Inflammation Through Perimenopause and Menopause: What’s Really Going On
When we hear the word menopause, most of us think about hot flashes and changes in our menstrual cycle. But one of the most important, and least talked about, shifts happening during the peri- and postmenopausal years is inflammation.
Inflammation can quietly build in the background and make many symptoms feel louder, more persistent, or harder to ignore. Understanding how hormone changes influence inflammation can help explain why so many women experience new or worsening symptoms during this stage of life, and why targeted support actually matters.
Why inflammation increases during perimenopause and menopause
Here’s the short version: hormones and the immune system are deeply connected, and menopause changes that relationship.
Estrogen is not just a reproductive hormone. It plays a key regulatory role across many tissues in the body, including the immune system, brain, metabolism, bones, joints, and cardiovascular system. One of estrogen’s most important roles is acting as a natural anti-inflammatory signal throughout the body.
During perimenopause, estrogen levels become more erratic, and over time they decline significantly. Without this anti-inflammatory influence, the immune system tends to shift toward a more pro-inflammatory state. As a result, the body may produce higher levels of inflammatory signaling molecules, even in people who have never had signs of chronic inflammation before.
Importantly, this effect is not limited to those with a known genetic risk for inflammation. Even with a “low-risk” genetic profile, the loss of estrogen’s protective effects alone can increase inflammatory activity.
How inflammation contributes to common menopausal symptoms
Increased inflammation during peri- and postmenopause can affect many systems at once, which is why symptoms often feel widespread or unrelated at first. Inflammation has been linked to:
Weight gain and metabolic changes, particularly increased abdominal fat and insulin resistance
Mood and memory changes, including brain fog, anxiety, and low mood, partly due to neuroinflammation
Joint pain and stiffness, as inflammatory signaling affects connective tissues
Bone density changes, since inflammation can accelerate bone breakdown
Increased autoimmune risk, as immune regulation becomes less stable in the absence of estrogen
This inflammatory shift helps explain why menopause often feels like a whole-body transition rather than a single symptom.
What can you do now?
The good news is that while hormonal shifts are unavoidable, how strongly inflammation shows up day to day is often modifiable through lifestyle factors.
Evidence-based strategies that can help reduce inflammatory burden include:
Anti-inflammatory nutrition, emphasizing fiber, omega-3 fats, colorful plant foods, and adequate protein (think Mediterranean diet)
Regular movement, including both aerobic exercise and resistance training
Stress reduction practices such as mindfulness, breathwork, quality sleep, and nervous system regulation
These interventions do not stop hormonal change, but they can meaningfully reduce how strongly inflammation impacts daily symptoms.
What about Hormone Replacement Therapy?
Hormone replacement therapy (HRT) can also influence inflammation during menopause, but the type of hormone matters.
Estrogen made by the body has anti-inflammatory effects. When estrogen levels drop, inflammation often rises. Bio-identical estrogen (estradiol) has the same chemical structure as the estrogen your body naturally produces, and when appropriately prescribed, it has been shown to help lower inflammatory markers and support immune balance.
Synthetic hormones, on the other hand, are structurally different and may increase inflammation or certain health risks for some individuals.
Hormone therapy is never one-size-fits-all, and not everyone is a candidate. If it’s something you’re curious about, we encourage you to have an informed conversation with your care team or a certified menopause practitioner.
How Golden Genetics supports menopause and inflammation
At Golden Genetics, we take a systems-based approach to menopause care. Our Golden Years Perimenopause Genetics Package is designed to uncover how genetics, hormones, inflammation, and metabolism intersect during this transition.
Through personalized testing and counseling, we help to:
Identify genetic patterns related to key cellular pathways such as inflammation
Connect symptoms to genetic testing results
Provide targeted nutrition, lifestyle, and care recommendations
Support informed conversations about hormone therapy and other treatment options with your care team
Menopause is not a one-size-fits-all experience. If you are navigating perimenopause or postmenopause and want a clearer, more personalized understanding of what is happening in your body, we invite you to take our quiz to see if our package would be a good fit for you.