Managing Menopause

 
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Menopause is a time in a woman’s life that’s both dreaded and celebrated. It starts with perimenopause -- a natural decline in reproductive hormones that starts between the ages of 40 and 50 for most women.

Periods are sometimes unpredictable but still occurring. Other symptoms such as hot flashes, mood changes, poor sleep and depression may be experienced. A woman is in menopause when her menstrual cycle has stopped for a straight 12 months. 1

Menopause means the end of monthly cycles and the symptoms, supplies and side effects that accompany it such as breast tenderness and bloating. Women stop worrying about birth control but have other issues to deal with including weight gain, bone loss and hot flashes.

Depression, anxiety, reduced libido and risk of heart disease also increase. It’s not exactly anything to jump for joy over. However, knowing what to expect and how to deal with it can make menopause more manageable for most. 2

Waist management
Likely the biggest complaint among menopausal women is weight gain. According to Kapoor, et. al., the average weight gain in women is 1.5 pounds annually in their 50’s and 60’s. As estrogen levels decline, weight gain around the midsection, becomes more common in menopausal women. 3

Other reasons for weight gain in menopause include poor sleep, which increases the chance of overeating. Decreased physical activity and increased food or alcohol consumption may also be at play. Decreases in muscle mass from reduced activity is one of the biggest contributors to weight gain. 4

New research also suggests the gut microbiome may play a role in menopausal weight gain. The gut microbiome influences the metabolism of estrogen and regulates metabolism. Menopause itself changes the gut microbiome and is associated with insulin resistance, abdominal fat deposition and decreased metabolic rate. 5

Hotter than ever
Hot flashes are exactly that- a sudden heat wave that feels like a 2- to 4- minute fever. This uncomfortable, hot feeling occurs due to the hormonal changes and can happen at any time during the day or evening, often during sleep. Poor sleep and consequential weight gain may be related to hot flashes. 6

Treatment of hot flashes may include hormone therapy such as estrogen replacement or CAM (complimentary and alternative medicine) such as herbal preparations or bioidentical hormone therapy. Buyer beware- bioidentical HRT (hormone replacement therapy) and over the counter supplements are not FDA approved.

Herbal treatments such as black cohosh, don quai, ginseng and red clover may also be used but are not regulated or FDA approved. Caution should be taken when using non-traditional treatments.

Moody blues
Another common complaint in women going through menopause is moodiness and depression. Change of life impacts women’s hair and skin in addition to their waistlines. Hair loss or graying hair, dry skin and even acne are common, which can impact self-esteem.

As many women experience their children leaving for work or school around this age, anxiety and depression can set in. Research studies are conflicting as to whether or not the loss of fertility is at play. Fluctuating hormones, insomnia and uncomfortable hot flashes may lead to depression as well.

Risk factors for depression include heredity, previous depression, negative attitudes towards aging, surgical menopause, and vasomotor symptoms (AKA hot flashes). 7

How diet helps:

While the picture of menopause seems bleak, there is hope. Research suggests a healthy diet can reduce the unwanted side effects of menopause while reducing risk for diabetes, cancer and heart disease. Below are a few suggestions:

1. Reduce alcohol intake. Alcohol is a depressant that impacts sleep and mood. It’s been found to exacerbate hot flashes and contributes unwanted calories. Three drinks per week is advised to reduce risk of breast cancer.
2. Eat more soy. Several studies indicate that the isoflavones in soy aid in reducing hot flashes. Soy isoflavones may also reduce heart disease and bone loss risk by lowering cholesterol and improve bone density, respectively. 8
3. Drink more water. Hot flashes can leave you high and dry. Stay hydrated throughout the day with at least 16 oz of water with meals and 12-16 oz. between meals. Water helps with dry skin, too.
4. Include berries in your diet. Berries are a source of powerful antioxidants, including anthocyanin and polyphenols. A recent study found that berry intake reduced depressive symptoms by 39%. 9
5. Go fish (especially the fatty kind). Salmon is a source of omega-3-fatty acids, the kind that reduces inflammation. A summary of observational cohort studies indicates that 1 serving of fatty fish per week may aid in reducing depression, especially in women. 10

And here's a free handout for your clients!

By Lisa Andrews, MEd, RD, LD

References:

  1. Women’s Reproductive Health | CDC
  2. What Is Menopause? | National Institute on Aging (nih.gov)
  3. Kapoor E, Collazo-Clavell ML, Faubion SS. Weight gain in women at midlife: a concise review of the pathophysiology and strategies for management. Mayo Clinic Proceedings. 2017;92(10):1552–1558. doi:10.1016/j.mayocp.2017.08.004
  4. Proietto J. Obesity and weight management at menopause. Aust Fam Physician. 2017 Jun;46(6):368-370.
  5. Becker SL, Manson JE. Menopause, the gut microbiome, and weight gain: correlation or causation? Menopause. 2020 Nov 23;28(3):327-331.
  6. Bansal R, Aggarwal N. Menopausal Hot Flashes: A Concise Review. J Midlife Health. 2019;10(1):6–13. doi:10.4103/jmh.JMH_7_19
  7. Vivian-Taylor J, Hickey M. Menopause and depression: is there a link? Maturitas. 2014 Oct;79(2):142-6. doi: 10.1016/j.maturitas.2014.05.014. Epub 2014 Jun 2.
  8. Martín Salinas C, López-Sobaler AM. Beneficios de la soja en la salud femenina [Benefits of soy in women's health]. Nutr Hosp. 2017 Oct 15;34(Suppl 4):36-40.
  9. Godos J, Castellano S, Ray S, Grosso G, Galvano F. Dietary Polyphenol Intake and Depression: Results from the Mediterranean Healthy Eating, Lifestyle and Aging (MEAL) Study. Molecules. 2018 Apr 24;23(5):999
  10. Yang Y, Kim Y, Je Y. Fish consumption and risk of depression: Epidemiological evidence from prospective studies. Asia Pac Psychiatry. 2018 Dec;10(4):e12335.
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