Menopause

Introduction to the #Menopause

The Menopause is the name given to the time when a woman’s ovaries slowly stop working and periods therefore cease. This is a gradual transition for most women, known as the peri-menopause. The average age when periods finally stop is 51, with most women finding it happens between the ages of 40 and 58 years of age.  The transition into the menopause usually begins with elongation of the cycle length, the term postmenopausal being used after one year with no periods.  The fall in levels of oestrogen is associated in variety of symptoms such as hot flushes, irritability and joint pains.

Roughly 80% of women suffer from some menopausal symptoms which last on average for 2 years, but for some women the symptoms can last for over 5 years. Symptoms vary from woman to woman and for some they are quite mild but for others it can affect quality of life.

The menopause can herald the onset of several conditions:

  • Insomnia
  • Depression
  • Fatigue
  • Hot flushes
  • Weight gain
  • Aching joints
  • Calcium loss from the bones which in individuals with lower bone mass can lead to osteoporosis
  • Rising blood pressure

These conditions are mostly caused by falling oestrogen levels and the most common symptoms found in western society are hot flushes, night sweats, vaginal dryness and sleep disturbance and the symptoms can start during the peri-menopuse.

The posts under the menopause section will hopefully give some insight into ways diet and lifestyle can reduce the secerity of menopusal symptoms and all findings and advice are based on recent solid research into the area.

Introduction to the Menopause

Introduction to the Menopause

Menopausal symptoms occur when the ovaries start to ‘wind-down’ and slowly cease to produce the hormone oestrogen.  This winding down phase is known as the peri-menopause and can occur for a number of years and may be accompanied by irregular periods and the start of the recognised menopausal symptoms.  The true menopause occurs when periods completely stop as a result of the oestrogen lack.  It occurs at an average age of 51 years, but may happen between the ages of 45 and 55.  Younger women can be affected too, due to a natural premature menopause or a premature menopause brought on by surgery, when both ovaries are removed.

 

Some   menopausal symptomsOsteoporosis, hot flushes, night   sweats, anxiety, depression, declining libido, panic attacks, palpitations,   poor urinary function, ageing skin, lack of energy, joint pains and general   aches and pains, irritable bowel syndrome, weight gain, headaches and change   in hair quality.

 

 

One of the most effective ways of treating menopausal symptoms is through diet and lifestyle; eating a healthy diet, being the right weight and keeping physically active.  .  These actions will also help overcome many of the other health problems that can develop at this time of life such as joint problems, thinning bones, weight gain and increased blood pressure.

Even if you receive treatment from your GP for difficult menopausal symptoms, a healthy diet will form a firm foundation and help the treatment work more effectively.  It may even help you to need the minimum of medication, whether it be blood pressure tablets, drugs or supplements for osteoporosis, or Hormone Replacement Therapy (HRT).  And eating for a healthy menopause does not need to be all soybeans, tofuburgers and mung beans.

 

This website has lots of ideas on what foods are good to eat during the menopause

Introduction to the Menopause

Today’s menopausal generation have many more ‘tools’ at their disposal for getting through the menopause than our grandmothers’ and even mothers’ generation had!  We now know so much more about it and sharing of ideas, reading about it and talking about it is no longer so taboo!.

One of those ‘tools’ we can adopt is to eat a healthy diet, and a diet that can be tailored to overcome or at least reduce those menopausal symptoms.  A healthy diet will also help us to overcome many of the other health problems that can develop at this time of life such as joint problems, thinning bones, weight gain and increased blood pressure.  Even if we receive treatment from your GP for difficult menopausal symptoms, a healthy diet will form a firm foundation and help the treatment work better.  It may even help us to require the minimum of medication, whether it be blood pressure tablets, drugs or supplements for osteoporosis, or Hormone Replacement Therapy (HRT).  There is so much nutritional information at our disposal nowadays, but some of it can be inaccurate..

These days there is an enormous variety of foods to choose from, so it is easier than ever to modify our diets to address particular health issues.  Furthermore, this variety of food is easily accessible at our major supermarkets.  Cooking and preparing food, with all the gadgets we have at our fingertips is also less labour intensive than before. 

