In this episode of The Choice Space, Dr Lee David speaks with GP and menopause specialist Dr Carys Sonnenberg about the ways menopause can affect both emotional wellbeing and physical health. The conversation explores how hormonal changes interact with sleep, stress, lifestyle habits and the wider pressures many women experience during midlife.
Menopause is often described primarily in terms of hormones. Yet for many women the experience is shaped by a wider set of influences – including changing energy levels, disrupted sleep, work demands and family responsibilities. The discussion reflects on how these different elements interact and why a broader understanding of menopause can support wellbeing during this stage of life.
Understanding hormonal change
One of the central themes in the conversation is the biological complexity of menopause. During the years leading up to menopause – often referred to as perimenopause – hormone levels do not decline in a steady or predictable way. Instead, they can fluctuate significantly from month to month.
These hormonal shifts can influence several systems within the body. Oestrogen, for example, interacts with neurotransmitters involved in mood regulation, sleep and energy. When levels change, some women notice increased anxiety, difficulties with concentration or disrupted sleep patterns. Others may experience relatively mild symptoms.
This variation highlights how individual the menopause transition can be. Some women move through this stage with few difficulties, while others find the changes more disruptive to daily life. Understanding this diversity can help create a more compassionate perspective on menopause experiences.
The wider context of midlife
Another theme explored in the episode is the broader life context in which menopause often occurs. For many women, this period of hormonal change coincides with a time of significant responsibility and transition.
Careers may be demanding, family roles may be evolving and caring responsibilities for ageing relatives can begin to increase. These pressures can combine with physical symptoms such as fatigue or sleep disruption, making it harder to maintain a sense of balance.
Looking at menopause within the wider context of midlife helps explain why the experience can sometimes feel overwhelming. Symptoms do not arise in isolation – they interact with the rhythms and responsibilities of everyday life.
Noticing patterns and habits
The conversation also highlights how everyday habits can shape wellbeing during this period. When people feel tired or overwhelmed, it is natural to fall back on familiar coping strategies. These might include late-night scrolling on phones, relying on caffeine for energy or turning to alcohol as a way to unwind after a long day. Often these habits develop gradually and become automatic, particularly during busy or stressful periods.
Simply noticing these patterns can be a helpful starting point. When people pause to observe how certain routines affect their sleep, mood or energy levels, it can create space to reflect on what feels supportive and what might be less helpful over time.
Responding to symptoms differently
Menopause symptoms themselves can influence how people respond to everyday situations. Experiences such as hot flushes, sudden waves of anxiety or disrupted sleep can feel unsettling, particularly when they occur unexpectedly.
The episode explores how cognitive behavioural approaches can help people respond differently to these experiences. Rather than focusing solely on eliminating symptoms, the emphasis can shift towards changing how they are interpreted and managed.
For example, experiencing a hot flush in a meeting may trigger thoughts about embarrassment or losing control. When these reactions soften, the experience itself may feel less overwhelming. The symptom may still occur, but the surrounding stress can reduce.
Creating space for regulation
Alongside changes in thinking patterns, the discussion also reflects on ways of calming the body during moments of stress. Simple breathing techniques can support the nervous system in shifting from a heightened stress response towards a more settled state.
Slowing the breath and extending the exhale can help regulate physical tension and reduce the sense of urgency that often accompanies anxiety. Even brief pauses can create moments of steadiness during busy or emotionally demanding situations.
These pauses do not need to be lengthy or complicated. Sometimes a few seconds of attention to breathing, posture or the sensation of the feet on the ground can help interrupt cycles of escalating stress.
Nourishment and energy
Nutrition also plays an important role in the conversation. Food provides the building blocks that support many systems within the body, including those involved in mood regulation and sleep. Certain nutrients contribute to the production of neurotransmitters linked to emotional wellbeing and energy. When nutrition becomes irregular or limited, these processes can be affected.
The discussion highlights the value of balanced meals that include protein, carbohydrates, healthy fats and a range of fruits and vegetables. Rather than focusing only on calorie intake, nutrition can be viewed as a way of supporting the body during a period of change.
Finding steadiness through movement
Physical activity is another area explored in the episode. Movement can support both physical and emotional wellbeing, helping to regulate stress, improve sleep and boost energy levels. Many people also find that time outdoors brings additional benefits. Being in natural environments can provide a sense of perspective and a break from the constant demands of daily routines.
Simple activities such as walking can offer opportunities to reconnect with both the body and the surrounding environment. These small moments of movement can provide a gentle sense of reset within a busy day.
Choice space takeaways – small, workable steps
- Notice patterns in daily habits – small routines can influence sleep, mood and energy over time.
- Pause before reacting to symptoms – moments of awareness can soften stress responses.
- Consider the wider context – menopause often interacts with many aspects of midlife.
- Support the body through nourishment – balanced meals can help sustain energy and wellbeing.
- Create space for calm – brief breathing pauses can help regulate stress.
- Reconnect with movement – gentle activity and time outdoors can support wellbeing.
Navigating menopause with perspective
Menopause is a significant biological transition, but it is also shaped by the wider rhythms of life. Hormonal changes, daily habits, emotional responses and external pressures can all influence how this stage is experienced.
This episode reflects on the value of approaching menopause with curiosity and compassion. Rather than searching for a single solution, understanding the broader patterns that shape wellbeing can open space for steadier ways of navigating this period of change.
About the guest
Dr Carys Sonnenberg is an NHS GP and British Menopause Society menopause specialist. She founded Rowena Health, an online service providing holistic menopause care for women. She is trained in CBT and nutrigenomics and is co-author of Women’s Health Made Easy, due to be published in 2026. Carys is also a member of the Primary Care Women’s Health Society wider committee and contributes to education through national conferences and webinars.
You can contact her via her website, or on LinkedIn, Facebook and Instagram: @drcaryssonnenberg
