Health, fitness and the supplement aisle. An independent South African desk.
Health · Journal
Hot flushes, brain fog, flagging libido, a waistline that won't budge. Midlife hormone talk is everywhere, from the UK to Denmark. Here's what's real, what's marketing and what actually helps.
Midlife hormones have gone mainstream. In the UK, celebrities talk openly about perimenopause on prime-time TV. In Denmark, fitness titles run whole series on eating and training through overgangsalderen, the menopause. And men's media is full of "low T" checklists and testosterone-boosting powders. Some of this conversation is long overdue. Some of it is a sales funnel. Let's separate the two.
For her
Menopause is defined as 12 months without a period, typically in your late 40s or early 50s. Perimenopause is the run-up, when hormone levels, especially oestrogen, rise and fall unpredictably. It can last several years, and the NHS notes that symptoms can start years before periods stop.
Common symptoms listed by the NHS include:
Many women don't connect these dots, especially when the first signs are anxiety or poor sleep rather than hot flushes.
You don't need a blood test to be diagnosed with perimenopause if you're over 45 and have typical symptoms. UK NICE guidance says diagnosis can be made on symptoms alone in that group.
HRT (hormone replacement therapy). The UK's NICE menopause guideline recommends offering HRT for symptoms such as hot flushes and night sweats after discussing the benefits and risks. For many women it's the most effective treatment. It isn't right for everyone, and risks vary with the type of HRT, your age and your personal history, which is why it needs a proper conversation with your doctor. In South Africa, talk to your GP or gynaecologist.
Strength training. Falling oestrogen speeds up bone and muscle loss, and the NHS lists osteoporosis among the longer-term risks after menopause. Lifting weights two or more times a week is one of the most powerful tools you have (see our Lift for Longevity plan).
Sleep and alcohol. Night sweats and alcohol make a poor combination. Many women find that cutting back on drinking eases flushes and improves sleep.
Protein and fibre. Eating enough protein supports muscle. Fibre supports gut health and helps manage the cholesterol changes that often come with menopause.
"Menopause blends", hormone-balancing teas and "adrenal" supplements are heavily marketed, often with little good evidence behind them. Some herbal products can interact with medicines. If a product promises to "balance your hormones", ask what trials back it up, and speak to your pharmacist before you buy.
For him
Not in the way the phrase suggests. The NHS is clear that the "male menopause" label is unhelpful. Testosterone in men declines gradually with age, at roughly 1% a year from around 30 to 40, and doesn't crash suddenly the way oestrogen does at menopause. Many midlife symptoms in men, such as low energy, low mood, poor sleep and reduced libido, are more often linked to lifestyle, stress, weight, alcohol or depression than to hormones alone.
That said, true testosterone deficiency (hypogonadism) is a real medical condition. The Endocrine Society's guideline says diagnosis should be based on consistent symptoms plus unequivocally low testosterone on repeated morning blood tests. A single result, or a symptom checklist on a supplement website, isn't enough.
If a website diagnoses your "low T" and sells you the cure on the same page, close the tab.
Testosterone therapy should only ever be prescribed and monitored by a doctor, after proper testing. It carries risks and can affect fertility. Over-the-counter "test boosters" are a different matter. Most rely on herbal ingredients with weak evidence, and some products sold online have been found to contain undeclared substances. Prohormones and steroids carry serious health and legal risks.
The same applies to men in their 40s and 50s: strength, cardio and recovery, adjusted to life as it is now, not as it was at 25.
For both
Whatever your sex, your 40s are the decade to get the basics measured. Ask your GP about:
Hormones change at midlife, more abruptly for women than for men. Women deserve proper, evidence-based treatment of perimenopause symptoms, including an honest conversation about HRT. Men deserve better than symptom quizzes and booster powders. For both, the same foundations do the heavy lifting: strength training, sleep, less alcohol, good food and a doctor who takes you seriously.
Educational information, not medical advice. Speak to a doctor, pharmacist or registered dietitian before using supplements if you are pregnant or breastfeeding, under 18, taking medication, or living with kidney, liver or heart disease. Prices were observed in October 2026 and are not offers.