Nutrition and Lifestyle for Menopause
The menopause is part of the natural cycle of life and is a time of change for all women to the next phase of life.
Menopause is a hot topic these last few months, and I am delighted to hear it getting the attention it deserves.
In this blog I want to share with you the current scientific evidence about the role food and good nutrition can play in alleviating the symptoms associated with perimenopause and then supporting you and your body systems as you move into menopause and beyond.
So what is going on in our bodies during the menopause? Well there are in fact 3 distinct phases…
Peri-menopause: this transition begins several years before menopause. It's the time when the ovaries gradually begin to release less eggs.
Menopause: The menopause occurs when a woman has her last period. It is thought to occur when there are no viable eggs left in the ovaries. Menopause is marked by a dramatic reduction in the amount of oestrogen produced by the ovaries once periods cease.
Very cleverly after your menstrual cycles stops and the ovaries are only producing a tiny amount of oestrogen your adrenal glands, which are located just above your kidneys and normally look after your stress hormones will take over production of oestrogen but at a much lower level
Post-menopause: This refers to the period of time after periods have ceased. You are usually considered to be post-menopausal if there hasn’t been a menstrual cycle for 12 months.
The menopause is a natural stage of life that all women will go through. It is not a disease or a disorder and in many culture’s, it is a time in a women’s life to be celebrated as a beautiful transition to a new stage of life.
That being said the effects can be very real and do need to be considered.
Perimenopause can be a time of complete hormonal ‘chaos’. Oestrogen levels can spike before they fall and ALL hormone levels will bounce wildly and everything can become extremely out of balance. These fluctuations can be a shock to the body and
can affect a women’s energy, mood, motivation, libido, emotional health, relationships and overall sense of wellbeing. Symptoms can become debilitating and without the correct support can greatly affect quality of life.
The fluctuating hormone levels are thought to be what causes the majority of these symptoms but various other factors will also be playing a part in our response to these changes in hormones and must be considered, such as; nutrient deficiencies, the oral contraceptive pill or any medications we are taking, unhealthy food habits, processed foods, lifestyle factors, stress levels, our liver and digestive function. All of these can aggravate or exacerbate many of the symptoms we automatically associate with menopause.
We often only associate oestrogen with reproductive health but it is actually used throughout the female body and we have oestrogen receptors on many of our major organs. Beyond maintaining your menstrual cycle oestrogen helps support healthy bones, your heart, brain and bowel function.
Low levels of oestrogen post-menopause are most commonly associated with an increased risk of osteoporosis and cardiovascular disease. But to say these risks are purely caused by declining oestrogen is far too simplistic and we must remember to look at the whole picture. Many other factors will be playing a part; nutrient deficiencies, stress, medications, environmental toxins, sedentary lifestyles, genes, liver and digestive function. All of these can contribute to our response to the decline in oestrogen and the development of chronic disease.
Good food choices and the right nutrition is therefore vital at each of the menopause stages. For reducing symptoms and to create hormonal balance during peri-menopause, and to support the whole person post-menopause so they can continue to live and age well.
So how exactly can food and nutrition help? Food is powerful and your diet forms the very foundation of your health. It is fuel that feeds the biochemical processes in your body, the nutrients you consume are used to make hormones, create energy and carry out an abundance of cellular tasks that keep us alive and in good health.
As humans, we need a fairly precise array of nutrients in order to do this and this must come from our food. In addition to the food we eat it is equally important that we consider our digestive and liver health as we are only ever as healthy as the food we eat, what we can absorb and then what we can safely eliminate or excrete.
So, taking a step back, reconnecting with the food you eat and being mindful of negative life habits is essential during the menopause.
Positive changes you make now to how you eat and live will have a profound impact on your menopause journey and for your long-term health.
To support yourselves through this time of change. It is particularly vital to…
Ensure your diet is providing all of the key vitamins, minerals and macronutrients. This will help keep hormones balanced, ease symptoms and support bones, hearts and brains.
Optimise liver and digestive function so you can effectively absorb all of the nutrients from the food you eat, eliminate toxins and old hormones.
Improve resilience to stress, nourishing your adrenal gland with foods rich in Magnesium and Vitamin C so they are better able to respond to their new role producing oestrogen post-menopause.