Remember, eating for a healthy menopause does not need to be all soybeans, tofuburgers and mung beans. 

Menopausal symptoms occur when the ovaries start to ‘wind-down’ and slowly cease to produce the hormone oestrogen.  To be strictly accurate, this winding down phase is known as the peri-menopause and can occur for a number of years and may be accompanied by irregular periods and the start of the recognised menopausal symptoms.  The true menopause occurs when periods completely stop as a result of the oestrogen lack.  It occurs at an average age of 51 years, but may happen between the ages of 45 and 55.  Younger women can be affected too, due to a natural premature menopause or a premature menopause brought on by surgery, when both ovaries are removed.  The most common symptoms of declining oestrogen levels are:

Some menopausal symptomsOsteoporosis, hot flushes, night sweats, anxiety, depression, declining libido, panic attacks, palpitations, poor urinary function, ageing skin, lack of energy, joint pains and general aches and pains, irritable bowel syndrome, weight gain, headaches and change in hair quality.

 

Alternative to HRT?

Phytoestrogens are naturally occurring hormones found in plant foods which can weakly mimic the female hormone, oestrogen.  However, they only do this when the females own oestrogen levels fall due to the menopause.  As well as possibly helping to reducing some menopausal symptoms, especially hot flushes, they may help reduce the risk of cancer, heart disease and osteoporosis. Although much weaker than HRT, they are believed to not increase the risk of breast or endometrial cancer.

Currently there is much research being done on phytoestrogens and what’s coming out is not always clear cut! If you do want to give them a go, Phytoestrogens seem to work best coming from the diet rather than supplements and they may work more efficiently if eaten with a diet high in fish oils and seeds which contain the omega 3 fatty acids.  So don’t forget to get some oily fish in your diet every week.

Phytoestrogens are found on many fruits, vegetables, seeds and beans, but are found in the highest concentrations in soya products, including tofu and soya milk, chick peas, linseeds and wheat bran.

Bone health

During the menopause, the bone looses calcium at an accelerated rate, so anything that helps to alleviate this is important.  As well as maintaining weight bearing exercise, the diet can play a big part.  Calcium contributes about 1kg to the average woman’s body.  As well as being vital in bone strength, it aids blood in clotting, helps the nerves transmit signals, prevents muscle cramps and skin problems, can help insomnia, depression and cognitive impairment. To provide the body with essential calcium, we must eat a wide range of  calcium rich foods which include, milk, cheese and yogurts, fortified soya milk, beans, tofu, sardines, dried fruit, beans and some peas and seeds.  In order to absorb calcium, we need to eat vitamin D, a fat soluble vitamin found in oily fish, eggs and butter or margarine.  Eating plenty of fruit and vegetables has also been shown to protect the bones, and phytoestrogens may be protective too.  To much salt and alcohol in the diet however are detrimental to bone health.

Ticker happy!

Increased risk of heart disease is also a result of the menopause.  Certainly, as women age, they catch up with men in the risk of cardiovascular disease.  There are several ways of decreasing the risk of heart disease and strokes:

  • Increase the use of phytoestrogens, these have been shown to have cardio-protective effects.
  • Don’t eat too much fat and use the right ones- any oils and fats based in rapeseed oil (called canola oil in the USA) or olive oil have been found to be the most heart protective- these are what we have used in our recipes.  Rape seed oil is best because it contains both a high level of monosaturated fats and is rich in heart protecting omega 3 fats.  Olive oil is also an oil rich in monosaturated fats.
  • Other seed/nut oils are also healthy because they tend to be monosaturated and /or rich in omega 3 oil.  These include walnut oil, sesame seed oil, and linseed (flaxseed) oil.  They are especially good if used in salad dressings as they retain their best nutritional benefits if they are not heated.  Sunflower oil, rich in polyunsaturated fats, is also not too bad and may help to lower harmful fats in the blood.  However eating too much polyunsaturated fat may cause oxidative damage to the body.
  • Avoid a diet high saturated fats- these tend to be based on animal fats and are harder at room temperature. This includes lard, butter, cream and dripping.
  • Avoid trans fats- these are artificially hardened fats and oils and are found particularly in cheap pastries, pies and biscuits. 
  • Cut down on your salt- salt increases your blood pressure which is a huge risk for stroke and heart disease.  In our recipes we have used the least salt necessary for flavour
  • Keep your weight down to sensible levels by eating good nutritious food but avoid the junk. 

