Ways to Reduce Menopause-Related Inflammation Without Hormone Therapy

When you’re riding the waves of hormonal fluctuations in perimenopause, it can feel like your body has a mind of its own. Joint aches, fatigue, weight changes, brain fog…the list of symptoms can feel endless. One important driver behind many of these changes is low-grade chronic inflammation.

As estrogen levels decline, your immune and metabolic systems shift, and inflammation tends to rise in response. Over time, inflammation can impact everything from how your joints feel day to day to your long-term heart and metabolic health.

“As estrogen levels fluctuate and decline during perimenopause and menopause, we lose one of the body’s natural anti-inflammatory regulators.  Estrogen plays a meaningful role in calming immune signaling.  When it falls, especially rapidly, the inflammatory response can become more amplified.  That heightened reactivity may contribute to joint aches, sleep disruption, brain fog, mood changes, headaches and a general feeling of the body being “off” or more sensitive than it used to be.  I often explain it this way: estrogen is like the volume control on your body’s inflammation.  During the reproductive years, it helps keep the background noise turned down.  As estrogen declines, the volume knob gets turned up and inflammation starts to show up in significant ways. Recognizing this shift allows us to intentionally lower the volume through restorative sleep, anti-inflammatory nutrition, stress reduction, and other healthy lifestyle habits that help quiet the system.”

"Menopause hormone therapy (MHT) can help address inflammation by stabilizing declining hormone levels. For many women, it’s an effective option, but it’s not the only way to target inflammation. Several science-backed, non-hormonal strategies can tame inflammation and support healthy aging." ~ Dr. Hayes

Why Inflammation Rises During Perimenopause and Menopause

Estrogen does more than regulate your menstrual cycle during your reproductive years. It also helps keep your immune system and metabolism in balance. As estrogen levels decline, that steady regulatory effect weakens, and inflammatory signaling can become more active, making low-grade, chronic inflammation more common during perimenopause and menopause.

This isn’t the kind of healthy, short-term inflammation you get after a cut or infection (that type is targeted and temporary!). Think of chronic inflammation as a silent assassin: it’s much quieter but more persistent than acute inflammation. It can manifest as muscle stiffness, fatigue, mood changes, increased abdominal fat, and elevated blood sugar levels, which can have significant implications for a woman’s metabolic health.

Research suggests that reproductive aging changes how the brain, immune system, and metabolism communicate with one another. As hormones fluctuate and fall, the body becomes more prone to sustained inflammatory responses.

But inflammation doesn’t happen in a vacuum. Stress, diet, sleep, movement, gut health, and genetics all influence how strongly it shows up during this stage of life. For some women, these factors amplify inflammation. For others, they may help buffer it.

How Inflammation Affects Symptoms and Long-Term Health

Inflammation doesn’t operate in isolation. It interacts with hormonal shifts, almost like turning up the volume on certain symptoms, making them feel more noticeable and persistent.

For example, declining estrogen combined with increased inflammatory signaling may contribute to joint pain and stiffness. Inflammation also affects temperature regulation, which can cause hot flashes feel more frequent or intense for some women.

On the metabolic side, chronic inflammation is linked to increased abdominal fat and insulin resistance, both of which raise your cardiometabolic risk. Over time, this can increase your chances of developing metabolic syndrome, type 2 diabetes, and cardiovascular disease, which is the #1 cause of death for US women.

Inflammation also affects your mood and brain health. The immune system and brain are closely connected, and persistent inflammation can affect cognitive function, focus, and emotional well-being.

In short, addressing chronic inflammation isn’t just about symptom relief today; it’s also about supporting healthier aging tomorrow.

Anti-Inflammatory Diet: Foods That Help During Menopause

One of the most powerful non-hormonal tools for calming inflammation is food. A Mediterranean-style eating pattern is a helpful benchmark.

In one study of peri- and postmenopausal women, those who more closely followed a Mediterranean-style diet, rich in vegetables, nuts, fruit, whole grains, olive oil, and fish, had healthier cholesterol levels and lower C-reactive protein, a marker of inflammation. Together, those changes can lower cardiovascular risk.

Another study found that postmenopausal women who ate a more anti-inflammatory diet reported a better menopause-specific quality of life and fewer moderate to severe physical and sexual symptoms.

That doesn’t mean you can never enjoy processed foods or alcohol. But regularly consuming highly processed foods, excess added sugar, or heavy alcohol can promote inflammation and worsen blood sugar control. Moderation is the key.

Gut Health: The Microbiome’s Role in Menopause Inflammation

Your gut microbiome, the community of bacteria living in your digestive tract, plays an important role in regulating inflammation levels across your entire body. When you enter perimenopause, no system remains unscathed—this transition can also throw off your microbial balance. 

A diverse, balanced microbiome helps regulate immune signaling and inflammatory responses. Part of this ecosystem, the estrobolome, even helps process and recycle estrogen, influencing both inflammation and symptoms during midlife.  Dysregulation of the estrobolome has been associated with estrogen-related diseases, including breast and uterine cancer, PCOS, and even endometriosis.

