Can diet help to optimize hormones and reduce menopause symptoms? Absolutely! Read on for more details.
In this blog you will learn:
- Which diet(s) helps to minimize menopause symptoms
- Which specific foods help with menopause symptoms
- Which specific foods worsen menopause symptoms
Menopause is a natural stage in a woman’s life that marks the end of the reproductive years when menstrual cycles stop. It comes with a range of potential symptoms like hot flashes, night sweats, sleep issues, weight gain, cognitive issues, sexual issues (low/no libido, vaginal dryness), metabolic body changes, cardiovascular disease risk, osteoporosis risk and potentially other symptoms.
Despite this, menopause does not necessarily have to be difficult. There is a lot we can do with lifestyle habits and diet. In this blog we will focus on the best diet and foods to eat to optimize hormone health and minimize menopause symptoms.
The Importance of Diet in Menopause
In menopause, the risk of cardiovascular diseases, tumors (especially hormone-sensitive breast cancer), insulin resistance, type 2 diabetes and osteoporosis all increase. Women are more susceptible to metabolic diseases, obesity, cancer, cognitive decline, depression and neurodegenerative diseases (Parkinson’s disease, Alzheimer’s disease, depression, dementia, stroke) (Wylenzek F, 2024). Post-menopausal women are more likely to be nutrient deficient. These risks can be managed and reduced by eating right and modifying lifestyle habits (Erdélyi A, 2024). The right diet can reduce symptoms and decrease the risk of menopause-related diseases.
- 60–70% of middle-aged women gain weight in menopause (Erdélyi A, 2024). Weight gain leads to an increase in abdominal (visceral) fat which is unhealthy.
- Body composition changes in line with the decrease in basal metabolism.
- Muscle mass can decrease, which leads to sarcopenia or muscle loss with age.
- The increase in abdominal fat and decrease in muscle function and muscle mass is unhealthy for aging.
- The incidence of metabolic syndrome in postmenopausal women is 2–3 times higher than before menopause(Erdélyi A, 2024).
Which Diet is the Best for Menopause?
The Mediterranean Diet Wins Again
The Mediterranean diet (MD) is beneficial for menopause. It is high in fiber, vitamins, minerals, antioxidants and phytochemicals (flavonoids, polyphenols, carotenoids). It is low in sugar and saturated fat and is anti-inflammatory. It can help to reduce weight, blood pressure, inflammation, total cholesterol and LDL levels. It can enhance overall health and quality of life for women in menopause (Gonçalves C, 2024).
Following the MD is linked to less severe menopausal symptoms in women with obesity (Vetrani C, 2022). The MD helps control hot flashes. In research, women following the MD experience fewer hot flashes and night sweats (Vetrani C, 2022).
- In one study, women with significant menopause symptoms had a significantly lower adherence to the Med Diet vs women with none-to-moderate symptoms (Vetrani C, 2022).
- An Australian study showed that closely following the Med diet was associated with less vasomotor menopausal symptoms, suggesting that the Med diet might help prevent hot flashes/ night sweats (Vetrani C, 2022).
- One clinical trial showed that postmenopausal women with overweight/obesity who ate a Med diet had an improvement of menopausal symptoms (Vetrani C, 2022).
As a reminder, the MD is a diet with plenty of plant foods; vegetables, fruit, low-refined cereals, legumes, nuts, olives and olive oil; moderate in fish, white meat, eggs and dairy products in the form of cheese and yogurt; and some red and processed meat and a little wine with meals. It is low in processed foods, pastries, cakes and sweets.
Are There Specific Foods to Eat during Menopause?
Olive Oil Wins Again
Women who consumed extra virgin olive oil had less depression and psychological /mood symptoms resulting from menopause (Vetrani C, 2022).
A study in obese women showed that daily consumption of extra virgin olive oil (52 ml/day) significantly reduced depression and anxiety (Vetrani C, 2022). Eating 25 ml/day of extra-virgin olive oil for 7 weeks significantly improved depressive symptoms (Vetrani C, 2022).