 

Weight issues

It is important to watch the weight as we get older.  It tends to be harder to lose weight as we age and easier too pile it on.  Excess weight after the menopause can contribute to increased cholesterol levels and other harmful blood fats, raised blood pressure, and increased risk of several cancers, worsening joint problems and diabetes. Eating nutritious food and avoiding the junk will help.

Some oils are better for us than others because of their balance of essential fatty acids (the omega 3 oils and omega 6 oils) and because they have less saturated fat (see above).  However all fats and oils, unless labelled reduces fat have the same number of calories which is roughly 900 calories per 100g or 45 calories per teaspoon!  So it is important to try and keep total fat intake down when watching our weight as fats are so calorie dense, but the fats and oils we do choose should be the healthier variety. Also, don’t forget we need to be active- you will be able to enjoy the recipes in this book even more if you are good and hungry for your next meal! 

However, we should not aim to be too thin: We continue to produce some oestrogen after the menopause, but it is manufactured in the adipose (fat) tissue rather than in the ovaries.  That is why it is not good to be too thin after the menopause as we miss out and producing some of our own natural oestrogen which may help to offset some of the menopausal symptoms.  Being too thin is also another risk factor for osteoporosis.

Menopausal symptoms and foods that can help

 

SYMPTOM                            FOOD

Hot flushes                             All soya foods.  Linseed

                                                Watch spicy foods, caffeine, and alcohol

Mood Swings, Anxiety &      Regular eating, try and include a starchy food with each

Irritability                              meal.

                                                Foods high in magnesium such as brown rice, whole wheat, whole rye, beans, lentils and peas and green vegetables

Watch caffeine, sugary foods and alcohol

Insomnia                                Avoid caffeine too late at night

                                                Avoid eating a big meal late in the evening but try a bedtime snack which contains some milk or yogurt and something starchy such as natural yoghurt and a banana or a rye crispbread with cottage cheese or just some hot milk and a couple of low fat biscuits. 

Heavy Bleeding                      Replace the lost iron with an iron rich diet, such as red meat, green vegetables, beans and sardines

Vaginal Dryness                    Soya products such as tofu or soya milk or linseed may help this as it replaces lost oestrogen

Osteoporosis                           Calcium rich foods and foods rich in Vitamin D.  Weight bearing exercise. Phytoestrogens rich foods may also help.

Night Sweats                          Sage taken as a tea at bedtime (3-5 leaves in hot, not boiling water).  Sage leaves in cooking.  Phytoestrogen rich foods as night sweats are also due to lack of oestrogen.

Ageing skin                            An anti-oxidant rich diet containing plenty of fresh fruits and vegetables, wholegrains and seeds.  All foods high in Vitamin E such as nuts, avocados, seeds and oily fish.  Essential fatty acids such as those found in vegetable oil, nuts and fish oils.

Depression                             A diet containing plenty of oily fish.  If you drink a lot of alcohol, then make sure you have a diet rich in B vitamins, such as meat, fish, eggs, milk and cheese and wholegrain cereals.

Joint pains                              Due to their anti-inflammatory properties, the oil found in oily fish (omega 3 fat) is believed to help alleviate joint pains. Low oestrogen levels can bring on joint pains too, so foods rich in phytoestrogens, see above can also help.

Bloating                                  Reduce the salt in your diet by not adding at the table, cooking with less and avoiding too many processed foods, especially cheaper ‘junky’ ones.  Keep the kidneys working efficiently by drinking plenty of fluid, especially plain water.

