October 18th is World Menopause day, bringing awareness to the event that impacts half the world’s population. Reaching the menopause is defined as one year since a woman’s last period occurred. In the UK, the average age for this is 51, so the average age for the last period is 50. Some people go through the menopause early, with 1 in 100 experiencing it before 40, 1 in 1000 before the age of 30. In these cases, it is important to speak to your GP.
There are many symptoms associated with going through the menopause, including hot flushes, difficulty sleeping, mood change, brain fog, recurrent UTI’s, lowered libido, heart palpitations and joint pain. Hormone replacement therapy (HRT) is one of the most popular solutions to managing symptoms, and is available in a variety of forms.
Nutrition can’t replace HRT and medicine, but it can play a role in supporting menopause management. This includes both foods that may support changing hormones, and those that support overall health after the menopause.
Soy products contain phytoestrogens, a variety of compounds similar to human oestrogen in structure. Some of these mimic oestrogen sufficiently as to act like oestrogen in the body. Others don’t mimic oestrogen, but can bind to oestrogen receptors instead of oestrogen. This has the effect of potentially regulating oestrogen levels, although not to the level of HRT. Including minimally processed soy products in the diet can help with the drop in oestrogen levels as the menopause occurs. This includes soy milks and yoghurts, tofu, tempeh and edamame beans.
Oestrogen has a protective effect against heart disease, and so as levels drop, a heart-healthy diet can minimise risk. UK recommendations for reducing cardiovascular disease risk are to consume a diet high in fibre and low in saturated fats. This works best when saturated fats are replaced with whole grains and polyunsaturated fats. For example, brown rice and oily fish, or porridge made with whole oats and flaxseed. Foods high in saturated fat, such as butter, red meat and coconut oil can still be included in the diet. Although eggs contain cholesterol, for most people this does not translate to raised cholesterol levels. The exception to this is in people with Familial hypercholesterolemia.
Loss in muscle mass can occur with the menopause, with protein turnover being reduced. As such, protein requirements are higher. This protects against impaired muscle function. Having a serving or source of protein in at least two meals of the day will help to meet requirements. Sources include a portion of meat or fish, 2-3 eggs, a 0.5-1 cup of beans or lentils, tofu/tempeh, unsweetened yoghurts and hard cheeses. Protein powders and shakes are also a convenient addition if needed. And if you don’t have diary, soy milk and yoghurt have the highest protein levels of plant based milk alternatives.
The perimenopause (months and years leading up to the menopause) are the last chance to lay down extra bone mass. To maximise bone mass density, and limit loss after the menopause, consume sufficient calcium and vitamin D. Calcium can be found in highest amounts in dairy and fortified alternatives (check the label). and fish where the bones are consumed. Beans, tofu and cooked leafy greens also contain calcium. For vitamin D in the UK, it is recommended to take a supplement of 10-25 ug from October until April.
Other recommendations for overall health and managing symptoms include exercise, sleep and reducing stress. Having a consultation with your GP or a Registered Nutritionist/Dietitian will allow you to cover any concerns and come up with an action plan together.