What Is Menopause?
Menopause occurs during the 12 months after a woman's last menstrual period. The changes that lead up to this transition, however, can begin years earlier and may linger after. The biological process of menopause is categorized into three distinct stages:
- Perimenopause. Roughly 10 years before menopause, the ovaries begin to slow down, producing fewer fertility hormones, especially estrogen and progesterone. This change may result in spotting, irregular or heavy periods and even initial menopausal symptoms such as hot flashes and night sweats.
- Menopause. Generally during a woman's late 40s or early 50s, this process will begin to accelerate, causing fertility hormones to plummet. The ovaries stop releasing eggs, causing menstruation to cease permanently.
- Postmenopause. The final phase of menopause is marked by the absence of a menstrual period for at least one year and lasts for the rest of a woman's life. For many women, symptoms may ease considerably, but some may remain.
While the median age of menopause is 51, the timing is different for every woman—and so is the experience. Lifestyle can affect the types and severity of symptoms as well as the timing of the onset of menopause with nutrition being an important environmental factor. Below are a few ways nutrition can help support some common symptoms of menopause.
Symptoms of Menopause and How Nutrition Can Help
Estrogen is best known for its role in fertility, but it also supports women's health in many other important ways. As levels of this hormone decline, you may experience these common symptoms: hot flashes, insomnia, flushing, reduced sex drive, weight gain, mood swings and depression. This article highlights the following menopausal symptoms and provides a few lifestyle suggestions to help you cope with their related effects:
Hot flashes. These sudden, intense bursts of heat in the face, neck and chest affect 75% of women. When they happen at night, they're often referred to as night sweats. While there's no cure for hot flashes, a healthy eating approach rich in plant compounds that mimic the action of estrogen, called isoflavones, may be beneficial. These are found in plant-based foods, especially ones from the legume family, which include soybeans, tofu, edamame, chickpeas, peanuts and pistachios. Flaxseeds are another good source. A recent survey of 500 peri- and postmenopausal women conducted at the University of Illinois Medical Center found that many women (70% of those polled) are also turning to botanical supplements for these estrogen-like compounds. Supplements with soy, red clover, hops and licorice root contain these plant compounds.
Weight gain. Due to the decline in estrogen, women will notice two key changes in their body composition. Even if you've never had a problem with your weight before, the loss of calorie-burning muscle during menopause can cause your metabolism to slow. At the same time, you may also begin to gain fat, especially around your stomach, as estrogen helps to modulate your energy balance. Exercise can help—including both resistance and aerobic training—and so can eating more muscle-building protein. Studies show that skeletal muscle mass and functional strength are positively associated with protein intake in postmenopausal women. Aim to eat at least a half gram of protein daily for each pound that you weigh. For example, if you weigh 150 pounds, aim for approximately 75 grams of protein per day. Here are some protein-rich meals to incorporate into your eating plan:
- Yogurt or cottage cheese with fresh fruit
- Scrambled eggs with whole-grain toast
- A turkey sandwich on whole-wheat bread
- Grilled chicken and veggies
- Fish tacos on corn tortillas
- Tofu or edamame stir-fry
- Bean chili over quinoa
Poor sleep. Between night sweats, insomnia and sleep apnea, 40% of menopausal and perimenopausal women experience sleep difficulties. Set yourself up for a better night's sleep by avoiding caffeine and alcohol in the afternoon and evening. Other tricks include turning down the thermostat before bed, wearing lightweight pajamas and maintaining a regular sleep schedule.
Decreased bone strength. The onset of menopause brings increases in chronic disease risks such as osteoporosis. Most peri- and postmenopausal women are deficient in or have low levels of vitamin D and magnesium. Estrogen helps the body use calcium to support bone health. A decline in estrogen combined with vitamin D deficiency can lead to bone loss. A woman may lose up to 10% of bone density during menopause, increasing the risk of osteoporosis and bone fractures. Balanced nutrition rich in bone-supporting nutrients such as calcium and vitamin D may offer support. Aim for 1,200 mg of calcium and 15 mcg of vitamin D (20 mcg if you're over age 70) each day from foods such as sardines, salmon with bones, fortified cow or soy milk and fortified orange juice. Your doctor may even suggest a higher level of supplemental vitamin D, up to 2,000 IU per day.
These dietary nutrients not only affect bone mineral density but may also be associated with the onset of menopause. In a large study of nurses, researchers found that those with the highest intake of dietary calcium had a slightly lower risk of early menopause, and those with the highest intake of dietary vitamin D had a significantly (17%) lower risk of early menopause. The association was especially strong with calcium and vitamin D from dairy foods. You may also consider speaking to your doctor about an oral nutrition supplement.
Heart troubles. Loss of estrogen not only changes a woman's metabolism, but can also increase inflammation that predisposes postmenopausal women to chronic diseases such as type 2 diabetes and cardiovascular disease. Estrogen helps to keep blood vessels relaxed and open. As estrogen decreases during the stages of menopause, cholesterol may begin to build up, increasing the risk of heart disease or stroke. Fortunately, that doesn't mean you can't still enjoy plenty of delicious foods. Substantial research shows a link between the Mediterranean Diet and beneficial heart health outcomes as well as weight management. Start by adding more fruits, vegetables, nuts, seeds, beans/lentils, fish, plant-based oils such as olive oil and whole grains to your plate. In addition to supporting heart health, plant-based foods may help to reduce some menopausal symptoms, too.
Despite what you may have heard, there are actions you can take to help manage the symptoms of menopause. In addition to making beneficial lifestyle and nutrition choices to promote long-term health, talk to your doctor about other evidence-based approaches you can incorporate to help ease this transition.