For Paula Fenegan, looking after your health through menopause is about much more than managing symptoms.

A nutritional therapist, reflexologist and wellbeing speaker, Paula works with women who are often approaching the later stages of menopause and beginning to think more about what comes next.

Her focus is practical: nutrition, movement, stress, energy and creating habits that support women as they get older.

Alexander Clementine founder Alex Perry spoke with Paula about overlooked menopause symptoms, changes in digestion and energy, nutrition after menopause, strength, stress and why she believes women need to start putting themselves higher on their own priority list.

Key takeaways

Paula Fenegan’s menopause perspective: menopause is about much more than hot flushes and mood changes; chills and digestive changes are among the experiences she sees women overlook; nutrition may need to evolve through midlife; maintaining strength matters more to her than pursuing thinness; stress can become harder to manage; small, realistic lifestyle changes are more useful than trying to overhaul everything at once; and women should make time for themselves and begin putting their own health higher on the priority list.

What is the biggest misconception about menopause?

Paula believes menopause is still reduced to a very narrow group of symptoms.

“People tend to think it’s just bad mood … and it’s hot sweats.”

Her view is:

“It’s just so much more than that.”

She talks about women going through menopause while simultaneously managing work, teenagers, older parents and responsibilities for other people.

For Paula, this is one reason self-care becomes so important.

“You really have to look after yourself.”

She also sees menopause as more than a biological change.

“Not only is it a biological transition, it’s a life transition as well.”

Paula describes women reaching a point in their careers where they begin questioning whether what they are doing still feels right for them.

What unusual menopause symptoms has Paula encountered?

Paula gives two examples.

The first is chills.

“The one that doesn’t really get talked about is the chills.”

Rather than experiencing heat, Paula says some women can feel extremely cold.

“You can get deathly chilled, to the point that you are really, really cold to the bone.”

She says women may simply assume they are naturally cold rather than associating the experience with menopause.

The other change Paula mentions is receding gums and dental problems.

She has encountered women experiencing gum issues and needing significant dental work during midlife.

For Paula, both examples reinforce her wider point that menopause can involve changes women may never have expected.

What changes in energy and digestion does Paula see in midlife?

One of the most common issues Paula identifies is:

“A lack of energy.”

She also talks about joint aches and pains and changes in digestion.

“But also, digestive issues.”

Paula describes women experiencing bloating and constipation and finding that foods they previously tolerated no longer feel as easy to digest.

She has experienced that personally.

“Things that you could eat before, not a problem. You can’t digest them as easily now.”

Her approach is therefore to look at the individual woman’s diet rather than simply reaching for one quick intervention.

How does Paula think nutrition should change after menopause?

Paula believes nutrition needs greater attention as women move through menopause and into post-menopause.

“You definitely need to look at it in a different way.”

One of her priorities is protein.

“Protein is more of an issue.”

She connects this with maintaining muscle mass and talks about combining nutrition with strength training.

Paula also discusses fibre, vegetables and complex carbohydrates as part of the way she approaches food with clients.

Her focus is not on a restrictive diet.

When discussing the nutritional changes she makes with women, Paula says:

“Often with the food, it’s only a few tweaks.”

For her, the important part is making those changes work within somebody’s actual life.

“It’s not about … this is a diet and you need to do.”

Instead, she starts with practical questions about what somebody is currently eating and where a realistic adjustment can be made.

Why does Paula focus on strength?

Paula sees strength as particularly important as women get older.

When Alex asks what she wishes more women understood about looking after their health after menopause, her immediate answer is:

“It’s not about being skinny, it’s about being strong.”

She feels women can become preoccupied with changes in appearance or weight because of the way society values thinness and youthful-looking skin.

But looking thin is not Paula’s definition of health.

“I know people that might look thin, but they’re not fit, they’re not healthy.”

Her preferred goal is:

“Being strong and happy in your own body.”

Paula also talks about strength training as a way of maintaining muscle as women age.

For her, the emphasis shifts away from appearance towards being physically capable and feeling good in your own body.

What role does stress play during menopause?

