Menopausal Symptoms

Menopause is a normal stage of life experienced by women all over the world. It occurs typically between the ages of 40 and 60 years when the ovaries stop producing the hormones estrogen and progesterone, which are responsible for the monthly menstrual cycles. When the ovaries stop making these hormones, the menstrual cycles stop as well.

Unfortunately, for many women, the drop in hormone production can cause uncomfortable side effects, such as hot flashes and vaginal dryness. The good news is that simple dietary changes may reduce some of these menopausal symptoms.

Eat more

  • Cold water fish such as salmon, tuna, herring, mackerel and halibut for their beneficial omega 3 fatty acids
  • Flaxseeds
  • Soy foods
  • Legumes
  • Whole grains and seeds
  • Sea vegetables
  • Wild yams

Avoid spicy foods.

Description

What Is Menopause?

This natural stage of life typically occurs in women between the ages of 40 and 60 years, when the ovaries stop producing the hormones estrogen and progesterone. In the United States, the average age of menopause is 51 years, though around the world the average is 60 years. Each year, approximately 25 million women worldwide go through menopause. The decrease in estrogen levels can also cause bone loss (osteoporosis) and put women at an increased risk of heart disease.

The perimenopausal period, which occurs 1-5 years before actual menopause, may also be a period of uncomfortable side effects for many women. Approximately 80% of perimenopausal women in the United States experience hot flashes as a result of changes in hormone levels; 30% of these women have hot flashes that are severe or frequent enough to interfere with normal life.

Symptoms

Hot flashes, or "power surges" as some women call them, can occur at any time of the day and typically last for 3-5 minutes. For some women, however, they can last for 30 minutes or more. Most women experience hot flashes for 6 months to 2 years, but some may experience them for much longer.

Symptoms of hot flashes may include some or all of the following:

  • A feeling of extreme warmth
  • Sweating that is sudden and may be drenching
  • Fatigue
  • Irritability
  • Headaches
  • Joint pain
  • Interruptions in sleep or night sweats

Hot flashes may be followed by a feeling of extreme cold and shivering. Vaginal dryness, which may lead to pain during intercourse, is another symptom of menopause that some women experience.

Hot flashes and other symptoms that may occur during the menopausal period are often treated with hormone replacement therapy, or HRT. HRT adds back in the estrogen and sometimes the progesterone that the body no longer makes.

Premarin, the most common form, is taken from the urine of pregnant horses. (Note: Many animal welfare groups question the treatment of the horses used for this process, as well as the treatment of the baby horses that result from the pregnancies, and urge women considering this therapy to ask their doctors about alternatives to Premarin.)

HRT has long been believed to reduce the risk of osteoporosis and heart disease in post-menopausal women. Recently, however, studies have reported that HRT may not help prevent these conditions after all. In addition, the use of HRT may increase the risk of uterine and breast cancer.

Contraindications to HRT use include current or past breast or uterine cancer, chronic or acute liver disease, endometriosis, current blood clots or a history of blood clots, a history of stroke, recent heart attack, pancreatic disease, gallbladder disease, fibrocystic breast disease, familial high cholesterol, high blood pressure that is aggravated by estrogen, migraine headaches that are aggravated by estrogen, uterine tumors, and undiagnosed vaginal bleeding.

Common side effects of HRT include breast pain, vaginal bleeding, nausea, leg cramps, and an increased risk of blood clots which can lead to stroke or heart attack. Given all this, it may be best for many women to seek alternative treatments for hot flashes.

The Process

Every woman is born with a set number of eggs in her ovaries. After puberty, these eggs start to mature, one at a time. When an egg matures, the cells in the ovary surrounding the egg start to produce hormones. Eventually the mature egg leaves the ovary and either gets fertilized to become an embryo or passes out of the body with the menstrual flow. The maturation of each of the eggs in the ovary causes the cyclical production of the hormones estrogen and progesterone that determine the menstrual cycle.

As time goes by, the supply of eggs starts to dwindle. As the number of eggs gets lower, the cycles begin to get more erratic, becoming closer together or further apart. When the egg supply has been exhausted, the ovaries stop making estrogen and progesterone, and the menstrual cycles stop altogether. After a full year without menstruation, women are officially said to be in menopause.

Unfortunately, many women experience uncomfortable symptoms as a result of the changes in hormone levels. One theory of how hot flashes occur is that the body’s temperature set-point, basically the thermostat setting at which the body maintains its temperature, drops temporarily. When this happens, the body thinks it needs to cool itself off. It does this by dilating all of the blood vessels in the skin, which causes flushing and drenching sweat.

When the set point goes back to normal, the body feels cold, which leads to chills and shivering. Researchers believe that these hot flashes are caused by drops in estrogen levels, and they do tend to go away shortly after menopause as the body readjusts to its new hormonal balance.

