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Managing Menopause with a Healthy Diet

Make ''The Change'' a Healthy One!

-- By Becky Hand, Licensed & Registered Dietitian and Rebecca Pratt, Staff Writer

Some women mourn it as the end of youth and fertility. Others welcome it as a time of freedom and new opportunities. Either way, menopause is a universal rite of passage for women, marking significant physical and emotional changes which can require some adjustment. Technically speaking, menopause refers to the time when a woman ceases menstruating (considered permanent after 12 months), but typically the term to refers to the ongoing and gradual process of reproductive aging, which also includes both perimenopause and postmenopause.

For most women, the process of menopause begins silently somewhere around age 40, when declining levels of estrogen and progesterone may cause menstruation to be less regular. The process also leads to other physical changes, such as reduced likelihood of pregnancy, onset of those proverbial “hot flashes,” and possible thinning of bones which could lead to osteoporosis. As with adolescence, menopause involves yo-yoing hormones and is different for every woman. For most it occurs between the ages of 40 and 58 (51.4 on average). A few women reach menopause in their thirties (before 40 it’s called premature menopause; it can be induced surgically or by drug treatment), and a smaller number don't reach menopause until they’re 60. The most likely predictor of how you’ll experience menopause is how your mother or grandmother fared.

Perimenopause, the period preceding menopause, is often more dramatic than menopause itself. During this preliminary phase, hormone levels fluctuate widely, causing a variety of symptoms, including:

  • Hot flashes: Experienced by 75-80 percent of all women, these can range from a strong blush to profuse sweating with intense heat, usually starting at the head and the neck.
  • Menstrual cycle changes: Menses can become heavier or lighter; occur more or less frequently; last longer or shorten in duration.
  • Mood changes:You may find yourself feeling more irritable, teary, emotionally-detached or worried than usual, or you may feel a vague sense of anxiety without a particular cause. Many women experience poor motivation and a general sense of fatigue.
  • Changes in appetite: You may experience food cravings (especially during the second half of your menstrual cycle), an increased appetite, or suffer from nausea.
  • Sleep disturbances: Disrupted sleep patterns are quite common, including difficulty falling asleep, or waking in the middle of the night (or early in the morning) and not being able to go back to sleep. Sleep problems can lead to feelings of depression, though many women may typically feel depressed at this time even without sleeping disturbances.
  • Memory changes: You may feel as if you forget things more easily. This may be due to lack of sleep or the fact that decreased estrogen levels are reducing the hundreds of estrogen receptors on the brain, thus affecting brain function.
  • Urinary symptoms: You may find that you have to urinate more frequently, can’t get to the bathroom fast enough or sometimes sustain slight leakage when you sneeze, cough, or laugh. It’s also common to have increased incidence of urinary tract infections (UTIs), because of changes in the normal bacteria in your vagina.
  • Sexual changes: Because of lowered estrogen levels, your libido (sex drive) may decrease. Due to vaginal dryness you might feel pain or discomfort during intercourse or even experience light spotting after sex (because the cervix’s lining is more fragile and thin). In addition, thinning of the vaginal lining—once maintained by higher estrogen levels—can cause uncomfortable vaginal dryness and itching, as well as decreased lubrication that can make intercourse painful and uncomfortable.
  • Skin sensitivity: Some women experience "crawling" skin—a tingling, dry, or even burning sensation.
  • Joint & muscle aches and pains
  • Digestive disturbances: Heartburn is a common complaint.
  • Heart jitters: The feeling of a pounding or racing heart can be very scary. In perimenopause, this pounding—harmless to your body—may be accompanied by shortness of breath and hot flashes. *It’s important to make sure this is due to perimenopause—if in doubt, talk with your doctor.
  • Ovarian growths: You may suffer from the growth of benign ovarian cysts. *Always consult your doctor to make sure it’s not something more serious.
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If these symptoms seem overwhelming, don’t be discouraged. Not only is it unlikely that you’ll suffer from all of them, but there is also strong evidence that you can alleviate or ease many of them by eating well. What’s more, many minor dietary changes that you make before and during menopause will help you feel better and establish healthy habits that will serve you well for the rest of your life. Consider these dietary tips to take on menopause:

Eat a healthy diet that includes unprocessed, unrefined, foods like lean meats, soy products, beans and legumes, fresh fruits and vegetables, whole grains, low-fat dairy products and healthy fats. These foods not only provide the body with essential nutrients but may also help balance hormones and improve mood and brain chemistry. Many unprocessed plant foods provide phytochemicals that protect the body. Phytoestrogens, for example, are structurally similar to the hormone estrogen, and may act as weak estrogen in the body. These chemicals "trick" the body into thinking it has more estrogen than it really does and may diminish some of the discomforts caused by low estrogen levels.

