This in-depth article presents the topic of Nutrition & the Menopause. It describes the nature of the menopause & the physiological aspects including the adverse symptoms that a woman can experience during this change of life. There is strong focus on osteoporosis as this is the most definitive and measurable symptom of the menopause, however additional physical, general & mental symptoms are also addressed.
The article covers the orthodox treatments of Hormone Replacement Therapy (HRT) and discusses why nutrition can be used as an alternative treatment approach, sharing evidence of essential food substances which have the potential to give significant physiological support to menopausal women.
The Nature of the Menopause
The menopause is a very obvious key point in a woman’s life. A time when menstruation and ovulation cease, with the obvious concomitant that reproductive life is at an end, is bound to be an emotive watershed. Unfortunately, some women mistakenly feel that the coming of the menopause will mean reduced sexual feelings and less sexual activity and satisfaction, whereas that is not necessarily the case. Negative feelings about the change are needless.
Most importantly, when contacts around one promote negative feelings about the menopause, especially feelings which connect it with either reduced sexuality or the onset of old age, these need to be set aside, and not accepted — for it truly has nothing to do with either of them.
The Physiological Aspects of the Menopause
It arises from the cessation of ovulation, which occurs regularly each month throughout the premenopausal period by the maturation of “follicles”. During this phase of a woman’s life, the active ovary produces the female sex hormones known as oestrogens, in a monthly cyclical manner. These hormones are largely responsible for the development of the so-called “secondary sexual characteristics” in females.
These activities of the ovaries are in turn controlled by other hormones from the anterior pituitary gland, known collectively as “gonadotrophins”. Once the ovary stops producing normal quantities of oestrogens and progesterone the pituitary gland increases its output of FSH and LH. The high level of LH, and in particular short-term surges in LH release, has been connected with the generation of the “hot flushes” of the menopause.
Natural menopause occurs in 25% of women by age 47, in 50% by age 50, 75% by age 52 and 95% by age 55.
Adverse Symptoms of the Menopause
It is unfortunate that in societies with a “Western” lifestyle, and to a lesser extent elsewhere, the onset and continuation of the menopause are often accompanied by undesirable symptoms. This however is not a fair and balanced view if one considers that by adjusting one’s lifestyle, these adverse symptoms may be largely overcome.
The best known of these negative symptoms is osteoporosis; a condition in which the bones lose a substantial proportion of the calcium phosphate mineral substance that hardens them. The result is a loss of strength in the bones and hence a tendency to fracture.
Hot flushes, vaginal dryness, night sweats and palpitations are additional physical symptoms. Fatigue, insomnia, poor stamina, feelings of weakness, stress symptoms, night leg cramps, easy bruising and spontaneous nosebleeds are also prominent general symptoms. Mental symptoms include anxiety, irritability, mood swings, depression, excessive worrying and memory loss.
Hormone Replacement Therapy
The orthodox medical solution to adverse symptoms of the menopause is to prescribe oestrogens and progesterone. Such a prescription constitutes HRT. It is a very simple and direct approach, lacking subtlety and ignoring the fact that women have undergone the menopause since our species first evolved.
Many women have found a better way, for them at least, by using a natural nutritional and herbal approach for the changes that accompany menopause.
Why Nutrition May Work Better
It has been reported that the incidence of hot flushes varies from 70-80% of menopausal women in Europe, 57% in Malaysia, but only 18% in China and 14% in Singapore. Whilst it could be genetically based, such a wide global divergence strongly suggests differences in lifestyle. Substantial dietary differences exist between these populations, especially with regard to the consumption of soya products.
Soya beans contain substances called phytoestrogens, which, although for the most part are not steroids like the normal human oestrogens, exert weak but definite oestrogenic effects in the human body. Obviously, such substances have the potential to give significant physiological support to menopausal women whose symptoms arise from relative oestrogen deficiency.
Foods that are high in phytoestrogens include certain fruits (apples, cherries, olives, plums, coconuts), legumes (soy beans, peanuts), tubers (carrots, yams), members of the nightshade family (eggplant, tomatoes, potatoes, peppers), and grains (cereal grains and especially wheat germ). Fennel, anise, and liquorice all contain estrogenic compounds.
