Menopause is a turning point in a woman’s life, she has to cope with various psychological and hormonal issues, along with her everyday life, work and family commitments.
There are ways though, to minimize menopausal symptoms through good nutrition and lifestyle choices.
A year after a woman’s last period marks the start of the menopause, and the end of fertility. This biological event occurs in all women between age 40 to 60, depending on genetics, smoking or other medical issues, surgeries or chemotherapy. (Mayo Clinic, 2016)
The physiological and hormonal changes in the production of estrogens and progesterone, that take place in the body during the 3-5 years of the perimenopause, and through menopause, create a number of symptoms. These symptoms vary from woman to woman but usually affect her both psychologically and physically.
It is important to make the necessary nutritional and lifestyle changes to reduce the negative effects of menopause, and enjoy life in the process.
SYMPTOMS, CHANGES & TREATMENTS
Physiological changes in the body during menopause, create various menopausal symptoms that can last a decade or longer (Harvard Women’s Health Watch, 2015), these may include:
Hot flashes: The most common symptom, that comes with increased heart rate, sweating and sleep problems. Treatment: Reduce alcohol, caffeine, hot beverages. (Harvard Medical School, 2009)
Heart disease: After menopause, risk of cardiovascular diseases (CVDs) is similar to men’s as high-density lipoprotein (HDL) decreases in perimenopause due to lower estrogen levels. (Harvard Medical School, 2016) Treatment: Regular physical activity that reduces tension and releases beneficial hormones that assist relaxation.
Weight gain: Weight gained during perimenopause (approximately 5kg) is maintained due to reduced physical activity and lower metabolic rate. Treatment: Good eating and exercise habits. Aerobic exercise to reduce fat.
Urinary problems: More women (30%) than men (5%) have incontinence problems between ages 50-64. Treatment: Kegel exercises, reduce diuretic beverages such as coffee or alcohol.
Headaches: Changes in estrogen levels, especially during perimenopause cause headaches, which may get better after menopause. (North American Menopause Society, 2016) Treatment: Consult with your doctor for medication, or estrogen supplement.
Libido issues: Sexual drive decreases in perimenopause and menopause. Low sexual desire is linked to lower estrogen levels and blood circulation issues. Treatment: Improve the quality of relationships, talk with your partner and if needed seek counseling. Estrogen supplementation.
Depression & Mood swings: Hormonal changes are not proven to be linked to mood swings and depression directly, but changes in the woman’s life pattern and sleep can be stressful, and leave the woman tired and overwhelmed. Decreased estrogen and mood swings do not cause clinical depression, and depression levels are not higher than at any other time in life. Treatment: Lifestyle changes, improving sleep and exercising that helps improve mood. Medication – antidepressants.
Insomnia: Sweating and hot flashes create sleep problems that may disrupt the restorative REM sleep. Difficulty to sleep or waking up early without being able to sleep again, is another common problem. Insomnia is linked to heart attacks and heart failure and sleep quality is important to be addressed. Treatment: Temporary medication, hot flashes treatment and other steps that may improve quality of sleep.
Memory & concentration problems: Often linked to insomnia, stress and sleep problems, more than hormonal changes. Treatment: Use brain in different ways, read books, learn a new language or musical instrument
Other physiological changes include skin dryness, unwanted hair growth or loss, dental or oral issues, and development of osteoarthritis. (Australian Menopause Society, 2016)
WEIGHT MANAGEMENT DURING MENOPAUSE
Women gain half a kilo (0.5kg) per year between ages 45 and 55, the weight increase is not caused by menopause, as reduced physical activity and metabolic rate due to aging are the culprits. The decrease in estrogen levels though are associated with increased body and abdominal fat.
Abdominal fat and obesity are major risk factors of CVDs, development of type 2 diabetes, which along with the reduced protection of HDL, due to lower estrogen levels, makes weight management very important for this new period of a woman’s life. (Australian Menopause Society, 2016)
For weight management during menopause the woman needs a healthy, balanced diet with regular meals, as eating at irregular times can make some menopausal symptoms worse, such as the feeling of tiredness. Therefore, a balanced diet offers the right foods in variety, nutrition and proportion to promote health and maintain healthy body weight. (NHS Choices, 2016)
Additionally, regular activity and strength training to build and retain muscle mass, improves metabolism and maintains bone mass.
