As women go through the full spectrum of menopausal changes, it’s important to embrace new and existing perspectives on health and well-being. This phase often involves changes that require effective strategies to manage symptoms and help women adapt confidently. By embracing various nutrition, lifestyle, and medical interventions, we can help manage this transition more comfortably and proactively.
Getting on the Same Page: Defining Perimenopause and Menopause
Menopause is defined as the cessation of menstruation for one year, while perimenopause is the transitional phase leading up to menopause.
Perimenopause is marked by fluctuating levels of the hormones estrogen, progesterone and testosterone. It can begin 8–10 years before a woman’s final menstrual period, typically starting in the mid-40s but sometimes as early as the mid-30s. The average is somewhere between 42-47 years of age.
You can loosely think of perimenopause as the warm-up act, and menopause the grand finale. That said, the symptoms that come with it are not always a welcomed performance.
The effects of the hormonal changes that come with perimenopause and menopause express themselves differently between individuals. Some may experience more commonly known symptoms such as hot flashes, night sweats, unexplained weight gain, and/or vaginal dryness. While others may also suffer from less commonly known symptoms like joint pain, insomnia, increased anxiety, mood swings, or simply, a general sense of something just not feeling right.
These symptoms are your body’s way of signaling change. Now that your hormones are different, your body may need a new routine in terms of diet and exercise. It’s time to give your body some grace as it transitions. Through focused adjustments to nutrition, movement, and healthy sleep with trusted medical providers, you can optimally support yourself and your new normal.
Dietary Optimization for Perimenopause and Menopause
Embrace a Whole Foods Diet Rich in Plants
Nutrition is one key aspect in helping to manage perimenopause and menopause symptoms. Research has shown that certain dietary patterns and nutrients can positively impact symptoms experienced during this time.
A diet rich in fruits, vegetables, whole grains, and legumes can reduce perimenopausal symptoms by 30% and postmenopausal symptoms by 37%. And, this way of eating may also lower the risk of heart disease, which is another area of concern for many women.
Fibre Intake is Powerful
Fibre is consistently praised by Dietitians for its health benefits, and for those transitioning through perimenopause and beyond, it can be especially powerful. Changes to our hormone levels affect every system in our body, including our microbiome. Those friendly bugs in your digestive tract also have to adjust to changing hormone levels. By incorporating at least 25-30g of fibre each day, you help your microbiome stay healthy and thrive. This can also help regulate blood sugar, increase satiety, support healthy digestion, reduce the risk of chronic diseases, reduce inflammation, and may even alleviate hormonal symptoms by stabilizing mood swings and preventing energy crashes.
Fibre is readily found in plant sources; like vegetables, fruits, nuts, seeds, legumes and whole grains. By focusing on adding more plant based foods to your day, you’ll be well positioned to reach your daily fibre needs.
Protein for Strength and Bone Health
Protein supplies your body with key amino acids to support your muscles, bones, hormones and even immune function. As hormone levels change, along with possible changes to our exercise routines, we can see our lean muscle mass decline. To build and maintain strong muscles and bones, prioritizing protein is key.
Though specific studies for perimenopausal and menopausal women are scarce, the following guidelines are grounded in sports nutrition, gerontology, and RDA guidelines (Recommended Dietary Allowance). A good target to aim for is 25-30g per meal with a goal of at least 100g of protein per day. Protein can be found in most food, in varying quality and quantities, so focus on finding enjoyable and consistent sources. It doesn’t have to come from protein powders or artificial supplements but if you find it challenging to get your daily needs, a Registered Dietitian can help.
Supplements to Enhance Women’s Health
The following supplements are often recommended for women in perimenopause and menopause. Please remember to consult your healthcare provider before taking any supplement, as they can assess your individual health needs, potential interactions with other medications, and the most appropriate dosages for you.
Vitamin D & K2
These vitamins are crucial for maintaining bone health, especially during perimenopause when the risk of osteoporosis increases. Vitamin D helps in calcium absorption, while K2 directs calcium to where you need it; the bones.
Magnesium
Magnesium can play a beneficial role in sleep, anxiety, and bowel health during the perimenopause and menopause stages of life. According to a 2015 Canadian Community Health Survey, over 45% of adults are not getting enough magnesium. Magnesium comes in several forms, including citrate, bis-glycinate, and threonate. The type recommended varies based on individual needs and issues, such as constipation, sleep disturbances, muscle cramps, and/or anxiety.
Psyllium and Soluble Fibre Supplements
Menopause is a time of increased cardiovascular risk, often marked by unexplained rises in cholesterol levels. Adding psyllium (or other soluble fibre supplement) can be a great first step to help manage this. Psyllium not only aids in lowering cholesterol but also improves digestion and promotes overall gut health. Its natural properties help regulate bowel movements, making it a beneficial addition to a balanced diet.
Please ensure that you go low and slow if you try these supplements. Take a ¼ of the recommended dose with lots of water and gradually increase as tolerated. Too much too soon can lead to digestive distress and constipation.
Creatine
Creatine is a highly researched, evidence-backed supplement beneficial for both men and women. Well known for its athletic benefits, there is now evidence to suggest it can support brain health, potentially enhancing cognitive function during a time when many women experience “brain fog” or memory lapses.
When it comes to muscles, creatine can help with recovery and reduce oxidative stress and inflammation, which can be particularly helpful during perimenopause. Creatine can also help muscles work more efficiently during your workout, so you can work harder during exercise, leading to greater gains in strength and endurance.
Common Natural Supplements for Hormone Balance
Alongside dietary adjustments, certain supplements have demonstrated potential in relieving common perimenopausal and menopausal symptoms due to the potential effect on hormone levels.