 

Constipation and                   Eat plenty of fibre which is derived from wholegrain.

Irritable Bowel Syndrome    cereals, fruit and vegetables.  Make sure you drink at least 2 litres of fluid a day and avoid too much caffeine and alcohol

To summarise

Eat a wide variety of foods. This will ensure our bodies get a mixture of all the nutrients we need.  To maximise flavour and nutritional content, we should also try and eat food which has been made from really fresh ingredients- this will also negate the need to enhance the flavour with salt.

Eat lots of fruit and vegetables and use ingredients based on wholegrains and foods which have not had their fibre rich outer layers removed.  This ensures we get the maximum nutritional value from the food and the fibre too!

Eat a little starch with every meal, e.g. brown rice, pasta, wholegrain bread or breakfast cereals.  The combination of a good quality starch regulates blood sugar effectively. Each main meal should also contain some protein and lots of vegetables or salad.  A diet containing plenty of phytoestrogens may help to combat many menopausal symptoms.

GLOSSARY

Amino Acids               Building blocks of protein.  There are 22 amino acids, but eight are essential because they must be obtained from food.  Protein is broken down into amino acids and then used to make other body proteins.

Antioxidants               Substances that stop oxidation (when a substance is exposed to oxygen).  When oxidation occurs it creates a chemical reaction which is linked to cancer, heart disease, rheumatoid arthritis and premature ageing

Betacarotene               The vegetable form of Vitamin A.  A powerful anti-oxidant.  Found in many vegetables and fruits with an orange or green pigment, such as carrots, dark leafy greens and oranges.

Flavonoids                  Substances with antioxidant properties which help neutralise potentially damaging free radicals.  They may also help to increase the effectiveness of vitamin C.  Sources include fruits (especially the skins). Onions, tea and wine.

Essential Fatty Acids  Unsaturated fats, which are a vital component of human cells and necessary to insulate nerve cells.  Keeps skin and arteries supple and may help balances hormones.  Found in nuts, seeds, oily fish and vegetables

Phytoestrogens            Some plants are rich in plant substances called isoflavones that are often referred to as phytoestrogens or plant oestrogens because they have a structure similar to the female oestrogen hormone, which can bind to oestrogen receptors and exert a weak oestrogenic effect when there are low levels of circulating oestrogen in the body.  Soya are particularly high in these isoflavones. Lignans are another form of phytoestrogen which is found particularly in linseed (flaxseed) and wheatbran.

Tuesday, May 1st, 2018

Dietary intake and age at natural menopause: results from the UK Women’s Cohort Study

 

  1. Yashvee Dunneram1,
  2. Darren Charles Greenwood2,
  3. Victoria J Burley1,
  4. Janet E Cade1

Author affiliations

Abstract

Background Age at natural menopause is a matter of concern for women of reproductive age as both an early or late menopause may have implications for health outcomes.

Methods Study participants were women aged 40–65 years who had experienced a natural menopause from the UK Women’s Cohort Study between baseline and first follow-up. Natural menopause was defined as the permanent cessation of menstrual periods for at least 12 consecutive months. A food frequency questionnaire was used to estimate diet at baseline. Reproductive history of participants was also recorded. Regression modelling, adjusting for confounders, was used to assess associations between diet and age at natural menopause.

Results During the 4-year follow-up period, 914 women experienced a natural menopause. A high intake of oily fish and fresh legumes were associated with delayed onset of natural menopause by 3.3 years per portion/day (99% CI 0.8 to 5.8) and 0.9 years per portion/day (99% CI 0.0 to 1.8), respectively. Refined pasta and rice was associated with earlier menopause (per portion/day: −1.5 years, 99% CI −2.8 to −0.2). A higher intake of vitamin B6 (per mg/day: 0.6 years, 99% CI 0.1 to 1.2) and zinc (per mg/day: 0.3 years, 99% CI −0.0 to 0.6) was also associated with later age at menopause. Stratification by age at baseline led to attenuated results.

