercise or rush to the toilet can affect confidence, intimacy and everyday activities. Urinary incontinence means any involuntary loss of urine. Although common during midlife, it deserves assessment and effective treatments can reduce leakage and, for some women, restore continence.

Vaginal dryness, painful sex and recurring urinary discomfort can be unexpected consequences of menopause. Many women assume these changes are something they must tolerate, or repeatedly treat them as thrush or urinary infections.

Genitourinary syndrome of menopause (GSM) is common and treatable. Understanding the underlying changes helps women choose appropriate support, from vaginal moisturisers and prescription medicines, to carefully selected complementary options.

In Part 1, we explored why pain can change during perimenopause and menopause. Changing oestrogen levels, disrupted sleep and existing health conditions can all contribute.

Complementary medicines may help relieve symptoms and support recovery, but choosing the right option starts with understanding the pain. An inflamed joint, nerve injury and menstrual cramps need different approaches. Most research concerns specific pain conditions rather than menopause itself, so treatment should be personalised.

Pain can become more noticeable during the menopause transition. You might wake up with stiff joints, find an old back problem flaring more often, experience more migraines or develop pain during sex.

These symptoms deserve attention. Hormonal changes can contribute, but pain during midlife has many possible causes. Understanding how oestrogen influences both body tissues and pain processing helps explain why familiar pain may worsen and why new symptoms can appear.

Hot flushes, sleep changes, weight gain and declining bone density are well-recognised features of the menopause transition. But there is another area of women's health that receives far less attention: our teeth and gums.

Changes associated with menopause and ageing may affect the gums, saliva, oral tissues and the bone supporting our teeth. Emerging evidence suggests that postmenopausal women may experience greater periodontal inflammation, probing depth and loss of attachment than premenopausal women, although researchers emphasise that the evidence is still evolving.

Insulin resistance is something I see discussed increasingly in relation to menopause, weight and metabolic health, but what does it actually mean?

Insulin is a hormone produced by the pancreas and one of its major roles is to help move glucose out of the bloodstream into our muscle, liver and fat cells, where it can be used or stored for energy.

Metformin is one of the world's most widely prescribed medications and has been used clinically for more than 60 years. Although best known for treating type-2 diabetes, interest in metformin has expanded dramatically as research investigates its potential role in healthy ageing and longevity.

Testosterone is often thought of as a “male hormone”, yet it also plays an important role in women’s health. Produced by the ovaries, adrenal glands and through conversion in peripheral tissues, testosterone contributes to sexual desire, arousal, responsiveness and orgasm. It also plays an important biological role in the brain, muscles and bones, although current evidence does not fully support prescribing testosterone specifically for fatigue, mood, cognition, muscle strength or disease prevention.

Although many women believe oestrogen "disappears" after menopause, the reality is more complex. Oestrogen production changes significantly during the menopause transition, but it doesn't stop completely. Understanding the different types of oestrogen and where they are produced after menopause can help explain why symptoms occur and why lifestyle choices remain important for lifelong health.

Menopausal hormone therapy (MHT) is an effective treatment for hot flushes and night sweats, but it might not be the right choice for every woman. Some women cannot take MHT for medical reasons, while others experience side effects or simply prefer a non-hormonal approach.

There are several non-hormonal prescription medications that you may come across which have been prescribed by a healthcare practitioner that can help manage menopause symptoms, particularly hot flushes, night sweats, sleep disturbance and in some cases, mood changes.

The terms progesterone and progestogen are often used interchangeably, but they are not the same thing. All progesterone is a progestogen, but not all progestogens are progesterone.

When women think about their heart health, they often focus on cholesterol, blood pressure, weight or blood sugar levels. However, there is another important cardiovascular risk factor that is rarely discussed yet may become increasingly relevant during perimenopause and menopause: Lipoprotein(a), often referred to as Lp(a).

Longevity is often defined as living a long life, but modern health science has expanded this definition significantly. Today, longevity is no longer just about adding years to life, it’s about adding quality of life to years. Researchers increasingly focus on healthy longevity, which refers to maintaining physical, cognitive, emotional, and social wellbeing throughout the lifespan.

Many women experiencing perimenopause and menopause reach for coffee to increase alertness and combat fatigue, but caffeine may actually be contributing to the very sleep problems that leave them feeling exhausted.

Menopause can accelerate the loss of muscle strength and function. Discover why grip strength is an important predictor of healthy ageing, mobility, bone health and independence for women over 40.

In 2002, the Women’s Health Initiative (WHI) dramatically changed how doctors and women thought about hormone replacement therapy (HRT), also known more recently as menopausal hormone therapy (MHT).

Shatavari (Asparagus racemosus) is a traditional Ayurvedic herb long used to support female reproductive health. Often called the ‘Queen of Herbs’, it has historically been used to help women maintain hormonal balance and vitality during periods of hormonal change such as perimenopause and menopause. Modern research is now investigating standardised extracts such as SRI‑81 to better understand their potential role in supporting women during the menopause transition.

ERr 731 is a standardised extract taken from the root of Rheum rhaponticum, also known as rhapontic rhubarb or Siberian rhubarb. It is a non‑hormonal, plant‑based option used to help relieve menopausal symptoms, particularly during perimenopause and early postmenopause. Unlike conventional menopausal hormone therapy, ERr 731 does not supply hormones.