Keep blood/sugars balanced to create stable energy. Fluctuations in blood/sugar levels can cause stress hormones to rise which can trigger hot flushes, anxiety and fatigue.
Promote a healthy microbiome which is vital for keeping hormones balanced and all aspects of long-term health
Maintain an ideal weight, this will protect bones, joints and hearts as you age.
As a nutritional therapist, I always start by ensuring my clients diet includes the latest evidence based recommendations on healthy eating. This includes:
Eating a wholefood, largely plant based diet
Make it colourful and diverse. This will provide nutrients in abundance. Try to stick to a ‘half plate rule’ so at every meal half of your plate is vegetables/fruit.
Eat the rainbow
Aim to eat fruit and vegetables from the rainbow of colours every day. This will provide an array of vitamins, minerals, and phytonutrients. Each colour contains a different set of beneficial plant compounds and nutrients that will all benefit your health in different ways. Evidence shows that the current recommendation of 5 fruit and vegetables a day is not enough and we need to be aiming for around 7 vegetables and 3 fruit each day.
Reduce saturated fat from animal products
Make fish, poultry, eggs, pulses, nuts and seeds your principal sources of protein. The association between saturated fat and heart health is well documented but research also shows that higher intakes of animal protein are associated with lower bone density so reducing your intake of animal products will benefit your bones and joints too.
Cut out / reduce processed foods
Processed foods are high in sugar, rancid oils, chemicals, preservatives which are all known hormone disruptors, promote inflammation, disrupt gut health and put a higher burden on the liver.
Switch to wholegrains
A 2018 Study showed diets high in refined carbohydrates were associated with earlier menopause. Wholegrains provide more stable energy and less spikes in our blood/glucose levels which can contribute to symptoms like hot flushes, fatigue, low mood. They are also rich in B vitamins which are needed daily for energy production, mood and overall brain health.
Avoid sugar, caffeine, alcohol
These all put extra pressure on organs such as the liver, which are vital for hormonal health. They contribute to blood/sugar fluctuations which will affect energy, mood and can exacerbate hot flushes, night sweats and sleep disturbances.
Seems simple but so vital for all aspects of health and staying adequately hydrated will have a big impact on the severity of symptoms like headaches, hot flushes, brain fog and can increase concentration and the circulation of nutrients.
Choose the best quality food you can afford and where possible eat organic. There is plenty of evidence now that shows us that organic food is far more nutritious and has far higher levels of nutrients. It also has far fewer chemicals and pesticides which are known hormone disruptors.
Feed your microbiome
Your gut bacteria plays a key role in detoxification processes and hormone balance. Science is also demonstrating the microbiomes role in all aspects of health. Aim to eat as diverse a diet as possible and include lots of fermented foods which are naturally rich in probiotics (good bacteria), organic acids, antioxidants, enzymes that enhance gut function and detoxification pathways. It is also important to feed the good bacteria with prebiotic foods like onion, garlic, asparagus and bananas.
As well as these healthy eating guidelines there are some key food groups that have been well studied for their role in helping reduce symptoms and the risks associated with post-menopause and declining oestrogen.
Omega 3 Essential Fatty Acids
Omega 3 rich foods are naturally anti-inflammatory, can help lubricate the body from the inside so they are great for symptoms such as dry skin, vaginal dryness, painful joints and hot flushes.
A 2018 study looked at how diet influenced the age of menopause and found a high intake of oily fish and fresh legumes were associated with a significantly later onset of natural menopause. Several human and animal studies have shown omega 3 to have a protective effect on bones by decreasing bone resorption.
Good sources are: oily fish (aim for 3 portions a week), flaxseeds, chia seeds, walnuts
An adequate intake of fibre can help keep blood-sugars balanced which is critical for stable energy and restorative sleep. Numerous studies show fibre has a beneficial effect on all aspects of heart health and digestive function and can help in maintaining a healthy weight.
Studies show that overall, women who regularly consume legumes have a lower BMI, lower blood pressure, lower cholesterol and overall reduced mortality from cardiovascular disease.