This is likely due to the beneficial and anti-inflammatory effects that good fats like olive oil have on the brain. We have written about olive oil and its positive effect on brain health and dementia/ Alzheimer’s prevention here.
Omega 3 & Fish
The Omega 3 fatty acids are EPA and DHA. Good food sources include fish, especially oily fish such as wild salmon, mackerel, anchovies, sardines and herring (SMASH). Seeds like chia and flax are a good source. Other healthy fats (think avocados, olive oil, nuts and other seeds) provide omega 3 fatty acids.
- Omega 3 fatty acids have anti-inflammatory, cardio-protective, insulin-sensitizing and bone-protective effects (Wylenzek F, 2024).
- Omega 3 fatty acids support bone health due to their anti-inflammatory characteristics. Postmenopausal women are susceptible to osteoporosis (decreased bone mineral density, increased bone turnover and a higher risk of fractures) and omega 3 fatty acids can help.
- Omega 3 fatty acids are beneficial for cognitive performance, cardiovascular health and the immune system. Omega 3 fats can support cognitive function (Wylenzek F, 2024), help decrease depression and anxiety and improve sleep quality(Vetrani C, 2022).
Vegetables, Fruit & Fiber
It is recommended to eat minimum 5 servings of vegetables and fruit daily, ideally as 3–4 vegetable servings and 1–2 fruit servings per day. The recommended dietary fiber intake is 30–45 g/day. These are the minimum recommendations and eating more veg and fruit is good for health on so many levels. Women who ate more vegetables and fruit had fewer menopausal symptoms than women who ate less vegetables and fruit (Safabakhsh M, 2020).
Nutrient levels change in menopause and can cause imbalances and a higher risk for disease. Women in post menopause are more likely to have deficiencies in vitamins B6, B12, D, iron, omega 3 fatty acids and lycopene (Wylenzek F, 2024). Nutrient absorption may decline as the gut becomes less efficient at absorbing nutrients during menopause.
Berries are a Superfood
Strawberries are cardioprotective.They can help manage blood pressure (BP) in postmenopausal women with high BP. In one study, consuming 25 grams of freeze-dried strawberry powder per day helped lower blood pressure compared to women who did not have the powder (Feresin RG, 2017).
Fiber from vegetables and fruit has many benefits (Erdélyi A, 2024):
- It slows down digestion and improves the feeling of satiety. This can help to feel fuller longer and prevent overeating, maintain a healthy weight and reduce the risk of obesity.
- Fiber improves the microbiome and gut health, regulates blood sugar levels and helps fight depression. It protects against heart disease, cancer, digestive conditions and type 2 diabetes (Erdélyi A, 2024).
- Fiber can reduce cholesterol and the risk of developing metabolic syndrome (Erdélyi A, 2024
).
Go slow when increasing fiber, so the body can adapt. Excessive fiber intake (more than 50 g of fiber per day) or increasing too quickly, may cause bloating and other digestive problems because the body needs time to adjust. When increasing fiber, eat vegetables and fruit like berries, green leafy vegetables and cruciferous vegetables (cabbage, broccoli, cauliflower, radishes, etc.) and chia and flax seeds.
High Quality (Animal) Protein
It is important in the menopause years to eat foods that preserve bone density. The decline in estrogen increases the risk of osteoporosis, when bones become less dense and fracture or break more easily.
- Women lose up to 10% of their bone density in the first 5 years after menopause (Rizzoli, 2018).
- Approximately 50% of women over 60 experiences at least one fracture due to osteoporosis (Rizzoli, 2018).
It is also important to preserve muscle mass and avoid sarcopenia. Sarcopenia is the decline in skeletal muscle mass and function that happens with age. It contributes to morbidity and physical disability. Declining estrogen in menopause can lead to sarcopenia.
- Lean muscle mass is 9-10% lower in late peri- and post-menopausal women compared to early perimenopausal women (Ko J, 2021).