Causes

Researchers don’t know the exact cause of hot flashes or why some women experience them while others do not. Many women report that certain triggers bring on their hot flashes including caffeine, alcohol, hot weather, a warm room, or emotional distress. Avoiding potential triggers can help reduce the frequency of hot flashes. Other women find that exercising regularly helps reduce their symptoms. Whatever their cause, hot flashes typically diminish with time.

Note: Since the risk of heart disease, the number one killer of women in the United States, rises rapidly after menopause, women approaching this stage of life are encouraged to read the Atherosclerosis write-up on this website for information about foods that may help prevent this condition.

Dietary Causes

Approximately 80% of American women experience hot flashes, while only about 20% of women in many parts of Asia experience them. The difference between the two, researchers believe, is the amount of phytoestrogens in the diet. These substances, which are found in plants, act a lot like estrogen when they get into the human body. Although these phytoestrogens are much, much weaker than regular estrogens, they may help to ease the symptoms of the menopausal period for many women.

In addition to soy foods, these substances are found in highest amounts in flax seeds, sunflower seeds, bean sprouts, and legumes like garbanzo beans and peas. The best and most well-studied source of phytoestrogens is soybeans and soy products. Increasing consumption of soy foods and also of vitamin E may really help ease the transition through menopause.

Some women report that certain foods or products, such as caffeine, alcohol, and spicy foods, can trigger their hot flashes. By avoiding these triggers, they find that they can greatly reduce the frequency of their attacks.

Nutrient Needs

Foods That May Help Include:

Soy Products

When you think of soy, what images come to mind? How about a tall glass of cool soy drink? Or a big plate of teriyaki stir-fried vegetables and tofu? Or a hot bowl of miso soup with rice noodles? Or a juicy, grilled soy burger with the works? Soy products now offer many more intriguing choices than a big block of tofu. The wide variety of soy foods available in stores today is staggering. Soy can now easily be a delicious addition to your diet.

Studies have shown that increasing the intake of soy foods, like soy drinks, tofu and miso, can cut the frequency of hot flashes in half. In addition, soy foods have much less fat than their non-soy counterparts, which can be a big help for those trying to lose weight. Regions of the world where soy foods are a big part of the diet enjoy much lower rates of breast cancer, prostate cancer, heart disease, and osteoporosis than in the United States. Although other lifestyle factors probably also contribute to this difference, eating soy products may help to prevent these diseases in some people. Some examples of soy products include tofu, soymilk, soy nuts, edame, soy burgers, soy hot dogs, miso, soy ice cream, and many other products to which soy or soy protein has been added.

Researchers at Queensland University of Technology (QUT) have attempted to translate the dietary and lifestyle patterns of Japanese women, one of which is regularly consuming soyfoods, to their Western menopausal counterparts with very beneficial results, which were summarized in a study presented at the Australasian Menopause Conference held in Hobart, Australia, November 2003.

According to Senior Lecturer in Women’s Health at QUT, Dr. Debra Anderson, “Japanese women are regarded as the healthiest women in the world, averaging a life span at least five years longer than Western women.” The Women’s Wellness Program, a 12-week lifestyle intervention program QUT researchers developed, involved a Westernized Japanese diet rich in calcium and foods high in phytoestrogens, e.g., soyfoods, along with walking and strength exercises.

Study participants, 120 women ranging in age from 50 to 65, were provided a book with lifestyle tips and exercises published by study authors Allen and Unwin, The Menopause Made Simple Program, and encouraged to increase dietary phytoestrogens to 40 mg per day through eating more soy-based foods and grains, raise calcium intake to 1500 mg per day. and drink eight glasses of water daily. Participants were also asked to record their daily diet and exercises in a journal.

Virtually all study subjects experienced significant reductions not only in menopausal symptoms such as hot flushes and palpitations, feelings of depression, fatigue and lack of motivation, but also in body fat, particularly abdominal fat, and blood pressure. Benefits were so significant that, Anderson reported, “Some of the women have ceased hormone replacement therapy, or are considering doing so, and we have encouraged them to discuss this with their GP.” Next on the research team’s agenda is further studies testing the use of nutrition only and exercise only to see which has the biggest impact. Anderson’s hunch is “that the combination of dietary phytoestrogens is allowing the body to convert the abdominal fat (that women get postmenopausally due to change of hormones) into muscle and the combination of exercise with phytoestrogens is accelerating this very quickly. This is good news for women as abdominal fat is linked very closely to heart disease and is often very hard for women to shift.”(December 3, 2003)

