Menopause is a natural stage in every woman’s life, typically occurring between the ages of 45 and 55(1). During this time, the body undergoes significant hormonal changes, particularly a decrease in the hormone oestrogen, which leads to irregular or heavy periods and the end of fertility(2). The effects of menopause vary from woman to woman and can bring about a range of changes, including shifts in blood pressure, cholesterol levels, bone density, and mental health. It is often accompanied by symptoms such as weight gain, hot flushes, night sweats, and gastrointestinal issues.
To help manage these symptoms, there are many strategies women can adopt. Your doctor may prescribe hormone replacement therapy (HRT) for low oestrogen; talk to your GP to understand if this is right for you. However, a combination of lifestyle adjustments, including regular exercise, stress management, and adequate sleep, can make a significant difference. One of the most effective ways to minimise menopausal symptoms is through a thoughtful, well-balanced diet.
Let's explore how proper nutrition can ease your transition through menopause and enhance your overall wellbeing.
Nutrition for Menopausal Health
Calcium
The decline in oestrogen during menopause accelerates bone loss, making women at this stage more susceptible to osteoporosis(1). To maintain strong bones during and after menopause, adequate calcium intake is essential.
While dairy products like milk, cheese, and yogurt are well-known sources of calcium, it's beneficial to include other options in your diet as well. Try incorporating green leafy vegetables, tofu, and fish with edible bones, such as sardines and anchovies, to boost your calcium intake.
Vitamin D
Vitamin D helps the body absorb calcium and is also essential for optimising your immune system(3). Vitamin D also plays a role in regulating oestrogen, which may help alleviate some of the symptoms associated with declining oestrogen levels during menopause(4). Our primary source of vitamin D is sunlight, however, many people, particularly in the winter months, do not get enough sun exposure to meet their needs. As a result, it's essential to obtain vitamin D from other sources, such as through diet or supplements.
Some of the best dietary sources of vitamin D include fatty fish like salmon and mackerel, fortified foods like cereals, egg yolks, and mushrooms. Supplementing during winter months can also help ensure adequate levels of this vital nutrient; however be mindful of the government recommendations to avoid taking too much.
Phytoestrogens
Phytoestrogens are plant compounds that mimic oestrogen in the body, which can be particularly beneficial during menopause when oestrogen levels decline(5). Incorporating phytoestrogens into your diet may help alleviate symptoms such as hot flashes and digestive discomfort. While some research suggests that these compounds may be effective in reducing menopausal symptoms, the evidence is not yet conclusive enough to make definitive claims.
Nevertheless, including phytoestrogen-rich foods in your diet offers additional health benefits due to their content of unsaturated fats, fibre, and micronutrients. Foods high in phytoestrogens include soy products like tofu and soy milk, flaxseeds, lentils, chickpeas, as well as a variety of fruits and vegetables.
Antioxidants
Research shows that oestrogen produced in the body is a natural antioxidant. During menopause oestrogen levels deplete, which may lead to increased inflammation within the body. Inflammation is a normal bodily response to harm, but when it persists, it is associated with chronic disease, such as cancer, cardiovascular disease and Alzheimer’s. Therefore, during menopause it is important to eat foods that are high in antioxidants to reduce inflammation.
We can get antioxidants from plant foods, such as berries, leafy green vegetables, nuts and seeds and so on. Spices are also a good source of antioxidants, particularly turmeric which has excellent anti-inflammatory and immune protection properties.
Fibre
Fibre is the indigestible part of plants that cannot be easily broken down in the digestive system until it reaches the intestines, where it is partially broken down by our gut microbes(6). The microbiome significantly influences overall health and is linked to chronic diseases such as cancer, heart disease, inflammatory bowel disease, and mental health disorders.
The relationship between oestrogen and the gut microbiome is complex and interconnected. During menopause, as oestrogen levels decrease, this change can alter the composition of your microbiome, potentially affecting your overall health and increasing the risk of chronic diseases. This highlights the importance of nurturing your gut microbes.
