Whilst I believe that age is a mindset, our biological clock is a different story… Our diets matter in all life stages and our diet for the menopause is no different.
Before delving into diet and the menopause lets first define what we mean when we describe the menopause.
What exactly is the menopause?
Women are born with a finite number of eggs which are stored in our ovaries. The ovaries are also where the hormones, oestrogen and progesterone, are made which control menstruation and ovulation throughout our fertile life. Menopause occurs when the ovaries stop releasing eggs every month and thus periods stop… whilst this might sound appealing, menopause brings with it a whole host of other challenges. Oh the joys of womanhood!
Sadly, the menopause isn’t talked about nearly enough even though half the population are destined for it and roughly 85% of women will experience menopause symptoms to some degree (hot flushes, mood changes and night sweats to name a few).
It’s good to know that there are lots of treatment options for menopause symptoms, from lifestyle changes to medication including Hormone Replacement Therapy (HRT). In particular, what we eat can really help with the menopause transition.
Have you ever wondered what to eat for the menopause? Or what foods could help with symptoms like hot flushes? Read on as we explore all things diet and menopause.
What are the stages of the menopause and when will it happen to me?
Let’s define the three stages of menopause:
- Perimenopause: a.k.a. the ‘menopausal transition’, or what women mean when they say they’re ‘going through’ the menopause. During perimenopause, there is a chaotic fluctuation in reproductive hormones, like oestrogen, as the ovaries prepare to stop releasing eggs. Periods become irregular and women can experience other menopausal symptoms like hot flushes, night sweats, insomnia, weight gain, low mood and irritability. Perimenopause begins at around 45 years of age, and lasts on average for 4 years, although some women may be in this transition phase for only a few months, or more than 4 years.
- Menopause: by definition, menopause occurs after 12 months of having no period (for no other medical reason other than reaching the age of menopause). The ovaries stop producing eggs entirely, and oestrogen levels reduce significantly. In the UK, the average age for natural menopause is 51 years.
- Post menopause: this stage follows the menopause, and menopausal symptoms often reduce during this stage, but more hidden effects on the body are happening like bone density loss, risk of fracture and cardiovascular disease.
What are the symptoms of the menopause?
There are a broad range of menopausal symptoms, which affect women very differently but most experience at least one of the following symptoms:
- Hot flushes
- Night sweats
- Weight gain
- Vaginal dryness or discomfort during sex
- Sleep disturbances
- Mood changes such as depression, anxiety and loss of sense of self
When you start noticing these symptoms, it’s important you make note of them so that you can approach your GP or health professional with an accurate record of what’s been happening. The Balance app created by a renowned menopause specialist, Dr Louise Newson, allows you to track your symptoms and download a health report which I’d recommend as a good place to start.
What to eat for menopause?
Our diet can really help with easing the menopause transition. There are a number of dietary factors to consider, to protect our bones, our heart health, and help with menopause symptoms. Before we dive in, it’s important to remember that there’s no ‘one-size-fits-all’ policy to any dietary regimen and that no diet is healthier than having a good relationship with food so keep this in mind before implementing any dietary changes to your regime.
In this ‘eat for menopause’ series we’re going to explore:
- What does a menopause-friendly diet look like?
- What to eat for bone health
- What to eat for heart health
- What are phytoestrogens and do they help with menopause?
- Foods to ease menopause symptoms
What does a menopause-friendly diet look like?
Broadly speaking, there is evidence that a whole-foods diet high in fruits and vegetables, whole grains, high-quality protein and dairy products can help with reducing menopause symptoms. Phytoestrogens and healthy fats, such as omega-3 fatty acids from fish, may also help.
These dietary principles summarise the Mediterranean Diet, which is a way of eating based on the traditional cuisines of Greece, Italy and other countries that border the Mediterranean Sea. So, if you want a quick answer for what diet is best for menopause… the Mediterranean Diet is the one!
Another key consideration for any diet is controlling our blood sugar and this is particularly important during the menopause. You might have heard of the importance of blood sugar regulation for maintaining our energy levels throughout the day. During menopause, changes in the hormones oestrogen and progesterone affect how cells respond to insulin (the hormone which regulates blood glucose). This can trigger fluctuations in blood sugar levels which affects our energy levels and feelings of hunger. Tips for maintaining blood sugar levels include eating regular balanced meals with gaps in-between them, limiting grazing/snacking throughout the day and increasing protein and fibre intake. Foods with a low glycaemic index such as wholegrain foods, non-starchy vegetables, beans and pulses, are really good choices for our blood sugar.
