This week, we will be exploring the symptoms of menopause, usually starting at the perimenopausal stage, and learn about diet and menopause symptoms.

Previously, we discussed the three stages of the menopause: perimenopause, menopause, and post-menopause, and the nutritional considerations for each stage. 

• Perimenopause: the lead up to the menopause, where most of your symptoms will start.
• Menopause: when you have not had a menstrual period for the last 12 months.
• Post-menopause: the period following the menopause.

To read the blog post on menopause and nutrition, click here.

Menopause Symptoms

There are several symptoms of the menopause that women can experience, with varying levels of severity, including:

• Hot flushes
• Night sweats
• Vaginal dryness
• Sleeping problems
• Low mood
• Anxiety
• Reduced libido
• Trouble with memory and concentration

These symptoms can appear before your periods stop and can last for a number of years after your periods stop. However, this varies between women.

Treatments for Menopause Symptoms

Some current treatments for the symptoms of menopause include:

• Hormone replacement therapy (HRT) – used to replace oestrogen and relieve symptoms
• Vaginal oestrogen creams and lubricants – to reduce vaginal dryness
• Cognitive behavioural therapy (CBT) – to help you with low mood and anxiety, through talking therapy
• Exercise – to encourage a healthy weight and to help you stay fit

These can be used to help if you suffer with severe menopausal symptoms that may be affecting your everyday life. However, a healthy, balanced diet is also a suggestion for reducing the symptoms of menopause. There are numerous dietary changes that you can implement and as a result help to manage your symptoms [1].

Diet and Menopause Symptom Considerations

Hot Flushes and Night Sweats

There are several nutrients of interest advised to help manage the symptoms of hot flushes and night sweats. Phytoestrogens are compounds in the body, similar to human oestrogens. The two main types of phytoestrogens are:

• isoflavones
• lignans.

Firstly, isoflavones can be found in foods such as legumes, lentils, chickpeas, soya beans, and tofu. Secondly, lignans are found in cereals, flaxseeds, and fruit and vegetables. Since these foods contain weaker versions of oestrogen, they may help to alleviate some of your symptoms of the menopause, such as hot flushes. A recent study into the efficacy of phytoestrogens on menopausal symptoms concluded that phytoestrogens reduce the frequency of hot flushes, with no serious side-effects seen [2].

Fruit and vegetables are also recommended to reduce to incidence of hot flushes. A one-year intervention study into menopausal women found that women who ate more fruit, vegetables, soy, and fibre had 19% less hot flushes and night sweats, compared to a control group [3]. Cruciferous vegetables, such as broccoli, cauliflower, and cabbage, have additionally been found to be beneficial to menopausal women. One study found that broccoli can actually help to promote good oestrogens to protect against breast cancer and decrease levels of oestrogen that are related to breast cancer [4].

Sleep

In addition, what we eat can influence out sleep quality. There are a number of nutrition factors that can influence your sleep. It is recommended to avoid drinking caffeine, as caffeine blocks adenosine receptors in the brain and interferes with circadian melatonin rhythms. Adenosine is a chemical that promotes sleep, so when adenosine receptors become blocked, we feel more alert rather than sleepy. The quality and onset of sleep can additionally be affected by caffeine intake.

If you do choose to consume caffeine, it is suggested that you should do this earlier in the day. This is as the amount of time it takes for your body to process half of the caffeine ingested is around 4-6 hours. Some examples of foods containing caffeine are [5]:

• tea
• coffee
• fizzy drinks
• cacao .

Another suggestion would be to stop eating around 2 hours before bedtime. This is because when we eat our bodies produce insulin which suppresses melatonin, a chemical that promotes sleep. It is also important to ensure that meals before bedtime are not very high in carbohydrates as a significant trend between worse sleep quality and increasing carbohydrate intake has been reported, particularly with frequent consumption of energy drinks and fizzy drinks [6]. Therefore, a high carbohydrate intake can increase the number of times you wake up during the night and decrease the amount of deep sleep that you get [7]. 

Mood and Cognitive Function

What we eat can have an impact our brains, and there are a number of key nutrients that can promote good mood and healthy cognitive functioning. Our brains use 20% of the total energy that our bodies need, which means that carbohydrates are essential for brain health. When we don’t have enough glucose in our blood, we can feel tired, weak and ‘fuzzy minded’. However, eating regular meals throughout the day, containing wholegrain sources of carbohydrates, can help to ensure that you have adequate levels of glucose in our blood [8].

Vitamins and minerals for mood: nutrition and menopause symptoms

The lack of certain vitamins and minerals may also influence your mood and cognitive functions, this includes:

• Iron (red meat, fish, beans, pulses, and fortified cereals) – a lack of iron can cause us to feel weak, tired, and lethargic
• B vitamins (fortified foods, meat, fish, eggs, and dairy) – a lack of B vitamins can cause irritability, low mood, and tiredness
• Folate (liver, green vegetables, citrus fruits, beans, and fortified foods) – a lack of folate can cause increased feelings of depression, especially in older individuals 
• Selenium (brazil nuts, meat, fish, seeds, and wholemeal bread) – a lack of selenium can increase the incidence of negative moods.

Additionally, Vitamin D is another nutrient of concern as many people are deficient in it. A symptom of its deficiency includes depression [9]. Vitamin D can be found in oily fish, red meat, egg yolks, and fortified foods, but a supplement of 10 micrograms may be taken if you are at particular risk of vitamin D deficiency [10].

Finally, healthy fats, particularly omega-3, are an important part of your diet to promote good cognitive function and mood state. Foods containing omega-3 include oily fish, nuts, green leafy vegetables, seeds, and fortified eggs. Recent studies have identified a link between low levels of omega-3 in the body and incidence of depression and anxiety [11]. Additionally, there are numerous studies identifying the positive relationship between omega-3 intake and cognitive function [12, 13, 14].

Top Tips for diet and menopause symptoms

1. Eat plenty of fruit and vegetables to alleviate hot flushes and night sweats

2. Avoid or limit your caffeine intake too close to bedtime to prevent sleep disruptions

3. Eat plenty of wholegrain carbohydrates to fuel the brain

4. Ensure you’re meeting all your micronutrient needs to prevent any effects on mood

5. Eat plenty of foods containing omega-3 to promote good mood and cognitive function

Summary

In conclusion, what you eat can help to manage your menopause symptoms and exploring how you could make changes to your diet using the top tips as a guide is a great starting point. If you would like 121 support with making dietary change, email me at caroline@carolinehillnutiriton.co.uk

References

[1] https://www.nhs.uk/conditions/menopause/

[2] https://www.tandfonline.com/doi/full/10.3109/13697137.2014.966241

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3428489/

[4] https://pubmed.ncbi.nlm.nih.gov/10952093/

[5] https://www.sleepfoundation.org/nutrition/caffeine-and-sleep

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015038/

[7] https://www.sleepfoundation.org/physical-health/sleep-and-blood-glucose-levels

[8] https://www.intechopen.com/chapters/68362

[9] https://www.sciencedirect.com/science/article/pii/S0165032716308928?casa_token=TBOdstvV2_4AAAAA:8MURgFHosOfj7CGVqp8AhFA-hMjcad1xL9lkmy-52PBdnvJmg0d-dD2_cCEDxu29lntYUH5L86U

[10] https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/

[11] https://www.frontiersin.org/articles/10.3389/fphys.2018.01047/full

[12] https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/omega-3-fatty-acids-and-cognitive-health-in-older-people/BD61558597DEAB67B4D7EA1649A45642

[13] https://lipidworld.biomedcentral.com/articles/10.1186/s12944-019-1143-z

[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2826215/