Conclusion Our results suggest that some food groups (oily fish, fresh legumes, refined pasta and rice) and specific nutrients are individually predictive of age at natural menopause.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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Monday, January 22nd, 2018

Menopause and Insomnia

Thanks to the organisation ‘Tuck’ advancing better sleep , for this article

 

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Menopause and Insomnia

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Sleep onset insomnia (trouble getting to sleep) and sleep maintenance insomnia (trouble staying asleep) get worse during perimenopause and menopause. Menopause brings longer sleep latency and decreased length of time spent in slow-wave sleep. Scientists still don’t totally understand the effect of estrogen on the circadian rhythm and somatic thermoregulation (how the body controls its own temperature), although estrogen supplements tend to prevent these unwelcome sleep changes. It used to be common for doctors to prescribe estrogen supplements for older women, but the general use of estrogen replacement has largely been eliminated.

One idea is that insomnia in menopausal women has two causes: the vasomotor symptoms and depressive symptomas.

Surveys indicate that women consider insomnia among the most irritating of menopausal symptoms. “Hot flashes” (due to fluctuation in estrogen and progesterone levels) are another common symptom, and many times, the reason for insomnia is due to the body’s inability to maintain a consistent temperature. A hot flash includes a surge of adrenaline, which tends to awaken sleepers. Many women experience night sweats. Both these sweats and the tiredness resulting from insomnia can have a large negative effect on subjective “quality of life”. The International Classification of Sleep Disorders (ICSD) includes premenstrual insomnia and premenstrual hypersomnia within the category of menstrual-associated sleep disorder.

Both longer sleep latency and less slow-wave sleep are characteristics of menopausal sleep. Hormone replacement therapy seems to alleviate these problems, but HRT is used less today than in the past because of problems with it.

Like insomnia from other causes, this insomnia can be a challenge to live with and to treat. The first line of action for the insomniac is making sure good sleep hygiene is practiced, including a comfortable dark room and a regular sleep schedule.

In bad cases some doctors prescribe medicines, including nonbenzodiazapines. Researchers are looking into phytoestrogens and other estrogenic substances for control of many symptoms related to menopause and this may eventually result in some treatment in the future. The use of hormone supplements to address menopause has a long and contentious history which we won’t go into, but doctors do still have this tool in their arsenal if they feel if is appropriate for women with vasomotor symptoms in sleep.
A recent study showed that Zolpidem was effective in treating insomnia in menopausal women, and of course there are many over-the-counter and prescription sleep aids.

Postmenopausal women (but not premenopausal women) with sleep apnea have been found to have changes in heart EKG patterns. The changes may indicate a higher chance of heart problems.

Obstructive sleep apnea can occur in menopausal women because of diminishing levels of progesterone in the bloodstream. This hormone is a respiratory stimulant and upper airway dilator and the body needs time to adjust to the decline. Increased body weight with older age also increases the risk of apnea.

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Thursday, November 2nd, 2017

Being underweight can trigger early menopause

Being underweight can trigger early menopause

A large study of nearly 80,000 women found that being underweight could lead to early menopause.

The women sampled were part of the Nurses’ Health Study II between and, amongst other information gathered, the researchers collected stats on their height, weight, and menopausal status.  Early menopause was defined as occurring before the age of 45.

It was found that women with a body mass index (BMI) below 18.5 at any age were 30% more likely to experience early menopause compared with women whose BMI was between 18.5 and 22.4 which is considered normal.  They also discovered that women whose BMI was between 25 and 29.9 were up to 30 % less likely to experience early menopause.

The highest likelihood of having early menopause seemed to be among women who, when they were 18 years old, had a BMI below 18.5 and reported having experienced “severe weight cycling.”  Also, women who had a BMI lower than 17.5 at the age of 18 were 50% more likely to have an early menopause compared with normal-weight women.

An early menopause occurs in about 10% of women and is associated with a higher risk of cardiovascular disease, and other health conditions such as cognitive decline, osteoporosis, and premature death.  So being underweight at any time of their fertile years should be avoided

Reference:

https://academic.oup.com/humrep/article/4562350

 

 

 

 

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