Hot flushes affect quality of life for at least one in two women going through menopause. While hormone replacement therapy (HRT) is effective in reducing symptoms, many women are unwilling or unable to take. Several diet and lifestyle changes can help, however, of which the most important are to:
- Consider following a more organic diet – a wide range of agricultural chemicals (pesticides, weed killers, fungicides, fumigants, growth promoters, growth retardants, antibiotics, hormones and artificial fertilisers) can affect hormone balance and have been implicated in worsening menopausal symptoms.
- Obtain more plant hormones with an oestrogenic action such as soy isoflavones and lignans.
- Eat more live yogurt which boost the activation of plant hormones.
- Obtain sufficient vitamins and minerals which are needed for hormone production and cell responses to their effects.
Plant oestrogens for menopause
Some plant hormones, such as isoflavones, flavonoids and lignans, have a weak oestrogen-like action which provides a useful, natural boost when your hormone levels are low. In Asia, soy is a dietary staple and intakes of isoflavones are thirty to fifty times higher than in the West. As a result, less than a quarter of Japanese women complain of hot flushes around the menopause compared with up to 85% of Western women.
To increase your intake of natural plant hormones, aim to eat more:
- beans, especially soy products, chickpeas, lentils, alfalfa and mung beans
- members of the cabbage and turnip family, such as broccoli, spinach, Chinese leaves, kohl rabi, radishes and fennel
- nuts and seeds, especially flaxseed, pumpkin, sesame and sprouting seeds
- sweet potatoes which have a high lignan content
- apples and onions which are the richest dietary source of flavonoid polyphenols.
Plant oestrogens help to relieve the short and medium term menopausal symptoms such as hot flushes, nights sweats and intimate dryness, as well as helping to protect against the long-term effects of oestrogen withdrawal such as increased risk of coronary heart disease and osteoporosis. Although not as powerful as prescribed hormone replacement therapy, they can significantly reduce troublesome symptoms and are sometimes referred to as nature’s HRT.
Fruit and vegetables in general are key for menopausal health, so aim to eat at least 5-a-day. Researchers who followed over 6000 women through a natural menopause found that those eating the most fruit (especially strawberries and other berries, pineapple, melon, apricots and mango) or who followed a Mediterranean-style diet providing plenty of garlic, capsicum peppers, mushrooms, salad greens and fish, were almost 20% less likely to report hot flushes and night sweats compared with similar women who did not follow these patterns of eating. In contrast, those who ate the most sweet biscuits, cakes, jam, meat pies and confectionary were 23% more likely to experience troublesome menopausal symptoms.
Healthy fats are also important. While it’s a good idea to cut back on fat in general to reduce calories and help you maintain a healthy weight, concentrate on obtaining essential fatty acids that contribute to a healthy hormone balance, reduce inflammation and improve cholesterol balance such as monounsaturated and omega-3 fats that are found in nuts, olive oil, rapeseed and flaxseed oils, avocados and oily fish.
Soy isoflavones for menopause
Soy isoflavone supplements are an easy way to increase your intake of plant hormones if you don’t want to make drastic changes to your way of eating.
A large analysis of data from 62 trials, involving 6653 women, found that taking phytoestrogens such as isoflavones can reduce the daily frequency of hot flushes by 1.3 flushes, reduced their severity by 21% and improved intimate dryness. Significant differences are usually noted within 6 weeks, with maximum effects continuing over the following months. It can take at least 48 weeks to achive 80% of their maximum effects, so don’t give up on soy isoflavones too soon.
Increasing evidence also suggests that soy isoflavones can improve cognitive function (the ability to think straight), have beneficial effects on bone mineral density, and may have protective effects against breast, ovarian and intestinal cancers. If you have a personal or family history of these conditions, however, follow your doctor’s advice on whether or not to take isoflavone supplements as opinions vary.
Probiotic supplements for menopause
Isoflavones and lignans are mostly eaten in an inactive form and the active components are released by bacterial digestion in the gut. Different women metabolise plant oestrogens in different ways, depending on the balance of bacteria within their intestines. Those who possess good amounts of probiotic bacteria are able to metabolise one of the isoflavones found in soy (daidzein) to a more powerful oestrogen called equol. Equol producers therefore obtain more benefits from soy isoflavones than non-equol producers so eat live bio yogurt and/or take a probiotic supplement to increase your equol production. Supplements with a higher genistein content are also more effective against menopause symptoms.
Taking a probiotic supplement together with your isoflavone will help to optimise their benefits.
Black cohosh for menopause
Black cohosh – also known as squaw root – has lovely white and pink flowers but it is the root that is used medicinally. Black chosh roots are a traditional herbal medicine used to relieve menopausal symptoms of hot flushes, night sweats, intimate dryness, mood swings, anxiety and restlessness. Although it contains a number of oestrogen-like plant hormones such as formononetin, its main action is believed to result from a direct action on the brain to lower levels of LH (luteinising hormone). It also helps to improve sleep quality by reducing night waking and has an effect on blood vessel dilation to reduce hot flushes and sweating.
