Nutritionist Sally Duffin on menopause and immunity

From urinary tract infections and food sensitivities to allergies and autoimmune conditions, immune health can come under pressure during perimenopause and menopause. Here we explore the links between midlife hormonal changes and immune function and look at nutritional ways to strengthen our natural defenses.

Where is my immune system located?

The immune system is a complex network of cells and tissues scattered throughout the body. These cells and tissues belong to either the innate immune system or the adaptive immune system.

The innate immune system includes physical barriers like our skin and the mucous membranes lining the digestive tract, airways, and vagina. It also involves saliva and stomach acid that can kill harmful organisms, and specific immune cells like Natural Killer cells, white blood cells, and mast cells.

The adaptive or acquired immune system is run by T-cells and B-cells that adapt their responses according to the types of infections we come into contact with. These cells are programmed to remember different pathogens so that we know how to defend ourselves if we encounter them again.

What happens when the immune system doesn’t work properly?

A healthy immune system needs to be able to:

  • Identify invading organisms like bacteria and viruses
  • Tell the difference between normal healthy cells and harmful pathogens (this is known as self and non-self)
  • Deal with infections quickly and effectively


When the immune system doesn’t work properly it stops being able to mount an effective response to infections and may even start to attack normal healthy cells. This attack on normal cells is called autoimmunity.

Auto immune diseases like rheumatoid arthritis, multiple sclerosis, and psoriasis affect significantly more women than men, with women making up approximately 80% of all patients diagnosed with auto immune conditions. The exact reasons for this remain unclear, but autoimmune conditions are often triggered by hormonal changes such as menopause.

How does menopause affect immunity?

As we get older, our immune systems become slightly less effective. This is a recognised part of the ageing process called “immunosenescence”. It happens to us all – males and females – but for those of us experiencing menopause, the effect is amplified by falling levels of oestrogen, progesterone, and testosterone.

Sex hormones help regulate immune cell activity and keep inflammation in check. Once their levels drop, we become more prone to inflammation and less effective at fending off pathogens.

During perimenopause and menopause, a number of other factors are at play too:

Poor sleep – sleep is vital for strong immunity but insomnia, hot flushes, and night sweats can ruin your chances of getting a good night’s sleep. Research shows that having less than 6 hours sleep per night increases your chances of getting the common cold, while chronic poor sleep can increase susceptibility to cardiovascular disease, obesity, and diabetes.

Stress – by the time we reach menopause (on average, in our early 50’s) we are likely to be juggling a variety of stressful family and work responsibilities. Whether its teenage kids, elderly parents, or an increasingly demanding job, finding time to relax and unwind can be difficult. Unfortunately, chronic stress has a negative impact on immune function, leaving us more susceptible to infections, inflammation, and slower recovery from illness.

Heavy periods during perimenopause can deplete iron stores. Iron plays a key role in immune function, helping immune cells to mature and respond properly to infections.

Hormone changes affecting digestive health – fluctuating hormones can affect the balance of the gut microbiome – the billions of microbes that live in the digestive tract. As well as supporting healthy digestion, the microbiome regulates our immune response. When the microbiome is disturbed, it can lower our natural defences and increase the risk of auto immune conditions.

Tiredness and fatigue – being Tired All The Time (TATT) is a common reason for visiting the GP during perimenopause and menopause. Feeling exhausted all day also makes us more likely to reach for sugary snacks and caffeine. But grazing on snacks and caffeine leads to the blood sugar rollercoaster – bursts of energy followed by a sharp drop – and this makes tiredness even worse.

How to naturally support your immune health

If your immune system seems to be struggling during perimenopause or menopause try these nutrition tips to bolster your natural defenses.

Nourish your gut microbiome

Our beneficial microbes enjoy colourful fruits and vegetables, wholegrains, beans, and pulses, which contain soluble fibres for them to feed upon.

Fermented foods like sauerkraut, kefir, kimchi, and natural yoghurt help too. They contain different strains of natural bacteria that support the balance and diversity of our own microbiome.

Cut back on free sugars

High amounts of free sugars like table sugar and sugars found in syrups, sweets, chocolate, cakes, honey, and fruit juices (but not whole fruits) disturb the gut microbiome and weaken the ability of immune cells to respond to infections.

Check your vitamin D levels

Vitamin D is crucial for immune health yet deficiency is common in Northern hemisphere countries like the UK. Government advice is for all adults to take a supplement between October and April and you may need to supplement all year round, especially if you have darker skin, cover most of your skin, or have little time outdoors.

Top up on iron

If you still have regular periods, it’s a good idea to eat plenty of iron-rich foods like red meat, poultry, eggs, dried apricots, leafy green vegetables, lentils, and tofu.

Eat a rainbow of fruits and vegetables

Colourful fruits and vegetables supply vitamin C, beta carotene, and plant-based antioxidants that help manage inflammation and support immune cell activity. Combining vitamin C foods like berries, watercress, broccoli, and kiwi with plant-based sources of iron aids iron absorption too.

Menopause affects every part of the body including the immune system and new conditions can be triggered by our changing hormones. Focusing on foods and nutrients can be a helpful way to manage symptoms and strengthen immunity for life after menopause.

For more stories, advice and interviews, head to the Menopause Your Way Stories hub. To browse and shop a curated edit of menopause products, visit the Menopause Your Way page on QVC.

The content of the QVC website is for information only. It is not intended as a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your doctor or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the QVC website.

We understand there’s a lot of information out there on the menopause. You can read through the NICE guidance on menopause management, as well as the NHS overview on the menopause.