Whole Soyfoods, But Not Isolated Isoflavones, Found Cardioprotective

Research published in the December 2003 issue of Arteriosclerosis Thrombosis and Vascular Biology suggests that while a diet rich in soy foods may be cardioprotetive, soy isoflavones by themselves will not produce much effect. In this five month study, 60 female monkeys whose ovaries had been removed to simulate menopause, were divided into three groups of 20 all of which were fed an atherogenic diet (one which was likely to promote heart disease) with only the source of protein differing among the three groups. One group was given milk-based protein; the second received protein in the form of soy, and the third was fed milk protein supplemented with soy isoflavones. At the conclusion of the study, those eating the soy protein had 50% less damaged LDL (bad cholesterol) in their coronary arteries compared to those given either the milk-based diet or the milk-based diet supplemented with isoflavones. Researchers noted that the reduced LDL cholesterol seen in the carotid arteries with soy was due to decreased delivery of LDL to the arteries, which could partly explain the soy’s cardioprotective effects. Once again, it appears that the combination of nutrients Mother Nature supplies in whole foods is better calibrated to promote health than are components of whole foods extracted from the matrix in which they function as part of a comprehensive whole. (January 29, 2004)

Legumes

Getting a little tired of soy? Well the same substances in soy, the phytoestrogens, that are so good for menopausal symptoms, are also found in a number of other legumes. Chickpeas, lentils, and peas are relatively higher sources, but most other beans contain some phytoestrogens.

These phytoestrogens act a little like the estrogen that your body used to produce, but are much more mild. Enjoying a plate of cooked beans over some brown rice, or a bean burrito or two may be enough to help you start feeling better. And with all of the other health benefits of beans, you can't go wrong.

Flaxseed

Have you ever sprinkled some ground flaxseeds over your salad or into a bowl of oatmeal? You might want to give it a try. Flaxseeds are the richest food source of substances called lignans. In the body, lignans act a little like estrogen, one of the hormones that women stop producing at menopause. Although these lignans are much weaker than real estrogen, they may have just enough of an effect to put a damper on those uncomfortable symptoms.

High-lignan flaxseed oil is also a source of lignans and can be used to replace other vegetable oils in salad dressings. (High-lignan flax oil is a specially-processed version of this oil that has been allowed to retain some of the particulates found in the seed). It is important, however, to never cook with flaxseed oil as it can damage the beneficial omega-3 fats.

Sea Vegetables

Although flaxseeds are much higher in lignans, sea vegetables, including dulse, hijiki, and arame, also contain lignans that may be helpful with those hot flashes. Throw some hijiki on that salad, right on top of the flaxseeds, and eat your way to a symptom-free menopause.

Whole Grains and Seeds

The lignans found in high levels in flaxseeds are also found in a number of other foods. In particular, they have been found in rye, oats, barley, and wheat germ. Sunflower seeds and bean sprouts also contain other types of phytoestrogens that may be helpful. Including some of these foods in your diet may not only help with this natural stage of life, they will also add wonderful variety.

Yams

There are some reports that seem to indicate that yams (those of the Dioscoreae family) may also be helpful during the menopausal period. Some cultures believe that eating yams can be beneficial, especially around this time of life. Laboratory studies have shown that yams contain compounds that are similar to substances that the body uses to make progesterone, another hormone that is normally produced prior to menopause. Like estrogen, however, production of this hormone stops during the menopausal period. Unfortunately, it is unclear whether or not these substances are actually used by the human body to make chemicals that would act like the missing progesterone. But since yams are so nutritious anyway, it certainly couldn't hurt to give them a try!

Nutrients in Food That May Help Include:

Vitamin E has been reported in several studies to reduce the frequency of hot flashes in some women. Vitamin E is especially recommended for treating the hot flashes of women with a history of breast cancer who cannot take HRT.

It is unknown exactly how vitamin E prevents hot flashes, though it is known that vitamin E is very good for stabilizing blood vessel function. It may therefore prevent hot flashes by preventing the blood vessels from dilating so much and causing flushing. In addition, vitamin E is also excellent for preventing atherosclerosis and heart disease. Mustard greens, chard, turnip greens, and sunflower seeds are a few excellent sources of vitamin E.

Magnesium may help decrease stress and promote normal sleeping patterns through its ability to relax and calm the nervous system. Chard and spinach are two excellent food sources of magnesium.

Calcium has been found to reduce bone loss that accompanies the drop in estrogen levels caused by menopause.

Excellent sources of calcium include spinach, turnip greens, mustard greens, and collard greens.

Omega-3 Fatty Acids have been found to reduce risk of heart disease and may help regulate hormone levels.(When estrogen levels drop, women become at greater risk for heart disease.) Some food sources of omega-3 fatty acids are flax seeds, walnuts and cold water fish, like salmon, cod, and halibut.

Vitamin C, B-vitamins, and zinc have also been reported to be helpful. Unfortunately, relatively little research is available to support these claims. Hopefully, in the future, more research will be done to validate the beneficial effects of these other nutrients.

