What is inflammaging - and why should women care?

How long-term inflammation develops in your body

Inflammation is your body’s natural defence mechanism and plays a vital role in keeping your immune system healthy. It helps protect against harmful germs, supports tissue repair, and clears away damaged cells.

When your body detects a threat - such as an injury, infection, or exposure to harmful substances - it triggers an inflammatory response, releasing protective cells and chemicals to help defend and heal the affected tissues. In the short term, this process is both normal and beneficial, helping your body recover from illness and injury.

Health issues arise when inflammation becomes long-term (chronic). Instead of switching off once the threat has passed, the inflammatory response continues, placing your body under constant stress. Over time, this persistent, low-grade inflammation can damage healthy tissues and increase your chance of developing a range of serious health conditions.

Richa Puri

According to Puri, these changes can leave women particularly vulnerable to inflammation.

“Oestrogen is strongly anti-inflammatory,” she says. “As women transition into perimenopause and menopause, their hormone levels begin to fluctuate.

“This can increase insulin resistance, triggering metabolic changes that contribute to weight gain, raised blood sugar levels, and elevated cholesterol - all of which raise your chance of developing cardiovascular disease, arthritis, type 2 diabetes, and even dementia.”

Signs and symptoms to look out for

Puri notes that some women may experience symptoms that could indicate they are experiencing inflammaging.

These can include:

• Excessive tiredness (fatigue).

• Joint aches and pains.

• Weight gain, or weight that becomes increasingly difficult to shift - particularly around your abdomen.

• Changes in digestion.

• Mood swings.

• Forgetfulness and brain fog.

• Skin changes - such as rosacea, acne, dry skin and reduced elasticity.

Inflammaging is something you naturally become more vulnerable to as you get older. While it can’t be completely prevented, there are steps you can take to help reduce its impact, just as you would with other age-related changes.

Puri suggests that if you are approaching or going through menopause, it is worth having a detailed conversation with your doctor or a menopause specialist. They may recommend medical treatments, such as hormone replacement therapy (HRT), depending on your individual health history and needs.

However, she explains that HRT works best as part of a wider approach to health. Evidence consistently shows that combining HRT with the following practical strategies can help slow the onset of inflammaging and deliver the greatest overall benefit for women.

Sleep and stress regulation

Adults generally need around seven to eight hours of quality sleep each night. Getting enough rest offers a wide range of health benefits, from supporting memory, mood, and energy levels to helping regulate metabolism and immune function.

To maximise these benefits, Puri recommends aiming for a consistent sleep routine - ideally going to bed by 10 pm and waking up at the same time each morning.

“Consistent sleep timing is particularly important for women in perimenopause and beyond,” she says. “Disrupted sleep accelerates the hormonal shifts that drive inflammation, and poor sleep raises cortisol, which directly suppresses oestrogen.”

Cortisol is a hormone your body produces to help you respond to stressful situations. But when cortisol levels stay elevated over time - as can happen with long-term stress or declining oestrogen during perimenopause and menopause - it can fuel inflammation, potentially contributing to inflammaging.

To help counter these effects, Puri recommends incorporating activities that activate the parasympathetic nervous system - your body's natural ‘rest and digest’ mode.

“Activities such as walking in nature, yoga, Pilates, yoga nidra, breathwork, acupuncture, reflexology, and magnesium salt baths all help lower the inflammatory load,” she says. “These are particularly valuable for women whose stress response becomes less buffered as their oestrogen declines.”

Movement and muscle health

Physical activity plays an important role in keeping long-term inflammation in check. Both cardiovascular exercise, which strengthens your heart, and resistance training, which builds and maintains muscle, can help keep long-term inflammation in check.

Puri suggests you aim for resistance training at least three times a week.

“Women from their thirties onwards begin losing muscle mass at a faster rate than men, and this accelerates at menopause,” she says. “Building and preserving muscle directly reduces inflammatory markers and protects against osteopenia and osteoporosis, to which women are disproportionately vulnerable.”

Food and inflammation

Adding certain foods to a healthy, balanced diet may help regulate inflammation and reduce your chance of developing conditions associated with long-term inflammation.

“Omega-3 fatty acids are strongly anti-inflammatory and support brain health, which is important given that women account for most dementia cases,” says Puri. “الحصول على كمية كافية من فيتامين د also helps modulate your immune system, supports bone density and plays a role in hormone regulation. Many women in the UK are deficient in this - particularly through the winter months.”

Puri also advises making sure you're getting enough protein - around 1.5 to 2 grams per kilogram of body weight each day. For women, adequate protein intake helps preserve muscle mass and supports stable blood sugar levels, which can become harder to regulate as your oestrogen declines. It may also help reduce the tendency to gain weight around your abdomen - a common consequence of hormonal changes during midlife.

“Beyond protein, actively reducing refined carbohydrates and eating in a way that avoids blood sugar spikes - for example, eating vegetables and protein before carbohydrates - directly reduces glycation and inflammaging,” she says. “This is particularly relevant as insulin sensitivity declines with oestrogen.”

Puri adds that foods such as flaxseed, soy, chickpeas, and sesame contain phytoestrogens - naturally occurring plant compounds that have a similar structure to oestrogen - may have mild hormone-supporting effects.

She also recommends keeping your magnesium levels topped up. This important mineral helps regulate cortisol, supports better sleep, and may help keep your inflammation under control. Many women don't get enough magnesium, particularly during perimenopause, making it a nutrient worth paying attention to.

Supporting gut health

Experts can’t stress enough how important it is to support your gut health. An unhealthy or imbalanced gut can affect your health in multiple ways and is closely linked to increased inflammation throughout the body.

“Aim for at least 30 grams of fibre per day from a wide variety of fruit, vegetables, oats, nuts, seeds, legumes, and lentils,” says Puri. “Diversity is important - each plant variety feeds different gut microbes, and a healthy microbiome actively reduces systemic inflammation.”

She notes that fermented foods such as sourdough, kefir, kimchi, kombucha, sauerkraut, and miso are valuable additions.

Lifestyle and environmental factors

Reducing the amount of processed food in your diet, limiting alcohol intake, and minimising exposure to endocrine-disrupting chemicals (EDCs) may all help reduce long-term inflammation.

Ultra-processed foods (UPFs) can be affordable and convenient, but many are associated with increased risks of conditions such as cardiovascular disease, داء السكري من النوع 2, certain cancers, and chronic systemic inflammation. Reducing these foods and prioritising whole, minimally processed alternatives can support both your overall health and gut function.

“UPFs are directly linked to visceral fat accumulation,” says Puri. “This is the most inflammatory fat depot and increases significantly post-menopause.”

When it comes to alcohol, even moderate intake can disrupt your hormonal balance, negatively affect sleep quality, impair gut barrier function, and be independently associated with an increased risk of breast cancer.

“Plastics (BPA), certain cosmetics, and cleaning products contain EDCs that interfere with hormone balance and drive inflammation,” adds Puri.