Perimenopause marks the transition to menopause, typically starting in the 40s, as oestrogen levels decrease, and periods become irregular. This stage may last several years, with menopause confirmed after 12 consecutive months without a period, usually between ages 45 and 55, with the average onset at 51 in the UK. An estimated 8 in 10 women will experience common symptoms. Common menopause signs and symptoms include:
Weight gain
Hot flushes
Poor sleep
Night sweats
Mood swings
Anxiety
Fatigue
Vaginal dryness
Brain fog
Headaches
Changes in libido
Joint and muscle aches and pains
Bladder control
Diagnosis
In women over 45 blood tests are not recommended to diagnose perimenopause and menopause. Symptoms should be used instead. You can track symptoms using Menopause trackers such as the Balance App.
Protein and Menopause
Oestrogen decline can lead to a loss of lean muscle mass, which is essential for a healthy metabolism. Ensuring an adequate protein intake helps support muscle repair and retention. Aim to include protein-rich foods like lean meats, poultry, fish, eggs, legumes, tofu, and dairy. For optimal results, consume 1-1.2g of protein per kilogram of body weight daily and combine with strength exercises to preserve muscle mass.
Bone Health
As menopause often triggers a decline in bone density, the risk of osteoporosis increases due to reduced oestrogen levels. Counter this by consuming sufficient calcium and Vitamin D. Foods rich in calcium include dairy products, calcium-fortified plant-based drinks, tinned fish (with bones), spinach, tofu, and dried figs. Vitamin D aids calcium absorption and regulates oestrogen production. In the UK and Ireland, where sunlight is limited in winter, it’s recommended to take a daily Vitamin D supplement of at least 10 micrograms. Vitamin K is also vital for bone health and I often recommend a supplement that contains both Vitamin D and Vitamin K.
Phytoestrogens and Menopause
Phytoestrogens, plant compounds that mimic oestrogen, may help reduce symptoms like hot flushes and night sweats. Foods rich in phytoestrogens include:
Soy products such as tofu, tempeh and edamame beans (opt for organic, silken works well in smoothies)
Flaxseeds (opt for ground and keep in your fridge)
Legumes such as lentils, chickpeas
Sesame seeds
Berries
Apricots
Barley
You can read more about phytoestrogens here.
Weight Gain
Menopause weight gain is a common experience for many women, typically occurring as hormonal changes, particularly the reduction in oestrogen, affect how the body stores fat. This shift often leads to an increase in abdominal fat, even for those who previously maintained a stable weight. Additionally, metabolism tends to slow down during menopause, making it easier to gain weight and harder to lose it. You can read more about this in my blog post here.
Gut Health
The gut microbiome, a collection of bacteria and microorganisms in the digestive system, plays a key role in overall health and hormone balance, particularly during menopause. The "oestrobiome" refers to a subset of the gut bacteria that help regulate oestrogen levels. When the gut microbiome becomes imbalanced, often due to a lack of bacterial diversity, this process can be disrupted, leading to lower circulating oestrogen levels To support your gut microbiome, include probiotic-rich foods like yoghurt, kefir, sauerkraut, and miso in your diet and ensure your diet contains a wide variety of plant foods.
Managing Caffeine and Alcohol
Many women find that reducing caffeine, alcohol, and spicy foods helps alleviate hot flushes. Being
mindful of these triggers can offer symptom relief.
Conclusion
Menopause brings about significant changes, but proper nutrition can be an effective tool for managing symptoms and maintaining long-term health. A diet rich in protein, calcium, Vitamin D, phytoestrogens, and gut-friendly foods, alongside reducing caffeine and alcohol, can make a noticeable difference. For personalised advice, consult a nutritionist or dietitian to develop a plan tailored to your needs during menopause.
Useful Resources
The following website may be useful for further information:
The British Menopause Society https://thebms.org.uk/
Directory of pelvic floor physios https://squeezyapp.com/directory/
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