Importantly for menopause, fibre is essential for detoxification processes and helps your body safely eliminate old oestrogen and other waste products via your stool. This ensures that during the perimenopause when hormones are fluctuating that all unwanted and used hormones are removed from circulation and not contributing to the chaos.
Some of the best sources of fibre include nuts, seeds, legumes/beans, whole grains, vegetables and fruit.
Phytoestrogens are possibly the most studied food in relation to menopause. They are plant-based chemicals that mimic oestrogen and they are found in many foods such as soya, lentils, flaxseed, sesame, fennel, beans, chickpeas and some herbs and spices (sage, cinnamon).
Phytoestrogens are extremely clever and have been well researched for their ability to help balance hormones and reduce symptoms and risk factors associated with menopause.
Research shows that the phytoestrogens in food can block the effects of cellular uptake when circulating levels of oestrogen are high, this dilutes the effect of excess oestrogen in the body and can reduce associated peri-menopause symptoms.
Conversely when oestrogen levels in women are low phytoestrogens in food can stimulate uptake, helping reduce the risks associated with low oestrogen post-menopause.
Phytoestrogens have a natural affinity to oestrogen receptors in the brain, bones and heart so will have beneficial effects on bone health, cognitive ability and heart health.
Studies show that women who eat a diet rich in phytoestrogens report fewer hot flushes. 4 tablespoons of freshly-ground flaxseed every day has been shown in one study to reduce hot flushes by half and to help to establish a healthy oestrogen balance.
Try to include some cruciferous vegetables such as broccoli, cabbage and kale daily.These contain plant compounds which naturally helps to balance oestrogen levels and are also high in fibre.
Their sulphur-containing nutrients will support liver function and enhance liver detoxification processes and the safe removal of oestrogen. This will help reduce the circulating hormone load and can protect against cancer cell formation too.
Many herbs are touted as being beneficial during the menopause and there are some robust studies for their effectiveness at alleviating symptoms. Research suggests that Black Cohosh is one of the most effective herbs for relief of hot flushes, while St. John’s wort can improve anxiety and lift mood.
I would suggest that anyone wanting to try herbal remedies does so with support from a professional and as part of a whole programme of change.
Something simple we can all do though is to cook more with garden herbs like parsley, rosemary, coriander, sage and basil. Herbs are highly nutritious and contain plant compounds that will support detoxification processes, reduce inflammation, improve immune function and will generally support all body systems.
Incorporating anti-inflammatory spices in your cooking that boost circulation to the muscles, such as turmeric and ginger, can also help support bone health. Studies have found ginger effective at reducing hot flushes too.
Herbal teas are also a great way to use herbs safely. For hot flushes and reducing anxiety try camomile, lemon balm or sage.
Managing stress is critical during the menopause. Stress is a key factor influencing the severity of perimenopause symptoms, particularly hot flushes, anxiety, mood and disturbed sleep.
Incorporating daily practices such as yoga, meditation and mindfulness can be helpful. Massage, lunch with friends, whatever relaxes you. Laughter is known to be a great tonic so fill your life with people who make you smile.
Supporting bone health
Osteoporosis is one of the most commonly discussed risks associated with declining oestrogen. Ensure your diet is rich in food and nutrients that support good bone health, we automatically think of Calcium but there are other important nutrients too - Magnesium, Boron, Zinc, Vitamins D and K. Our bones require a steady supply of nutrients to maintain their density and strength, once we reach menopause this is increasingly important - Don’t forget to get regular sun exposure if you can too.
Daily weight bearing exercise is vital to maintain bone density once oestrogen levels start to decline. It can also help reduce stress, improve mood, circulation, protect our hearts and help us maintain an ideal weight. It should become a non-negotiable part of your lifestyle as you approach the menopause and beyond.
The most important thing is to be kind to yourself and to listen to what your body needs. Prioritise self-care, nourish your body with good food, surround yourself with happy people and remove anything ‘toxic’ from your life. Small changes can have a big impact and you are worth it.
If you would like some individual support with your menopause journey then I run nutritional therapy clinics in Bristol, Cheltenham and the Chew Valley and would be very happy to help.
Anita Beardsley is a qualified Nutritional Therapist using a functional medicine approach to support women's health. Anita offers 1:1 nutrition support and coaching online or at her Bristol clinic.