Foods for bone health in menopause
The rate of bone mineral density loss increases during menopause due to the decline in oestrogen levels. One in three postmenopausal women have osteoporosis, meaning a loss of bone mass, which increases fracture risk. To maintain bone strength and help prevent osteoporosis, try to incorporate the following nutrients in your diet:
Public Health England (PHE) recommends a daily intake of calcium for adults 19-64 years to be 700mg. Good dietary sources of calcium include dairy, dark leafy greens, calcium-set tofu, sardines (or other fish eaten with bones), fortified plant-based drinks and dried figs.
Vitamin D helps our body to absorb calcium and adults should be getting 10 micrograms (µg) of the stuff every day. It is produced in our skin when we are exposed to UV radiation from the sun. During the summer months in the UK we should get enough sun exposure to make vitamin D and meet our needs. However, for the rest of the year we can’t rely on the sun, so we need to ensure that we are consuming it through out diets. Dietary sources of vitamin D include:
• Oily fish
• Red meat
• Fortified foods (some cereals and dairy products)
However, as these dietary sources of vitamin D are limited, PHE recommend that everyone in the UK should take a 10µg vitamin D supplement every day at least during the winter months, and since the COVID pandemic, PHE now recommend that everyone take a vitamin D supplement in the summer months as well.
Foods for heart health in menopause
Post-menopausal women have an increased risk of cardiovascular disease, as oestrogen plays a role in maintaining our arteries and healthy cholesterol levels. Lower oestrogen levels also impact body composition, meaning fat is more likely to go to the tummy. Carrying more fat on the tummy is associated with heart disease risk factors. With this increased risk it’s important to maintain a diet that lowers the risk.
Some important principles of a heart healthy diet include:
• Reducing salt intake- daily salt intake should be less than 6g, try opting for unsalted nuts for example and reducing salt in cooking.
• Replace saturated fats with unsaturated fats like substituting butter for olive oil.
• Increase your fibre intake, choosing wholegrain alternatives like brown bread, pasta and rice, eating your 5-a-day, and including beans and pulses.
• Eating fish twice a week, especially oily fish (such as salmon, sardines and mackerel)
Other lifestyle factors that are important for heart health include avoiding smoking, exercising regularly, getting good quality sleep and limiting alcohol intake.
What are phytoestrogens and do they help with menopause?
Don’t be put off by the name! Phytoestrogens are just plant compounds with oestrogen-like properties. There are two main types: isoflavones which are found in soybeans, and lignans which are found in flaxseeds, whole grains, fruits, vegetables and legumes. Due to their chemical structure, when oestrogen levels are low (i.e. during menopause and post-menopause), these compounds can bind to oestrogen receptors and people may experience a mild oestrogenic effect such as less severe hot flushes.
Most of the research on these compounds for the menopause focuses on isoflavones found in soya-based foods. Although the research is mixed, there do seem to be benefits through eating around 50 milligrams of isoflavones daily to reduce frequency and severity of hot flushes. You’ll get this from just 2 servings of soya-based foods (like tofu, tempeh and soya milk).
Combining phytoestrogens as part of diet rich in plant-based foods seems to be provide the most benefit. In this study, 86g cooked soyabeans were consumed and hot flushes decreased by 79%.
It can take 2-3 months for the benefits of plant oestrogens to be seen and the effects can vary between individuals.
What about breast cancer risk and phytoestrogens?
You may have heard of soya linked to breast cancer risk. This is because some breast cancers are oestrogen-dependent. However, it has been concluded that isoflavones are chemically different to oestrogen and soya products are safe to eat as part of a healthy balanced diet without increased breast cancer risk.
So overall there is no harm in including sources of phytoestrogens in your diet particularly as these foods are also good sources of fibre, protein, vitamins and minerals and for some women they make a big impact.
One thing to note is being careful of added salts, sugars, and fats in some soya-based foods (like some soya-based meat alternatives).
We’ll delve into all these areas in more detail over the coming weeks and months, but for now I hope you find this overview on diet and the menopause helpful.
For more tips, you can download my free video guide to boosting energy in the menopause by signing up to join my community.