(by Ben Semmens, Head of Nutrition at 13 Seeds) 

What is menopause?

The word “menopause” refers to the end of female’s reproductive life. Most woman will experience natural menopause between the ages of 45-55 due to the reduced production of hormones that include oestrogen, progesterone, and testosterone in a woman’s ovaries. These diminishing hormones in the ovaries prevents the growth of uterus tissue resulting in no shedding of uterus (aka a woman’s period)(1).

What are symptoms of menopause?

• Irregular periods
• Vaginal dryness
• Hot flushes/ Night sweats/chills
• Sleep disturbance
• Mood swings
• Weight gain
• Thinning hair and dry skin
• Loss of breast fullness
• Painful sex
• Loss of muscle mass/strength
• Joint pain
• Heart palpitations
• Reduced libido

 

What is peri-menopause?

“Peri-menopause” refers to the time leading up to menopause when a woman may start to experience changes in her menstrual cycle that include irregular periods, changes in flow, shorter or longer cycles. Other symptoms may also include hot flushes, night sweats, aches and pains, fatigue, irritability as well as premenstrual symptoms such as sore breasts (1).

 

Complications associated with menopause

Other health complications may arise as a result of menopause. This is believed to due to reduced oestrogen in the body and may lead to:

• Osteoporosis
  • A condition that causes your bones to become brittle and weak that can result in increased fractures. Loss of bone density can occur after menopause due to oestrogens role in bone health. (2) 

• Heart disease (cardiovascular disease)
  • Loss of oestrogen in the body can lead to increased risk of heart disease, as oestrogen is considered to be protective for the heart. Heart disease is the leading cause of death in women and men as well! (3) 

• Weight gain
  • After menopause your metabolism can slow down, and this can result in weight gain (4)

• Breast cancer
  • As women age, the fat cells in their breasts tend to produce greater and greater amounts of aromatase (enzyme) that promotes the production of oestrogen. Consequently, with age, the levels of oestrogen present in women's breasts increases. This locally produced oestrogen plays a role in both the development and growth of breast cancer in postmenopausal women (5).
    
    

10 tips to help you manage menopause naturally!

1. Phytoestrogens

Phytoestrogens are compounds found in certain plant foods that can have both oestrogen-like and anti-oestrogen-like effects in the body. Phytoestrogens can be found in high amounts in flaxseeds, soy products (tofu, tempeh), sesame seeds, kidney beans, chickpeas, lentils, and oats. Whether or not phytoestrogens can help in the management of menopausal symptoms is still unclear based on the current research, this is due to difficulty of studying a single compound as foods contain many!

Based on the fact that hormone replacement therapy (HRT) may not be as effective as once thought (and may even increase the risk of breast cancer) and the promising effects that phytoestrogens have on menopause-related conditions such as improving bone mineral density, including these foods may be a possible natural approach in supporting menopausal symptoms (6).

What’s even more fascinating is that phytoestrogens may help ease the symptoms of low oestrogen when oestrogen is low, however this only occurs in approximately one in three women. This is because only about a third of the population has the specific gut bacteria that can metabolise the isoflavones (a type of phytoestrogen) in soy to a more potent phytoestrogen called equol. The amount of isoflavones needed daily to achieve therapeutic effects is contained in about 200g of tofu, or 100g of tempeh (7)

2. Calcium & Vitamin D

Bone mineral density loss (the amount of bone minerals in bone tissue) can occur during menopause as a result of low oestrogen and lead to complications such as osteoporosis. Increased calcium and vitamin D in the diet are required to offset these loses (due to their role in bone health). Both calcium and vitamin D play a crucial role in bone development and metabolism. Increasing your consumption of dairy products, green leafy vegetables (eg. kale and spinach), soy products, and oily fish can help to provide the calcium necessary to continue to support bone health during menopause (8).

Vitamin D combined with calcium can not only help to enhance calcium absorption in the body, but can also improve muscle health, and further support bone health to help prevent osteoporosis. Vitamin D is difficult to obtain from food (approx. only 5-10%) so therefore must be obtained through UV exposure from the sun. Aim for minimum one hour in the sun daily. If you live in an area of poor sunlight it might be best to get your vitamin D levels tested at the doctors (9).

3. Essential fatty acids

Fats are required in the diet to help produce cholesterol that has a role in hormone production. Essential fatty acids include both omega 3 and omega 6 fatty acids that have a role in reducing inflammation, supporting brain chemical (neurotransmitter) function, and have a role in supporting heart health.

During menopause one of the most common symptoms are vasomotor (eg. night sweats, hot flashes), depression and anxiety. Considering the role that these essential fatty acids have not only on brain health, but their ability to improve heart health markers may make the consumption of these fats a simple addition to the diet to help manage symptoms of menopause. Aim to eat wild caught oily fish (eg. salmon/sardines) twice a week or alternatively consume plant-based sources daily such as hemp seed oil, flaxseed oil, and chia seeds (10) (11).

4. Probiotics

There is some evidence to suggest that probiotics may provide a beneficial role in protecting vaginal health. A healthy vagina typically contains lactobacilli (a type or bacteria) that help to protect against disease causing organisms (pathogens). The disruption of the vaginal microbiome (bacterial environment) correlates with vaginal symptoms of menopause.

