Eating well in menopause (plus recipes)

Nutritionist Mikki Williden on how your diet can help reduce some of those dreaded symptoms

Menopause, according to Google, is a condition that “can’t be cured”, which is an interesting way to describe this natural phase of the life cycle that women experience going into the best years of their life. What isn’t natural (or inevitable) are the symptoms associated with it, and these can begin around 10 years before going through menopause, from the ages of 35-55. The average amount of time spent in menopause is around four years, but like all “averages” this is highly variable.

What’s happening?

As a woman heads into menopause all hormone levels change. There is first a decrease in progesterone, which changes the balance of progesterone to oestrogen (some describe this as “oestrogen dominance”), testosterone also declines, and this is an important hormone for sex drive. Finally oestrogen drops — and while we will continue to produce oestrogen (this occurs not only by the ovaries but in the liver, breasts, adrenal glands and by fat tissue), it is at amounts of around 30-60 per cent lower. Due to the many actions of hormones in our body (including mood, energy, bone health. cognitive function), any change in these hormones can have negative consequences for a woman, including heavy periods, hot flashes, breast tenderness, lower sex drive, decreased sense of wellbeing, brain fog, mood swings and insomnia (to name a few).

Many women going into menopause also have a low thyroid function due to age-related changes in thyroid physiology, including a reduced uptake of iodine which is essential for the production of our thyroid hormones. Weight gain is a common complaint for women during this phase of life, partly due to the insulin sensitising effect of oestrogen influencing our glucose uptake — lower levels make it harder for women to metabolise carbohydrate to use for fuel, thereby storing more body fat. Of course some women are absolutely fine going into menopause, others though can have real problems and this may be worse if a woman is coming off a contraceptive pill which will change the levels of hormones present in the body and contribute to a number of the symptoms mentioned.

Minimising the symptoms

A healthy functioning liver is important to minimise symptoms of menopause, as its job is to package up the breakdown products of oestrogen and remove these from our bloodstream through our detoxification pathways. We need our inbuilt antioxidants to be firing on all cylinders for this to happen smoothly, and it is made more difficult when there is any level of inflammation in the body, something that an increasing number of women experience. We also require adequate amounts of certain nutrients: selenium, B vitamins and glycine (not present in large amounts in the standard diet) for our detoxification pathways to function properly. Even if the oestrogen is broken down and conjugated for removal, unhealthy gut bacteria can unpackage it and push it back out into the bloodstream as more toxic forms of oestrogen.

Ensure a healthy gut

Bloating, excessive gas, cramps and diarrhoea or constipation are not the normal consequence of eating (though they are extremely common). Keep a food diary to establish what might be causing your digestive upset by connecting your symptoms to your food intake. Work with a health practitioner experienced in “real food” digestive health to help not only heal your gut, but seal it too.

Limiting alcohol consumption is also important as it impairs oestrogen clearance rates from the liver, which may influence the relationship between alcohol and breast cancer risk.

Some women benefit from limiting or omitting dairy, as it can increase oestrogen in the body, increase insulin release and because the A1 casein in dairy is pro-inflammatory.

Ensuring vitamin D status is at an optimal 100-150 nmol/L for hormone production is also key, and reducing intake of carbohydrate if eating a higher carbohydrate diet, along with removing processed, refined foods and sugar.

Brassica vegetables, such as broccoli, brussels sprouts, cauliflower and cabbage, provide di-indolylmethane (DIM) which targets certain proteins in our body that help reduce inflammation and balance hormones (particularly detoxifying oestrogen). Supplementing with this is also really helpful, but only once you establish that oestrogen clearance is an issue for you — super unhelpful otherwise (a practitioner can help you find this out).

Turmeric in therapeutic doses (more than you can get from food) helps reduce oestrogen related oxidative stress and prostaglandins (inflammatory biomarkers) — opt for one that is also combined with bioperine (to make it more bioavailable) or is formulated to have smaller, more bioavailable particles. Supplementing with low doses of iodine can be extremely helpful in supporting the pathways associated with thyroid hormone production which in turn affect the sex hormone production pathways. While it's important to talk to your health practitioner to determine if supplementation is necessary for you, including iodine-rich food such as kelp, nori sheets and seafood will increase the iodine amount in your diet.

Finally, 2-3 brazil nuts to provide selenium is also recommended.

From a lifestyle perspective, resistance training a couple of times per week to maintain muscle mass and improve insulin sensitivity, ensuring an adequate amount of sleep (so important for restoration and recovery) and stress management techniques (such as journalling, yoga, deep diaphragmatic breathing or meditation) all aid in hormone balance and an easier transition for women who experience the often normalised, but not normal, symptoms of menopause.

Putting the plan on the menu

Vitamin D

As a woman heads into menopause all hormone levels drop. It's important to ensure you get enough vitamin D for hormone production. See our feature on boosting your vitamin D intake over winter. Mushrooms, especially sun-dried shiitakes, have very high levels as does oily fish. Try these recipes:

• Beef and shiitake stir-fry (photographed above)
• Agedashi sesame tofu with shiitake mushrooms
• Mixed mushrooms on sourdough
• Winter salmon and mushrooms
• Ultimate smoked fish pies
  

Boost your brassicas

Brassica vegetables, such as broccoli, brussels sprouts, cauliflower and cabbage, provide di-indolylmethane (DIM) which targets certain proteins in our body that help reduce inflammation and balance hormones (particularly detoxifying oestrogen). Boost your intake with this lip smackingly good broccoli pasta and these other recipes.

• Pasta with broccoli (above)
• Cauliflower and cashew salad (photographed at the top of the page)
• Cauliflower fritters with garlic yoghurt
• Super seedy slaw
• Autumn vegetable soup
• Charred broccoli with lemon and chilli ricotta
• Spiced cauliflower fritters with coriander and carrot yoghurt
• Cauliflower with warm spices and egg
• Brussels sprout, apple and sesame Asian slaw
• Cabbage with ginger and coconut cream
• Cauliflower, brussels sprouts and citrus salad

Up your iodine

Many women going into menopause have a low thyroid function, including a reduced uptake of iodine, essential for the production of thyroid hormones (which help control weight and support the sex hormone production pathways). Including food such as kelp, nori sheets and seafood will increase iodine in our diet.