The menopause is the time when periods stop. It is defined as occurring 12 months after the last menstrual period and usually happens between the ages of 45-55.
The period leading up to the menopause is called the perimenopause, this is usually what women mean what they talk about ‘going through’ the menopause.
During the perimenopause your body can change in different ways. As oestrogen levels fall, your periods may become irregular and/or heavy and you may lose your fertility. You may notice other physical changes including higher blood pressure, changes in cholesterol levels (increasing risk of heart disease), and losing calcium from your bones (raising the risk of osteoporosis). Other symptoms of the perimenopause can include weight gain, hot flushes, night sweats, irritability, poor concentration, more frequent headaches, and joint pains. These symptoms are mainly due to falling oestrogen levels, and can last for just a few months or for several years. The range of symptoms and how severe they are, is different for each woman.
A range of lifestyle changes can make symptoms more tolerable. Hormone replacement therapy (HRT) can be used by many women to help control these symptoms, however some women cannot take HRT due to other health problems, whilst others choose not to. The decision to take HRT or not should be discussed with your doctor. For all women, diet and lifestyle changes can help with symptoms. This can include taking dietary supplement products.
During the menopause, muscle mass reduces which means that you may need fewer calories. Over time this can lead to weight gain. Being careful about how many calories you consume, your portion sizes and doing more physical activity can help prevent weight gain. Resistance activities, such as using weights, are especially important to both preserve and build muscle mass. Thirty minutes of fast walking a day could lead to around 7kg (15lb) weight loss in a year, and also reduce the risk of heart disease. The BDA Food Fact on Weight Loss has tips on safe effective weight control.
Taking HRT helps to maintain oestrogen levels and protect bone health. There are also lots of nutrients that help to keep bones healthy, so it’s important to have a balanced diet. Choose a variety of foods and consume plenty of fruit, vegetables and dairy foods as these are a source of calcium.
Aim for two to three portions of calcium-rich foods every day which can include:
Vitamin D is also very important for bone health. Your skin makes it in response to sunlight, but in the UK this can only happen between April to September. During this time, it’s recommended you expose your skin to direct sunlight for around ten minutes, once or twice per day, but avoid burning. All adults should consider taking a daily supplement containing ten micrograms of vitamin D, especially during autumn and winter. Women over the age of 65, those with dark skin, from African, African-Caribbean and South Asian backgrounds or who have low sunlight exposure should also consider taking a vitamin D supplement of ten mcg per day all year round. There are not many foods that are good sources of vitamin D. Find out more in our Vitamin D Food Fact Sheet.
Foods that contain vitamin D include:
Menopause can increase your risk of developing heart disease. Eating a heart healthy diet can help to lower cholesterol levels and blood pressure, here are some very simple lifestyle changes you can make to reduce the risk:
Plant oestrogens (also called phytoestrogens) are very similar to human oestrogen. If eaten regularly, and in sufficient quantities, they can start to have mild oestrogen-like effects – which is useful as oestrogen levels decline.
For some women these effects could be sufficient to help relieve menopausal symptoms, particularly hot flushes. It is worth knowing that:
Both caffeine and alcohol can make hot flushes worse so try to moderate intake of caffeine from drinks like coffee, tea and colas or choose decaffeinated drinks if you are sensitive to its stimulatory effects. Keep to sensible alcohol limits – no more than two to three units per day, avoid altogether if you feel it makes symptoms worse.
A lifestyle approach to the menopause
Menopause – Information Sources
National Center for Complementary and Alternative Medicine (2019) Menopausal Symptoms and Complementary Health Practices [online] available from <https://nccih.nih.gov/health/menopause/menopausesymptoms> [last accessed 28/03/2019]
National Institute for Health and Clinical Excellence (2015) Menopause: diagnosis and management (NG23), plus (2017) Menopause (QS143) [last accessed 27/03/19]
National Institiute for Health and Clinical Excellence (2016) CG181 Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease [online] available from <https://www.nice.org.uk/guidance/cg181> [last accessed 28/03/2019]
Practice-based Evidence in Nutrition (2008) Women’s Health Menopause [online] available by subscription from < http://www.pennutrition.com/SearchResult.aspx?portal=PEN&terms=bWVub3BhdXNl&filter=1> [last accessed 06/11/12]
SACN (2016) Vitamin D and Health Available on line https://www.gov.uk/government/publications/sacn-vitamin-d-and-health-report [accessed 28/03/2019]
Cochrane World Menopause Day (2018) www.cochrane.org/news/world-menopause-day
Bedell S, Nachtigall M, Naftolin F (2014) The pros and cons of plant estrogens for menopause. J Steroid Biochem Mol Biol 139: 225-36. doi: 10.1016/j.jsbmb.2012.12.004
Franco OH et al (2016) Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. JAMA 315: 2554-2563Crawford AL et al (2013) The impact of dose, frequency of administration, and equol production on efficacy of isoflavones for menopausal hot flashes: a pilot randomized trial. Menopause 20: 911–921