The mineral chromium has also been shown to play a role. One report by Evans et al indicates that by ensuring adequate status of chromium in the body after the menopause, a woman can increase her internal production of the oestrogen dehydroepiandrosterone by some 20%.
Rosetta Reitz wrote, “Among the women I interviewed I found that those who were concerned with the food they ate were experiencing their menopause with more ease.” And, “Altogether, I have noticed that the women who take vitamins regularly have less problems.”
The incidence of hot flushes varies from 70-80% of menopausal women in Europe, but only 18% in China and 14% in Singapore. Such a wide global divergence strongly suggests differences in lifestyle.
Nutrient-Hormone Interaction Network
How nutrients interact with hormonal pathways during the menopause
Osteoporosis — The Nature and Orthodox Treatment
As explained already, osteoporosis is the condition in which the bones lose mineral content and, as a result, become structurally weakened. It is a major health problem in all Western countries. In one study made to determine the influence of diet on bone mass, no significant correlation was found between current calcium intake and bone mass at any site. Iron, zinc and magnesium intake were positively correlated with forearm bone mineral content. These results indicate that bone mass is influenced by dietary factors other than calcium.
It should be noted that the bone density of premenopausal women is important because those women who enter the menopause period with well mineralised bones will fare best and be the more likely to avoid osteoporosis problems.
The Crucial Need for Micronutrients
The non-mineral nutrients necessary for a healthy organic matrix of bone are vitamin C, and the B vitamins B6, B12, and folic acid. A deficiency of any or all has been shown to cause defective organic matrix, which then cannot be effectively mineralised.
Vitamin K
Research has shown that vitamin K deficiency could lead to impaired mineralisation of bone due to decreased osteocalcin levels. Vitamin K is found in abundance in green leafy vegetables. Osteoporotic women have been found to have only 35% of the blood vitamin K levels that are normal in age-matched controls.
Essential Fatty Acids
Omega 3 fatty acids are both nutritionally essential yet rather scarce in the UK and US diet except among those who consume a fair amount of fatty fish. They are essential for many processes within the body and this has been shown to include the maintenance of strong bones.
The Role of Trace Minerals
Boron
Supplementing the diet with 3mg of boron daily reduced urinary calcium excretion by 44% and dramatically increased the levels of the most biologically active oestrogen, oestradiol.
Strontium
In its non-radioactive form, strontium is non-toxic, accumulates in bone, occurs naturally in food and has a beneficial effect on bone health. In one study, 85% of the subjects experienced a marked reduction in bone pain and 75% displayed increased bone density on X-rays.
Magnesium
Magnesium is required as a co-factor for the activities of hundreds of different enzymes. Osteoporotic women have low whole body content of magnesium and low bone concentrations of the element. Low dietary magnesium is extremely common in both the UK and the US and several studies have shown that it is quite critical for bone health.
Zinc and Manganese
In one two-year study of non-osteoporotic late menopausal women fed a supplement containing calcium, manganese, zinc, and copper, these women gained 1.3% in bone mineral density. In contrast, a group that was only calcium supplemented lost 1.6% in bone mineral density.
Chromium
The strong case for using chromium supplements in osteoporosis has been made already. 200-400mcg per day can be used. The GTF form (Glucose Tolerance Factor form) should be used and this distinction is important.
Diet and Lifestyle Factors in Osteoporosis
Factors which positively influence the uptake of calcium into bones include:
- Plenty of fresh unprocessed vegetables and, to a lesser extent, fruit in the diet
- Limited intake of or no junk food
- Adequate exposure to sunlight (for vitamin D)
- Regular weight-bearing exercise
- Adequate but not excessive protein intake
- Minimising intake of salt, sugar, caffeine and alcohol
It is far easier to prevent osteoporosis than to reverse its consequences. This stresses the importance of using a diet far superior to the current British or American diet before the menopause, rather than trying to pick up the pieces afterwards.
One should always bear in mind that it is far easier to prevent osteoporosis than to reverse its consequences. This stresses the importance of using supplements and/or a diet far superior to the current British or American diet, before the menopause, rather than trying to pick up the pieces afterwards.