Menopause sadly continues to be a taboo topic. My mother never discussed it, nor did any of my older friends, neither during nor after ‘The Change’. It is only recently, as I approach fifty, and many of my friends as well, that I start to hear women speak of the changes they are experiencing.
Change is inevitable. The best gift we can give ourselves is to embrace these changes and make good choices regarding our health.
Let’s chip away at the taboo of menopause – and discuss what is happening in the body, and how we can prepare ourselves and thrive through this transition. And let’s take steps towards good and sustained health and well-being at each stage of the menopause.
What phase are you in?
Premenopause is the phase from the first period until they become irregular in perimenopause.
Perimenopause is when the sex hormone levels start to drop and the periods become irregular, until menstruation stops with the menopause. This phase tends to start around the early- to mid-40’s, and can last anywhere between two to six years.
Menopause is the date of your last period. This tends to be around 50 years of age, but can happen earlier or later.
And postmenopause begins 12 months after your last period.
Women are no strangers to the roller coaster ride that hormones can have on the body and the mind – entering puberty, through menstruation, with pregnancy. This trend continues into perimenopause, as our hormone levels start to drop, triggering physical and emotional symptoms associated with menopause.
Until menopause, the ovaries produce most of our sex hormones. Menopause occurs when there not enough eggs left for the ovaries to ovulate. At that point, the adrenal glands and fat cells take over, producing a less potent form of oestrogen. The adrenals continue to produce reduced amounts of progesterone and testosterone.
The decrease in our sex hormones can trigger both physical and emotional symptoms:
Physical – hot flushes, night sweats, decreased libido, fatigue, weight gain, headaches, joint pain, vaginal dryness, dry skin and hair, hair loss.
Emotional – depression, mood swings, anxiety, brain fog, impaired memory.
Hormonal levels are further influenced by molecules that enter the body known as phytoestrogens and xenoestrogens.
Phytoestrogens are foods that behave somewhat as oestrogen in the body, by attaching to oestrogen receptors. It means that they can ‘top-up’ the declining oestrogen levels. Natural sources include flaxseeds (linseed), chickpeas, lentils and miso. Research shows that women consuming flaxseed products generally report a reduction in breast tenderness, bloating, hot flushes, sweating, vaginal dryness, and other systems related to PMS and menopause (Hutchins A, Cancer Epidemiol Biomarkers Prev, 2000).
Xenoestrogens are chemicals which also mimic oestrogen in the body, but which are linked to hormonal disruption. Examples include dioxins, nonylphenols, phthalates and bisphenols, and can be found in pesticides, plastics, cosmetics, carpets, etc. Residues of hormonal medications such as birth control pills and HRT found in drinking water are another form of xenoestrogen. Increased levels of xenoestrogen in the environment have coincided with an earlier onset of puberty. Xenoestrogens can remain stored in the fat of overweight persons.
Fortunately, hormonal levels tend to stabilise from postmenopause, though at lower levels than before menopause.
Tips for good health through all stages of menopause
Good nutrition as medicine and healthy lifestyle choices provide excellent ways to minimise the symptoms associated with each stage of menopause.
Add phytoestrogens to your diet. Include lignans such as flaxseeds – phytoestrogens are found in the husk, rather than the oil – and other oily seeds, such as sunflower seeds. Add isoflavones, found chickpeas and lentils. Soya is another good source – but opt for fermented soya products, such as miso and tempeh, and as unprocessed as possible.
Avoid xenoestrogens by reducing exposure to plastics and pesticides. Replace non-stick pans with stainless steel or cast iron. Opt for natural cosmetics and cleaning products – try making your own! Buy organic foods where possible.
Cut refined sugar out of your diet. Sugar causes a roller coaster of our blood sugar, and the adrenals pump out stress hormones to try to stabilise blood sugar levels. It’s important to protect the adrenal glands during menopause, so that they are able to produce sex hormones.
Switch from refined to unrefined carbohydrates. The process of refining carbs strips away the fibre and other nutrients, releasing glucose too quickly into the bloodstream and fuelling to the blood sugar roller coaster. Unrefined carbs include beans, brown rice, oats, barley, nuts and fruits.
Reduce stimulants, which activate the stress response in the adrenal glands. Caffeine and alcohol cause a quick rise in blood sugar, which can trigger mood swings and low energy. Stimulants have a diuretic effect, depleting the body of nutrients. Consider herbal tea and clean water as an alternative.
Omega-3 fats are key in reducing inflammation in the body. Many of the symptoms of a lack of omega-3 can resemble menopause symptoms, such as fatigue, difficulty losing weight and mood swings. Omega-3 is found in oily fish, such as salmon, sardines and mackerel. It is important that it is wild, rather than farmed, or even bio – which tend to be higher in pro-inflammatory omega-6. Flaxseeds are a vegetarian source of omega-3.
Supplementation of fish oil could be useful. Not all fish oil supplements have sufficient EPA to be effective - ensure that it contains more EPA than DHA, and aim for total omega-3 in excess of one gram.
Protect the liver with herbs. It is important that the body is able to detoxify oestrogen in the liver and eliminate it from the body. Herbs which have been shown to protect the liver, and also to reduce menopausal symptoms, include: black cohosh, agnus castus, dong quai, milk thistle and sage.
Prioritise a healthy sleep hygiene. Sleep can be problematic during menopause due to symptoms such as night sweats. Aim to go to bed and wake at the same time each day, and avoid screens at least an hour before bedtime. Get plenty of sunshine, particularly in the early part of the day, to help regulate the circadian rhythm.
Stress management is more important than ever in menopause. Stress is hard on the adrenal glands, forcing them to pump out cortisol – which can amplify mood swings. But during menopause, it is important to protect the adrenal glands and enable them to produce sufficient levels of oestrogen. Try mindfulness and breathing techniques as tools to deal with difficult thoughts and emotions. Connect with nature. Get sufficient exercise and restful sleep. And don’t forget to make time for yourself each day. Maintaining good emotional health will play a large role in managing the stages of menopause.
A Functional Nutritionist can help to unravel the extensive information obtained through detailed functional lab testing and a thorough medical history. S/he can help to plan a course of action, potentially including diet and lifestyle recommendations. Supplements may be considered, for example: nutrients, enzymes, amino acids, neurotransmitters, plants and herbs.
The good news is that menopausal symptoms can be reduced through healthy dietary and lifestyle choices.
Wishing you good health and smooth sailing through this transition!
Author: Written by Scotti McLaren, a student of nutritional therapy and functional medicine at CNELM. Prepared in collaboration with Nutri-360.