Millions Are Experiencing Menopause… So Let’s Talk About It!
Written By: Tracy Pritchard (MS, CNS, LDN)
Let’s take a minute to talk about something that impacts approximately 1.3 million women each year. This is not a condition or disease, it is a stage of life called menopause. Over one million women enter menopause each year, typically around the age of 51 but can range from 45 to 55. Menopause is reached after 12 consecutive months with no menstruation. It is a natural part of the aging process but often associated with some undesirable symptoms. These may include hot flashes, night sweats, heart palpitations, migraines and urogenital symptoms. Some women report more feelings of anger, irritability, sleep disturbances, anxiety, depression, and loss of confidence during this time. The time before menopause is called perimenopause; this phase can last for several years before menopause. Since we are reviewing terms here….early menopause occurs before age 40, and post menopause is the time after established menopause.
What are some of the factors affecting symptoms and age of menopause? While there is no single predictive predictor of menopause age, maternal menopausal age appears to be a strong predictor. Interesting, this is not something that many women in older generation talked about too much! Some other factors include gestational age at birth, age of first menstrual cycle, decreased ovulation (this can be influenced by the use of oral contraceptives, number of pregnancies, and duration of lactation), body mass index, use of alcohol or tobacco, physical activity, and many more factors.
What are some of the symptoms that may start during perimenopause? Spoiler alert – these are often overlooked or attributed to other factors. Many women experience some of these and wonder….what the heck is going on? These may include cognitive concerns like lack of focus or memory lapses or other mood concerns. Prior to cycles occurring less often some may experience irregular cycles that are more often, PMS symptoms, and urinary/pelvic floor concerns. Some other common symptoms include headaches, insomnia, joint and muscle aches, GI Issues (bloating or constipation), and the dreaded weight gain.
There are numerous physiological shifts and increasing health risks during this time. The physiological shifts primarily involve a decline in estrogen and progesterone levels, which result in a change to a women’s reproductive system, metabolism, and other functions such as bone health. Inflammation, HPA axis dysregulation, insulin resistance, cardiovascular changes, are some of the changes that may occur during this time. If you live with someone in this age range….she may seem a little different from one day to the next. That’s because her estrogen may be fluctuating. Progesterone is also going down resulting in less stress resilience – meaning that small things that weren’t irritating in the past may become a much bigger problem. If this is you…..we need to understand ourselves and explain to those around us that we are changing! We may need a little more compassion.
While we can’t change our age or our genetics, there are some things we can use to support our health and wellness during this time. Experts recommend adopting a therapeutic diet and nutritional considerations including a Mediterranean style diet (high in omega-3 fats) with a high intake of phytonutrients and phytoestrogens from plant-based foods. Phytoestrogens are plant -derived compounds that have a chemical structure similar to estrogen that potentially reduce menopause symptoms. While the isoflavones in soy typically get all the attention, phytoestrogens are found in a variety of foods including flaxseeds, beans, berries, broccoli, and garlic. Fiber from whole foods and fermented foods should also be included. Some fermented foods include plain Greek yogurt, sauerkraut, and miso. While added more nutrient dense foods, consider removing or reducing added sugars and processed carbohydrates. It is also important to identify dietary triggers for vasomotor symptoms (hot flashes, increased heart rate). These can vary from one person to the next but the common triggers are hot beverages, alcohol, caffeine, and spicy foods.
Some targeted nutrients to address menopausal concerns:
Calcium & Magnesium: During perimenopause and menopause, women are at an increased risk of osteoporosis due to the loss of estrogen. Calcium and magnesium will help to maintain healthy bones and prevent bone loss.
*Calcium: Dairy foods, dark leafy greens, canned fish (salmon, sardines)
*Magnesium: Avocado, dark chocolate, nuts/seeds, legumes, leafy greens
Low Glycemic Foods: As you transition into menopause, you may experience sudden weight gain and have difficulty controlling your blood sugar. This can be due to insulin resistance. Eating the proper amount and type of carbohydrate can help balance insulin levels.
*Non-starchy vegetables, apples, berries, lean protein, nutes and seeds
Protein: During menopause, the natural decline in estrogen levels causes a loss of muscle mass and strength. Getting enough daily protein will help prevent muscle loss, balance blood sugar, and maintain a healthy weight.
*Chicken, turkey, fish (especially salmon), eggs, beans/legumes, dairy (plain Greek yogurt, cottage cheese), tofu, nuts/seeds
Healthy Fats: High quality fats are associated with a lower risk of both heart disease.
*Avocado, extra virgin olive oil, fatty fish, and flaxseed/chia seeds.
Lifestyle interventions should be considered as well. These include weight-bearing exercises and movement-based activities to support healthy bone/muscle mass, mood, sleep, and to potentially lower the risks of falls and bone fracture. Speaking of sleep, it is critical to have proper sleep hygiene techniques to improve sleep quality. Women may need to be more intentional during this life stage and make sleep a priority. For those who are overweight or obese, modest weight loss is recommended since obesity is associated with a higher rate of menopausal symptoms. Lastly, since anxiety and depression are common during the transition, stress management techniques or psychological counseling should be considered. In addition, finding community and fellowship with other women in the same life stage is invaluable and may even provide some comic relief.