- Sarcopenia occurs in approximately 30% of peri- and post- menopausal women and in about 7% of early menopausal women (40-45 y.o.) (Ko J, 2021).
Eating enough protein can maintain lean muscle mass and bone density. Protein also prevents excessive fat mass increases and maintains a healthy body composition into the menopause years.
How Many Grams of Protein do you Need per Day?
Women going through menopause should eat 1–2 grams of protein per kilogram of body weight (Wu, 2016). For protein, eat eggs, meat, fish, legumes, beans, Greek yogurt and other dairy products. Add good quality protein and collagen powders to smoothies, yogurt, hot drinks or other dishes.
Dairy
Dairy products like milk, cheese and yogurt can help manage menopause symptoms. Dairy is associated with lower menopausal symptoms like hot flashes, night sweats, sleep and psychological issues (Abshirini M, 2020).
- Weight: Yogurt is associated with less weight gain and lower obesity risk in women during menopause (Yuan M, 2023). In one study, women who ate the most yogurt – 2 or more servings of yogurt per week (compared with <1 serving/month) – had the lowest weight gain and a 31% lower risk of obesity (Yuan M, 2023). This was not true of other forms of dairy (Yuan M, 2023).
- Bones: As estrogen declines, bone health can deteriorate. Dairy contains nutrients; calcium, magnesium, phosphorus, potassium, and vitamins D and K; that promote bone health. High-quality dairy provides good nutrition for bone health in women in the menopause transition.
- Muscle mass: Women lose muscle mass with age and menopause. This changes body composition, increases fat mass and contributes to weakness and weight gain in older age. Dairy and in particular, milk, is high in protein which improves strength, muscle mass and a healthy fat to muscle ratio.
- Sleep: Changing hormone levels can cause sleep problems in menopause. Hot flashes, night sweats and anxiety can disrupt sleep. Dairy products are high in tryptophan, a precursor for serotonin and melatonin. Serotonin and melatonin both help to fall and stay asleep.Foods like milk and cheese have tryptophan and can help menopausal women to sleep better (St-Onge MP, 2023).
Be aware of weight gain. Many dairy products are high in calories, so too much can cause weight gain.
Dairy products have very small quantities of estrogen, progesterone and androgens. Eating milk, cheese and yoghurt is unlikely to significantly alter the natural hormonal balance. But some women do find that dairy can make hormonal imbalance worse which can intensify some menopause symptoms.
Women need 1,000 milligrams (mg) of calcium per day (NIH, 2024). This increases to 1,200 mg per day post menopause to help support bone health (NIH, 2024). One 8 oz serving of dairy milk provides approximately 300 mg of calcium. Consuming excessive caffeine, added sugar and alcohol can offset the bone-building benefits of dairy.
Electrolytes & Hydration
Good hydration is needed to regulate temperature, detoxification, gut function and the skin. Fluid intakehelps transport nutrients and oxygen.
With age,it is harder to maintain proper fluid and electrolyte balance. Older people are more susceptible to dehydration and electrolyte imbalances, unrelated to menopause.A decrease in thirst sensation, kidney function, and lower percentage of body water occur with age. Replacing fluids and restoring hydration after dehydration is slower in older people vs in younger people, due to slower kidney function (Stachenfeld, 2014).
Estrogen and progesterone affect fluid and electrolyte balance and help regulate water and sodium in the body and in the brain (Erdélyi A, 2024). Estrogen’s effects on fluid regulation in older women are related to kidney function (Stachenfeld, 2014).
How much water needed per day depends on age, weight and activity levels as well as the weather. A general guideline is to drink about 11.5 cups (2.7 Liters) of fluid per day for women. Women with intense or frequent hot flashes or night sweats should probably drink more.
Drink good quality water or other non-sugary drinks like herbal teas. Add lemon, lime, mint and berries to water to add taste. Add water-rich foods to your diet like cucumbers, salads, watermelon and other fruits. Natural electrolyte drinks include coconut water and pickle juice. Or add a pinch of good quality salt like Himalayan pink salt to water. Electrolyte powders that do not contain lots of sugar and chemicals are also helpful.