IMPACT OF NUTRITION
Adequate nutrition is important for all functions of the body, as maintaining the right weight and getting all necessary nutrients protects us from a long list of health conditions, reducing drastically the risk of their occurrence.
Nutrition has a serious impact on the following, menopause related conditions:
OSTEOPOROSIS
Lack of estrogen causes loss of bone mass, as bone breakdown becomes faster than bone buildup. Women over 50, especially those who are thin and short, have the greatest risk of developing osteoporosis, and are four times as likely to develop osteoporosis than men.
Appropriate nutrition will include the needed daily amounts of calcium (1200-1500mg for ages over 50), from good sources such as light yogurt, dark green leafy vegetables, and calcium fortified products. Vitamin D is also very important as it is used to absorb calcium, and the RDA (400-2000 IU) can be taken from eggs, salmon, cereal and fortified products, as well as by being out in the sun for 20 minutes per day. (Cleveland Clinic, 2016)
BREAST CANCER
After menopause, overweight women have an increased risk of breast cancer. Maintaining a healthy body weight reduces that risk, and adequate nutrition includes:
Up to 25% of daily calories coming from fat, avoiding trans fats and processed foods, and limiting saturated fats to less than 10% of fat intake (<2.5% of daily kcal).
Foods high in omega-3 fatty acids.
More than 5 cups of fruits & vegetables.
Whole grains and 28g of dietary fibers per day.
None, or up to 1 alcohol serving per day.
Adequate calcium, folate and vitamin A intake, through food or supplement. (Reid, et al., 2014)
Being protected from osteoporosis also helps reduce the risk of breast cancer development, so adequate nutrition will have an impact on overall health. (American Cancer Society, 2016)
CARDIOVASCULAR DISEASES
Dietary habits are known to affect many CVD risk factors, reducing blood pressure, LDL cholesterol, triglycerides, heart rate & arrhythmias, inflammation, and increasing HDL cholesterol levels. (American Heart Association, 2013)
An adequate diet pattern will:
Help reach and maintain healthy weight, which is linked to most CVD risk factors.
Increase fruit & vegetable servings, as each serving reduces CVD risk by 4%.
Increase whole grain & fiber intake, as 2.5 servings was found to reduce CVD risk by 21%.
A DASH diet with low sodium intake, reduces blood pressure by 7.1-11.5mm Hg in adults. (American Heart Association, 2013) CVDs are the highest health risks that women face after menopause, as their protective HDL drops with estrogen levels. Following a healthy diet will safeguard their health and enjoy life.
TIPS FOR HEALTHY AGING
Healthy aging can be helped by nutritional and lifestyle changes, as good nutrition habits and regular exercising improves overall health by maintaining healthy body weight, reducing stress levels and various risk factors that are able to damage our health over time.
NUTRITIONAL RECOMMENDATIONS
A balanced diet will provide protection from the health conditions discussed above, and give the needed calories and nutrients that the body needs to stay healthy, offering a variety of healthy choices to improve your nutritional habits:
Caloric needs may drop about 200kcal in the 50s compared to the 30s or 40s. A healthy diet will avoid energy dense foods, and prefer nutrient rich foods low in calories, that will help you feel full and will give all necessary nutrients. (Mayo Clinic, 2016)
Limit caloric intake to maintain healthy weight to 1600kcal if physical activity is low, 1800kcal if moderately active or 2000-2200 if physical activity is high. Consult your doctor or dietician for a personalized assessment. (National Institute on Aging, 2008)
Avoid or limit alcohol that adds unnecessary calories to 1 serving per day.
Protein requirements increase with age, choose lean meat, poultry or fish and cook it well. (NHS Choices, 2016)
Prefer fresh foods instead of processed.
Shift from sweets and sugary beverages to fruits, whole grains and other healthier choices.
Eat smaller, regular meals.
Limit fat intake up to 30% of daily caloric needs and increase oily fish consumption for omega-3 fatty acids. (Australian Menopause Society, 2016)
Get adequate calcium (1200mg), vitamin D (800+ IU), vitamin B12 (2.4mcg) and B6 (1.5mcg) and other required nutrients according to their RDAs. (National Institute on Aging, 2008)
Additionally, plenty of fluids are needed for good health, especially water.
