Supporting Your Health During Menopause
Many menstruating people will agree that hot flashes, interrupted sleep and weight gain are common symptoms they experience during menopause. But did you know that a lot more is happening beyond those physical symptoms that you might not necessarily feel or notice?
What Is Menopause?
There are three phases of menopause: perimenopause, menopause and postmenopause. Perimenopause is the time around the transition into menopause when estrogen and other hormone levels increase and decrease and periods start becoming irregular. This typically occurs between the ages of 45-55, although like anything, some people may experience it younger, and others might be older. Because of the fluctuating hormones, many people experience irregular periods that may be shorter or longer than usual, hot flashes, trouble sleeping, mood swings, vaginal & bladder issues, and loss of bone, among others.
Once a menstruating person has gone 12 consecutive months without a period, they are considered postmenopausal. Your body has stopped producing estrogen and progesterone; you will remain postmenopausal for the rest of your life.
During this phase, how the body uses energy (aka burns calories) and absorbs nutrients changes, sometimes drastically, therefore, maintaining (or starting) a healthy, well-rounded, whole-food diet is as important as ever. Areas of particular concern during menopause are bone loss and cardiovascular risk.
Bone Loss During Menopause
You felt those hot flashes and night sweats and probably noticed any weight you might have gained, but did you know your bones were changing too? Estrogen is a necessary hormone in promoting bone health. As you move from menopause to postmenopause, the body significantly reduces its production of estrogen and progesterone. This, coupled with natural aging, means we’re not replenishing our bone cells as quickly as they are diminishing. This can sometimes lead to a diagnosis of osteoporosis.
How can you support bone health during menopause & postmenopause? The first step is eating a well-rounded diet, keeping in mind foods that are high in calcium and vitamin D. You might consider speaking with your doctor about possibly supplementing with a calcium and vitamin D supplement; however, this isn’t always necessary for everyone and, it’s almost always more beneficial to get nutrients from food instead of supplements. However, know your body and always speak with your doctor before starting a supplement regimen. High levels of calcium supplementation may lead to an increased risk of kidney stones, so like everything, balance and moderation are key.
If you’d rather increase your calcium by eating calcium-rich foods and skip the supplement, try:
Dairy products (whole milk, hard cheese, full-fat yogurt & cottage cheese)
Leafy greens (spinach, kale, collard greens, bok choy, broccoli)
Canned sardines and salmon (with bones)
Tofu
Black beans
Almond milk
Almonds, chia seeds, sesame seeds
Getting an appropriate amount of calcium per day isn’t as hard as you may think. It could look something like: a cup of Greek yogurt at breakfast and a spinach salad at lunch topped with almonds; or, a cup or two of kale added to a smoothie with almond milk and a tablespoon of chia seeds, plus some cottage cheese for a snack during the day. Calcium doesn’t need to come from all dairy products (nor should it), so don’t be afraid to add some leafy greens to your day or a handful of almonds to change things up.
Vitamin D is critical for calcium absorption, but unfortunately, very few foods provide adequate amounts of vitamin D, which is why so many people turn to supplements. Foods high in vitamin D include:
Fish (specifically cod liver oil, salmon, swordfish, tuna and sardines)
Egg yolk
Beef liver
Some mushrooms
Of course, perhaps the best source of vitamin D is the sun, but that comes with its own set of risks, which is a topic for another post. Getting some sun exposure, without sunscreen, definitely increases the vitamin D that your body receives; however, it needs to be done responsibly (preferably outside of the hours of 10 am-2 pm, and only for 10-20 minutes at a time. There are always exceptions to this, so again, know your body and act accordingly).
Vitamin D has lots of other benefits besides aiding calcium absorption. It is instrumental in immune health, is a natural anti-inflammatory, promotes cell growth and healthy blood pressure, and helps regulate blood sugar. Most people are vitamin D deficient, but the only way to truly know is by doing a simple blood test. Excess vitamin D can be problematic, so you shouldn’t supplement unless necessary. Vitamin D supplementation can also interact with certain medications, so check with your healthcare provider before starting any supplement regimen.
