I reversed menopause after finding these simple cures for the worst symptoms. Most women don't realize they're making six major mistakes... suffering is optional

Dr Anna Cabeca understands the complexities of menopause better than most.

A triple board-certified obstetrician-gynecologist based in Texas, she has helped thousands of women in midlife successfully navigate 'the change'.

But her expertise is also deeply personal. Cabeca began experiencing early menopause at just 39 years old, and was told she would never have children.

Refusing to accept the diagnosis, she began researching so-called 'superfoods' and supplements believed to support hormonal balance – including maca root, turmeric and acerola cherries – and overhauled her fitness, incorporating regular walking and hiking into her routine.

According to Cabeca, these changes had a dramatic impact. In 2008, at the age of 41, she says she was able to reverse her symptoms and went on to conceive a healthy baby girl. She later went through menopause for a second – and final – time at 56.

Now, Cabeca is on a mission to help other women avoid what she believes is unnecessary suffering during this stage of life. She argues that many of the most common symptoms – including hot flushes, weight gain, hair loss and vaginal dryness – can often be managed naturally by avoiding key lifestyle mistakes she frequently sees in her patients.

'Menopause is natural and mandatory, but suffering is optional,' Cabeca told the Daily Mail. 'It's an opportunity to optimize our nutrition and lifestyle. Menopause is not the beginning of the end.'

Here, she outlines the six most common missteps women often make during perimenopause and menopause – spanning diet, exercise, sleep and sex – and how to avoid them.

Why diet drinks could do more harm than good in midlife

Diet sodas are marketed as low- or no-calorie alternatives to sugary, high-calorie drinks that contribute to weight gain, diabetes, heart disease and dental damage.

Instead of sugar, they use artificial sweeteners like aspartame and sucralose – but while this cuts down on calories, Cabeca urges menopausal women to steer clear.

The key concern is emerging evidence that suggests consuming them may also cause people to gain weight. 

Because these drinks provide a sweet taste, but without the calories the body expects, they can confuse the brain and interfere with the release of hormones that regular hunger and feelings of satiety. 

This can ultimately cause people to eat more, says Cabeca.  

In addition, one 2025 review suggested artificial sweeteners may disrupt healthy bacteria in the gut and attack the gut's protective barrier, promoting inflammation throughout the digestive system, which may trigger menopausal symptoms such as bloating, constipation and acid reflux. 

Instead of diet sodas, Cabeca suggests keeping it simple. 'Water, water, water,' she says. 

'I drink three liters [about 100oz] of water on an average day. We don't realize how dehydrated we are.' 

She also notes dehydration promotes bladder distention, which is when the organ becomes overly stretched and enlarged because it cannot fully empty out urine. Menopause already raises this risk due to decreased estrogen that normally helps the bladder stretch.

Left unaddressed, bladder distention may lead to incontinence. 

Why menopausal women shouldn't give up on sex 

Around half of women suffer vaginal dryness during and after the menopause.

Estrogen plays a key role in maintaining the vagina's natural lubrication. As levels decline, the tissues can become drier, thinner and more irritated, often leading to discomfort. 

As a result, millions of women report having less sex.

'I always explain to patients, if you go up to play baseball and you get hit by the ball every time you're up to bat, you're not going to want to play. That's not a fun game,' Cabeca says. 

'The same is true here. If we're having intimacy but there's dryness, there's discomfort, our body knows that experience isn't good, so it doesn't feel safe. Your body loses trust in the experience.'

However, recent research shows regularly having sex during menopause helps counteract many of these physical changes by promoting blood flow to the pelvic muscles, moisturizing the vagina and improving its elasticity.

Lubricants can help reduce discomfort during sex, but Cabeca urges paying attention to their ingredients. She suggests steering clear of parabens and ingredients like propylene glycol, which may further disrupt the production of estrogen. 

'The vulva and vaginal tissues are very sensitive,' Cabeca adds. She recommends a water-based lubricant with soothing aloe vera and hydrating ingredients such as hyaluronic acid, which help retain moisture.

Pelvic floor therapy, which involves exercises like Kegels to strengthen the pelvic muscles and organs, can also help restore blood flow and release tension. 'Pelvic floor exercises are crucial,' Cabeca says.

Putting off exercise can make you feel even more tired

Fatigue is one of the most commonly reported and debilitating symptoms of the menopause, affecting up to 85 percent of women.

