It's official. The Food and Drug Administration (and the American medical establishment) now describes menopause and menopausal symptoms like hot flashes as a disease process and not a continuum of normal aging. Indeed, the only FDA-approved method of treating hot flashes is hormone replacement therapy. HRT fell out of favor after the Women's Health Initiative—the study that was supposed to prove the safety of HRT—was stopped prematurely when those taking the drug demonstrated an increased incidence of cancer. But it's now enjoying somewhat of a revival, with newspapers awash with new studies supposedly showing its benefits and safety.
But most menopausal symptoms can be easily resolved through diet. Here are the main symptoms and what to do about them.
What to eat:
There are many studies showing that a diet rich in soy and isoflavones can decrease the occurrence of hot flashes. In one study, a group consuming a little over 2 ounces (60 grams) of soy protein powder daily reported a 45 percent decrease in the number of daily hot flashes after three months.1 A recent review of studies has shown that soy isoflavones decrease the frequency of hot flashes, especially in women with more frequent episodes.2
The isoflavones genistein, daidzein and glycetin contained in soy are known as 'phytoestrogens'—or plant estrogens—because they act like a weaker version of estrogen in the body, with the potential to bind to estrogen receptors.
However, because of this estrogen-binding potential, there are debates as to whether or not these phytoestrogens increase cancer risks in postmenopausal women.
Susan Dopart goes further in her book A Recipe For Life By The Doctor's Dietitian (SGJ Publishing, 2009), giving examples of soy's potentially harmful effect on the thyroid by interfering with the absorption of thyroid hormones and highlighting how many soy products use genetically modified plants.
She also points out that "in Asian cultures, soy is used as a condiment rather than a food... Asian cultures use about 2 teaspoons per day fermented soy versus the unfermented soy foods Americans consume (1-2 cups per day)." The take-home message? Soy can be added as a healthy part of the menopausal diet, but choose traditional sources like fermented soy in moderation. Good examples of fermented soy products include miso, natto, fermented tofu and fermented soy milk.
Also cut down on foods that increase the incidence of hot flashes. Researchers from the University of Oklahoma Health Sciences Center recommend cutting caffeine from the diet after finding increased rates of night sweats in women who consume caffeinated drinks.3 Other studies have shown that in addition to phytoestrogens, vitamin C, vitamin E and evening primrose oil can help to decrease hot flashes.4
What to eat:
We all know that large amounts of caffeine can keep us awake and that we should decrease caffeine consumption before bedtime, but alcohol has also been shown to impair REM (rapid eye movement) cycles during sleep,5 so try lowering your alcohol intake for a more restful night.
One study found that carbs can help you sleep: eating a high-glycemic-index meal four hours before bedtime decreased the time it took for the study participants to fall asleep.6
However, this approach might not work for women who are trying to avoid carbs for other reasons, such as sticking to a Paleo diet.
Another cause of reduced sleep is a diet deficient in vitamin B12 (cyanocobalamin),7 so increase your consumption of foods rich in B12 like meat, poultry, fish, eggs and dairy. Also avoid stomach acid inhibitors like Zantac, Pepcid, and Prilosec, which can create deficiencies in vitamin B12 due to malabsorption.
These strategies can also help to increase the production of l-tryptophan, a precursor to melatonin—the sleep-inducing hormone secreted in your brain before bedtime.
If you can increase melatonin at night by eating a meal of a slightly carbohydrate nature and increasing foods rich in vitamin B12 (meats, cheeses and eggs), it may help with sleep induction.
Finally, take 400 mg of magnesium at bedtime in chelated or oxidized form along with a chamomile tea or a hops-valerian tea to aid sleeping.
What to eat:
Some weight gain in menopause may be the body's way of creating its own estrogen. If you were already overweight or obese before menopause, then there may be a need to lose weight, but if you were at a healthy body mass index and gained 5 to 10 pounds during menopause, it may be normal to allow your body to try and respond naturally to the change. Make sure you balance your meals with a lean protein, vegetables and grains with a low glycemic index, limit sugars and sweeteners, eat healthy fats like olive oil, cold-water fish or flax seeds, limit alcohol and increase exercise. Importantly, realize that you will make mistakes—don't see them as a cause to give up, but as a teaching aid to help you avoid the same pitfalls in the future.
What to eat:
Too often, women's mood swings are blamed on hormones. What is usually absent from the conversation between physicians and menopausal patients is how foods and certain dietary restrictions can alter mood.
Diets low in omega-3 fatty acids may contribute to depressive symptoms,8 and in this era of low-fat diets, women trying to lose weight may be making menopausal mood symptoms worse.
Low levels of the amino acid tryptophan may also play a role in depression.9 While the data on tryptophan and serotonin production is limited, eating a diet high in spinach and seaweed as well as soy proteins can provide high levels of tryptophan.
Not only do women with lower levels of omega-3 fatty acids have higher rates of depression, but the extent of the omega-3 deficiency is correlated with the severity of depression.10 A comprehensive review of the available data on the subject concluded that one gram per day of the omega-3s eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) had a protective effect against mood disorders.11
Sources of omega-3 include cold-water fish, flaxseed, walnuts, soybeans and green leafy vegetables. Vitamin B6, found in beef, pork, fish, cereals, avocados, bananas and grains, has also been shown to improve mood symptoms in premenstrual syndrome.12
If you suffer from bouts of depression or low mood, also try eating smaller balanced meals five to six times per day to help stabilize blood sugar levels.