Easing Through Menopause The Holistic Way
Menopause is a natural process that all people with periods will experience as they approach their later years. For some, it passes without too much trouble, while for many others, the transition to menopause can be a particularly tricky time in their lives. The symptoms, including hot flashes and brain fog, can be widespread and often debilitating, affecting physical and emotional health and consequentially, work, home life and relationships too. Because of this, it is incredibly important that people are supported through this phase. While Hormone Replacement Therapy (HRT) may be offered as a treatment, it does come with its own risk factors and side effects[i]; as such, people are becoming increasingly curious about managing their symptoms holistically.
Not all people with periods experience the same menopausal symptoms, or to the same level. In fact, research shows that symptom type and severity vary significantly across different cultures. For example, it is reported that around 75% of females in Western countries experience hot flashes, while this ailment only affects around 25% of those in Japan[1]. What is causing these vast differences? There are likely many factors at play, including social attitudes towards menopause, but we do know that the way in which we live our lives can have substantial effects. Let’s explore how lifestyle changes can support those going through menopause to reduce symptoms and transition to the next phase of life with ease…
Firstly, what is menopause?
Menopause, most commonly occurring between the age of 45 and 55, is the time at which menstrual bleeds (periods) end, officially defined as 12 months after the last bleed. The monthly menstrual cycle ceases and periods stop, fertility ends and pregnancy is no longer possible. Reproductive hormones, specifically oestrogen and progesterone, fluctuate throughout this time and eventually, decline and settle to a much lower baseline than pre-menopause. Often when we refer to menopause, we are actually talking about perimenopause – the phase in which the body transitions to menopause. Perimenopause can last from a few months to many years and while it is a natural biological process, symptoms can be and often are experienced. Common symptoms include night sweats, hot flashes, mood swings, anxiety, depression, irregular periods and brain fog; due to lowering hormone levels, joint and bone pains can also be experienced. Furthermore, menopause poses issues to long-term health, including increased risk of osteoporosis and heart disease.
How can we ease through menopause?
Several metabolic changes occur during menopause as a result of declining oestrogen levels. These include increased likelihood of fat gain (particularly around the waist), muscle loss, heightened blood pressure and blood sugar disturbances[2]. While these changes are to be expected, they are also all heavily influenced by the foods we eat. Therefore, for people already at increased risk of disease development, it is extra important to ensure they are eating a healthy, balanced diet to support health and wellbeing in later years. In fact, research demonstrates that women following a high-quality diet during perimenopause report less symptoms, of less severity, than those who did not, with one particular study finding hot flashes and sleep disturbances to be 30% less likely[3].
Ensuring daily protein needs are met is imperative, as it comprises the vast majority of the volume and mass of all tissues in the body. As muscle loss is common during this period, increasing protein intakes can help to counteract this effect, in turn supporting blood sugar regulation and reducing other negative metabolic changes, such as increased triglycerides levels associated with menopause. Furthermore, consuming enough protein is vital for bone health, helping to mitigate the risk of brittle bones, osteoporosis and fractures. Evidence suggests consuming approximately 1g protein per kg body weight daily can improve body fat mass and fat-to-lean ratio in post-menopausal women[4].
The gut and healthy fats
Improving the health of the gut should also be priority during the transition. Gut health is paramount to the health of the entire body, influencing blood sugar regulation, inflammation, nutrient absorption and more, all of which have direct links to the symptoms experienced in menopause. As such, eating a plant-rich diet, full of wholegrains, fruits, vegetables, legumes, nuts and seeds, is advisable, as it is rich in fibre. Eating adequate fibre boasts a plethora of benefits, including supporting healthy digestion, minimising blood glucose spikes, reducing cholesterol levels and improving the integrity of the gut lining. These effects may limit menopausal symptoms and help reduce associated disease risk[5].
