Why is it that some women appear to sail through the menopause, whilst others can suffer from a wide range of pretty unpleasant symptoms? Genetics certainly could be playing a part, but our genes are rarely 100% to blame.
If your symptoms are really getting you down, why not try some of the following diet and lifestyle changes before reaching for the HRT or resigning yourself to suffer in silence.
SO, WHAT EXACTLY IS THE MENOPAUSE?
The menopause marks the natural end of a woman’s reproductive years and is therefore a normal part of ageing. This gradual decline in fertility tends to happen over a period of years making menopause more of a process rather than a distinct point in time. Menopause itself is classed as officially having taken place once a woman has stopped her period completely for an entire year.
Women often start to notice changes in their menstrual cycle in their forties (although it can happen earlier) when they enter what is often referred to as the peri-menopausal phase. This tends to start with an increase in anovulatory cycles (where no egg is released), and often followed by increasingly irregular cycles, larger fluctuations in hormones and an increase in the symptoms commonly associated with menopause. Eventually, a women’s periods will stop altogether, usually in her fifties.
SYMPTOMS OF PERI-MENOPAUSE AND MENOPAUSE:
People often associate menopause with hot flushes, but symptoms can be quite wide ranging, affecting lots of different aspects of health and wellbeing. The following is not an exhaustive list, but includes some of the more common symptoms:
- Hot flushes
- Night sweats
- Changes in body composition, including a reduction in muscle mass and an increase in body fat
- Brain fog and difficulty concentrating
- Poor memory
- Low mood or depression
- Feeling tearful
- Unexplained fatigue
- Sore breasts
- Vaginal dryness
- Painful intercourse
- Stress incontinence
- Low sex drive
- Changes in skin and hair
- Increased risk of osteoporosis
Whilst many of these symptoms are driven by natural fluctuations in hormones, there are a number of diet and lifestyle factors which could be having a significant impact on the severity of symptoms, as well as overall health and wellbeing during this time.
HOW DIET AND LIFESTYLE COULD HELP
Eating a healthy balanced diet, getting enough sleep, reducing stress and exercising are usually advisable at any time in your life, but if you need a little extra motivation, here are a few good reasons to ramp these up during menopause:
DIET TIPS DURING MENOPAUSE
Aim to include some form of protein with every meal and snack
One of the reasons that protein is so vital during this stage of life is its role in preserving lean muscle mass, which tends to decline as you age. Protein also provides the amino acids required for the production of neurotransmitters which are vital for mood and sleep, and for making the transport molecules which are responsible for moving specific sex hormones around the body.
Another benefit of protein is that it tends to help you feel fuller for longer after eating, reducing the need for snacking between meals which can in turn help with weight management.
Examples of protein rich foods include meat, poultry, fish, seafood, eggs, cheese and yogurt, beans (including soy), chickpeas and lentils, nuts, seeds and quinoa.
Choose your carbohydrates wisely
Food and drinks containing sugar, and refined starches such as those found in things like white bread, rice, pasta and cakes can wreak havoc on your blood glucose levels, contributing to energy fluctuations, food cravings, anxiety, stress and weight gain. Moreover, eating meals that lead to spikes in blood glucose are often followed by a “crash” (low blood glucose or hypoglycaemia) a few hours later which may actually be a trigger for hot flushes[i].
In order to help keep blood glucose stable, when choosing carbohydrates opt for wholegrain options over white and limit sugar as much as possible. If you do fancy something sweet, have it at the end of a meal when you might be less likely to eat as much, plus the sugar should have less of an impact on blood glucose if you have just eaten a balanced meal.
Load up on fibre
Like protein fibre helps you feel fuller for longer, often helping you go longer between meals making it great for appetite control and weight management. Fibre also helps remove toxins from your body, including oestrogen metabolites. Oestrogen metabolites are created when the liver breaks down oestrogen after it has served it purpose in the body, and whilst it might feel counterintuitive get rid of oestrogen at a time when levels are naturally declining, you still need to support its safe removal from your body.
Include some omega 3 fats in your diet
These are found in particularly high levels in oily fish, but also in certain nuts and seeds. Some eggs are also fortified with omega 3. Omega 3 has been shown to be beneficial for low mood, anxiety and memory as well as healthy skin and joints. If you don’t eat fish, you might like to consider supplementing with omega 3 (there are vegan options available if preferred), just check with your GP or pharmacist first if you are taking any prescription medications.
Ensure your diet contains plenty of calcium, magnesium and vitamin D and K to help support healthy bones
A lot of people just think about calcium when it comes to bone health, but you also need to consider other micronutrients such as magnesium, vitamin D and vitamin K as these all work together alongside calcium to help maintain healthy bones. These nutrients are important throughout your life but are particularly relevant during menopause when bone loss is more common.
Calcium is best known for its role in healthy teeth and bones, but it is also needed for muscle contraction, nerve transmission, regulating heart rate, regulating cell division, activating insulin, blood clotting and much, much more.
Traditionally people tend to think of dairy as the best source of calcium, but it is by no means the only one. Other calcium rich foods include fortified dairy alternatives (such as milk, cheese and yogurts), almonds, broccoli and other green leafy vegetables, egg yolks, dried figs, sardines (with the bones in), soybeans, turnips, sesame seeds and molasses.
Magnesium is necessary for hundreds of different processes in the body, including maintaining healthy bones, having a supportive role in energy production and helping you to relax both physically and mentally. Magnesium also plays a role in the safe removal of oestrogen from the body.
