Can you make menopause easier by changing your diet?

Yes, improving your diet could help – eating a healthy balanced diet and losing any extra weight can help ease your symptoms of menopause. Changing certain aspects of your diet is also more important when you are going through menopause.

What is the evidence for diet affecting menopause symptoms? – there is some evidence that adjusting your diet reduces both the short term and the long term effects of your menopause such as hot flushes and protecting your heart and bones. Lifestyle adjustments such as stopping smoking and reducing alcohol intake also has a positive effect in helping to reduce symptoms such as hot flushes. Some dietary adjustments currently have conflicting evidence such as phytoestrogens and are not part of official guidelines.

So eating well is important for menopause? – eating a healthy balanced diet is important in all stages of your life, but it can also help ease some of your menopause symptoms. Official guidelines suggest that every woman should include a healthy balanced diet as part of her lifestyle changes to help make the transition through menopause easier and to minimise long term health problems. Eating healthily in general is based on the Eatwell guide, which is a policy based on what the government recommends to have a healthy and balanced diet.

Are there any diets I could try? – there is no evidence that specific diets can treat menopause, but a healthy balanced diet is recommended to help ease you through menopause.

Can diet affect individual menopause symptoms?

Vasomotor symptoms are the ones targeted by treatment – the most common symptoms for which HRT is prescribed for are to relieve the ‘vasomotor symptoms’. They are a form of temperature dysfunction in the body as a result of the declining hormones. They include hot flushes and night sweats.

Vasomotor symptoms commonly interrupt your regular sleeping pattern which leads to other symptoms such as, difficulty sleeping, excessive tiredness and mood swings. Most of the adjustments in your diet will help with the vasomotor symptoms, which are one of the most common symptoms of menopause. 

Specific diet changes – there is evidence for the following adjustments improving certain symptoms of your menopause:

• Cutting out sugar can help to minimise fatigue and weight gain, as a low sugar diet lowers your blood sugar levels

• Reducing refined carbohydrates such as white pasta and bread can improve your mood swings and tiredness

• Reducing caffeine can improve your mood and cause less disturbance with your sleep pattern

• Reducing alcohol improves your sleeping pattern and mood swings. You also reduce calories to your daily intake and improve your weight control

• Spicy food increases your body temperature and should be avoided to help with hot flushes

Trying 'phytoestrogens' – there is some research that phytoestrogens in your diet help reduce your menopause symptoms. They are present as dietary supplements and are marketed as natural alternatives to oestrogen replacement therapy. They are found in a range of plants with the most common one being soya. There is currently insufficient evidence that they reduce menopause symptoms but they may help some women with hot flushes.

Flaxseeds – flaxseeds contain lignans, which are a type of nutrient that may help in menopausal symptoms such as hot flushes and in improving bone health. Current evidence is limited, but they are a still a good source of fibre and omega-3 which promotes heart health.

Can diet or weight affect when your menopause starts?

Diet could affect when menopause starts – diet may be associated with the age at the onset of natural menopause. The onset of menopause varies for each woman but menopause that occurs too early or late can affect your health long term. 

Risks of early menopause – menopause that starts early can affect your fertility and deprive you of the positive effects of oestrogen such as protection against heart disease and bone health. Menopause that starts late can increase the risk of breast, ovarian and womb cancer.

Diet for later menopause – there is some evidence that shows a healthy diet rich in oily fish, legumes and certain nutrients including vitamin B6 and zinc is associated with a later onset of natural menopause. A diet high in refined carbohydrates such as pasta and rice are associated with an earlier age of menopause.

How much you weigh can determines when you enter menopause – oestrogen is stored in body fat. Overweight women are at a greater risk of a late menopause as they have more body fat. Thinner women are at greater risk of early menopause as they have less body fat in which to store oestrogen. 

Some research suggests that the association between weight and the onset of menopause is stronger if you are underweight or overweight at least five years before the onset of menopause.

Weight control during menopause – if you are not overweight before you start menopause then all you may need is to control your energy intake in your diet and to increase your exercise. If you are overweight or obese then a low energy and balanced diet is best to help control your weight during menopause.

Being proactive about weight – ideally if you are going through the menopause, you should begin to try and control your weight before it becomes a problem. It is important to be mindful about your daily diet and to be keep active.

Does losing weight help improve symptoms in general?

Menopause can cause weight gain – the decline in your sex hormones can cause you to gain weight during menopause. This is usually due to the redistribution of fat around your stomach area. Weight gain can be anything between 2 to 5 kg. 

