Around 13 million women in the UK are either peri- or post-menopausal and yet this feels like the last taboo in terms of media coverage, employer acceptance or knowledge of healthcare professionals. According to a Nuffield Health Study, two thirds of women feel that there is a general lack of support and understanding of the condition among GPs. Now in my early 40s, I am experiencing a range of peri-menopausal symptoms from night sweats and anxiety to palpitations and brain fog. I know, right; fun times! I don’t really feel fully like a grown up and my ovaries are already failing me! My GP is pretty good but with my background, I know what questions to ask to get the appropriate care. Most women aren’t as lucky as me! I’m going to try to give you the facts to manage the menopause as best you can with nutrition. Please bear in mind that I am not a magic fairy and anyone who promises miracles is lying (and usually selling snake oil). I am also not a doctor, so I have to stay in my nutritional limits too!
Getting your nutrition right as you enter the peri-menopause won’t send all your symptoms packing but it can help to promote your long term health. I’ve summarised below the 5 nutrients you should prioritise for a healthier menopause.
Falling levels of oestrogen mean that we lose bone density as we age. The bones become spongey looking and more brittle and are therefore more fragile. Calcium forms the scaffolding of our bones and it’s important to ensure you eat enough calcium-rich foods to help reduce those losses of bone density that, over time can lead to osteoporosis, which can cause fractures, breaks and loss of mobility. Unfortunately, because of the loss of oestrogen at the menopause, women are affected by osteoporosis far more than men, although men can still have thinning bones (often the cause of which is unknown).
Fortunately, you can find calcium in a wide range of foods:
Known as the sunshine vitamin, we make vitamin D when our skin is exposed to the sun’s rays (or more specifically the UV light from the sun). Unfortunately, if you live in the UK or any high latitude county, between the months of October and March, the sun is too low in the sky for enough UV rays to penetrate the atmosphere, so however much you lie in the January sun, you’re not going to make vitamin D. And seriously, you’ll catch your death, put some clothes on. Or emigrate to the equator!
Vitamin D helps the body to incorporate calcium into bones, so again, is important for maintaining your skeleton. It also helps support your immune system.
There are a few sources of vitamin D in the diet. Oily fish like mackerel (yep, those again), sardines and salmon, red meat and eggs contain some vitamin D, as do foods with added vitamin D like margarine, breakfast cereals and some plant-based milks. You can also buy special mushrooms (not the magic kind) grown under UV lamps, that contain vitamin D.
However, the Department of Health advises taking a supplement that provides 10 micrograms of vitamin D each day in those dark winter months. For post-menopausal ladies, you might want to increase this to 15 micrograms from a supplement. During the sunnier months, if you’re fair skinned, try to get 20-30 minutes a day in the sun without sunscreen (more if you’re darker skinned). Obviously, if you’re out for longer, then be sun-safe and get some cream on. You don’t need to don a bikini every lunch break but try to have parts of your arms and hands or your lower legs exposed to the sun.
I’ve already talked about the importance of protein, particularly for over 50s, and how important it is to combine a diet with enough protein and some resistance exercise to prevent age related muscle loss. From our 40s and 50s, we progressively lose our lean muscle tissue, partly because we tend to be less active and partly because our bodies become less efficient at building muscle. This can lead to a gradual loss of strength and balance, which, over time can lead to falls and reduced mobility.
Doing resistance exercise (like lifting weights or bodyweight exercises, including pilates) and eating around 25-35g protein per meal (depending on your body weight) can help to reduce these muscle losses and also help maintain bone health. Ignore the scaremongering articles about how protein and dairy cause a loss of calcium form your bones. As long as you eat enough calcium with your protein, the two combined with help preserve bones.
Here’s how you can get 25-30g protein in a meal:
Or you can find 10g protein in the following snacks:
As we go through the menopause and our levels of oestrogen fall, our cardiovascular risk increases (just another joy to be found with getting older!) It’s important to get the right balance of fats, so try to eat less saturated fat from meat, cheese and butter and eat more unsaturated fats, particularly omega 3 fats from oily fish and flax or chia seeds. Omega 3 fats are linked to heart health and can help to reduce cholesterol too, as long as you consume them as part of a balanced diet, with exercise, moderate alcohol intake and no smoking – you know the drill – they can’t work miracles! Unsaturated oils like olive oil are also healthier fats and can fit into a vegetable rich Mediterranean style diet.
The big question on everyone’s lips is: can plant-based oestrogens, like the ones found in soy, lentils and chickpeas really mimic the body’s natural hormones and help alleviate some of the symptoms of the menopause? As a side note, male body builders also ask me if they’ll get boobs if they eat too much soy protein so, plusses and minuses eh?
The answer is, while some studies show that consuming isoflavones (the plant-based oestrogens in soy beans, lentils, chickpeas, tofu etc.) might help relieve some menopausal symptoms like hot flushes and dryness in the lady regions, more studies are needed to confirm the safety of using isoflavone supplements. But guys, you’re not going to grow boobs unless you eat an absolute ton of soy and even then you probably won’t.
Which brings me to supplements in general. There are a whole host of herbal remedies that claim to relieve the symptoms of the menopause. Now herbal medicines are regulated differently from pharmaceuticals or vitamins and mineral supplements. In short, if the seller can demonstrate that they have sourced the herbal extracts appropriately, they can use claims that relate to the traditional historical use. But they are not subject to the same safety or efficacy testing as pharmaceutical drugs, so you really don’t know what you’re getting. In some people, they may be effective and in others, they may notice no benefits. Crucially, they may interact with prescription medicines too so, if you are going to try traditional herbal remedies, please be careful and have a chat with your doctor first.
I appreciate this has been a bit of a whistle stop tour and, of course, can’t possibly cover all aspects of the menopause in one blog. Obviously, I’m also not a doctor or endocrinologist so I can’t advise on the more medical aspects of the menopause but I might address some of my more personal experiences in future blogs, if I get the test results back saying I am peri-menopausal and I might do a deep dive into phyto-oestrogens for you in the future, so do watch this space.