Please note: Just because supplements are labelled ‘natural’ does not always mean ‘safe’. They may have harmful interactions with other medications, supplements, or health conditions that need thorough consideration and often medical advice before starting.
Black Cohosh
Black cohosh has been traditionally used to manage hot flashes. Studies have shown a reduction in frequency and severity of hot flashes and an improvement in mood due to its effect on serotonin receptors.
Chaste Tree
While there is very limited research on this particular botanical, Chaste Tree may help regulate hormones during this time. There is evidence to suggest that it can help to reduce common menopausal symptoms.
DIM
DIM is a compound that may support hormonal balance by promoting healthy estrogen metabolism.
Soy Supplements
Research is mixed on soy supplements, but some benefits have been observed. Soy may benefit peri and postmenopausal women by offering cardiovascular, bone, and potential cognitive advantages.
Additional Supplements for Bone Health, Skin Concerns & Weight Management
The following supplements have shown promising results that support some of the challenges women face during the perimenopause and menopause phase of life.
Berberine
Berberine is a promising prebiotic that enhances digestive mucus secretion which is the primary fuel of the healthy digestive bacteria, Akkermansia muciniphila. This beneficial bacterium is thought to have GLP-1 like effects, helping to curb appetite, enhance satiety and support a healthy gut-brain connection.
Fortibone™
Fortibone™ is a specific bioactive collagen peptide that has been shown to increase bone mineral density in postmenopausal women which may be especially helpful for women experiencing age-related reductions in bone density. Supplementation has been shown to improve bone health, helping bones grow and reducing their breakdown.
Resveratrol
Resveratrol is a plant-derived polyphenol found commonly in things like grapes, and select berries, and is recognized for its antioxidant effects and potential benefits to overall health. This polyphenol may improve pain perception, especially for age-related osteoarthritis and those with post-menopausal symptoms.
Verisol
Verisol, another patented form of collagen, has shown encouraging outcomes for skin health. In a randomized controlled trial involving women aged 45-65, after just eight weeks, participants experienced noticeable wrinkle reduction and enhanced skin elasticity.
Lifestyle Tips for Navigating Perimenopause & Beyond
Menopause can often lead to weight gain, muscle loss, and lifestyle changes, resulting in increased fat storage, especially around the abdomen. To mitigate cardiovascular risks, it’s important to incorporate strength training and cardiovascular exercises into your routine and prioritize quality sleep to support overall health during this transition.
Exercise and Sleep Guidelines
The benefits of exercise for sleep are well documented and include the following recommendations:
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- Participate in 150 minutes of moderate aerobic exercise each week, complemented by at least two strength training sessions
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- Reduce sedentary periods to under 8 hours daily, ensuring no continuous sitting exceeds 3 hours
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- Regularly get 7-9 hours of high quality, consistent sleep
If you struggle to find ways to incorporate these guidelines, reach out to your care providers for support.
The Role of Hormone Therapy
Nutrition, exercise, and lifestyle habits can have a huge impact on helping women navigate perimenopause, but it’s important to also discuss the role of hormone therapy. Specifically, the myth that hormone therapy is unsafe and unnecessary.
Following a 2002 publication, the use of hormone therapy for menopause drastically declined due to concerns regarding an increased risk of breast cancer. Clearing up misconceptions about these risks is crucial to help women and their doctors make informed decisions. The study’s findings have been reevaluated, with experts suggesting that the cancer concerns were overstated. More recently, the same publication acknowledged that hormone therapy is the most effective treatment for managing menopausal vasomotor symptoms such as hot flashes.
“A generation of women has been deprived of hormone therapy largely as a result of this widely publicized misinterpretation of the data,” notes the authors of this critical review published in Menopause, The Journal of the Menopause Society.
When it comes to hormone therapy, it’s important to note that estrogen receptors are located all over the body. They are not only in the reproductive tract and breasts, but also in tissues like bone, brain, liver, colon, skin, and salivary glands. All these systems can be affected by declining hormone levels and, when it comes to symptom control, hormone replacement therapy (HRT) is the most effective treatment for managing menopausal vasomotor symptoms.
HRT as Antidepressant and Disease Prevention
New studies also hint that hormone therapy might have similar effects to antidepressants for perimenopausal symptoms. Estrogen and progesterone can help alleviate mood swings, depression, and other neurological symptoms.
HRT is most commonly started within 10 years of menopause onset. A recent study demonstrated that women who continue HRT beyond age 65 may experience additional health benefits compared to those who discontinue or never use HRT. The study revealed significant reductions in the risks of various health conditions. Specifically, women continuing to undergo estrogen therapy experienced a 19% decrease in overall mortality, a 16% reduction in breast cancer risk, a 13% lower risk of lung cancer, a 12% decrease in colon cancer risk, and an 11% reduced risk of heart attacks.
Menopause is Easier with Support
Navigating the complexities of menopause requires informed decision-making, as investment into women’s health is on the rise and new evidence is constantly emerging. Researchers and healthcare experts are actively investigating innovative therapies and treatments to enhance the quality of life for women going through perimenopause and beyond.
At Harrison Healthcare, we emphasize the importance of personalized approaches that effectively balance the benefits and risks of each treatment and recommendation. With carefully chosen nutrition, supplements, and therapies, alongside healthy lifestyle habits such as tailored exercise regimens and optimized sleep patterns, women can significantly improve their quality of life.
We encourage a review with your family physician to discuss your specific symptoms and determine whether hormone replacement therapy (HRT) would be appropriate for you. We are committed to empowering women with the knowledge and resources needed to navigate this pivotal life stage with confidence and vitality.
