The menopause is a natural process, diagnosed when there is an absence of a menstrual period for 12 months and no other biological or physiological cause can be identified. Menopause usually occurs between 45 and 55 years of age. The hormonal changes, in particular fluctuations and a decline of the sex hormones progesterone, oestrogen and testosterone, can result in symptoms which can last for several years up to and including the menopause.
What are the symptoms and effects on the body?
Up to 80 percent of women will experience symptoms such as depression, anxiety, poor memory and concentration, fatigue, insomnia, and hot flushes. Around 25 percent of women will experience such bad menopausal symptoms that their quality of life is affected.
A reduction in sex hormones, especially oestrogen results in lowered bone strength which is one of the biggest risk factors for osteoporosis, and an increased risk of heart disease. Weight gain is a common problem at this time, in particular with hormonal changes affecting appetite and increasing fat storage, and also the natural reduction in muscle mass with aging, and reduced activity playing a role.
Stress on our bodies such as from our diet, emotional stress, and not getting enough exercise, relaxation or quality sleep can impact on our hormones and wellbeing. As well as other lifestyle changes, a healthy diet can help to reduce stress and manage the symptoms of the menopause.
Which foods should I reduce or avoid?
Some foods or drinks exacerbate menopausal symptoms, so avoiding or cutting them down can help. These include alcohol, refined sugars, processed food, caffeine, saturated fat, spicy foods and foods high in salt. Sugar in particular can play havoc on symptoms such as sleep problems, hot flushes, mood swings, weight and energy levels.
How can diet help with my symptoms?
Complex carbohydrates or slow release carbohydrates take longer to digest than simple sugars, and give sustained energy. They help to lower cholesterol and aid in achieving a healthy weight. They are packed with fibre which helps to maintain gut health, and to remove toxins and waste. Complex carbohydrates can be found in wholegrains such as brown rice, quinoa, brown bread and pasta, and vegetables, legumes such as black beans, chickpeas and lentils, nuts and seeds.
Eat healthy fats daily. These contain omega 3 which is an essential nutrient that our body cannot produce, so comes from diet alone, Healthy fats are needed to produce hormones as well as maintain hormone function, and have been shown to reduce inflammation, improve skin, brain function, stabilise blood sugar and improve joint health. Great sources of healthy fats are nuts and seeds, avocados, olive oil, and oily fish such as salmon or mackerel.
Have a good quality protein with each meal from good quality meat or fish, nuts and seeds, dairy and legumes. Protein is needed to make hormones, and is important to help build muscle, bones, cartilage, skin and blood, and can help balance blood sugar levels. All of these are particularly important around the time of menopause!
Keep well hydrated! Dehydration symptoms can occur with the loss of just 2% of your body’s usual water volume, and can leave you feeling lethargic, with poor concentration and mood, and may affect your skin and digestion.
Eat regular meals. This can help to keep your blood sugar levels stable, boost metabolism, maintain energy, prevent hunger and help to maintain a healthier diet.
Have a wide variety of different coloured vegetables. Vegetables contain different nutrients including vitamins and minerals. Cruciferous vegetables including broccoli, cabbage, sprouts and kale can help to support oestrogen balance and reduce inflammation.
Which vitamins and minerals are important at the time of menopause?
Vitamin D and Calcium help to support strong bones and teeth. It is important to protect bone strength at the time of menopause when there is an increased risk of osteoporosis. Many women do not have adequate calcium from their diet normally and even more so during menopause. Low levels of calcium can contribute to anxiety, mood swings and stress. Vitamin D helps to regulate the movement of calcium in and out of our bones. It is largely sourced from sunlight which converts it into its active form, but can also be found in dietary sources such as oily fish, eggs and red meat. Good calcium sources are in dairy foods, nuts, cabbage and kale. Public Health England recommend that all adults take a Vitamin D supplement, and if you are not outside enough or eating the right foods, this is even more important.
Iron helps with energy and bone strength, and is essential for the production of red blood cells which transport oxygen around the body. Red meat, chicken, pork and egg yolks are all good sources of Iron, so those on vegan and plant-based diets, and women who are menstruating are particularly prone to low iron levels.
Magnesium is a vital nutrient for menopause! It is needed for adequate hormone production including progesterone, oestrogen and testosterone, and it helps to regulate cortisol, the stress hormone. Magnesium also helps to relieve premenstrual symptoms including bloating, irritability, mood swings and anxiety, and having sufficient levels can also contribute to better sleep. It also plays a critical role in maintaining bone density. Good sources include dark leafy greens, seeds, nuts, black beans, chickpeas, wholegrains, peas, cabbage, and green beans.
B Vitamins have a wide range of benefits during the menopause, including playing a key role in managing stress, boosting energy and mood and protecting cognitive functions such as memory. In particular Vitamin B12 is required for bone strength and memory and creating red blood cells, and Vitamin B6 helps to make serotonin which fluctuates during menopause, and can contribute to mood swings and anxiety. As you age, your body loses some of its ability to absorb Vitamin B12, so it is commonly taken as a supplement. B Vitamins work in harmony together so a good intake of all B Vitamins is important. Good food sources include good quality meat, fish, eggs, wholegrains, fresh fruit and vegetables.
Vitamin C is a powerful antioxidant and is important for the function of our immune system, and easing stress, and is essential during the menopause for a variety of reasons. It is vital for the production of collagen, a protein which gives your skin its smoothness, volume and tautness. Collagen is also required for production of connective tissue in our joints and ligaments, and helps to support the pelvic floor. Studies have shown that women can lose up to 30 percent of their collagen in the first 5 years of menopause. Vitamin C also helps to control histamine levels and may help to reduce itchy skin which is a common menopause symptom. It is also needed for the absorption of iron, and helps to keep blood vessels strong and healthy which improves circulation. The best sources of Vitamin C include yellow and red peppers, kale broccoli and berries.
Vitamin E is another powerful antioxidant that can help to ease stress, and may help to lower inflammation in the body and reduce your risk of depression, as well as provide protection for your heart and brain. Studies have suggested that Vitamin E may also help with hot flushes. Good sources of Vitamin E include nuts, avocado, broccoli, shellfish, butternut squash and spinach.
Zinc is an important mineral that your body requires for the activity of over 300 enzymes. It is needed to support our immune system and is also helps with production of sex hormones in particular testosterone, which is often low in women at menopause. When testosterone is low it can lead to loss of confidence, low mood, low libido and loss of muscle mass. Good sources of Zinc include meat, shellfish, legumes, nuts, seeds, wholegrains and dairy.
Dr Katherine Hodgkinson, Hampshire Health & Hormones