Soy & Isoflavones
Isoflavones are a type of phytoestrogen found in legumes, particularly soybeans. Phytoestrogens are plant compounds with a similar structure to estrogen and can cause estrogen-like effects in the body. Foods high in phytoestrogens can help balance estrogen levels in the body.
Isoflavones are both estrogen-agonist and estrogen-antagonist. Estrogen agonists stimulate estrogen receptors while estrogen antagonists inhibit estrogen receptors. For example, we may want estrogen agonists to stimulate estrogen receptors in bone to encourage bone growth and increase bone mineral density. Estrogen antagonists inhibit estrogen receptors, for example in the breast, to prevent breast cancer cells from spreading or growing.
Soy and other phytoestrogens in the diet is somewhat controversial for women’s health and menopause. Research both for and against soy can be found.
Soy and isoflavones can help reduce the strength and frequency of menopausal symptoms (Erdélyi A, 2024) and (Vetrani C, 2022). Menopausal hot flashes are rarer in countries where people regularly eat soy in their normal diet (Erdélyi A, 2024).
Yet phytoestrogens can be negative in the treatment of hormone-sensitive breast tumors (Erdélyi A, 2024). Prolonged use of estrogen agonists/antagonists in postmenopausal women is associated with an elevated risk of stroke, pulmonary embolism and DVT (Raina, 2024).
In Aisa, the typical intake of isoflavones is 5-80 mg/day. In Western countries, it is usually less than 3 mg/day (Vetrani C, 2022). One Italian study, presumably mirroring the Mediterranean diet, reported an isoflavone intake of 18-31 mg/day (Vetrani C, 2022).
- One study recommended 20 mg/day of soy isoflavones supplementation during perimenopause for symptom reduction. This equals 80 g/day of soy in the form of tofu, tempeh or fermented soy products (Erdélyi A, 2024).
- Another study says 42 mg/day of soy isoflavones may have a tumor-reducing effect (Erdélyi A, 2024).
- In a third study, regular soy consumption did not increase breast cancer risk. But anti-estrogen therapy through the medication Tamoxifen is less effective with regular soy consumption (Erdélyi A, 2024).
- Asian population studies on isoflavones show that 10–15 g of soy protein in a balanced diet and healthy lifestyle can be safe even in these cases (Erdélyi A, 2024).
There is not really a consensus on the effect of dietary soy on breast cancer and its treatment. The above-mentioned safe intake of soy applies to soy foods in the diet and not soy isoflavones taken as dietary supplements(Erdélyi A, 2024). Supplements can be more potent whereas eating soy foods is a more natural way to get isoflavones.
If you are going to eat soy, be sure to eat organic, non-GMO, fermented soy. Eat the type of soy products traditionally eaten in Aisa. Modern, non-fermented GMO soy will not provide the same health benefits!
Are there any Specific Foods to Avoid in Menopause?
A number of foods can make menopause symptoms worse. This is especially true of hot flashes and night sweats. Avoid trigger foods which include:
Caffeine
Surprisingly there is not a lot of research on caffeine and menopausal symptoms. One older study did find a link showing that caffeine worsens vasomotor – hot flashes/ night sweats – symptoms (Faubion S, 2015). Of course, too much caffeine will worsen sleep. Remember that caffeine has a half-life of 4-6 hours which means caffeine can keep you awake at bedtime. Caffeine is also not ideal for people with anxiety, which can increase during peri and menopause. If you are menopausal and suffering from severe hot flashes, sleep issues or anxiety, then try cutting out caffeine to see if symptoms improve.
Keep caffeine consumption to a reasonable level of 2 cups per day, early in the day. More caffeine-sensitive people will need to drink less. Stop drinking coffee or other caffeinated drinks by 2pm. The cutoff time varies for different people because people metabolize caffeine at different rates. Slower caffeine metabolizers will need to stop caffeine at an earlier time.
