Perimenopause, Menopause and Nutrition

Each year on 18th October, we mark International Menopause Day, and as we approach that date, I wanted to take a moment to talk about menopause. While my expertise as a registered dietitian lies in nutrition, it’s essential to have a well-rounded understanding of menopause and perimenopause. This allows me to refer patients to other professionals, such as consultants, physiotherapists, or psychologists.

In the UK, menopause services recently gained attention through a BBC Panorama programme, highlighting concerns around menopause care. While it is important to remain cautious about misleading information, particularly about products marketed towards menopausal women, not all services should be viewed with suspicion. It’s essential to seek advice from trained healthcare professionals and, if unsatisfied with the guidance you receive, do not hesitate to seek a second opinion.

Menopause and perimenopause are areas that have historically received less focus in medical research, but that’s starting to change. There’s now a growing conversation around female health, and the NHS is making strides, though it remains under-resourced to meet the full demand for menopausal care. Many women turn to private healthcare for support, and the current gaps in the system can be frustrating. I faced challenges in my early perimenopause journey, as GPs often lack the training and time to offer comprehensive support in this area.

Fortunately, progress is being made. Updated guidelines are expected in November 2024, which will help improve care for women during this stage of life. It is important to remember, though, that the process is very iterative and relies on your expertise about yourself—not just the experience of the person advising you.

Women have been wise about their own bodies for centuries. We are no less wise now: it’s sometimes hard to hear and trust our voices in all the noise.

Understanding Menopause and Perimenopause

Menopause is a natural process that affects all women. In the UK, the average age of menopause is 51, though hormonal changes begin years earlier during perimenopause.

Menopause Symptoms

While periods may still occur in perimenopause, women often experience many of the same symptoms as menopause, such as hot flushes, night sweats, vaginal dryness, and brain fog. Some women may experience early menopause, while for others, it occurs later in life.

Symptoms vary widely among women and may not occur all at once. While some women experience mild symptoms, others face more significant challenges, impacting their daily lives. In the UK, statistics reveal that 1 in 5 women leave their jobs due to menopause-related symptoms—a striking figure considering its long-term implications.

The Role of Nutrition in Managing Menopause

Preparing for menopause involves finding the right tools, and nutrition plays a key role in this. By understanding how your nutritional needs change during this transition, you can better manage both the physical and emotional symptoms.

1. Balanced Diet: Hormonal changes during menopause can lead to weight gain due to a slower metabolism. A balanced diet is essential, and the recent emphasis on plant-based diets is a positive step. Increasing dietary fibre, and whole grains, and reducing processed sugars helps manage these changes. It’s also important to manage gastrointestinal symptoms, such as bloating or constipation, which can arise during this time. Ensuring proper hydration is crucial.
2. Bone Health: As oestrogen levels decline, bone density decreases, increasing the risk of osteoporosis. Therefore, ensuring an adequate intake of calcium-rich foods is vital. Dairy products or fortified alternatives like almond milk, tofu, and leafy greens are good sources. Vitamin D is also essential, particularly in the UK where sunlight is limited during winter months. The current advice is to take a vitamin D supplement from October to April, but some people may require year-round supplementation depending on factors such as skin tone and lifestyle. Foods such as oily fish, eggs, and fortified cereals are good dietary sources.
3. Physical Activity: Weight-bearing exercises are highly beneficial for bone and muscle health. Exercises such as resistance training not only support physical health but also have significant mental health benefits. They help regulate hormones like serotonin and endorphins, which can improve mood, reduce anxiety, and alleviate symptoms of depression. Studies show that physical activity can have a positive impact on cognitive function and emotional well-being.
4. Phytoestrogens: While phytoestrogens found in foods cannot replace the body’s declining oestrogen, they may help alleviate some symptoms, like hot flushes. Soy products, legumes, and flaxseeds are good sources of phytoestrogens, and incorporating them into your diet may offer some relief.
5. Cardiovascular Health: As menopause increases the risk of cardiovascular disease due to changes in fat distribution and cholesterol levels, maintaining a heart-healthy diet becomes even more important. This includes increasing fibre intake, consuming oily fish, and opting for healthy fats from nuts, seeds, and olive oil while limiting saturated fats and processed sugars.
   

In summary, nutrition plays a critical role in managing menopause, not only by helping with symptoms but by promoting overall good health. This can reduce the number of women forced to give up work due to menopause-related issues. By staying informed and working with healthcare professionals, women can better navigate this transition with confidence.