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“Ageing is not ‘lost youth’ but a new stage of opportunity and strength” Betty Friedan
Is this how you see menopause? Or are you dreading it? If you are a woman in a perimenopausal age and already thinking about it, or perhaps you are currently going through it and struggling, read on and we’ll delve deeper into how to have an easy transition through menopause and avoid or minimise some of the most common symptoms.
Menopause is the permanent cessation of menstruation, resulting from the loss of ovarian follicular activity and hence a significant drop in the primary female hormones – oestrogen and progesterone. In the UK, the average age for a woman to reach menopause is 51, although women can experience the menopause in their 30s or 40s.[i] Perimenopause is the period that precedes menopause that can start a few years before a woman’s period stops completely. In this phase, hormone levels are gradually starting to decrease and a number of symptoms can start to appear, including irregular menstrual cycles and hot flushes.
Biologically, the ovaries are retiring from their hard work of producing sex hormones. This baton is passed on to the adrenal glands and adipose tissue which take over the role of hormone production. Due to the widespread activity of oestrogen, menopause is associated with a range of physiological changes such as endothelial dysfunction, oxidative stress and increased risk of cardiovascular diseases[ii] and osteoporosis.[iii]
Medical treatment predominantly focuses on hormone replacement therapy (HRT), which relies on oestrogen and/or progesterone supplementation to compensate for the natural loss. However, this approach comes with multiple risks, such as cardiovascular disease (heart attacks and stroke),[iv] as well as oestrogen-related cancers of the breasts or ovaries.[v] Furthermore, it exaggerates the sole role of hormones in menopause-related symptoms, where a number of other, often pre-existing dysfunctions and imbalances can play a large part of why some women have an awful time going through menopause and others don’t.
Our sex hormones regulate so many bodily functions, from cardiovascular function, energy production and immunity, to hair or bone growth, which is why menopause often brings on a lot of uncomfortable and debilitating symptoms. Factors such as weight, smoking, alcohol consumption, lack of exercise[vi], use of oral contraception[vii], history of PMS,[viii] and stress[ix] can increase risk of menopausal symptoms.
The main symptoms that can occur include:
As common as these symptoms are, they are do not have to be our destiny. Let’s look a little further into what dietary and lifestyle factors can affect or support menopause.
As mentioned, once our ovaries stop producing oestrogen, that responsibility goes to our adrenal glands, through the production of androstenedione, which is the converted to oestrogen in fatty tissue in the body, and also small amounts of progesterone. The adrenal glands also produce our stress hormones – cortisol and adrenaline. High and chronic stress may preferentially ‘steal’ another hormone - pregnenolone (a pre-cursor to androstenodione and cortisol) to make more cortisol, which may lead to reduced levels of oestrogen.[x],[xi] The stress response also increases body temperature, which may be an additional trigger to hot flushes.[xii],[xiii] Oestrogen also promotes the REM phase of sleep, which is a vital process for healing and repair. When oestrogen levels drop so does time spent in REM cycles which leads to less refreshing and restorative sleep.[xiv]
Oestrogen is known to have an influence on our gut bacteria, which means that the decrease in oestrogen may contribute to digestive symptoms such as bloating, reflux or constipation during menopause. On the other hand, certain bacteria help to metabolise oestrogen. This gut-hormone interaction has been suggested as an important factor in reducing the risk of oestrogen-dependent cancers.[xxii] Furthermore, good levels of beneficial bacteria in the genitourinary area is important to prevent vulvovaginal atrophy at menopause, and other complications such as thrush[xxiii] and urinary tract infections.[xxiv] Another, exciting role of these bugs is aiding metabolism of fats and carbohydrates as well as insulin levels. Hence why poor bacterial balance in the gut can actually increase menopause-associated weight gain.
