Menopause

There is still a lot more research to be done, but it looks as if the right foods could help reduce hot flushes and protect you from heart disease. This is important because after the menopause women become just as prone as men to heart disease.

Here are 12 dietary tips that may ease menopause symptoms:

1 Eat more phyto-oestrogens. These are plant chemicals, found in some fruit, vegetables, beans and seeds, which act like weak forms of oestrogen. They might ease menopausal symptoms slightly if you eat enough of them and eat them regularly. Rich sources include soya products, including tofu and linseed/flaxseed (see below).
2 Eat more fruit and vegetables. As well as phyto-oestrogens, they contain vital vitamins and minerals, including boron, which seems to help the body keep hold of oestrogen and calcium.
3 Eat tofu and other soy products. This is not because they help prevent hot flushes, or (as it used to be said) reduce ‘bad’ cholesterol, but because they are very healthy, low-fat, high protein foods. Soy products are rich in fibre, omega-3 oils, and essential protein. They have more vitamins and minerals than meat or dairy proteins, and contain ‘good’ (polyunsaturated) fats, which are healthier than the saturated fats found in meat, butter and cheese.
4 Eat beans and sprouted seeds. They are full of fibre, contain phyto-oestrogens, and may help keep your blood sugar at an even level. (Sudden rises in blood sugar may encourage hot flushes.)
5 Eat more of the right fats. Some fats are harmful. Some, such as omega-3 oils (found in oily fish like mackerel and olive oil), help prevent heart disease and cancer. But saturated fats and trans fatty acids (found in manufactured baked goods, and deep-fried foods such as chips) make us more prone to heart disease, diabetes and possibly prostate and breast cancer. So it makes sense to switch to olive oil, and eat more fish and less animal fat.
6 Reduce alcohol and caffeine. As well as cutting down on tea, coffee and alcohol, you should increase your intake of fruit juices and vegetable juices because they are rich in phyto-oestrogens and anti-oxidants
7 Snack, don’t feast. Eat frequent small meals to keep your blood sugar level even. Don’t miss breakfast – it gives you the energy boost you need first thing in the morning. Have light lunches and no late-night big meals when you’re about to rest and your body will store the surplus as fat.
8 Eat calcium-rich foods. You can get calcium not just from milk products but also from seeds and grains. Taking in enough calcium helps maintain strong bones.
9 Shun foods that are high in fat and sugar. Preventing weight gain is important. Women don’t just ‘naturally’ gain weight when their periods stop. Keeping your fat and sugar intake low will help you control your weight.
10 Add ground-up flaxseed (linseed) to your food. This is one of the richest plant sources of phyto-oestrogen and also provides the vegetable version of the omega 3 oil that helps prevent harmful blood clots. But note that bottled flaxseed oil does not contain phyto-oestrogens.
11 Take vitamin D supplements if you need them. Oily fish and dairy products are good sources of vitamin D, and sunlight helps the body make vitamin D. If your diet is poor and you don’t get into the sun, ask your doctor about a vitamin D blood test. If it’s normal, there’s no point in taking vitamin D. If it’s low, your GP will prescribe it for you.
12 Exercise so that your body burns fat faster. Exercising will help lower your blood cholesterol levels, improve your mood, reduce bone loss, boost your circulation and heart health, lower your risk of getting breast cancer and make your heart and lungs work better.

Summary
Cutting down on alcohol and stopping smoking are likely to improve your health generally. Like caffeine, alcohol can affect the quality of your sleep and worsen the anxiety and low mood that can occur in menopause.

Moderate drinking means no more than two drinks a day for men and one drink a day for women. A unit of alcohol is half a pint of ordinary strength beer, lager or cider or a small pub measure (25 ml) of spirits or a standard pub measure (50 ml) of fortified wine such as sherry or port (20% alcohol by volume). A small (125ml) glass of basic wine is 1 and a 1/2 units.

Evidence
It does seem that alcohol and smoking may make hot flushes worse. A survey of 28,000 women in France found that smokers and drinkers were more likely to get menopausal symptoms.

Safety
Cutting down on smoking and alcohol is safe, but if you are cutting down from heavy use, there can be side effects including loss of appetite and difficulty sleeping. There are unlikely to be side effects if you are cutting down a moderate alcohol intake but if you are a very heavy drinker, it is better to get help with cutting down.

