Good nutrition can influence menopause symptoms like hot flushes, poor sleep, weight gain and vaginal dryness. Read on to see what you can do and to download your free quick and simple guide to menopause nutrition.
Perimenopause, Menopause & Health
Perimenopause (often referred to as “going through menopause”) and menopause (one year after your last period) have a profound effect on women’s bodies, cognition, mood and long term health. Oestrogen gradually stops being produced during perimenopause, and this is the cause of the symptoms that many people suffer with. Because so many of our cells have oestrogen receptors, many systems are affected when there’s no circulating oestrogen in the body. Muscle, bone and cardiovascular are three major systems affected, as well as a part of the brain called the hypothalamus which is responsible for hot flushes. Muscle and bone mass go down and cholesterol and blood pressure go up along with body weight.
There are many medical options for treating menopause symptoms, including but not limited to hormone replacement therapy, so if you are suffering, go and see your GP who will be able to advise you. But, what you eat can influence the symptoms associated with the menopause, and can also moderate the risks of non-communicable diseases that increase following it. Having a good nutritional foundation will always help you feel better and help your long term health. Let’s have a look at some of the things that proper menopause nutrition can help with.
Mental health, menopause & nutrition
Anxiety, low mood and poor cognition are all symptoms that can arise as a result of menopause, but there are some simple ways to minimise the risks of developing them. B vitamins play a really important role in so many cellular functions affecting mood, energy levels, behaviour and nerve function, as well as acting as catalysts and co-factors in the synthesis of hormones and neurotransmitters[i]. So it is easy to see how deficiency in these vitamins can contribute to mental health issues during this life stage.
Mood disorders and cognitive issues like ‘brain fog’ during perimenopause and beyond may be worsened by a lack of B vitamins[ii], particularly vitamins B5, B6 and folate, and helped by eating a diet rich in them. Good sources of B6 are bananas, peanuts, soy and poultry, and folate can be found in dark green leafy vegetables, citrus fruits an d peas. Taking a supplement may also be useful if getting these foods in your diet is difficult, but eating the whole food has so many additional benefits beyond the vitamin content that I always recommend food over supplements.
Omega 3 has been shown in studies to regulate the production of serotonin and help to relieve major depressive disorder due to menopause[iii]. It is also thought to be protective against cognitive decline and the development of dementia. Omega 3 is an essential fatty acid, which means our bodies can’t make it and we must get it through the diet. It is found in oily fish, walnuts and flax seeds. Although there is no recommended daily intake for omega 3 in menopause, 1-2 portions a week are recommended by the British Dietetic Association for general health.
Weight gain, Menopause & nutrition
While weight gain itself is a symptom of the menopause, it can also make other symptoms such as hot flushes and aches and pains worse[iv]. And losing weight has been shown to improve them[v]. However, weight loss during the perimenopause and in the years following the menopause has been shown to have a negative effect on bone health[vi], which is a serious long term problem for women as they lose hormonal protection of their bones. This is especially likely with calorie restriction where it becomes more difficult to get all the micronutrients you need.
The Mediterranean Diet has been shown to help keep weight, cholesterol and blood pressure in check[vii], and along with weight-bearing exercise can preserve bone density. So with this in mind, The British Dietetic Association recommends getting enough calcium and vitamin D and calcium for bone health; eating plenty of vegetables, fruit, beans and pulses and wholegrains which provide vitamins and minerals and fibre to lower cholesterol and blood pressure; and good fats which are heart healthy.
Menopause nutrition and healthy weight loss isn’t just about what you eat though – it’s also about what you don’t eat. Refined carbohydrates can push blood sugar above a safe level which can result in that sugar being converted to fat. Try to switch to wholegrain carbs like brown rice, granary bread, beans and lentils and avoid white bread, white pasta and sugary foods and drinks. Portion sizes are also important. Stick to around a fist-size portion of carbohydrate at a time. This can also have a marked difference in energy levels.
Sexual wellbeing, Menopause & Nutrition
Polyphenols are chemicals found in plants that are beneficial for our health above and beyond the vitamin and mineral content. This is one reason why eating a diet rich in plant foods is better than just taking a multivitamin. Isoflavones are a type of polyphenol which can help relieve vaginal dryness because it is a plant form of oestrogen[viii]. Although more research is needed to see if every perimenopausal women can benefit, there have been some promising studies that supplementing with polyphenols and a microbial metabolite called equol[ix] can significantly improve menopausal women’s reported quality of sex. Soy products are especially high in isoflavones, but you can also get them from many fruits and vegetables.