Despite the levels of oestrogen dropping after menopause, it is still important to support healthy breakdown of oestrogen in the body. This is because different oestrogen metabolites have different potencies and some of them can be more toxic that others,[xxxi] driving more inflammation, free radical production, tissue damage and increasing the risk of cancer and cardiovascular disease, for example.
Clinically, we often see that women who struggled with hormonal issues in their reproductive years often have a harder time going through menopause, which may indicate a link with poor oestrogen detoxification, either due to nutritional or genetic causes. A number of nutrients are important to support specific detoxification pathways, namely methylation, glucuronidation and sulphation. These include folate and vitamin B12 for methylation, and vitamins B3, B6 and iron for glucuronidation. Menopausal women are often deficient in folate, B12,[xxxii] zinc and copper.[xxxiii]
In addition, avoiding synthetic chemicals which have harmful oestrogen-like[xliv] effect in the body should be a priority too. Those chemicals are often found in plastic, cosmetics and make-up, and non-organic foods so switching to organic and natural foods and beauty products can significantly reduce our exposure.
Japanese women are well known around the world for their easy transition through menopause, with far fewer symptoms than women in the Western countries.
One proposed idea is their high intake of plant oestrogens or phytoestrogens (aka isoflavones), mostly in the form of soya (e.g. tofu, tempeh). These plant molecules structurally resemble body oestrogen but are much less potent, so by increasing your intake through diet, you may fill in the gap of low oestrogen production, and also help with healthy oestrogen metabolism, and even reduce weight gain.[xlv]
Red clover is also a good source of isoflavones and has been shown to reduce hot flushes, vaginal atrophy, insomnia, cognitive impairment and bone density loss in menopause,[xlvi],[xlvii] as well as improving insulin sensitivity.[xlviii] Interestingly, one paper suggested that the differences in severity of symptoms found in different women around the world may be due to cultural differences in how menopause is perceived and approached.[xlix]
A popular Japanese philosophy called ‘Wabi Sabi’ encourages the acceptance of transience and imperfection; perhaps we need to try to embrace the change and support our body and mind through the transition, rather than fighting and resenting it?
By improving your diet; increasing your vegetable and fibre intake (especially from cruciferous and allium vegetables), reducing stress and improving sleep, you can make menopause a much easier transition. If you are however experiencing severe symptoms, a good place to start is a good multivitamin containing methylfolate and methylcobalamin, alongside some isoflavones and extra detoxification support in form of antioxidants and sulphur molecules.
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[i] Women’s Health Concern. 2017. The menopause [online] Available at https://www.womens-health-concern.org/help-and-advice/factsheets/menopause/
[ii] Lee et al. Independent association between age and natural menopause and hypercholesterolemia, hypertension and diabetes mellitus. Japan Nurses Health Study. J Atheroscler. 2013; 20: 161-9.
[iii] Tella SH and Gallagher JC. Prevention and treatment of postmenopausal osteoporosis. J Steroid Biochem Mol Biol. 2014; 142: 155-70
[iv] Kuller LH. Hormone Relplacement therapy and Risk of Cardiovascular Disease: implications of the results of the Women’s Health Initiative.Arterioscler Thromb Vasc Biol. 2003; 23(1): 11-6
[v] Wentzensen N and Trabert B. Hormone therapy: short-term relief, long-term consequences. Lancet. 2015; 385 (9980): 1806-8
[vi] Morris et al. Body Mass Index and other lifestyle factors in relation to age at natural menopause. Am J Epdiemiol 2012 175:998-1105
[vii] Pokoradi et al. Factors associated with age of onset and type of menopause in a cohort of UK women. Am J Obstet Gynecol 2011, 205;1-13
[viii] Freeman et al. Premenstrual Syndrome as a predictor of menopausal symptoms. Obstet Gynecol 2004,103;90-6.
[ix] Pimenta et al. Menopausal Symptoms: do life events predict severity of symptoms in peri-and post-menopause? Maturitas 2012, 72:324-31
[x] Gibbs JC et al. The association of a high drive for thinness with energy deficiency and severe menstrual disturbances: confirmation in a large population of exercising women.Int J Sport Nut Exerc Metab. 2011; 21(4): 280-90.
