A Quick Menopause Guide
Are you still unsure about what to expect from your transition into menopause? It affects every woman at some point so why does it feel like we’ve swept this subject under the carpet for too long?
Let’s be clear. The menopause actually pinpoints the stage when you haven’t had a period in 12 months, which is distinctly different to the time when your body thermometer goes off the scale, you can’t sleep, you have belly fat that wasn’t there before and you can only manage your life if you’ve created innumerable lists. And only then if you can remember where you’ve put said lists.
"The stage that comes as a surprise to many is the peri-menopause"
This is, literally, pre-menopause and the time when there is a distinct reduction in both the quality and quantity of viable eggs in your ovaries and thus a chaotic fluctuation in the hormones responsible for reproduction. An increase in oestrogen can cause a change in the length of your menstrual cycle, heavy periods with surprise flooding, breast tenderness, and irritability. The rapid decline in oestrogen is associated with night sweats, hot flashes, low mood and problems with memory.
The good news is that nutrition can play a leading role in not only reducing symptoms but future proofing your health.
The severity of your symptoms could be genetic so if your mother can elucidate you on her own peri-menopause and menopause, that may give you an idea of what to expect.
"It's a natural progression, not a disease"
The key issue is that this time of your life is a natural progression, not a disease. And whilst everyone is different, Jon Wardle, ND, PhD suggests that a combination of targeted nutrition and lifestyle factors which may be beneficial (3). His tips include
Focusing on improving your quality of life
Reducing your symptoms
Managing your weight
Reducing your stress levels
"Which nutrition and lifestyle interventions work?"
We know that your weight can affect your symptoms. Whilst balance is key, some women with a slightly higher BMI tend to have fewer symptoms, particularly night sweats and hot flashes, than those whose weight is within the ideal range (1).
The reason for this is fascinating.
Your body is always trying to find the ideal balance. In response to lower ovarian oestrogen, your body will lay down fat cells (particularly around your belly) capable of oestrogen production. It’s your body’s way of topping up hormones levels and whilst high oestrogen can cause an array of unpleasant symptoms, oestrogen docking stations are found all over your body helping to support bone and heart health, memory and concentration as well as your genitourinary system. So a little belly fat is, in fact, helpful.
An excess is associated with heart disease so balance is key. Additionally, the more weight you carry the less physically active you may be, and we know that the duration of some symptoms is shorter in women who have higher physical activity (2).
Improving your quality of life may seem a daunting prospect. But talking therapies, particularly CBT, can relieve anxiety, night sweats and hot flashes (4). Your GP may be able to refer you for CBT on the NHS and there's a plethora of free, local talking therapies and stress reduction workshops available here.
Exercise has also been shown to alleviate some symptoms and improve a woman’s quality of life (5).
Smoking (6), caffeine and alcohol are adversely associated with menopausal symptoms so avoid these where you can. They place stress on the body and whilst they may give you a short term fix, they deplete your body of vital nutrients that it needs. You can relieve associated anxiety and stress with magnesium-rich green vegetables, wholegrains and nuts, as well as B vitamins found in meat, offal, fish, eggs, oats, brown rice and nutritional yeast.
There’s evidence that you’ll experience fewer menopausal symptoms the more vegetables and fruit you eat (7), so aim for at least 5 portions per day and focus on eating regular meals packed full of nutrition. Include whole foods (beans and legumes, fish particularly oily ones such as salmon, mackerel and sardines, poultry, nuts, seeds, olive oil, some wholegrains including brown rice, oats and quinoa, and a little red meat) to nourish your body, keep your blood sugars stable and balance your hormones.
Following a low glycaemic load or Mediterranean (8) diet could help keep your weight down. You’ll also find that as your fibre intake increases, you’ll feel fuller for longer, excrete troublesome excess hormones and feed your gut bacteria. The bacteria in your gut are fundamental to feeling healthier. They help you to obtain key nutrients from your food; support your immune system to keep you healthy; provide an environment where your feel good brain chemical, serotonin, is made; influence weight and even make vitamins.
Plant based oestrogens
You may find that increasing the amount of phytoestrogens in your daily diet reduces symptoms. These plant compounds have mild oestrogenic effects, displacing your own oestrogen if there’s too much or increasing activity if your levels are low (9). Soya is a good source of phytoestrogens with tofu, tempeh and edamame beans all being versatile ingredients, plus ground flaxseed and wholegrains.
Remember that sleep gives your body a chance to repair and rebuild itself. Additionally, poor sleep can create a heightened perception of your menopausal symptoms (10) so wind down with soothing Lemon Balm or Chamomile teas and top up levels of nature’s tranquiliser, magnesium, by adding a cupful of Epsom Salts to warm bath water and soaking for 20 minutes twice a week.
If you can’t switch off, talk to us abut how nutritional therapy could help.
"It's a marathon, not a sprint"
Above all, remember that this journey towards menopause can start in your forties and end, on average, around the age of 51. It’s a marathon, not a sprint, and whilst addressing your nutrition may not produce overnight results, the evidence points towards real improvements. Not everything here may work for you so talk to us about nutritional therapy based on your symptoms and aims. Also, talk to other women in the same shoes, share information, swap recipe ideas. For we know that talking to each other is important too.
1 Tan, M., et al. (2014). The effect of physical activity and body mass index on menopausal symptoms in Turkish women: a cross-sectional study in primary care. BMC Women's Health, 14(1).
2 Guthrie, N., et al. (2009). Duration of vasomotor symptoms in middle aged women, a longitudinal study. Menopause, 2009; 16(3), pp. 453-7.
3 Wardle, J., (2016).’ Menopause’ in Clinical Naturopathy - an evidence-based guide to practice (2nd ed.), Chatswood:Elsevier Australia, p. 474.
4 Norton, S., et al. (2014). Cognitive-behavior therapy for menopausal symptoms (hot flushes and night sweats). Menopause, 21(6), pp.574-578.
5 Elavsky, S. (2009). Physical activity, menopause, and quality of life. Menopause, 16(2), pp.265-271.
6 Whiteman, M., et al. (2003). Smoking, body mass, and hot flashes in midlife women. Obstetrics & Gynecology, 2003;101(2), pp.264–272.
7 Soleymani, M., et al. (2018). Dietary patterns and their association with menopausal symptoms. Menopause, e-pub ahead of print [online] Available at: https://www.ncbi.nlm.nih.gov/pubmed/30363011 (Accessed 4 February 2019).
8 Sayón-Orea, C., et al. (2015). Adherence to Mediterranean dietary pattern and menopausal symptoms in relation to overweight/obesity in Spanish perimenopausal and postmenopausal women. Menopause, 22(7), pp.750-757.
9 Rietjens, I., et al. (2016). The potential health effects of dietary phytoestrogens. British Journal of Pharmacology, 174(11), pp.1263-1280.
10 Larson, R. & Carter, J. (2016). Total sleep deprivation and pain perception during cold noxious stimuli in humans. Scandinavian Journal of Pain, 13(1), pp.12-16.
11 Türközü, D. & Şanlier, N. (2015). L-theanine, unique amino acid of tea, and its metabolism, health effects, and safety. Critical Reviews in Food Science and Nutrition, 57(8), pp.1681-1687.