The menopause is the term used to describe the time when a woman’s periods come to an end.
This is when the ovaries stop producing eggs, signalling the end of a woman’s reproductive years. Despite common belief, the menopause is not sudden, periods will become less regular. Many women will start to experience changes between the ages of 40 and 60.
For the first few years the menstrual cycle will become less regular, with some women suffering heavier periods than normal. Many women can find this quite stressful; the time leading up to the menopause is called the perimenopause and can last up to four years.
This fact-sheet will look at the different stages of menopause and what symptoms to look out for. We will discover how nutrition can ease symptoms and how a nutritionist can help you. We will also explore the treatments for menopause, including herbal remedies and whether supplements could effectively help to ease some of the side effects of menopause.
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The perimenopause is the time when the majority of women will start noticing changes. This may include hormonal changes and unstable moods. Many women will experience menopausal symptoms throughout all stages, with some finding it difficult to control the unpleasant side effects.
While some women are fortunate and do not suffer any adverse side effects, common symptoms include:
The emotional and physical changes during this time can unfortunately result in a range of sleep disturbances including night sweats, difficulty falling asleep, insomnia and restlessness. Regular sleep disturbances will often become debilitating, the person may start to feel irritated and lack concentration.
The menopause is known for causing hot flushes. A sudden sensation of heat in the face and chest can develop and may result in skin redness and perspiration. Usually, hot flushes will only last for a matter of minutes, but the intense heat can cause weakness and nausea.
Night sweats are hot flushes that occur during the night. Symptoms are similar to daytime flushes, although some women can experience excessive perspiration resulting in an uncomfortable sleep.
An estimated one third of women going through the menopause will suffer vaginal dryness. Symptoms can include itchiness and discomfort, causing sex to become painful.
While bladder conditions develop with age, the menopause has a tendency to increase a woman’s susceptibility to urinary tract infections, cystitis and bladder weakness.
Other common symptoms can include:
- sensation of the heart racing
- mood change
- difficulty concentrating
- loss of libido.
When does the menopause happen?
According to the NHS, 2014 data found the average age for menopause in the UK was 52. The menopausal stage is said to begin once periods have been absent for one year, after which the woman is considered to be post-menopausal.
What causes the menopause?
The changing hormone balance caused by the menopause means the body stops producing oestrogen. This oestrogen reduction is what causes the menopausal symptoms that women experience. While the menopause is a natural aging process, there are things that can cause the menopause to happen before the age of 40, these include:
- autoimmune disease
- radiotherapy around the pelvic area
- oophorectomy and hysterectomy
- medical conditions, such as Turner syndrome.
While the symptoms of menopause can start to take effect in women between the ages of 45 and 55, some women will experience the menopause in their younger years.
It is estimated that one per cent of women will go through the menopause before they are 40 and 0.1 per cent will see symptoms of the menopause in their 20s.
In addition to the natural menopausal symptoms, women who are undergoing an early menopause may have to cope with other physical and emotional worries.
If your mother or sister have experienced an early menopause, or you have been trying to become pregnant for more than a year, you may have to visit your doctor for diagnosis. Your GP may request blood tests to measure your follicle-stimulating hormone (FSH) - this is the hormone that causes your ovaries to produce oestrogen. If this production is slowing down, your levels of FSH will be high and may indicate an early menopause.
Few women seek advice from a medical professional with regards to their menopausal symptoms. This is often because symptoms naturally begin to subside after two to five years, though they may persist for longer.
If menopausal symptoms reach the stage where they are beginning to have a detrimental effect on everyday life, there are various treatments that may help. The type of treatment you will be offered will depend on your symptoms and medical history, treatments available include:
Selective serotonin reuptake inhibitors (SSRIs) are a common antidepressant prescribed to menopausal women as they can help reduce hot flushes. Despite the high success rate in SSRIs, they can have side effects such as nausea, anxiety and a reduced libido.
Hormone replacement therapy (HRT)
There are various types of HRT available, all of which are based around the premise of replacing the missing oestrogen that the ovaries are no longer producing. There are three main types of HRT:
- Cyclical HRT - Contains oestrogen and progestogen for women who are experiencing symptoms but are still having periods.
- Oestrogen-only HRT - This is for women who have had their womb and ovaries removed.
- Continuous-combined HRT - This is for post-menopausal women who have not had a period for over a year.
HRT can effectively prevent hot flushes, night sweats and vaginal symptoms. Prolonged use has also been found to contribute to the prevention of osteoporosis and bowel cancer.
Despite the benefits, there are risks to taking HRT. Studies have found that HRT is linked with stroke and breast cancer in women; if you are worried then visit your GP to discuss your concerns.
Like HRT, tibolone is often used as a substitute for combined HRT for post-menopausal women. This can help reduce hot flushes, night sweats and sexual concerns.
Moisturising creams and lubricants can help ease vaginal dryness. These can be purchased from most pharmacies.
Designed as a treatment for high blood pressure, clonidine has been found to help reduce night sweats and hot flushes in some women.
As with all medicines, do visit your GP to discuss the potential risks of taking treatments, your concerns and other options.
Herbal remedies for menopause
Many women experiencing mild menopausal symptoms or who are concerned about the possible side effects of hormone replacement therapy turn to complementary and alternative treatment. There is no hard evidence that they are an effective treatment. Yet herbal remedies for menopause are relied upon by millions of women who have found them to be beneficial.