[xi] Lasley B et al. Ovarian adrenal interactions during the menopausal transition. Minerva Ginecol. 2013;65(6):641-651.
[xii] Gerber LM, Sievert LL, Schwartz JE. Hot flashes and midlife symptoms in relation to levels of salivary cortisol. Maturitas. 2017;96:26–32.
[xiii] Wods N et al. Cortisol Levels during the Menopausal Transition and Early Postmenopause: Observations from the Seattle Midlife Women’s Health Study. Menopause. 2009;16(4):708-718.
[xiv] Schwartz and Mong. Estradiol modulates recovery of REM sleep in a time-of-day dependent manner. Am J Physiol Regul Integr Comp Physiol. 2013; 305 (3): R271-280
[xv] Park et al. Pilot Phase II trial of magnesium supplements to reduce menopausal hot flashes in breast cancer patients. Support Care Cancer. 2011; 19: 859-63.
[xvi] Park et al. Pilot Phase II trial of magnesium supplements to reduce menopausal hot flashes in breast cancer patients. Support Care Cancer. 2011; 19: 859-63.
[xvii] Shechter A, Kim EW, St-Onge MP, Westwood AJ. Blocking nocturnal blue light for insomnia: A randomized controlled trial. J Psychiatr Res. 2018;96:196–202.
[xviii] Awad R, Muhammad A, Durst T, Trudeau VL,Arnason JT. Bioassay-guided fractionation of lemon balm (Melissa officinalis L) using anin vitromeasure of GABA transaminase activity. Phytotherapy Research 2009; 23(8): 1075–8.
[xix] Ito K et al Effects of L theanine on the release of alpha brain waves in human volunteers. Nippon Nogeikagaku Kaishi 1998;72:153-157.
[xx] Lu K et al. The acute effects of L-theanine in comparison with alprazolam on anticipatory anxiety in humans. Hum Psychopharmacol. 2004; 19 (7): 457-465.
[xxi] Cases J et al. Pilot trial of Melissa officials L leaf in the treatment of volunteers suffering from mild to moderate anxiety disorders and sleep disturbances. Med j Nutrition Metab 2011;4(3):211-218.
[xxii] Vieira AT, Castelo PM, Ribeiro DA, Ferreira CM. Influence of Oral and Gut Microbiota in the Health of Menopausal Women. Front Microbiol. 2017;8:1884.
[xxiii] Falagas ME, Betsi GI, Athanasiou S. probiotics for the prevention of recurrent vulvovaginal candidaiasis: a review. Journal of Antimicrobial Chemotherapy 2006; 58: 266-272
[xxiv] FEMS Immunol Med Microbiol. 2012 Nov;66(2):147-56
[xxv] Van Dokkum et al. Effect of nondigestible oligosaccharides on large-bowel functions, blood lipid concentrations and glucose absorption in young healthy male subjects. Eur J Clin Nutr. 1999 Jan; 53 (1): 1-7
[xxvi] Guess et al. A randomized controlled trial: the effect of inulin on weight management and ectopic fat in subjects with prediabetes. Nutrition & Metabolism. 2015 12:36.
[xxvii] Neary NM, Small CJ, Druce MR, Park AJ, Ellis SM, Semjonous NM, Dakin CL, Filipsson K, Wang F, Kent AS, et al. Peptide YY3–36 and glucagon-like peptide-17–36 inhibit food intake additively. Endocrinology2005;146:5120–7.
[xxviii] So PW, Yu WS, Kuo YT, Wasserfall C, Goldstone AP, Bell JD, Frost G. Impact of resistant starch on body fat patterning and central appetite regulation. PLoS One2007;2:e1309.