A diet high in fibre is arguably one of the most important ways to support the beneficial microbes in the gut. To increase your fibre intake, focus on a diverse diet rich in plant foods, including fruits, vegetables, legumes, pulses, nuts, and seeds. A simple way to boost your fibre consumption is by choosing wholegrain options over white rice, pasta, and bread.
Unsaturated Fats
After menopause, women face a higher risk of cardiovascular disease. While research is ongoing into the exact causes, one major factor is the increase in body fat due to declining oestrogen levels, which can lead to higher inflammation, blood pressure and cholesterol - significant risk factors for heart disease.
Healthy fats, particularly monounsaturated fats, are linked to reduced inflammation in the body and offer various health benefits. Olive oil, in particular, is a rich source of these fats and has been associated with a lower risk of post-menopausal breast cancer(9). Incorporating olive oil and other sources of healthy fats, such as avocados and nuts, into your diet can support overall health during menopause and beyond.
Hydration
Maintaining proper hydration is key to overall health, energy levels, and skin vitality during this life stage. Hot flushes and night sweats can cause significant fluid loss, increasing the risk of dehydration during menopause. To counter this, it’s essential to stay properly hydrated by drinking plenty of water throughout the day. In addition to water, consuming herbal teas and hydrating foods like cucumber, watermelon, strawberries, and lettuce can help maintain adequate fluid levels.
It's also important to limit excessive caffeine and alcohol, as both have a diuretic effect, leading to further water loss. Opt for decaf options where possible and limit alcohol consumption to help prevent dehydration and support more stable body temperature regulation, reducing the severity of menopausal symptoms.
Navigating menopause can be challenging but adopting a balanced diet rich in essential nutrients like calcium, vitamin D, and fibre, as well as healthy fats, can make the transition smoother. Proper nutrition not only helps alleviate common symptoms like hot flushes, night sweats, and mood changes but also supports long-term health, reducing the risk of chronic conditions such as heart disease, breast cancer and osteoporosis. By making informed dietary choices, women can better manage the physical and emotional changes that come with menopause, promoting overall wellbeing and a healthier future.
Sources
(1) British Nutrition Foundation, 2022. Nutrition and menopause. Available at: https://www.nutrition.org.uk/nutrition-for/women/menopause/ [Accessed 11 October 2024].
(2) British Dietetic Association, 2019. Menopause and diet. Available at: https://www.bda.uk.com/resource/menopause-diet.html [Accessed 11 October 2024].
(3) British Nutrition Foundation, 2023. Vitamins and minerals. Available at: https://www.nutrition.org.uk/nutritional-information/vitamins-and-minerals/ [Accessed 11 October 2024].
(4) Hong, S.H., Kim, H., Oh, Y.M., Yang, H., Choi, K.C., and Lee, J.H., 2017. 'Effect of Vitamin D3 on biosynthesis of estrogen in porcine granulosa cells via modulation of steroidogenic enzymes', Toxicology Research, 33(1), pp. 49-54.
(5) British Nutrition Foundation, 2022. Managing menopause with diet. Available at: https://www.nutrition.org.uk/nutrition-for/women/menopause/managing-menopause-symptoms-with-nutrition-and-diet/ [Accessed 11 October 2024].
(6) British Dietetic Association, 2021. Fibre. Available at: https://www.bda.uk.com/resource/fibre.html [Accessed 11 October 2024].
(7) Durack, J. and Lynch, S.V., 2019. 'The gut microbiome: Relationships with disease and opportunities for therapy', Journal of Experimental Medicine, 216(1), pp. 20-40.
(8) González-Palacios Torres, C., García-Moncó-Fernández, R., Aguirre-Mendoza, L., 2023. 'Mediterranean diet and risk of breast cancer: An umbrella review', Clinical Nutrition, 42(4), pp. 600–608.
(9) Breast Cancer UK, 2017. Benefits of a Mediterranean diet in breast cancer. Available at: https://www.breastcanceruk.org.uk/benefits-of-a-mediterranean-diet-in-breast-cancer/ [Accessed 11 October 2024].