Data from 7 trials involving over 1000 perimenopausal women, showed that Black cohosh reduced hot flushes and night sweats by 26% more than placebo. This is an impressive result given that the placebo itself reduced the severity or frequency of hot flushes by 25% to 30% after 4 weeks treatment. When Black cohosh was used together with St John’s wort, the combined improvement was 33% greater than that seen with placebo.It may be taken together with soy isoflavones if you wish.
Some reports linked Black cohosh with liver toxicity, but when these were investigated it was found that other factors such as a high alcohol intake, or the use of paracetamol or other drugs known to affect the liver, was involved. Reassuringly, there was no evidence of liver toxicity or changes in liver function in 5 studies, involving 1,117 women, who used Black cohosh for 3 to 6 months.
Sage leaf for menopause
Sage is a well-known Mediterranean herb whose name, Salvia, comes from the Latin salvere which means ‘to be saved’. Its leaves – especially those from the red purple-tinged varieties – contain a number of essential oils such as borneol and camphor, and the polyphenol, rosmarinic acid, which has beneficial effects in reducing excessive perspiration.
Sage leaf extracts can relieve menopausal hot flushes and are especially helpful for night sweats. A study involving 69 women who were experiencing at least five flushes a day found that sage leaf extracts reduced the frequency of mild hot flushes by 46%, moderate flushes by 62%, severe flushes by 79% and stopped very severe flushes altogether. The intensity of flushes fell by half within 4 weeks and reduced by 64% within 8 weeks.
Sage leaf is also used to improve memory and alertness, and to promote feelings of calm and contentedness.
St John’s wort for menopause
St John’s Wort is sometimes referred to as nature’s ‘sunshine’ herb for its beneficial effects in lifting a low mood. It has vibrant yellow petals which, when held up to the light, reveal numerous pinpoint red glands that contain a fluorescent red dye. This dye contains numerous substances with a natural, antidepressant action, including hypericin and hyperforin.
St John’s wort is believed to work by helping to prolong the action of a wide range of neurotransmitters in the brain, including serotonin, noradrenaline, dopamine, GABA and L-glutamate.
St John’s Wort helps to lift a low mood that can occur around the time of the menopause. Data from 27 studies, involving over 3,120 people with depression found that St John’s wort extracts were as effective as prescribed antidepressant drugs (SSRIs) with no differences between treatment in clinical response, remission, and reduction in depression scores. Treatment with St John’s wort produced significantly fewer side effects, however, and the researchers concluded that St John’s wort extract was a safer treatment for mild-to-moderate depression.
St John’s wort also helps to overcome low sex drive and physical exhaustion in menopausal women. In one study, 60% of menopausal women with low libido became interested in sex again, and even initiated sex with their partner. Eighty-two per cent also experienced reduced irritability, anxiety, low mood, hot flushes, sweating and disturbed sleep. They also reported increased self-esteem, as well as a marked increase in self-confidence and self-respect.
NB Before taking herbal supplements, check with a pharmacist if you are taking other herbal or prescribed medications to rule out any interactions.
Vitamins and minerals for menopause
Most vitamins and minerals are involved in the production of sex hormones, or the way that cells to respond to them properly. Lack of vitamins and minerals can worsen menopausal symptoms and, in the long-term can increase your risk of future health problems, including brittle bones. Vitamin and mineral deficiencies can also contribute to low sex drive.
Calcium supplements help to improve bone mineral density and can reduce the risk of bone fractures.
Vitamin D is needed for calcium absorption and is also involved in immunity, cardiovascular, brain and joint health.
Folic acid, vitamin B6 and vitamin B12 help to maintain a healthy heart and circulation and may reduce the risk of developing dementia. B vitamins are also involved in energy production and overcoming fatigue.
Magnesium is needed for over 300 metabolic enzymes to work properly, and is involved in hormone balance, muscle contraction, nerve conduction and blood vessel dilation. It helps to improve sleep, constipation and may reduce restless leg syndrome which is common at this time of life.
Zinc is needed for hormone production and responses and deficiency can worsen menopausal symptoms.
Several multivitamin blends are designed for women experiencing menopause, and often contain additional beneficial ingredients such as soy isoflavones.
Evening primrose oil for menopause
Whatever else you take, I recommend that you also use evening primrose oil supplements. These supply essential fatty acids that are involved in making sex hormones, reducing inflammation and improving calcium metabolism so that it is better deposited in bones.
As a bonus, evening primrose oil improves skin quality, reduces skin dryness and itching, and making a noticeable difference to skin smoothness and lustre. It may even reduce the appearance of skin wrinkles. In a trial involving women in their forties, those taking 3g evening primrose oil experienced a twenty per cent improvement in skin moisture, smoothness, elasticity and firmness within three months. Evening primrose oil was also found to significantly reduce the frequency, severity and duration of menopausal hot flushes compared with inactive placebo.
|My book, Menopause Diet: Eat To Beat Hot Flashes is available on Amazon.co.uk and Amazon.com.|
Which dietary changes or supplements have you found most helpful for menopause-related symptoms? Please share your experiences below.