A Word of Caution: Researchers are unsure if consuming high quantities of plant estrogens will increase the growth or risk of estrogen-sensitive cancers. If you have had estrogen-dependent cancer, check with your health care provider or seek the advice of a registered dietitian before eating additional soy and phytoestrogens-rich foods.
  • Enjoy soy! Soy foods contain isoflavones, (plant hormones) that act like a weak form of estrogen in the body. Two servings daily may help to relieve menopausal symptoms. Learn how to incorporate soy foods into your diet.
  • Bring on the beans (and legumes). These guys are the perfect little package of fiber, protein, calcium, folic acid and phytoestrogens. They can help with blood sugar control. Aim for five or more servings each week by adding canned legumes to salads, pastas, soups and stews, or trying bean dips and hummus.
  • Sneak in zinc. Zinc is a precursor for progesterone, a hormone involved in balancing estrogen. Zinc also keeps your immune system in tip-top shape. Good sources of zinc include lean meats, seafood, eggs, and milk.
  • Boost your boron. This mineral helps the body hold onto estrogen. It also helps keep the bones strong by decreasing the amount of calcium needed each day. Meet your boron needs by eating a variety of fruits and vegetables daily.
  • Hold off the "hot flash" foods. Certain foods and beverages may worsen hot flashes. Avoiding or limiting spicy foods, caffeine, and alcohol may lessen the severity or frequency of your symptoms.
  • Pile on the Produce. A variety of fresh fruits and vegetables contain beneficial plant estrogens. Before menopause, aim for five servings (minimum) each day. During menopause, however, eating seven to nine servings is a must!
  • Keep bones strong. Due to a lack of estrogen, menopausal women are at risk for developing osteoporosis. Calcium and vitamin D (along with a healthy diet and regular exercise) may help prevent this disease. Check with your health care provider first, but many suggest that menopausal women consume 1200-1500 milligrams of calcium daily. Here are 15 ways to boost your calcium intake. If you must supplement, calcium carbonate and calcium citrate are absorbed well by the body. To absorb calcium, your body needs vitamin D, which it can make through sun exposure. Just 15 minutes of sunshine on the face and arms, three times per week will meet your needs. Milk that is fortified, along with calcium and multivitamin/mineral supplements are also good sources of vitamin D.
  • More magnesium! It helps with mood swings and insomnia. It is also a key player in bone health. Go for beans, legumes, nuts, green veggies and whole grains.
  • Understand good and bad fats. Fat should provide 30% or less of your total calories. Avoid saturated and trans fats, which tend to raise blood cholesterol levels and increase the risk for heart disease in post-menopausal women. Limit these unhealthy fats by cutting back on fatty meats, whole milk, ice cream, margarine and butter, and snack foods. The right fats, however, can protect against heart disease and certain cancers. Research indicates that monounsaturated fats and omega-3 fatty acids are very beneficial to menopausal women.
  • Watch for hidden sugar. Too much sugar can cause blood sugar to spike, which stimulates the pancreas to release more of the hormone insulin. Limit your consumption of soft drinks, syrups, jam, table sugar, candy, desserts, sweetened yogurt and sugary breakfast cereals. Find out how much hidden sugar is lurking in your foods.
  • Feast on flax. Including ground flaxseed in your diet is one of the safest ways to help with hormonal balance during menopause. Ground flaxseed offers a high amount of essential fatty acids and lignan, a natural antioxidant and phytoestrogen. Add 1-2 tablespoons of ground flaxseed to your daily diet. Here's how.
There’s no getting around it—as you go through “the change” of menopause you will probably suffer some of the less-than-fun symptoms most women experience. But by being aware of the changes—and meeting them head on with healthy diet—you can ensure that this transitional time involves some “change" for the better.
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