Vitamin D[x],[xi] has also been shown to be beneficial in reducing vaginal dryness. Vitamin D levels tend to drop with time after menopause, but replacing vitamin D can help to moderate the negative effects of the lack of oestrogen on the cells lining the vagina[xii]. It is actually in very few foods but vitamin D is made in the skin in the presence of sunlight, but you can also take a supplement if you don’t get much sun! 10mcg/d (400IU) is the current recommendation, although there are no specific menopause nutrition guidelines as yet.
Nutrition for Hot Flushes & Night Sweats
Unfortunately caffeine and alcohol can make hot flushes and night sweats worse[xiii], so the recommendation is to cut down on these. Smoking also increases the risk of these, symptoms, as well as having long-term consequences for your cardiovascular and brain health so if you smoke, giving up should be a priority.
As with other symptoms, polyphenols like isoflavones may reduce hot flushes and night sweats in some women but a recent study found that it might be the overall dietary pattern rather than the just the inclusion of isoflavones[xiv]. It showed that a plant-based diet can reduce hot flushes significantly, although in this study the participants also lost weight while following the diet so it’s unclear which was having the effect. It’s likely that both things combined are beneficial.
Improving Sleep & Fatigue in Menopause
Sleep is important for good health at every life stage, not just for making us feel less fatigued, but also for essential repair and maintenance that can’t happen while we are awake. Unfortunately the menopause is notorious for sleeping difficulties. Magnesium can improve sleep quality and duration[xv], so if you find it hard to get your head down and to stay asleep once you have dropped off, increasing your magnesium intake could help.
Magnesium is found in lots of high-fibre plant foods like dark-green leafy vegetables, beans, nuts, seeds and wholegrains. It’s also found in meat in smaller quantities.
Getting good quality sleep can really help with other symptoms too so it can become a positive cycle once you get going. As well as getting a good diet, practice sleep hygiene. This means having a regular bed time, have your bedroom cool, dark and quiet (investing in ear plugs and a sleep mask can help with this). It might surprise you to know that good sleep actually starts when you first wake up. Get plenty of daylight in the mornings which helps your circadian rhythm (aka your body clock) get in sync. Doing some physical activity – it can be as simple as a gentle walk – has also been shown to help people sleep better[xvi][xvii]. Caffeine can also affect sleep, as well as the frequency of hot flushes, so it’s a good idea to avoid caffeinated drinks in the afternoon.
Stabilising blood sugar can also help to feel more energetic throughout the day without slumps in the afternoon. Getting the right size portions of carbohydrates and limiting refined ‘white’ carbs and sugary foods keep energy levels more constant throughout the day. This can help with cognition as well as fluctuations in blood sugar can make ‘brain-fog’ more likely[xviii].
Get Help with Your Menopause Nutrition
Menopause nutrition can have a significant impact on the acute symptoms you feel in the moment, but also on the long-term health outcomes of women. You can book a consultation or a free 15min call to discuss your symptoms and how nutrition can help.
For a free guide on what to eat for perimenopause and beyond, click here.
[i] Kennedy DO. B Vitamins and the Brain: Mechanisms, Dose and Efficacy–A Review. Nutrients. 2016 Jan 27;8(2):68. doi: 10.3390/nu8020068. PMID: 26828517; PMCID: PMC4772032.
[ii] Milart P, Woźniakowska E, Wrona W. Selected vitamins and quality of life in menopausal women. Prz Menopauzalny. 2018 Dec;17(4):175-179. doi: 10.5114/pm.2018.81742. Epub 2018 Dec 31. PMID: 30766465; PMCID: PMC6372850.
[iii] Freeman MP, Hibbeln JR, Silver M, Hirschberg AM, Wang B, Yule AM, Petrillo LF, Pascuillo E, Economou NI, Joffe H, Cohen LS. Omega-3 fatty acids for major depressive disorder associated with the menopausal transition: a preliminary open trial. Menopause. 2011 Mar;18(3):279-84. doi: 10.1097/gme.0b013e3181f2ea2e. PMID: 21037490; PMCID: PMC3195360.
[iv] Shobeiri F, Jenabi E, Poorolajal J, Hazavehei SM. The Association between Body Mass Index and Hot Flash in Midlife Women: A Meta-analysis. J Menopausal Med. 2016 Apr;22(1):14-9. doi: 10.6118/jmm.2016.22.1.14. Epub 2016 Apr 26. PMID: 27152309; PMCID: PMC4854655.
