How to Menopause

How to Menopause (2025) is a self-help and medical book by Tamsen Fadal. Fadal, who is a journalist and menopause advocate, compiled a scientifically and personally backed catalogue of information, testimonials, statistical data, medical advice, reassurance, motivation, and strategies related to the experience of menopause. How to Menopause is part of a growing trend toward women’s health awareness and Removing the Mystery and Stigma Surrounding Menopause. Fadal discusses the importance of Managing Symptoms of Menopause while also Embracing Mid-Life As a Time of Empowerment and Growth. How to Menopause is a New York Times Bestseller and has gained global recognition.

This guide utilizes the 2025 Hatchette Book Group edition of the book.

Content Warning: The guide and source material feature depictions of sexual content.

Summary

Tamsen Fadal’s self-help book on menopause opens by detailing her personal experience with perimenopause, a physical experience and mental realization that shocked her. She explains how many women face confusing symptoms like anxiety, weight gain, hot flashes, and insomnia without understanding that they are related to this transitional stage in life. Much of this confusion is due to stigma and lack of dialogue on the subject. In Part 1, Fadal discusses the biological, emotional, social, and mental changes that occur in perimenopause and menopause, which are primarily the result of declining levels of estrogen and progesterone. She also introduces hormone therapy (HT), including its history of controversy and several studies on why it is safe. Fadal also discusses the growing movement toward menopause awareness and support and the importance of self-advocacy in the healthcare system.

Part 2 discusses the symptoms of perimenopause and how they impact women’s lives. Fadal begins with the topic of sleep, explaining how declining estrogen and progesterone can lead to many sleep disturbances. She provides strategies for better sleep, such as limiting screen time, maintaining a sleep schedule, limiting caffeine and alcohol, and natural sleep aids. Fadal then explores the symptom of brain fog, which can affect quality of life in several unforeseen ways. For Fadal, as a news anchor, it meant forgetting words on air and feeling anxious about her work despite her experience. Fadal explains the differences between brain fog and Alzheimer’s and dementia, clarifying that brain fog usually resolves on its own. She also suggests ways to help prevent Alzheimer’s and dementia, including puzzles, exercise, mindfulness training, and improving sleep quality. Alongside sleep challenges and brain fog are issues related to sex and libido. Fadal explains how menopause can cause vaginal dryness, thinning of the vaginal wall, and reduced libido. She explains the role of estrogen in sexual health and lists treatments such as vaginal estrogen, lubricants, therapy, and alternative approaches to enjoying sex, like using sex toys. She encourages women to talk openly with their partners about wants and needs.

Part 3 addresses how women can and should change their lifestyle to support health and well-being during and after menopause. Fadal begins with nutrition, discussing the weight gain and bloating she experienced and how she had to change her mindset to focus on her health rather than being thin or matching an ideal. She recommends the Mediterranean diet, which includes whole grains, lean proteins, vegetables, fruits, and healthy fats like olive oil, while limiting sugar, processed foods, and alcohol—all of which can have a negative effect on the various symptoms of menopause. Fadal also explains the importance of exercise for bone, heart, and brain health, encouraging women to build strength and improve balance to reduce the risk of injury or death. Fadal provides simple and quick fitness tests to assess current strength and balance and recommends beginning with walking. Fadal shifts to self-care, appearance, and aging. Fadal discusses changes to skin and hair that can occur during menopause, such as thinning hair, pigmentation, acne, and body odor. She encourages women to embrace their appearance while taking good care of it. She suggests choosing clothing that fits and makes women feel good. She also gives tips for simplifying makeup and organizing closets to make taking care of oneself (even when one is unwell) easier.

Part 4 explores the social and relationship changes that can happen during midlife and menopause. Fadal strongly emphasizes the importance of friendships and community support during midlife. Fadal explains how having a strong support system can reduce stress and improve health, while also making life more meaningful. She suggests ways of finding new friendships, like joining a church or volunteering, and provides inspiration for setting boundaries and ending toxic friendships. Fadal also talks about romantic relationships, including the high rate of divorce in midlife, which many women feel is the result of menopause. Fadal reveals her own experience with divorce and the financial struggles that followed, discussing how both the symptoms of menopause, and the feeling of prioritizing one’s own happiness, can both be major factors in divorce. She encourages women to prioritize their own needs and learn from past relationships. She gives advice on dating and states that fulfillment doesn’t have to come from romantic relationships. 

In the workplace, Fadal explores how menopause affects women’s careers and sense of direction or purpose. She discusses the stigma surrounding symptoms like brain fog and hot flashes and how these can affect confidence and performance. Fadal advocates for menopause policies in the workplace, such as flexible schedules, health coverage, and cooling rooms. She emphasizes that working women should not feel pressured to leave their jobs because of menopause and encourages open communication with women’s bosses. However, for some women, this life stage may be the right time to embrace a new career path.

Part 5 of the book looks ahead to life after menopause and how women can embrace this new chapter in their lives, also called a “second adulthood.” Fadal describes this period as a time of freedom, self-discovery, and possibility. With fewer social and familial obligations, women can focus on personal growth and pursue long-delayed goals. She explains that while aging can bring fears of becoming irrelevant or dying, many women find themselves happier, calmer, and more confident after menopause. She recommends de-cluttering both physically and emotionally—letting go of unused possessions, toxic relationships, and careers that no longer serve a purpose. Fadal proudly explains how she went from being a news anchor to becoming a menopause advocate, which gave her a new sense of purpose. She encourages readers to ask themselves what they want from the next phase of life and to create a plan to achieve it. Fadal closes the book by suggesting that changing how one thinks and talks about menopause can also shift how others see it. She believes that embracing aging with positivity and visibility can help change the way people see and feel about menopause and improve circumstances for future generations of women.