Nutrient Excesses

Substances to Avoid

Research has not identified any specific nutrients that make hot flashes worse. Many women report that certain foods, such as caffeine containing foods like coffee, black tea, chocolate, and soft drinks, alcoholic beverages, and spicy foods, can trigger their hot flashes. Avoiding these foods may therefore be helpful in reducing the occurrence of hot flashes.

Recommended Diet

How does one add plenty of soy to her diet without sacrificing flavor? It’s easier to do today than ever before.

You can start with a steaming bowl of miso soup, maybe with tofu, rice noodles, or even chicken if that’s what you’re in the mood for. Then maybe a plate of sweet and sour stir-fried vegetables with some marinated tofu on top for a vitamin and fiber-packed meal.

Leave those high-fat cow burgers in the freezer and throw a tasty soy burger on the grill instead. Add a whole wheat bun, tomato, lettuce, and onion and you’ve got nutrients, protein, and fiber on your plate. You could even follow that up with a big bowl of strawberry soy ice cream for a great end to a hot summer day.

Adding soy to your diet can be as simple as asking for a soymilk latte at your favorite coffe stand, pouring soymilk over your breakfast cereal or enjoying a soy burger or soy hot dog once in a while. Or it can be as elaborate as tofu stir-fry or marinated tofu shish-kabob.

Soy products can be used to replace common foods like hot dogs, hamburgers, ice cream, and milk, or they can be used along with these foods, mixed into hamburger meat, stir-fried with chicken strips, added to beef stew, etc. The only limit is your imagination. The health benefits of adding soy to your diet are great enough to warrant experimenting with soy. You'll find lots of outstanding recipes and quick serving ideas right here. Once you start, you’ll wonder why you didn’t try it sooner.

So what if you just don't want to eat that much soy? You're in luck. Plenty of other delicious foods may have similar effects on hot flashes as soy foods. You could try a big salad with some chickpeas, soaked arame, sunflower seeds, bean sprouts, and a high lignan flaxseed oil dressing to top it all off. Or you could try sprinkling some wheat germ and ground flaxseeds into your big bowl of breakfast oatmeal.

Need something nutritious for dinner? Most beans may help ease hot flashes, similar to the suggested benefits of soybeans. Whether it's a bean-stuffed burrito, a hot bowl of bean soup, or a steaming plate of beans and rice, you're bound to get some of those phytoestrogens. They're found in so many other foods as well, like a number of whole grains, that you almost can't help but have some every day.

The Condition Specific Meal Planner for Menopausal Symptoms has menus that cover the nutritional needs of this condition over a four day period.

References

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  • Anderson D. Research done as part of The Women's Wellness Program Study: www.hlth.qut.edu.au/nrs/research/wwps. 6th Australasian Menopause Conference, October 24-26, 2003, Sydney, Australia.
  • Eden J. Phytoestrogens and the menopause. Baillieres Clin Endocrinol Metab 1998 Dec;12(4):581-7.
  • Jubelirer SJ. The management of menopausal symptoms in women with breast cancer. W V Med J 1995 Feb;91(2):54-6.
  • Keller C, Fullerton J, Mobley C. Supplemental and complementary alternatives to hormone replacement therapy. J Am Acad Nurse Pract 1999 May;11(5):187-98.
  • Kronenberg F. Hot flashes: phenomenology, quality of life, and search for treatment options. Exp Gerontol 1994 May-1994 Aug 31;29(3-4):319-36.
  • Kronenberg F and Fugh-Berman A. Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials. Ann Intern Med. 2002 Nov 19; 137(10):805-13.
  • Miller KL. Alternatives to estrogen for menopausal symptoms. Clin Obstet Gynecol 1992 Dec;35(4):884-93.
  • Somekawa Y, Chiguchi M, Ishibashi T et al. . Soy intake related to menopausal symptoms, serum lipids, and bone mineral density in postmenopausal Japanese women. Obstet Gynecol. 2001 Jan; 97(1):109-15.
  • Vincent A, Fitzpatrick LA. Soy isoflavones: are they useful in menopause. Mayo Clin Proc 2000 Nov;75(11):1174-84.
  • Wagner JD, Schwenke DC, Greaves KA, Zhang L, Anthony MS, Blair RM, Shadoan MK, Williams JK. Soy protein with isoflavones, but not an isoflavone-rich supplement, improves arterial low-density lipoprotein metabolism and atherogenesis. Arterioscler Thromb Vasc Biol. 2003 Dec;23(12):2241-6. .
  • Whitten PL, Naftolin F. Reproductive actions of phytoestrogens. Baillieres Clin Endocrinol Metab 1998 Dec;12(4):667-90.

This page was updated on: 2004-11-21 15:25:04
© 2002 The George Mateljan Foundation