Paula sees stress as a major part of the midlife picture.

She describes women experiencing greater pressure while simultaneously finding that their tolerance of that pressure has changed.

“Your ability to deal with it is lower.”

Someone who previously managed a high-pressure environment may suddenly reach a point where it feels overwhelming.

“Stress is huge in that.”

Paula also points out that this often happens during a period of life that already contains significant responsibilities.

Women may be managing demanding careers alongside responsibilities at home.

For Paula, stress management therefore cannot be separated from the wider conversation about menopause wellbeing.

How does Paula approach stress management?

Paula’s first suggestion is movement, but she emphasises choosing the type of movement that feels appropriate for the situation.

“Exercise, for sure … but appropriate exercise.”

If somebody has already had a particularly stressful day, she talks about gentler movement such as Pilates, yoga or walking rather than automatically choosing an intense workout.

Paula also values getting outdoors.

“Get outside in nature … get fresh air, get a different perspective on it.”

And she places a strong emphasis on connection.

“You need your friends around you.”

That theme appears several times throughout the interview: women need time for themselves, but they also benefit from people around them with whom they can talk openly.

How does Paula combine nutrition and reflexology?

Paula works as both a nutritional therapist and reflexologist.

In her own practice, she sees the two as complementary.

“They both complement one another. They both stand alone in their own right.”

Paula describes reflexology as something she uses with clients who want time to relax and calm down.

She says:

“Some people just need the reflexology to calm them down, to calm the stress response down.”

From there, she finds some women feel more able to consider changes in other parts of their lives.

“Once they can do that, then they’re open to be able to make tweaks in their diet.”

Paula describes the relationship between her two areas of work as:

“Reflexology works from the outside in, and nutrition works from the inside out.”

For some clients, reflexology remains simply a regular opportunity to take time out for themselves.

For others, Paula says it can become a starting point for thinking more broadly about nutrition and wellbeing.

Why does Paula think women need to put themselves first?

This idea runs throughout the conversation.

Paula says women reaching midlife have often spent years prioritising children, partners, parents and careers.

“You really need to, at this time of life, start to put yourself first.”

She acknowledges:

“It’s not a natural thing for a lot of women.”

For Paula, looking after health after menopause means moving away from a fixation on weight or appearance and towards strength, enjoyment, connection and feeling comfortable in your own body.

As she puts it:

“You’re strong and happy in your own body, and you’re doing something that you enjoy doing, and then you’ve got good friends around you. Well, that’s a good life, really, isn’t it?”

What would Paula say to men supporting someone through menopause?

Paula’s advice centres on listening rather than immediately trying to solve the problem.

“Just listen, don’t try to fix.”

She says sometimes a woman simply wants the opportunity to talk through what she is experiencing.

“Just listen to me, let me offload.”

Paula suggests asking:

“Is there anything I can do to help?”

She also believes women benefit from having female friends around them who may recognise or relate to experiences they are going through.

Her broader point is that partners can support women through the transition rather than treating it as a problem that needs an instant solution.

What is Paula’s biggest piece of advice for someone beginning menopause?

Paula’s answer returns to the idea of making yourself a priority.

“Carve out time for you every day, even if it’s only 10 minutes.”

That does not need to mean a major lifestyle overhaul.

It could simply mean finding a small amount of uninterrupted time.

Her next piece of advice is:

“Put your health number one.”

Paula also emphasises simple, practical changes rather than trying to change everything at once.

Her final message is:

“Take time for you. So many people don’t.”

For Paula, what women do during this stage can form the foundations for the years that follow.

“It’s the foundations.”

About Paula Fenegan

Paula Fenegan is a nutritional therapist, reflexologist and wellbeing speaker.

She delivers workplace talks focused on menopause and healthy ageing and works with women individually on practical nutrition and lifestyle changes.

Much of her work is with women in their 50s who are moving through the later stages of menopause and want to feel stronger, healthier and more energised.

This conversation forms part of Alexander Clementine’s Expert Conversations, sharing perspectives from people working across menopause and women’s health.