There are various homeopathic remedies believed to reduce symptoms, these include:
Black cohosh is a highly researched herbal remedy for menopause. Made from the root of a black cohosh plant, studies have found it can help treat hot flushes. Please note this remedy for menopause may not be suitable for people who suffer liver problems.
Wild yam creams and pill supplements are popular herbal remedies for menopause treatment. The natural compounds in yams appear similar to human hormones, including estrogen and progesterone. Some women find this an alternative to HRT but no clinical studies have found evidence of these easing symptoms.
Red clover is a popular, well-known player in the list of herbal remedies for menopause. Whilst many women use red clover to ease their menopause symptoms, researchers saw mixed results.
If you are considering introducing alternative remedies into your lifestyle, please be aware that long-term safety has not been assessed. Many do contain oestrogenic properties, meaning they are not suitable for women who should not take oestrogen. Individuals should consult their GP and a qualified alternative therapist before making any changes.
What to eat during the menopause
There are certain stages in our lives where we must adjust our lifestyle and diet habits to keep up with any changes happening to the body.
Frequent exercise, light clothing and a reduced caffeine and spicy food intake may help ease the night sweats. Plenty of rest and relaxation techniques such as yoga have been found to help improve mood fluctuations.
The menopause will result in women finding their need for certain nutrients reduced, while other levels need to increase. Women should be aiming to include the following food groups in their menopause diet:
These provide the energy and fuel the body needs to function. These energy levels need to remain high for menopausal women as the hormonal changes can result in daily feelings of exhaustion.
A balanced, menopause diet should include whole grain cereals, wholemeal pasta and starchy vegetables (sweet potato) that are high in fibre and essential vitamins. Nutritionists often advise women to try and avoid refined carbohydrates such as white bread and pasta.
When a woman enters menopause, the body produces far less oestrogen. The lack of oestrogen subsequently increases the risk of osteoporosis - a condition in which the bones are more prone to breaking due to them thinning and becoming weaker. During the menopause it is important for women to keep their calcium levels up in order to help protect against the condition.
Not only is calcium vital for bone health, it can help keep blood, muscles and nerves in working order. Good sources include dairy, canned fish, green leafy vegetables and tofu.
Reducing your intake of saturated fats may help to protect against heart disease. Try semi-skimmed or skimmed milk as a full-fat alternative. But it is important to introduce healthy fats. For example, oily fish such as sardines and mackerel can contribute to a reduced risk of both heart disease and diabetes.
As we age, it is important to keep protein in our diets. It is vital in helping the body recover from illness, infection and surgery. It is important for women to consume protein as part of their menopause diet. Protein is found in meat, nuts and pulses.
Fruits and vegetables
Plants hold a particular chemical called phytoestrogen that has a similar structure to oestrogen. Experts believe the chemical tricks the body into thinking it is producing more oestrogen than it really is. This misunderstanding of the body is believed to ease the discomfort caused by low oestrogen levels and other symptoms.
Another common food remedy for menopause, flaxseed is believed to help treat mild menopausal symptoms. While they are a good source of lignans, a chemical that can balance female hormones, there is no evidence of flaxseed treating hot flushes.
Vitamin D and calcium are vital for bone health. Vitamin D is a suggested remedy for menopause as the body needs it to absorb calcium. Most adults need 600 IU (international units) per day, whilst those older than 71 need 800 IU per day. During the menopause onset try and get some sun exposure to promote calcium absorption.
Supplements for menopause
Soy is believed to be an effective remedy for menopause due to its estrogen-like compounds. Research saw that menopausal women in Asian countries were eight times less likely to suffer hot flushes than US women. Is the popular soy-rich diet in Asian countries the secret to treating menopausal symptoms? A popular belief among menopausal women, but the research is inconclusive.
After the age of 30, our bodies’ natural levels of the DHEA hormone drop. Some studies suggest DHEA to be an effective remedy for menopause due to its hormonal properties. DHEA supplements are commonly made from wild yam or soy products. While evidence is mixed, many women have found DHEA to ease symptoms such as hot flushes and low libido.
How can a nutritionist help?
Consulting a qualified nutritionist may benefit women who are struggling to cope with the changes. Some women find researching nutrition and treatments an independent task. Others who are experiencing more severe menopausal symptoms may want the support of a professional.
As well as ensuring the essential nutrients are regular in their menopause diet, a nutritionist will work to create a symptom management strategy and balanced diet plan. The strategy can include targets, recipes, meal plans and motivational advice. It is common for the plans to include a physical activity schedule, as exercise is important for maintaining a healthy weight. Weight management and fitness can also help to manage certain menopausal symptoms.
The advice suggested by the nutritionist should be both realistic and achievable. These will be discussed with the client to ensure confidence. Regular meetings are advised in order for the client to stay happy with the strategies.
While each plan is tailored to the individual, below are some of the common suggestions made by nutritionists:
- eat more of the right fats
- stay well hydrated
- reduce alcohol intake
- try to avoid smoking.
During the menopause, the body may need help maintaining the necessary levels of the required nutrients. In some cases, a nutritionist may suggest taking dietary supplements. Do make sure to always consult your GP before introducing any supplements to your menopause diet.
Content reviewed by nutritionist, Julie Weston. All content displayed on Nutritionist Resource is provided for general information purposes only, and should not be treated as a substitute for advice given by your GP or any other healthcare professional.
Page reviewed 01/10/2015
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