Supporting gut health doesn’t necessarily mean you need to do a total diet overhaul. Small, consistent habits can help: eating fiber-rich foods daily, incorporating fermented options like yogurt, kefir, kimchi, or sauerkraut, and rotating protein sources to encourage microbial diversity. In some cases, a synbiotic (a combination of pre- and probiotics) supplement may offer your microbiome some additional support.

Emerging research suggests phytoestrogens (such as soy isoflavones in tofu and edamame) may support the gut microbiome and, in turn, calm inflammation during menopause.

Exercise: Moving Your Body to Lower Inflammation 

Another holistic tool that will help put out the inflammation fire? Consistent movement.

Both cardio and strength training have been shown to dial down inflammatory activity, support joint function, improve metabolic health, and reduce abdominal fat. Exercise also helps steady blood sugar and improve insulin sensitivity, which further reduces strain on your inflammatory system.

Let’s not forget that regular movement can boost mood, improve sleep quality, and support energy levels, all of which can also lower inflammation.

You don’t need to do workouts you dread to see these health benefits. The best routine is the one you’ll actually stick with. Brisk walking, cycling, swimming, Pilates, yoga, and strength training are all great examples of inflammation-fighting workouts.

A helpful target is about 150 minutes of moderate aerobic activity per week, plus strength training two to three times weekly. But if some weeks fall short, that’s okay. Consistency matters more than intensity. Showing up regularly, in whatever way you can, supports both how you feel now and your long-term health.

Stress, Sleep, and Emotional Resilience: Calming the Inflammatory Response

Inflammation doesn’t just have physical repercussions; it can also affect your stress and emotional health. That relationship is bidirectional: low-grade chronic inflammation can influence your mental and emotional well-being, and elevated stress can trigger inflammatory responses.

Chronic stress raises cortisol levels, which can amplify inflammatory signaling and symptoms, including fatigue, abdominal weight gain (colloquially known as menopause belly), and sleep disruption. Over time, that stress-inflammation cycle can make midlife symptoms feel harder to manage.

Practices like mindfulness, meditation, breathwork, therapy, and meaningful social connection can help regulate the stress response and quiet immune activation. Sleep is also nonnegotiable. Poor or inconsistent sleep is linked to higher inflammatory markers and disrupted hormone balance. Aiming for seven to nine hours each night, keeping a relatively consistent sleep schedule, and doing a calming wind-down routine nightly can all keep inflammation in check.

Finally, give yourself extra compassion as you navigate the menopause transition. Emotional resilience, or your ability to adapt to change and manage stress, can also help keep inflammation at bay. Setting clear boundaries and fostering strong support systems matter just as much as nutrition and exercise.

When to Seek Medical Advice for Persistent Inflammation

If symptoms are severe, getting worse, or interfering with daily life, it’s worth checking in with a clinician. Persistent joint pain, unexplained weight changes, ongoing fatigue, or mood shifts may signal underlying conditions that deserve evaluation.

A menopause-informed provider can help determine whether further testing or additional therapies make sense for you. Together, you can agree upon a plan that takes your health history, risk factors, and personal goals into account.

The bottom line is this: having higher inflammation levels during menopause is common, but it is not something women simply have to accept.  When we understand how declining estrogen amplifies the inflammatory response, we can respond with intention - prioritizing restorative sleep, consistent exercise, anti-inflammatory nutrition, and thoughtful stress management.  These daily choices are powerful tools, helping to calm the system, decrease symptoms, and positively impact your healthspan and overall quality of life. 

Frequently Asked Questions: How does the decline of estrogen during menopause specifically trigger inflammation?

Estrogen acts as a natural anti-inflammatory regulator that helps calm immune signaling and keeps "background noise" in the body turned down. As levels fluctuate and fall, this regulatory effect weakens, and the volume on the inflammatory response is turned up. This heightened reactivity can lead to low-grade chronic inflammation, which contributes to joint aches, brain fog, mood changes, and a general feeling of being more sensitive or "off."

What are the long-term health risks associated with chronic inflammation during this transition?

Chronic inflammation is not just about daily symptoms; it is linked to increased abdominal fat and insulin resistance, both of which raise cardiometabolic risk. Over time, this persistent inflammation can increase the chances of developing type 2 diabetes, metabolic syndrome, and cardiovascular disease—which is the leading cause of death for women in the United States. It also impacts brain health and cognitive function.

How does gut health influence inflammatory levels during perimenopause?

The gut microbiome regulates immune signaling and inflammatory responses throughout the entire body. A specific part of this ecosystem, the estrobolome, helps process and recycle estrogen. When the microbial balance is thrown off during perimenopause, it can lead to dysregulation that is associated with increased inflammation and estrogen-related diseases. Supporting the gut with fiber-rich foods, fermented options, and phytoestrogens like soy can help calm this system.

What lifestyle strategies are most effective for "lowering the volume" on inflammation?

Beyond medical options like Menopause Hormone Therapy (MHT), several non-hormonal strategies are effective. These include following a Mediterranean-style diet rich in whole foods and fish, engaging in regular cardio and strength training to improve insulin sensitivity, and prioritizing seven to nine hours of sleep. Additionally, stress-reduction practices like mindfulness and breathwork help regulate cortisol levels, which otherwise amplify inflammatory signaling.