Diet During Perimenopause and Menopause

What is menopause?

Menopause is a transitionary stage that women go through after which their periods stop, and they are no longer able to convince naturally. It usually kicks in between the ages of 45 and 55 and is caused by a decline in oestrogen levels. Unfortunately for us ladies, menopause is often accompanied by an array of symptoms which for some can be very severe and debilitating, such as hot flushes, night sweats, low mood or anxiety, low libido, difficulty sleeping and discomfort during sex. Before menopause women are considered peri-menopausal in which they experience PMS-like symptoms; this stage can go on for years and women are only described as menopausal after a full year without a menstrual period (1). Despite the menopause impacting all women at some point in their lives it’s still somewhat of a taboo, but this belief is changing – hence why we’re talking about it today!

The risks during and after menopause

Due to the decrease in oestrogen levels during and after menopause women are at an increased risk of cardiovascular disease (e.g., heart attack, stroke) as well as osteoporosis (weakened bones and increased risk of fractures).

How to reduce the risks

• –       Increase physical activity

• Maintain a healthy body weight
• Avoid excessive alcohol consumption – limit it to 14 units per week
• Don’t smoke

Specifically, how to improve cardiovascular health:

• Swap saturated fats for unsaturated fats (e.g., switch butter and coconut oil for olive and rapeseed oils and spreads).
• –       Reduce salt intake – consume less than 6g per day.

• Consume two portions of fish per week (one of which should be oily e.g., salmon, mackerel, sardines).
• Increase fibre consumption e.g., wholegrains, pulses, fruit, and vegetables.

Specifically, how to reduce the risk of osteoporosis:

• –       Take vitamin D supplements – 10 μg per day.

• Avoid overconsumption of vitamin A (liver, supplements, fish liver oil supplements).

(2,3)

There has also been some evidence to suggest that certain herbal remedies can be beneficial in easing menopausal symptoms. Most notably phytoestrogens: the two most researched being isoflavones and lignans which have a similar structure to oestrogen. Thus, they may help to reduce the symptoms caused by the low oestrogen levels linked with menopause. Isoflavones are found in soyabeans, legumes, chickpeas, and lentils, and lignans are found in fruits and vegetables, cereals, and linseeds. However, further research is needed to confirm this link (4). Always be dubious of herbal remedies or treatments claiming to ease menopause or any other condition or illness, they often lack the scientific evidence to support their claims. It’s best to check with a registered dietitian or your GP before taking any herbal remedies or supplements.

Menopause and weight gain

There are many studies that associate menopause with weight gain; this is primarily due to the fluctuating hormone levels caused by menopause. As a result, women can feel fatigued and consequently their physical activity levels reduce – because who wants to work out when they’re exhausted! These hormone changes can also impact one’s food choices. As well as this, they can result in mood swings and emotional eating, causing further weight gain (5). Many factors contribute to menopausal weight gain, however, there are some simple changes you can make to aid weight management during this time in your life:

1. Eat smaller portions – avoid processed foods, sugar, and saturated fat, they’re calorie-dense and less nutritious than whole foods such as wholegrains, lean meat, legumes, and fruit and veg!
2. Be mindful of your alcohol consumption – sorry ladies this one just keeps coming up!
3. Be more active – another popular one! Even if it’s just a short walk every day, try to make it habitual.
4. Minimise stress – I know, easier said than done, but cortisol (our stress hormone) promotes abdominal fat deposition. Try talking to friends, family or a professional if managing stress is something you struggle with.(6)

References

1. NHS (2018) Menopause. Available at – https://www.nhs.uk/conditions/menopause/
2. British Nutrition Foundation (2020) Menopause. Available at – https://www.nutrition.org.uk/healthyliving/lifestages/menopause.html
3. British Nutrition Foundation (2020) Healthy eating and the menopause. Available at – https://www.nutrition.org.uk/healthyliving/lifestages/menopause.html?start=2
4. Estrada-Camarena, E., López-Rubalcava, C., Valdés-Sustaita, B., Azpilcueta-Morales, G.S. and González-Trujano, E.M., 2017. Use of phytoestrogens for the treatment of psychiatric symptoms associated with menopause transition. A Multidisciplinary Look at Menopause. Eds. JF Rodriguez-Landa, J. Cueto-Escobedo. InTech, pp.81-109.
5. Chopra, S., Sharma, K.A., Ranjan, P., Malhotra, A., Vikram, N.K. and Kumari, A. (2019) Weight management module for perimenopausal women: A practical guide for gynecologists. Journal of mid-life health, 10(4), p.165.
6. NHS (2020). Menopause and weight gain. Available at – https://www.liverpoolwomens.nhs.uk/media/3538/menopause-and-weight-gain-patient-information-leaflet.pdf