Losing weight could help reduce symptoms – including symptoms such as hot flushes and night sweats. One study found that women who were not already on HRT but were on a healthy low fat diet and managed to lose around 10 lb, had fewer hot flushes or night sweats the following year compared to women who lost less weight or whose weight stayed the same.

Weight and menopause aren't full understood – it is not yet fully understood how losing weight can improve menopause symptoms and research is still ongoing. It is thought to be related to the fluctuating hormones in your body and the brain signals regulating body temperature.

Overweight women tend to produce more oestrogen – this can aggravate hot flushes and night sweats. Fat cells have the ability to produce oestrogen in the body making the body work harder to turn calories into fat in a bid to increase levels. You therefore deposit more fat in your body during menopause.

How can I lose weight during the menopause? – there are many ways to help weight loss during the menopause which involve adjusting your diet and lifestyle such as:

• Take regular exercise such as walking, cycling – aim for 30 to 45 mins daily 

• Eat regularly – skipping meals makes it difficult to maintain a healthy weight

• Eat at least five portions of fruit and vegetables a day

• Always keep well hydrated and drink plenty of water – this also helps to reduce bloating

• Include low glycaemic carbohydrates with each meal such as oats, barley or couscous. This help with mood swings.

• Include phytoestrogen rich food in your diet daily. This includes yogurts and pulses.

• Include 2 - 3 daily servings of low fat dairy foods to keep your calcium levels high

• Avoid excess caffeine – aim to drink no more than 3 or 4 cups of coffee or tea a day

• Avoid putting on excess weight and try not go above a size 16 dress size

• Avoid excess alcohol – try not to exceed 2 – 3 units a day

• Avoid excess sugar

• Quit smoking – this also improves your bone health

• Maintain a regular sleep pattern – aim for 6 – 8 hours each night

Can you use diet instead of medical menopause treatments?

No, it shouldn’t completely replace treatment – A healthy balanced diet is currently recommended to all women going through the menopause. It can help with short to long term symptoms. It is currently not recommended as a replacement for medical treatment.

When should I seek medical treatment? – If your menopause symptoms are troublesome and affect your daily life then it is advised that you speak to your doctor to discuss treatment options. Diet alone does not always help with symptoms or provide relief quicker than medical treatment.

What are the medical treatments for menopause? – Hormone Replacement therapy (HRT) is the main treatment for menopause symptoms. HRT is a well-known and effective treatment that works by replacing your declining sex hormones.

There are two different types of HRT:

• Oestrogen only (no progesterone) – for women who have had a hysterectomy (surgical removal of the uterus) and do not need progesterone to protect the womb lining

• Combined HRT (oestrogen and progesterone) – for women with a womb

HRT can be taken in the following ways:

• Tablets

• Skin patches

• Vaginal creams

• Vaginal tablets (pessaries)

• Gel

• Implants

HRT treatment has an important and positive role to play in improving your quality of life – HRT however, does come with some risks and it is important to discuss both the benefits and risks with your doctor.

Other treatments for menopause are:

• Tibolone – a synthetic steroid whose effects and benefits are similar to combined HRT

• Anti-depressants – selective serotonin reuptake inhibitors (SSRI’s) or serotonin noradrenaline reuptake inhibitors (SNRI’s) can help with hot flushes, but they are not licensed for this use

• Clonidine – a prescription medicine that can help reduce hot flushes or night sweats

• Bioidentical hormones – hormone preparations made from plant sources that are promoted as being similar to human hormones. It is not known how effective they are in reducing menopausal symptoms

• Complimentary therapies – Black Cohosh and St John’s Wort have some positive evidence against reducing hot flushes but generally other complimentary therapies don’t and are not advised because their safety isn’t guaranteed

How do these treatments compare to diet?

• Fewer risks with dieting – adjusting your diet is a naturally safer way to manage your symptoms in comparison to medical treatment. Risks associated with changing your diet are almost none unless you have an allergic reaction to a new food. Many women may be reluctant to use HRT because of the associated risks of breast cancer and heart disease. It is important to discuss this with your doctor as the risks and side effects of HRT are specific to each woman

• Faster results with HRT – the benefits of HRT are usually seen within the first few weeks of treatment whereas with a diet the effects may or not be seen until over a longer period of time

• Weight loss with dieting – HRT does not help you to lose weight but a healthy diet can help you lose or balance your weight through your menopause

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