Why is menopause easy for some & brutal for others?

From the age it starts, to the age it finishes, to the sheer variety of symptoms we may or may not experience, it’s very clear that menopause is not a one-size-fits-all process. 

And this can be one of the most frustrating parts of the entire transition. 

Because it leaves so many women wondering: why is my friend breezing through, while I feel like I’m falling apart? 

Why do you feel fine one year; then two years later it feels like you’re going through hell?
Why do you finally get on top of one symptom, only for something else to pop up out of nowhere? 

There are reasons why menopause varies so widely - not just between women, but within the same woman from one year to the next. 

Understanding those reasons is one of the most empowering things you can do, because it shifts your mindset from: 

“What is wrong with me?”
to
“Ah. Right. Makes sense.” 

And when things start to make sense, you can start to make better decisions. 

First, timing is often genetic 

Some women have very clear indications that they’re entering the menopause transition from their mid-30s onwards - and yes, that can still be within a perfectly natural menopause timeline. 

Remember, natural menopause is defined as 12 months from your final period, and typically happens between the ages of 45 and 55, with the UK average sitting around 51. 

But perimenopause can last up to 10 years. 

So symptoms in your late 30s or early 40s aren’t unusual. 

On the other hand, some women barely notice anything. Their periods stop, perhaps there’s the odd mood wobble, the odd hot flush, a little weight gain… but nothing that truly disrupts their day-to-day life. 

These differences in when you start are, by and large, genetically driven. 

If your mother, aunties or grandmothers went through menopause around 50, chances are you’ll be somewhere in that region too. 

Lifestyle and health conditions can shift things slightly, but in a natural menopause, genetics usually sets the baseline. 

Symptoms are where it gets messy: genetics meets environment 

When it comes to the symptoms themselves, it’s rarely as straightforward as genetics alone. 

Symptoms tend to sit somewhere in the messy overlap between: 

• your genetic tendencies 
• your current environment 
• and your lifestyle load 

If there’s one area that deserves far more attention in menopause, it’s stress. 

Stress has a role in so many of the symptoms women report. 

Hot flushes. Sleep disruption. Digestive issues. Brain fog. Mood swings. Energy levels. Aches and pains. 

Stress doesn’t just sit in the background. It changes the way your entire system functions. 

So the woman next door might be having the same hormonal transition as you, but if her stress load is different, her experience may look completely different. 

This is why menopause is a time where we need to start asking a very honest question: 

How much of what I’m feeling is sex hormones, and how much is the weight of everything I’m carrying? 

Because if your body is already running close to capacity, menopause will amplify that. 

Digestion and gut health can become a bigger player 

If you’ve always been prone to IBS-type symptoms, it’s not uncommon to find they ramp up during menopause. 

Or it may be that long-standing habits are catching up: eating too quickly; bolting food; eating on the run; eating under stress; eating without chewing properly.

All of those things matter in the experience of reflux, heartburn, bloating, flatulence, etc. 

And then there’s the gut microbiome - the bacterial population living in your digestive tract - which can also shift over time, and may be influenced by changes in oestrogen levels. 

This matters not only for digestion but for mood as well. 

Menopause and anxiety: it’s not just “in your head” 

Women are twice as likely to be diagnosed with anxiety or depression post-menopause. And gut health can be one of the contributing factors. 

Alterations in gut bacteria can influence inflammation, neurotransmitter activity, and the signalling pathways that affect how we feel mentally and emotionally. 

The gut and brain are not separate systems. They are intimately connected through the gut-brain axis, with the vagus nerve acting as a major communication highway between the two. 

If vagal tone isn’t functioning optimally, the messages between gut and brain can become distorted or dampened. 

Practical ways to support vagus nerve function, including things as simple as: 

• singing 
• gargling 
• cold water exposure (even a cold blast at the end of a shower) 

Not because they’re magic. But because they stimulate the nerve and support nervous system regulation. 

And then there’s progesterone. 

Declining progesterone may also play a role in anxiety for some women due to its relationship with GABA, a calming neurotransmitter system. 

So if you feel like you’ve become more anxious, more reactive, or less resilient, it isn’t weakness: there is biology behind it. 

Social context & status also matter more than is typically acknowledged. 

If you are living in a culture or circumstance where older women are not valued, where you don’t feel secure, where financial pressures are mounting, where support is limited: Then yes, your menopause experience may be affected. 

It would be strange if it weren’t. 

Menopause does not happen in a vacuum. It happens in real life - with real responsibilities, emotional load, caregiving, work pressures, and societal expectations. 

And the body responds accordingly. 

Genetics can also influence how we metabolise neurotransmitters. 

Are you a “warrior” or a “worrier”? 

Some people are naturally more efficient at processing the byproducts of stress - they thrive under pressure, stay steady, and recover quickly. 

Others are less efficient, meaning neurotransmitters may build up more easily, and stress can hit harder. 

This isn’t a personality flaw. It’s genetic predisposition. 

And it can help explain why one woman seems unshakeable, while another feels overwhelmed and anxious from the same level of challenge. The good news is that this genetic predisposition can be effectively supported with targeted lifestyle measures. 

Sleep and energy are often downstream symptoms 

Sleep, or lack thereof, is one of the most common issues women report, and it’s also one of the most complex. 

Stress and anxiety can disrupt sleep. Hot flushes can disrupt sleep. Blood sugar instability can disrupt sleep. Poor sleep can then worsen everything else. 

Energy levels are similar. 

Some women bounce through their days. Others feel as if they are dragging themselves through mud, no matter how early they go to bed. 

In some cases, there may be nutrient depletions - whether due to diet, absorption issues, or heavy bleeding in perimenopause. 

And then, of course, we have the reality that HRT, whilst extremely beneficial for many women, is rarely a total silver bullet. 

It can be transformational, but it doesn’t always resolve every symptom. 

Which is why lifestyle still matters. 

Blood sugar: another hidden driver of symptoms 

If you are struggling with hot flushes, mood swings, sleep disruption, energy crashes, cravings, it is worth considering blood sugar regulation. 

A high sugar, highly refined diet can contribute to blood sugar dysregulation - and dysregulation can worsen symptom intensity. 

It’s not about perfection. It’s about recognising that your body in midlife is less forgiving of dietary chaos than it once was. 

Menopausal mood swings may be part of a longer history. 

There is evidence that women who struggled significantly with PMS may be more likely to struggle with mood swings during menopause. 

So if you’ve always been hormonally sensitive, menopause may not be the start of the story, it may simply be the next chapter. 

And then there’s the thyroid, and the liver, and everything else… 

Fluctuating sex hormones can have knock-on effects on other systems, including the thyroid. 

Then there’s liver metabolism, which plays a role in hormone processing and detoxification pathways. 

Regardless of diet, some women have genetic predispositions where certain pathways are naturally upregulated or downregulated. If we recognise this pattern, bespoke measures can be effective. 

But this is all why there is rarely one universal solution that works for everyone. 

The takeaway: you are not failing. You are complex. 

Menopause isn’t one-size-fits-all because women aren’t one-size-fits-all. 

Your genetics, your gut health, your nervous system, your stress load, your sleep, your diet, your life circumstances, your hormonal history… they all feed into your experience. 

And this is exactly why you can feel steady one year, and floored the next. 

It doesn’t mean you’re going backwards. It means your body is responding to the combination of internal change and external pressure. 

Menopause isn’t one-size-fits-all. And neither is the solution.