Mood swings. Weight gain. Waking up to sweat-soaked pyjamas and bedsheets. Your body suddenly doing a lot of stuff you don’t recognise. Menopause can be a weird, uncomfortable and downright scary time for many women. If you are a woman (or if you coach women), understanding what’s changing during menopause, why it’s happening, how to deal with it and what food to eat can make the whole process a lot less confusing, uncomfortable and frustrating.
What is menopause?
Think back to puberty. The whole process took quite a few years and so do the changes related to the menopause. A woman’s transition to menopause usually involves a transition through perimenopause first. Typically, perimenopause begins in a woman’s 40’s and the menopause can happen anytime between a woman’s 40’s and 60’s. Officially, menopause occurs when a woman hasn’t had a period for 12 months in a row. In the UK, the average age for this to happen is 51 years.
What happening to your hormones?
Naturally with aging, our hormonal profile changes. As the menopause nears, the ovaries decrease the production of two main female sex hormones, oestrogen and progesterone.
As ovarian hormone production declines, sex hormones are secreted by body fat and other organs such as the adrenal glands however overall levels of these hormones are much lower. With this decrease in hormonal levels, changes to a women’s menstrual cycle (period) begin to happen. Firstly, it can become irregular and then it eventually stops. Many women go through this change feeling fine, both physically and psychologically however some women experience many physical changes that also happens as their body adapts to different levels of hormones. Some of the symptoms include the following;
- Loss of the menstrual cycle
- Hot flashes and night sweats
- Cardiovascular disease
- Osteoporosis
- Emotional changes
- Vaginal dryness/infections
- Incontinence/urinary tract infections
- Decline in sex drive
- Insomnia
How to deal with menopause
Menopause is a naturally occurring event and many women do not require any treatment at all however some women may need more support. Your GP or menopause specialist can treat menopausal symptoms with hormone replacement therapy (HRT). These hormones can be administered by pills, creams, skin patches, skin gels or implants., A talking therapy such as Cognitive behavioural therapy (CBT) can be used to help women dealing with low mood and anxiety. Eating a healthy and balanced diet and exercising regularly can also improve some menopausal symptoms. The key when going through the menopause is to not go it alone. Ask for help. Build a strong support network that includes heath care experts, counsellors, other women, family and friends.
Which foods in particular play a role?
While all the interactions of our reproductive systems are far too complex to predict, one thing is clear: The hormonal phenomena and experience of the menopause is strongly affected by other factors such as stress levels, level of activity, alcohol intake and dietary intake.
Early research looking into the role of nutrition in the menopause were from observations made when looking at dietary patterns of Asian women in comparison to Western women and the correlation with the incidence of hot flushes. In one study it was found that only 25% of Japanese women experience hot flashes vs. 85% of North American women. Although there are probably many factors involved such as genetics, other dietary factors such as fish/seafood consumption or the variation may also be due to the difference in the consumption of soy are also thought to play a role. Soy contains plant-based oestrogens called phytoestrogens. Phytoestrogens are very similar to human oestrogen. Dietary surveys shows that women in the west consume less than 3 mg of isoflavones per day, while women in Eastern Asia consume between 20 and 80 mg/day.
More recent studies show that an intake of 50- 100mg/ day of isoflavones from food could relieve hot flushes by 20.6% and severity by 26.2%. However, it’s worth knowing the following:
- Consuming plant oestrogens several times a day appears to be more effective compared to one larger dose
- It can take two or three months for benefits of plant oestrogens to be seen
- They seem to work better for some women than others which maybe down to differences in gut bacteria
- It’s best to get isoflavones from food rather than supplements. Isoflavone supplements might interfere with thyroid function and inhibit mineral absorption, so stick with whole food sources
- Not all soya foods contain isoflavones. Processing removes 80-90% of isoflavones (i.e. isolated soya protein)
Menopause foundations to good nutrition. The five steps
- Tap into plant power: Experts all over the world agree that perimenopausal and menopausal women should eat more vegetables and fruits, wholegrains, beans and pulses as well as nuts and seeds. There are many reasons for that. Firstly, there is strong research showing that areas where women consume more plants, less animal protein and less saturated fat have fewer and less intense perimenopausal symptoms, including hot flashes and weight gain. Plants based foods are also high in fibre which is key for your gut bacteria. The microbiome is a key lever in the body’s estrogen levels. Certain bacteria that produce an enzyme called beta-glucuronidase can either increase or decrease estrogen levels. Higher estrogen levels mean a later onset of menopause but also lower levels of diabetes and common cancers like breast or endometrial cancer. One of the most effective ways to support the gut bacteria is by consuming more fiber. Recommendations are that you have 30g of fibre per day, however clinical practice shows me that perimenopausal women should be aiming for about 35-50grams of fiber per day to promote the good bacteria in your gut and cut back on the bloat.
- Focus on balance. With fluctuating hormones, balance is the name of the game. Particularly balance of your blood sugar levels. At the centre of good nutritional habits to help women manage their weight, stabilise mood and controlling hot flushes is good blood glucose control. We need a certain amount of glucose/sugar in the blood at all times but having too much or too little in the blood is stressful to body. Stress may cause your blood sugar levels to become more unbalanced so the food choices can have a big impact. Refined sugar for starters (think biscuits cakes, many breakfast cereals, white pasta, white rice and alcohol) are not good for blood glucose levels as they create the perfect storm for a hormone roller-coaster. Protein is broken down slowly which means it releases its energy slowly and when eaten with carbohydrate it also slows carbohydrate absorption. Eating protein with each meal or snack will therefore sustain you longer by reducing fluctuations in your blood sugar levels.
- Don’t cut out carbs. Eat the right ones. Wholegrains, beans and lentils are a great carbohydrate choice during menopause. Why? The combo of high fibre and protein help to keep blood sugar levels stable after meals and snacks which provides a nice buffer to those blood sugar levels. In addition, they contain some phytoestrogens. If eaten regularly and in sufficient quantities, they can start to have oestrogen-like effects which is useful as oestrogen levels decline. Legumes are also rich in B-vitamins including folate, B6 which serve as cofactors for enzymes involved with oestrogen metabolism. They also contain zinc which can help to prevent dry skin a common complaint of women in perimenopause.
- Flaxseed on everything. Lignans are naturally occurring in plant foods like fruit and vegetables, wholegrains, nuts and seeds. However, the lignan content of flaxseeds in almost 100 times higher than any other food. The lignans are concentrated in the outer shell of the flaxseeds; grinding them, therefore, enables you to absorb the lignans better. Research shows that 40g of flaxseed a day may alleviate hot flushes for some women and has a positive impact on vaginal atrophy for other women. It’s also been linked to positive cardiovascular health.
- Speak to an expert. Every woman’s experience is unique. If you want to optimally manage your symptoms and are considering supplementation then it is recommended that you seek help from a dietitian or registered dietitian who specialising in hormone health.