Another key dietary component to consider is healthy fat. Fats not only provide energy and protect vital organs, but they are also required to aid the absorption of fat-soluble vitamins. Of particular importance in menopause is vitamin D; vitamin D helps the body to regulate its calcium levels, protecting bone health and reducing bone density loss, alongside supporting brain function which often declines during this time. Healthy fats, from eggs, fish, olive oil, nuts and seeds, also help to regulate inflammation, which is already heightened during menopause as a result of falling oestrogen levels.
Finally, regularly consuming soy products may be a useful dietary strategy to help alleviate symptoms. Soy products, such as tofu, edamame beans, tempeh and soy milk, contain phytoestrogens, which mimic the effects of oestrogen in the body. While results are inconsistent, several studies have shown a reduced number and severity of hot flashes in menopausal people when regularly consuming soy products[6]. The high consumption of these types of foods in Asian countries may explain why Japanese people report so few menopausal symptoms in comparison to the Western world. It has been suggested that it may take 2-3 months of daily consumption for the phytoestrogens to take effect[7].
Easing through the menopause – beyond food?
Beyond food, there are other things perimenopausal people can do to ease symptoms and stay happy and healthy. Firstly, engaging in regular weight-bearing exercise, such as weightlifting, yoga and walking, is advised to strengthen joints and prevent bone loss[8]. Caffeine and alcohol add additional stress to the body, and many people find they worsen hot flashes, so it may be useful to reduce or avoid intake during this time. Herbal supplements, such as horsetail, red clover and turmeric, may be considered to support the body’s systems and ease symptoms. Finally, emotional stress should be well-managed, as stress increases cortisol production which in turn can result in hormonal imbalances.
References
[1] Obermeyer, C.M. (2000) ‘Menopause across cultures: A review of the evidence’, Menopause, 7(3), pp. 184–192. doi:10.1097/00042192-200007030-00009.
[2] Bermingham, K.M. et al. (2022) ‘Menopause is associated with postprandial metabolism, metabolic health and lifestyle: The zoe predict study’, eBioMedicine, 85, p. 104303. doi:10.1016/j.ebiom.2022.104303.
[3] Staff, Z.E. (2023) Zoe Podcast – Menopause: Does Diet play a part?, ZOE Podcast – Menopause: Does Diet Play a Part? Available at: https://joinzoe.com/learn/podcast-menopause-role-of-diet (Accessed: 01 August 2023).
[4] Gregorio, L. et al. (2013) ‘Adequate dietary protein is associated with better physical performance among post-menopausal women 60–90 years’, The journal of nutrition, health & aging, 18(2), pp. 155–160. doi:10.1007/s12603-013-0391-2.
[5] Barnard, N.D. et al. (2021) ‘The women’s study for the alleviation of vasomotor symptoms (WAVS): A randomized, controlled trial of a plant-based diet and whole soybeans for postmenopausal women’, Menopause, 28(10), pp. 1150–1156. doi:10.1097/gme.0000000000001812.
[6] Abshirini, M., Omidian, M. and Kord-Varkaneh, H. (2020) ‘Effect of soy protein containing isoflavones on endothelial and vascular function in Postmenopausal women: A systematic review and meta-analysis of randomized controlled trials’, Menopause, 27(12), pp. 1425–1433. doi:10.1097/gme.0000000000001622.
[7] British Dietetic Association (2019) Menopause and Diet: Food Fact Sheet, Menopause and diet | British Dietetic Association (BDA). Available at: https://www.bda.uk.com/resource/menopause-diet.html#:~:text=foods%20containing%20plant%20oestrogens%20(such,day%20before%20opting%20for%20supplements. (Accessed: 01 August 2023).
[8] Mishra, N., Devanshi and Mishra, V. (2011) ‘Exercise beyond menopause: DOS and don′ts’, Journal of Mid-life Health, 2(2), p. 51. doi:10.4103/0976-7800.92524.
[i] Hormone Replacement Therapy (HRT) (no date) NHS choices. Available at: https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/ (Accessed: 01 August 2023).