Hormonal fluctuations, problems sleeping and changes to brain chemistry are all causes.   

To add to this, falling estrogen slows metabolism and muscle recovery, which can make exercise feel significantly harder.

But Cabeca advises pushing back against the urge to take it easy.

'We like to have that mentality of, 'Let's take the elevator because we're old' or 'I'm not going to get a house with stairs' in menopause,' she says. 'But why are we limiting ourselves based on our age? Things like that, I think, are ridiculous.'

She points out that resistance training like lifting light weights, for example, has been shown to combat bone loss that occurs during menopause and improve balance issues that occur when estrogen depletes. 

Additionally, a recent review in the Journal of Mid–Life Health found that aerobic activity such as walking or cycling lowers blood pressure and cholesterol that naturally rise during menopause. 

Cabeca suggests starting small and getting outside. 'Hiking is so underrated,' she says. 'Walking on uneven grounds, carrying a pack, helps stabilize our muscles. Hiking does not get enough credit.' 

People who are newer to exercise can also implement simple measures such as parking further away and taking the stairs whenever possible.   

Cabeca also recommends Pilates 'because that's all core strength and flexibility,' which counteract the loss in muscle mass and protect a naturally weakened spine from damage.

Tackling poor sleep should be a priority 

Between hot flashes and constantly getting up to use the bathroom, getting a full night's sleep can be difficult during menopause. 

In fact, recent estimates suggest 40 to 60 percent of menopausal and postmenopausal women suffer from sleep disturbances - including actress and Goop founder Gwyneth Paltrow, 53, who spoke about suffering the symptom last year. 

However, Cabeca says: 'Sleep is so important for hormone regulation.'

Like estrogen, melatonin, a hormone that helps regulate sleep by causing drowsiness, naturally declines during menopause. 

This increases the risk not only of insomnia and fatigue but weight gain, as melatonin also helps regulate appetite. 

Sleep deprivation also creates a frustrating feedback loop: Symptoms such as hot flushes, night sweats and anxiety, make it difficult to sleep. 

But losing sleep makes the body hypersensitive and worsens those symptoms. Stress hormones can also exacerbate bladder issues, meaning women have to go more often during the night. 

Cabeca suggests focusing on stopping that cycle. 'I recommend fluid restricting, like drinking no more than four to eight ounces of fluid after dinner and stopping any fluids three hours before bedtime,' she says. 

'If you're getting up in the middle of the night, we have to retrain the bladder to calm down at night.'

This means staying away from food and drinks at dinner with diuretic effects, meaning they increase urine output. These include tea, cranberry juice, alcohol and water-rich fruits like cucumber, watermelon and pineapple.

'If your medicines are diuretic, make sure you're taking them early in the day, not later,' Cabeca says.

Fasting too much – or not enough

Up to 70 per cent of women gain weight during the menopause - including former first lady Michelle Obama, 62, who has spoken about her struggles in midlife.

Many might be drawn to dieting in a bid to lose the extra pounds. But the big question is, with so many regimes around, which one is best? 

Cabeca recommends intermittent fasting, which involves restricting calories during a specific time window and eating normally the rest of the time. 

In one 2025 review, researchers concluded this kind of diet can help menopausal women lose weight, regulate their estrogen levels and reduce the risk of age-related conditions like osteoporosis. 

However, Cabeca argues not all fasting plans are created equal. 'When the weight gain starts coming on, many people are now fasting too much, and that can actually circle back and cause more cortisol and inflammation,' she said. 

Cortisol is the body's primary stress hormone, fueling the natural 'fight-or-flight' response, which influences energy use, blood pressure and sleep, among a laundry list of other functions. 

Declining estrogen and progesterone in menopause leaves the body more prone to stress and cortisol spikes, which worsen issues like weight gain. 

Cabeca suggests following what she calls a 'keto-green' diet – a play on the low-carb ketogenic diet. The plan involves prioritizing healthy fats and alkaline foods such as fresh fruits and vegetables, nuts and beans, while stripping out grains and dairy, both of which she claims can fuel inflammation. 

If weight loss is the goal, she recommends eating breakfast no later than 10am and fasting for 13 to 16 hours after. This means someone eating breakfast at 7am would have dinner between 8pm and 11pm. 

Go-to keto-green meals for Cabeca include smoked salmon with capers, olive oil, sprouts and arugula, as well as kofta with tomatoes, herbs and a side salad.