In addition to calcium and vitamin D, protein is especially important, specifically collagen. Protein makes up 50% of our bones, with collagen constituting half of that. Bone broth is my preferred source of collagen and lean protein such as pasture-raised chicken, bison, and grass-fed beef. It’s important to also consume an appropriate amount of vitamin C, as it promotes collagen production in the body.
Outside of food, weight-bearing exercises are key to maintaining bone health. Bones that are not used lose stop regenerating, therefore losing strength and mass. Simple exercises, such as squats or pushups (modified is great, too), put enough stress on the bones to signal the body to keep producing new bone tissue.
Cardiovascular Risks during Menopause
Another area of concern during menopause is cardiovascular health. Many menstruating people experience weight gain during menopause, which is a contributing factor, as well as an increase in blood pressure and a change in sodium sensitivity. All three factors contribute to a higher cardiovascular risk. Unfortunately, in many cases, it’s hard to know what came first. Changing hormones or an increase in weight could affect blood pressure. Weight gain may be because, in general, we become more sedentary as we get older, or it may be because menstruating people process calories differently than in perimenopause. It’s hard to tell, and more studies are needed for conclusive information.
In the meantime, it’s still important to focus on a diet full of whole foods and stay active as much as possible. Daily outdoor walks are a great activity at any age; they get you outside (fresh air, plus some vitamin D!) and are easy to start small and build on. Maybe you start by walking to your neighbor’s driveway, but the next day you make it down the street. If you’re already active, maybe take your walk to a nearby trail for a change of scenery or add some hills to your route. It’s amazing what starting small can do and adding just a few baby steps along the way!
Foods to Focus on During Menopause
Healthy eating is imperative no matter which stage of life you are in. To support your body’s changes during menopause, it’s especially important to focus on a variety of whole foods that provide the necessary vitamins and minerals. If you notice your symptoms worsen with any of these foods, try reducing or eliminating them to see if symptoms improve.
In general, you should focus on:
A variety of vegetables, including broccoli, cauliflower, squash, carrots, asparagus, Brussels sprouts, kale, spinach, mushrooms, peppers, sweet potatoes, and so on.
Lean proteins, such as chicken, fish, turkey, pork, lentils and beans, and occasionally including in red meat such as beef, lamb or bison.
Dairy products, like full-fat milk, Greek yogurt and cheese.
Whole grains, nuts and seeds. Sometimes starchy foods can exacerbate menopausal symptoms, so if these foods trigger your symptoms, either cut back or eliminate them to see if symptoms improve.
Sometimes starchy foods, such as white potatoes, rice, white pasta and white bread make menopausal symptoms worse. However, in a 2021 study, whole grains were found to be beneficial due to their higher fiber content. So when possible, try to choose whole grain bread and pasta instead of their white counterparts. Similarly, caffeine and alcohol can also negatively impact the hormonal changes occurring during this time. If you notice changes in your symptoms by removing these items from your diet, then perhaps it’s worthwhile to eliminate them or at least cut back.
Ultimately, nutrition is all about trial and error. You may go through menopause at 55, but your best friend experienced it at 40. Her night sweats may have lasted a couple of months, and it seems like yours are lasting an eternity. Everyone is different, and what works for one person rarely works the same way for someone else. As your unique body changes, so does its ability to process and use nutrients. What you could eat in your 20s you may not tolerate in your 40s. That is normal and is why it’s important to pay attention to how you feel, know your body and be able to tweak accordingly.
And remember, it’s never too late to start eating healthier!
Sources
Cleveland Clinic
National Institute for Aging
Mayo Clinic
Silva, Thais R et al. “Nutrition in Menopausal Women: A Narrative Review.” Nutrients vol. 13,7 2149. 23 Jun. 2021, doi:10.3390/nu13072149