Diet and Menopause

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A natural part of aging ‘Menopause’, the word comes from the Greek words mens, meaning monthly, and pausis, meaning cessation, is the end of a woman’s monthly menstrual periods. It has been described by the World Health Organization as:
 “…the permanent cessation of menstruation resulting from the loss of  ovarian follicular activity.”
                                                       (WHO, 1996)
The process usually occurs around 45 to 55 years of age, signaling an end to fertile years. Menopause may be part of a number of adjustments that women experience around midlife in her fifties. Managing menopause can take place amidst changing family roles, looking after aging parents, thinking about retirement and wondering what she will do with the rest of her life. 
Menopause – the final menstrual period is known with certainty only in retrospect a year or more after the event. The term perimenopause includes the period immediately prior to the menopause and the first 12 months after the menopause. Postmenopausal period refers to the time dating from the final menstrual period, regardless of whether the menopause was natural or brought on.
For some women however, menopause may occur at an earlier age. Early menopause (also known as premature menopause) affects almost 10 per cent of women under the age of forty. Surgical menopause is when the ovaries are removed at surgery prior to natural menopause (also known as oophorectomy). 

Few years immediately before the menopause, the production of oestrogen and progesterone falls gradually, along with the reduction in egg production. At this stage periods can become heavier and less regular. Eventually, despite the increased production of these hormones, there is insufficient circulating oestrogen to stimulate growth of the uterus lining. This is when a woman reaches her menopause.
During menopause, fluctuations in estrogen levels can cause symptoms like hot flushes (sudden intense waves of heat and sweating), night sweats, depression, anxiety, forgetfulness, headaches,  mood swings,  insomnia, vaginal dryness or inflammation, infections, urinary incontinence, irritability, difficulty concentrating, weight gain and skin and hair changes. While some may have a smooth sail into menopause, others are distressed with severe symptoms. For some women, they may last for just a few months or linger for several years.
After menopause, a woman also faces a much higher risk of developing osteoporosis and heart disease and consequently a reduced quality of life.
Although not as simple as swallowing a pill, a healthy diet and regular exercise can help ease the symptoms of menopause and reduce the risk of chronic diseases.
A healthy diet rich in whole grains and pulses especially soy, fruits and vegetables, low fat dairy and nuts and seeds with limited intake of sugar, salt, harmful fats (trans fats) and alcohol is recommended. Special nutrients which have been found useful include calcium, magnesium, manganese, copper, zinc, vitamins B6, B 12, E and K, phytoestrogens, essential fats and bioflavonoids.
Foods which are known to worsen symptoms are excessive caffeine (coffee, tea, chocolate, colas) alcohol and spicy foods.
Studies have shown that soy foods not only help ease hot flushes but also protect against heart disease. Soy foods contain Isoflavones, which have a weak estrogenic effect in the body. Soy foods can be included in the diet in the form of tofu, soybeans, soy beverages, soy nuts, and soy protein. While Soy foods are safe enough, the safety and efficacy of isoflavone supplements have not been demonstrated. Addition of even small amounts on a regular basis, like a few servings a week can be beneficial. Excessive consumption, particularly, for those with a history of hormone related cancers can be counter-productive.
Other foods that contain phyto-estrogens are flaxseeds, chickpeas and other legumes, and in lesser amounts in carrots, corn, apples and oats. By mimicking estrogen, these phyto-estrogens may help alleviate menopause related symptoms like hot flushes and also protect against heart disease and osteoporosis.
Four important nutrients for menopause:
Vitamin E: Considered useful in alleviating hot flushes and thought to offer some heart protection, a recent study showed that 400 IU of vitamin E taken twice daily did not seem to offer significant benefits. Although, benefits of supplements have not been shown consistently, stepping up foods rich in vitamin E is recommended. In case of severe symptoms short term supplementation may be useful. Foods rich in vitamin E include nuts and seeds, egg yolk and wheat germ.
Calcium:   A woman may lose 10-20 percent of her bone mass in the decade following menopause, with a slower but still significant loss thereafter. Calcium intake has to be optimum during this period to help prevent the development of osteoporosis. Good sources are milk and milk products, almonds, ragi, amaranth, broccoli and spinach. To absorb calcium, body needs vitamin D, which can be made by the skin after exposure to the sun, dietary sources of this vitamin include fortified milk, eggs and fish oil. Eat three to four portions of calcium-rich foods every day
Magnesium: Works with calcium to maintain bone density. Some studies even point to magnesium intake as a stronger predictor of bone density than calcium intake. It is found in whole grains, milk & milk products, tofu, nuts and seeds and legumes.
Essential fats: Rich sources of omega 3 fatty acids are flax seeds and oily fish. They play important role in controlling depression and mood swings. They are also helpful for general well being and to prevent chronic degenerative diseases like heart disease, high blood pressure and cancer.
Exposure to sunlight, a significant source of vitamin D, is beneficial for women at this time, especially those who seldom go out in the sun. Also, adequate amount of vitamin D should be taken in the diet, in the form of oily fish, or a supplement.
Evening primrose oil, an essential fatty acid, is a significant source of GLA; without which the body cannot maintain the right balance of prostaglandins. Prostaglandins help in reducing inflammation, blood pressure and blood clotting. GLA ordinarily is made in the body, however, with age and consumption of toxic fats (trans fats), the production of GLA declines. Senior citizens often benefit from pre-formed GLA found in Primrose oil.  
Various herbal supplements, such as Black cohosh, Dong quai and wild yam have been used as a part of alternative therapy to ease the symptoms of menopause, but, as yet, there is not sufficient evidence to support their effectiveness.
Together with a healthy diet rich in calcium, exercises such as weight bearing exercises -brisk walking, jogging, aerobics, swimming help keep bones strong and maintain good heart health.