A Nutritional Approach to Menopause Symptoms

Menopause, the natural end of a woman’s menstruation, can feel like a hormonal earthquake. Hot flashes, trouble sleeping, weight gain, and other symptoms can disrupt women’s lives for months or years. Nutrition, in addition to regular exercise and not smoking, may play a major role in managing menopause symptoms. Generally, I recommend that women who hope to alleviate menopause symptoms through changes to their diet increase their intake of some foods while decreasing their intake of others.

Hot Flashes
Up to 75% of women experience hot flashes—sudden, brief, periodic increases in their body temperature—during menopause. Their frequency and intensity may be lessened by increased intake of various foods.

Many fruits and vegetables contain phytoestrogens, which act as a weak form of estrogen in your body and may be particularly helpful to menopausal women. Try to incorporate some of these foods into your diet: soybeans, tofu, tempeh, soy beverages, flax seeds, sesame seeds, wheat, berries, oats, barley, dried beans, lentils, rice, alfalfa, mung beans, apples, carrots, and wheat germ. Daily intakes of 45 mg of phytoestrogens have been shown to have beneficial stabilizing effects on hormone balance. Some evidence suggests that healthy fats, like omega-3 fatty acids like those found in salmon and flax seeds, might also help reduce the frequency of hot flashes and the severity of night sweats.

Limiting your intake of processed foods, which are high in refined sugars and salt, to less than 10% of your calories for the day may help reduce hot flashes during menopause. Whole foods, which often have great flavor, fiber, and an array of other nutrients, are the best choice.

Bone Density
Menopause sometimes causes decreases in bone density and muscle strength, factors which can increase women’s chances of bone fractures as they age. I recommend increasing sources of calcium, vitamin D, and high-quality protein. Try adding eggs, meat, fish, legumes, dairy products, and milk alternatives like almond milk or coconut milk, which are all good sources. Dark leafy vegetables, like spinach, kale, and Swiss chard, are also great sources of bone-building calcium.  

Sleep Disruption
Many women notice disruptions to their sleep during menopause. While there is some evidence that the dairy you are eating to improve bone density may also help improve sleep, women would likely find some relief to both hot flashes and disruptions in sleep by reducing intake of caffeine and alcohol. Trying a week or two without one or the other to see how you feel may be worthwhile.  

Heart Disease
Heart-related symptoms, like dizziness and cardiac palpitations, sometimes accompany menopause. In addition, hormone changes can make arteries less flexible, which can impact blood flow. A healthy diet, including whole grains, is the best defense. In a recent study, people who ate three or more servings of whole grains per day had a 20 – 30% lower risk of developing heart disease and diabetes, compared to people who ate mostly refined carbs. Look for “whole grain” listed as the first ingredient on the label when evaluating which packaged foods contain primarily whole grains.

Even a cursory look into research regarding menopause and nutrition will reveal that the evidence supporting specific foods’ impact on women’s hormonal changes is still emerging or even contradictory. What is certain is that you can’t go wrong with a diet of mostly fresh, whole foods. Experiment with small healthy changes to your diet and work with your healthcare provider or a registered dietitian for additional help to determine what other changes may make a positive impact for you. 

Kristin Irace, RD, is a registered dietitian for patients at Southwestern Vermont Medical Center in Bennington.