[v] Chopra S, Sharma KA, Ranjan P, Malhotra A, Vikram NK, Kumari A. Weight Management Module for Perimenopausal Women: A Practical Guide for Gynecologists. J Midlife Health. 2019 Oct-Dec;10(4):165-172. doi: 10.4103/jmh.JMH_155_19. PMID: 31942151; PMCID: PMC6947726.
[vi] Riedt CS, Cifuentes M, Stahl T, Chowdhury HA, Schlussel Y, Shapses SA. Overweight postmenopausal women lose bone with moderate weight reduction and 1 g/day calcium intake. J Bone Miner Res. 2005 Mar;20(3):455-63. doi: 10.1359/JBMR.041132. Epub 2004 Nov 29. PMID: 15746990; PMCID: PMC4042194.
[vii] Silva TR, Oppermann K, Reis FM, Spritzer PM. Nutrition in Menopausal Women: A Narrative Review. Nutrients. 2021 Jun 23;13(7):2149. doi: 10.3390/nu13072149. PMID: 34201460; PMCID: PMC8308420.
[viii] Gościniak A, Szulc P, Zielewicz W, Walkowiak J, Cielecka-Piontek J. Multidirectional Effects of Red Clover (Trifolium pratense L.) in Support of Menopause Therapy. Molecules. 2023 Jul 3;28(13):5178. doi: 10.3390/molecules28135178. PMID: 37446841; PMCID: PMC10343205
[ix] Mayo B, Vázquez L, Flórez AB. Equol: A Bacterial Metabolite from The Daidzein Isoflavone and Its Presumed Beneficial Health Effects. Nutrients. 2019 Sep 16;11(9):2231. doi: 10.3390/nu11092231. PMID: 31527435; PMCID: PMC6770660.
[x] Riazi H, Ghazanfarpour M, Taebi M, Abdolahian S. Effect of Vitamin D on the Vaginal Health of Menopausal Women: A Systematic Review. J Menopausal Med. 2019 Dec;25(3):109-116. doi: 10.6118/jmm.19194. PMID: 32307935; PMCID: PMC6952708.
[xi] https://www.ijrcog.org/index.php/ijrcog/article/view/5
[xii]Riazi H, Ghazanfarpour M, Taebi M, Abdolahian S. Effect of Vitamin D on the Vaginal Health of Menopausal Women: A Systematic Review. J Menopausal Med. 2019 Dec;25(3):109-116. doi: 10.6118/jmm.19194. PMID: 32307935; PMCID: PMC6952708.
[xiii] https://www.bda.uk.com/resource/menopause-diet.html
[xiv] Barnard ND, Kahleova H, Holtz DN, Del Aguila F, Neola M, Crosby LM, Holubkov R. 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. 2021 Jul 12;28(10):1150-1156. doi: 10.1097/GME.0000000000001812. PMID: 34260478; PMCID: PMC8462449.
[xv] Arab A, Rafie N, Amani R, Shirani F. The Role of Magnesium in Sleep Health: a Systematic Review of Available Literature. Biol Trace Elem Res. 2023 Jan;201(1):121-128. doi: 10.1007/s12011-022-03162-1. Epub 2022 Feb 19. PMID: 35184264.
[xvi] Sullivan Bisson AN, Robinson SA, Lachman ME. Walk to a better night of sleep: testing the relationship between physical activity and sleep. Sleep Health. 2019 Oct;5(5):487-494. doi: 10.1016/j.sleh.2019.06.003. Epub 2019 Jul 26. PMID: 31358470; PMCID: PMC6801055.
[xvii] Kline CE, Hillman CH, Bloodgood Sheppard B, Tennant B, Conroy DE, Macko RF, Marquez DX, Petruzzello SJ, Powell KE, Erickson KI. Physical activity and sleep: An updated umbrella review of the 2018 Physical Activity Guidelines Advisory Committee report. Sleep Med Rev. 2021 Aug;58:101489. doi: 10.1016/j.smrv.2021.101489. Epub 2021 Apr 9. PMID: 33934046; PMCID: PMC8338757.
[xviii] Warren RE, Frier BM. Hypoglycaemia and cognitive function. Diabetes Obes Metab. 2005 Sep;7(5):493-503. doi: 10.1111/j.1463-1326.2004.00421.x. PMID: 16050942.