[xxix] Zhou J, Martin RJ, Tulley RT, Raggio AM, McCutcheon KL, Shen L, Danna SC, Tripathy S, Hegsted M, Keenan MJ. Dietary resistant starch upregulates total GLP-1 and PYY in a sustained day-long manner through fermentation in rodents. Am J Physiol Endocrinol Metab2008;295:E1160–6.
[xxx] Tanja V Maier et al. Impact of Dietary Resistant Starch on the Human Gut Microbiome, Metaproteome, and Metabolome. American Society fro Microbiology. 2017. 8:5, e01343-17.
[xxxi] Oh H et al. Sitting, physical activity, and serum oestrogen metabolism in postmenopausal women: the Women’s Health Initiative Observational Study. British J of Cancer. 2017;117(7):1070-1078.
[xxxii] Milart et al. Selected vitamins and quality of life in menopausal women. Prz menopauzlny. 2018; 17(4): 175-179
[xxxiii] Manafa P et al. Cobalt, Copper, selenium and zinc levels in pre-menopausal and post-menopausal women in Nnewi, South-East Nigeria. Orient J Med. 2015; 27(3-4): 93-98
[xxxiv] Park EJ, Pessuto JM. Botanicals in cancer chemoprevention. Cancer Metastasis Rev 2002;21:231-55.
[xxxv] Nestle M. Broccoli sprouts in cancer prevention. Nutr Rev 1998;56:127-30
[xxxvi] Zhang Y, Callaway EC. High cellular accumulation of sulphoraphane, a dietary anticarcinogen, is followed by rapid transporter-mediated export as a glutathione conjugate. Biochem J. 2002; 364: 301-7
[xxxvii] Li et al. Sulforaphane, a dietary component of broccoli/broccoli sprouts, inhibits breast cancer stem cells. Clinical Cancer Research2010 16 (9): 2580–2590.
[xxxviii] Conaway CC, Getahun SM, Liebes LL, et al. Disposition of glucosinolates and sulforaphane in humans after ingestion of steamed and fresh broccoli. Nutr Cancer 2000;38:168-78.
[xxxix] Nestle M. Broccoli sprouts in cancer prevention. Nutr Rev 1998;56:127-30.
[xl] Barcelo S, Mace K, Pfeifer AM, Chipman JK. Production of DNA strand breaks by N-nitrosodimethylamine and 2-amino-3-methylimidazo[4,5-f]quinoline in THLE cells expressing human CYP isoenzymes and inhibition by sulforaphane. Mutat Res 1998;402:111-20
[xli] Michnovicz et al. Changes in levels of urinary estrogen metabolites after oral indole-3-carbinol treatment in humans. J Natl Cancer Inst 1997;89(10):718-23.
[xlii] Auborn et al. Indole-3-carbinol is a negative regulator of estrogen. J Nutr. 2003 Jul;133(7 Suppl):2470S-2475S
[xliii] Kunimasa et al. Biosci Biotechnol Biochem. 2008 Aug;72(8):2243-6. Epub 2008 Aug 7. Indole-3-carbinol suppresses tumor-induced angiogenesis by inhibiting tube formation and inducing apoptosis.
[xliv] Vinas R et al. Non-Genomic Effects of Xenoestrogen Mixtures. Int J Environ Res public health. 2012; 9(8):2694-2714.
[xlv] Vieira AT, Castelo PM, Ribeiro DA, Ferreira CM. Influence of Oral and Gut Microbiota in the Health of Menopausal Women. Front Microbiol. 2017;8:1884.
[xlvi] Bedell. The pros and cons of plant oestrogens for menopause. J Steroid Biochem Mol Biol 2012,epub Dec 25
[xlvii] Guttuso. Effect and clinically meaningful non-hormonal hot flash therapies. Maturitas 2012, 72;6-12
[xlix] Center For The Advancement Of Health. "Menopause Affects Japanese Women Less Than Westerners." ScienceDaily. ScienceDaily, 27 July 1998.