Good dietary sources of magnesium include, avocados, legumes (beans, chickpeas and lentils), nuts and seeds, tofu, oily fish, green leafy vegetables, bananas and cocoa powder (and therefore dark chocolate!).
Whilst you can get some vitamin D from your diet (oily fish is probably the best food source), a lot of people in the UK are actually low in this vital nutrient due to a combination of the lack of sunshine for much of the year and the fact that most of us spend a lot of time indoors. This could be bad news for your bone health, plus low vitamin D has also been linked to a whole host of health conditions so it might be worth asking your GP to test your levels. If low, you might be advised to start taking a vitamin D supplement.[ii] As before, if you are considering supplementation, always check with your GP or pharmacist first if you are taking any prescription medications.
Vitamin K is probably best known for its role in blood clotting,, but it is also a key nutrient in bone health as it helps transport calcium into the bones[iii].
Good dietary source of vitamin K include asparagus, broccoli, cabbage, kale, kelp, eggs, soybeans, oats and liver.
Caffeine is a stimulant and can increase feelings of anxiety and stress as well as potentially contributing to fluctuations in blood sugar (remember those hot flushes). Caffeine can also keep you awake at night.
If you are struggling to sleep, consider cutting back on overall consumption and limit caffeinated drinks to the first half of the day to lessen its impact on sleep.
Go easy on the alcohol
Whilst it may be tempting to have a glass or two of wine when you are feeling stressed, anxious or generally a bit fed up, it can have a negative impact on both physical and mental wellbeing, and more importantly the safe removal of oestrogen from your body. This last point is particularly important because anything that reduces your body’s ability to safely break down and remove oestrogen can potentially increase your risk of oestrogen sensitive diseases such as breast cancer, both during and after menopause.
GETTING ENOUGH SLEEP
Getting enough sleep is easier said than done sometimes (with or without menopause) however did you know nocturnal hypoglycaemia (low blood glucose at night) is a relatively common causes of insomnia? It is a significant consideration for diabetics[iv], but diabetic or not, if you have a tendency towards low blood glucose between meals this could be relevant for you as well. Low blood glucose can actually stimulate the release of adrenaline which could either keep you awake or, if you are already asleep, wake you up again. Nocturnal hypoglycaemia may also be a trigger for night sweats[v].
Eating a low GL diet, so one that is low in refined starches and sugars, can help to stabilise your blood glucose during the night which in turn could help you get a better night’s sleep.
Two other factors which might be contributing to both insomnia and night sweats could be alcohol (for a whole host of reasons) and intense physical exercise later in the evening, which can potentially both raise stress hormones and contribute to nocturnal hypoglycaemia.
There are lots of great reasons to exercise during menopause, including:
- Maintaining bone health – exercise can slow the rate of bone loss after menopause and reduces the risk of fractures and osteoporosis[vi]
- Preventing weight gain and associated disease risks. Where aerobic exercise can help to burn additional calories and resistance exercise helps to maintain muscle mass, which in turn helps maintain your metabolic rate. Achieving a healthy weight can also help to reduce your risk of certain types of cancer, cardiovascular disease and Type 2 diabetes.
- Boosting your mood – physical activity has been linked a reduced risk of anxiety[vii] and depression[viii]
Being stressed increases the production of the stress hormones adrenaline and cortisol which can have far reaching effects on both health and wellbeing – impacting on blood glucose, body composition, mood, sleep and even your immune system’s ability to fight infection. Moreover, your adrenal glands play a key role in the production of your sex hormones after menopause, so supporting adrenal health could potentially have a positive effect on the levels of these hormones in the longer term.
Whilst we can’t always remove stress from our lives (although practicing saying “no” more often might be helpful) we can take little breaks from it throughout the day by building in time to relax. Relaxation shouldn’t just be something you do once a week at a yoga class, it needs to be built into your routine every day. Find things you enjoy such as reading, listening to music, spending time chatting to friends, going for a walk or practicing breathing exercises or meditation and put them at the top of your to do list.
A PERSONALISED APPROACH WITH NUTRITIONAL THERAPY
If you are already incorporating most of above into your life but still struggling with symptoms, or if you are worried about certain health risks associated with menopause and beyond, you may benefit from a more personalised nutrition and lifestyle programme. As a nutritional therapist I offer personalised advice on diet and lifestyle as well as guidance on the safety and effectiveness of certain nutritional supplements which can sometimes be beneficial during menopause.
To learn more please get in touch to arrange a free 20-minute chat to see if this is something you would like to pursue.
Please note, this article should not be seen as a replacement for medical advice. Should you have any concerns about your health, please always speak to your GP.
[i] Serber SL, Rinsky B, Kumar R, Macey PM, Fonarow GC, Harper RM. Cerebral Blood Flow Velocity and Vasomotor Reactivity During Autonomic Challenges in Heart Failure. Nurs Res [Internet]. 2014 [cited 2019 Jul 15];63(3):194–202. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00006199-201405000-00006
[iii] Weber P. Vitamin K and bone health. Nutrition [Internet]. 2001 Oct [cited 2019 Jul 17];17(10):880–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11684396
[vii] Anderson E, Shivakumar G. Effects of exercise and physical activity on anxiety. Front psychiatry [Internet]. 2013 [cited 2019 Jul 17];4:27. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23630504