LIFESTYLE CHANGES
Along with a good nutrition plan, lifestyle offers another important set of areas that can be improved by making better life choices:
Move more, add regular aerobic and strength training to gain and maintain muscle, maintain healthy body weight and bone mass. (Mayo Clinic, 2016)
Exercise increases HDL and reduces total cholesterol, triglycerides & blood pressure, while burning calories and improving endurance, flexibility, balance, posture and mood & self-esteem. (Australian Menopause Society, 2016)
Quit smoking and limit alcohol and caffeine.
Get enough sleep and practice relaxation techniques such as deep breathing and massage. (Mayo Clinic, 2016)
Communicate better to reduce stress, build relationships, set limits and realistic goals to avoid anxiety, mood swings and depression.
Practice safe sex to avoid sexually transmitted diseases (STDs).
Get in the habit of checking regularly your skin, teeth and eyes health.
Get important vaccines for shingles and pneumococcal pneumonia, as well as a flu shot every fall, and other. (National Institute on Aging, 2008)
Ultimately, listen to your body and consult with your doctor and dietitian for any needed treatment, medication and safe health recommendations.
REFERENCES
American Cancer Society, 2016. What are the risk factors for breast cancer?. [Online] Available at: http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-risk-factors
American Heart Association, 2013. Nutrition & Cardiovascular Diseases. [Online] Available at: https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319591.pdf
Australian Menopause Society, 2016. Lifestyle advice for healthy ageing. [Online] Available at: https://www.menopause.org.au/for-women/information-sheets/876-lifestyle-advice-for-healthy-ageing
Australian Menopause Society, 2016. Menopause and Body Changes. [Online] Available at: https://www.menopause.org.au/for-women/information-sheets/33-menopause-and-body-changes
Cleveland Clinic, 2016. Menopause & Osteoporosis. [Online] Available at: http://my.clevelandclinic.org/health/diseases_conditions/hic-what-is-perimenopause-menopause-postmenopause/hic_Menopause_and_Osteoporosis
Harvard Medical School, 2009. Dealing with the symptoms of menopause, Boston, MA: Harvard Health Publications.
Harvard Medical School, 2016. Menopause. [Online] Available at: http://www.health.harvard.edu/topics/menopause
Harvard Medical School, 2016. Menopause Makeover. [Online] Available at: http://www.health.harvard.edu/womens-health/menopause-makeover
Harvard Women’s Health Watch, 2015. Menopause symptoms can last longer than you expect. [Online] Available at: http://www.health.harvard.edu/womens-health/menopause-symptoms-can-last-longer-than-you-expect
Johns Hopkins University Medicine, 2016. Menopause. [Online] Available at: http://www.hopkinsmedicine.org/gynecology_obstetrics/specialty_areas/gynecological_services/conditions/menopause/
Mayo Clinic, 2016. How risky is weight gain after menopause?. [Online] Available at: http://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menopause-weight-gain/art-20046058?pg=2
Mayo Clinic, 2016. Menopause. [Online] Available at: http://www.mayoclinic.org/diseases-conditions/menopause
National Institute on Aging, 2008. Menopause: Time for a Change, s.l.: U.S. Department of Health & Human Services National Institutes of Health.
NHS Choices, 2016. Healthy eating during the menopause. [Online] Available at: http://www.nhs.uk/Livewell/menopause/Pages/Themenopauseanddiet.aspx
North American Menopause Society, 2016. Staying Healthy at Menopause and Beyond. [Online] Available at: https://www.menopause.org/for-women/menopauseflashes/women's-health-and-menopause/staying-healthy-at-menopause-and-beyond
Office on Women's Health, U.S. Department of Health and Human Services, 2016. Menopause symptom relief and treatments. [Online] Available at: http://www.womenshealth.gov/menopause/symptom-relief-treatment/natural-alternative-treatments-lifestyle-changes.html
Reid, R. et al., 2014. Managing Menopause. Journal of Obstetrics and Gynaecology Canada, 36(9).