Alcohol
There isn’t much research on alcohol and menopause symptoms. Anecdotally, alcohol worsens symptoms, especially hot flashes and night sweats, which is backed up by some research. One study showed that daily alcohol consumption significantly increased hot flashes and night sweats (Leidy Sievert L, 2005). A newer study also found an increased likelihood of hot flashes with alcohol consumption (Yelland S, 2023).
Drinking alcohol can certainly disturb sleep in some people. For menopausal women with sleep issues, alcohol can make things worse. We also know that, overall, alcohol is not supportive of optimal health and is a toxin for the body. Based on this alone, it is advisable to keep alcohol to a minimum in one’s diet.
Ultra Processed & Processed Foods
Diets high in highly processed and ultra-processed foods and sugars are associated with more intense menopause symptoms (psychological, vasomotor, urogenital, somatic symptoms and sleep disturbances) (Noll PRS, 2023). The highest intake of ultra-processed food was associated with more intense hot flashes/ night sweats (Noll PRS, 2023). Sugar-sweetened beverages and sausages in the diet is associated with menopause symptoms and poor memory and concentration (Silva Noll P, 2022).
Women who ate more vegetables reported lower menopause symptom intensity and a better quality of life (Noll PRS, 2023). The highest vegetable intake was associated with greater protection against depressive mood, vasomotor symptoms, sleep disorders and a better quality of life (Noll PRS, 2023).
Ultra processed foods also lead to weight gain which can be a problem in menopause. They contribute to insulin resistance and general poor health. For these reasons it is best to avoid ultra processed foods completely. This means avoiding foods that are processed, packaged and are not whole foods (i.e. vegetables, fruits, meats, basic grains or dairy products).
Excess Refined Sugar
Excessive sugar worsens menopause symptoms like weight gain, insulin resistance, mood swings, fatigue and potentially poor sleep. Changes in estrogen and progesterone levels disrupt blood sugar regulation, cause potential insulin resistance and further disrupt hormones. High blood sugar can increase the frequency and severity of hot flashes. The blood sugar rollercoaster of sugar spikes and sugar crashes contributes to mood swings, instability and irritability.These spikes and crashes in blood sugar also cause fatigue and energy crashes.Weight gain happens when excess sugar is converted to fat, particularly around the midsection.Too much sugar and caffeine combined is negative for bone mineral density in postmenopausal women (de França NAG, 2016).
For these reasons and to optimize general health, do not eat excess sugar in the diet. This includes cookies, candy, cakes, sodas and even yogurts, breads, coffee drinks or other products that are processed and have added sugar.
Spicy Food
Although research is limited there is some evidence that spicy foods can make symptoms worse. Spicy food can make hot flashes and night sweats more intenseor more frequent.It can increase body temperature by stimulating nerve endings and dilating blood vessels, which can increase sweating. Spicy foods can add to heartburn issues that may appear in menopause. Try to decrease or eliminate spicy foods and see how hot flashes/ night sweats symptoms are affected.
If you are suffering from menopause symptoms, then get in touch with us at the Medicine with Heart clinic. We can help to manage symptoms, optimize your menopause experience and get your health back on track!
SUMMARY
- Diet is an important tool in managing menopause symptoms. Certain foods can improve or worsen symptoms.
- The Mediterranean diet is highly recommended to help manage symptoms like hot flashes, weight gain, mood issues, blood sugar control, inadequate nutrient intake, sleep disturbances, etc.
- Specific foods that help with menopause symptoms include olive oil, fresh vegetables & fruits, protein and dairy products. Hydration is important in menopause.
- Soy is somewhat controversial for menopausal women. It can help manage symptoms and it can
- complicate the treatment of hormone-sensitive breast tumors.
- Foods to avoid during menopause include the usual suspects of too much alcohol, processed foods and refined sugar. Caffeine and spicy foods can potentially make menopause symptoms worse.