Furthermore, the combination of a decline in oestrogen and loss of vaginal tissue leads to the depletion of lactobacilli and a rise in vaginal pH (acidity) that creates for the perfect environment for bacteria to colonise the vagina and cause infection of the vagina (eg. UTI). Increase your consumption of sauerkraut, kimchi, kombucha, kefir and yoghurt or Speak to your health professional or pharmacist about finding a probiotic that is right for you (12).

5. Antioxidants

High intakes of fruits and vegetables can delay the onset of menopause and prolong the reproductive lifespan because of the presence of antioxidants in fruits and vegetables that counteracts the adverse effects of pro-oxidants (damage causing cells). Some antioxidants include vitamin A, C, and E and can be found in large amount in bright coloured fruits and vegetables (13).

Furthermore, vitamin A helps to support the production of mucous membranes (eg. vaginal tissue) that may be compromised from lack of growth due to low oestrogen during menopause. Supplementing with individual antioxidants may actually cause more harm than good. Therefor it’s best to get antioxidants from foods – simply increase your intake of bright coloured fresh fruits and vegetables, nuts, whole grains and seeds (14).

6. Dietary Fibre

Fibre is the indigestible parts of plant foods, such as vegetables, fruits, grains, beans and legumes. It is type of a carbohydrate that helps keep our digestive system healthy. Dietary fibre has shown to reduce cholesterol (a marker of heart disease) in menopausal women. While dietary fibre and breast cancer still needs more evidence, high fibre intakes/low animal fat intake has shown to improve survival rates in post-menopausal women diagnosed with breast cancer. To increase your intake of dietary fibre increase your consumption of vegetables, fruits, whole grains, beans, and legumes. (15).

7. B vitamins

B vitamins are essential for the production of brain chemicals, heart health and energy production and should be a regular constituent in the diet. Menopause can commonly affect a woman’s mood, sleep quality, heart health and cause fatigue. B vitamins may help to reduce homocysteine (amino acid) that is an indicated to be marker of heart disease. As oestrogen loss increases risk of heart disease, getting enough B vitamins is important to help minimise the risk of heart complications. The easiest way to get B vitamins in the diet is to increase your consumption of green leafy vegetables (eg. kale, spinach), nuts, and seeds in your diet (16).  

8. Get rid of the bad stuff!

There are foods/drinks in the diet that may actually exacerbate symptoms of menopause. Excessive caffeine intake (>300 mg/d) can accelerate bone loses in women. Keep in mind that the average coffee contains approx. 100mg of caffeine so would need to be drinking at least 3 cups or more to start to have an effect (17).

And of course the usual suspects should be avoided as much as possible such as refined sugars and carbohydrates, saturated, trans and hydrogenated fats, and processed foods to minimise risk of other health complications (18). Spicy foods may also cause an increase in hot flashes and should be consumed with caution.

9. Exercise!

Physical activity is essential during menopause as it has many benefits that includes weight maintenance, strengthens bones, increased muscle mass and reduces the risk of other diseases such as cancer, diabetes, heart disease. Keeping in a healthy weight range is one the best things you can do to help manage menopause. Exercise intervention programs have demonstrated to reduce menopause symptoms, including bodily symptoms, psychological symptoms and to a lesser extent vasomotor (night sweats, hot flashes, and flushes) and sexual symptoms.

Exercise has not been proven to treat menopausal symptoms, however, physically active women during and after menopause are less stressed and have better overall quality of life. Overall, the evidence suggests that exercise is a useful intervention strategy for women during and after menopause to alleviate symptoms (19).

10. Meditate

Many women experience distress, embarrassment and anxiety during menopause. This mental distress can lead to an increase in the frequency of hot flashes and other physical symptoms. Mindfulness practice can help people to focus their attention to the present moment rather than the past or present and develop a non-reactive awareness to their thoughts, feeling and sensations. Mindfulness training programs have shown to be effective in helping people cope with sleep disturbance, stress, anxiety and panic and could be useful tool for any menopausal women experiencing psychological distress (20).

If you have any questions or would like to book a nutrition consultation, feel free to email our head nutritionist Ben at ben@13seeds.com.au

Disclaimer:

This article does not constitute medical advice and does not take into consideration your personal circumstances. Please see your medical professional before implementing the above. 

 

References:

6. https://www.menopause.org.au/hp/information-sheets/185-what-is-menopause
7. https://www.sciencedirect.com/science/article/abs/pii/0029784495004300
8. https://www.sciencedirect.com/science/article/abs/pii/014067369391158I
9. https://www.tandfonline.com/doi/full/10.3109/13697137.2012.707385
10. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/breast-cancer-and-oestrogen
11. https://www.sciencedirect.com/science/article/abs/pii/S0031942204001049
12. https://www.jeanhailes.org.au/health-a-z/healthy-living/nutrients/phytoestrogens
13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5643776/
14. https://www.betterhealth.vic.gov.au/health/healthyliving/vitamin-d
15. https://www.sciencedirect.com/science/article/abs/pii/S0021915006000694
16. https://www.mdpi.com/1422-0067/19/7/1849
17. https://www.sciencedirect.com/science/article/abs/pii/S0378512210002197
18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3566363/
19. https://www.nccih.nih.gov/health/antioxidants-in-depth
20. https://www.sciencedirect.com/science/article/abs/pii/S0378512210002197
21. https://pubmed.ncbi.nlm.nih.gov/15831132/
22. https://academic.oup.com/ajcn/article/74/5/694/4737535
23. https://pubmed.ncbi.nlm.nih.gov/18677156/
24. https://www.sciencedirect.com/science/article/abs/pii/S0378512214000255
25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3123409/