Cost
No costs are involved and think of the money you will save!

Further information
For more information, see the NHS information sensible drinking.

If you are giving up or cutting down on smoking you can order a Quit Kit from SmokefreeNHS. You can also phone the NHS Free Smoking Helpline on 0800 022 4332.

Summary
It is always important to have a healthy diet. This means a diet that includes enough vitamins and minerals, and plenty of fruit, vegetables and whole grains. Your diet should also be low in fat, sugar and salt. Improving your diet could help with your mood.

When your periods stop and your oestrogen levels go right down, your total cholesterol level rises. Research has shown that one type of cholesterol is bad for the body, while another type protects health. During the menopause, ‘bad’ cholesterol rises, while ‘good’ cholesterol levels fall.

Previous research suggested that soy products could help lower cholesterol and so prevent heart disease. But later research has indicated that this might not be the case; at least not if you only eat 25 g of soy protein a day. Nevertheless, soy products (such as tofu, soy butter, soy nuts and some soy burgers) are healthy foods because of their polyunsaturated fats, fibre, vitamins, minerals and low saturated fat. Eating less animal protein (which contains saturated fat and cholesterol) and substituting soy foods should therefore be good for the health of your heart.

Evidence
It seems that some foods can make hot flushes worse. For instance, a survey of 28,000 women in France found that those who ate sugary snacks were more likely to get menopausal symptoms.

Safety
If you want to make big changes to what you eat, it is a good idea to see a dietician or qualified nutritional therapist. They can help you make sure you are still eating a healthy diet and getting all the nutrients you need.

Cost
Eating a healthy diet and reducing or excluding some foods need not cost you anything. This is especially true if you prepare your own healthy meals, rather than buying costly ready-meals, which often contain a lot of hidden fats, salt and sugar. But if you consult a dietician or nutrionist there will be a charge, unless this is a service provided by your GP’s practice.

Summary
Some plants contain substances called phyto-oestrogens, which act in a similar way to oestrogen and may help to ease menopausal symptoms. But these foods have a much weaker effect on the body than oestrogen, and some may even have an ‘anti-oestrogenic’ effect. So it is difficult to predict which ones will be helpful. There are three kinds of phyto-oestrogens:

1 Isoflavones – good sources are soy products and pulses (such as lima beans and lentils).
2 Lignans – good sources are fruit, vegetables, grains and oilseeds (such as linseed).
3 Coumestans – good sources are sprouting seeds (such as alfalfa).

Many women now eat soy products as part of their everyday diet. The available evidence suggests that if you eat enough of them they might help mild to moderate hot flushes in early natural menopause. However, unlike synthetic HRT, none of the compounds researched so far seems to protect against breast cancer, bone fracture or heart disease.

Though phyto-oestrogens might help ease menopausal symptoms if you eat enough of them regularly, we don’t yet know how much is needed or how often. In fact the research to date has not proved that phyto-oestrogen foods or supplements are good for menopausal problem. Nevertheless, whole grains, ground flax and soy proteins are still great health-supporting foods, whether or not they have special benefits during the menopause.

Evidence
There have been lots of small studies of how different sorts of phyto-oestrogens affect menopausal symptoms. The results have been rather mixed, so we can’t firmly recommend adding them to your diet. But they are definitely safe, inexpensive, low-fat, high-protein food items.

Safety
Eating normal quantities of phyto-oestrogen-rich foods is unlikely to have any harmful effects. in fact these foods are generally very healthy.

Cost
No extra costs are involved if you prepare your own healthy meals using tofu, soy milk, pulses, whole grains, seeds, vegetables and fruit, rather than buying costly ready-meals, which often contain hidden fats, salt and sugar.

Summary
Relaxation will help with sleep problems, and with managing stress and coping with the tension or anxiety that women experiencing hot flushes and other menopausal symptoms often feel. Relaxation techniques are useful during rest periods or for helping you sleep.

Evidence
Relaxation techniques have been found to help reduce hot flushes in several research studies.

Safety
These techniques are generally safe unless you have a severe or long-standing mental health problem. For more on this, see our section on STRESS AND ANXIETY.

Cost
Once you have learned the relaxation techniques, there are no costs. There are many books and audio aids available and some people find it useful to join a class initially.