Dealing with menopause symptoms? Here's what to eat to stay healthy and feel better.

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On Nutrition

Menopause marks the end of a woman’s menstrual cycles, a biological transition that shifts hormones as well as nutritional needs and health concerns. Complicating matters are life changes that often coincide with it — such as becoming an empty nester — and may alter eating habits. Meal-skipping, grazing all evening instead of cooking dinner, and more frequent restaurant or takeout meals can make it harder for women to get the nutrients they need as they grow older.

Here’s what you need to know:

Reducing menopausal symptoms

Menopause comes with a variety of symptoms, including “brain fog,” sleep disturbances and mood changes, but of these, hot flashes are perhaps the most uncomfortable — and embarrassing. Many women turn to herbal remedies like black cohosh and licorice extract for hot-flash relief, but whether they actually help is unclear. Foods containing soy can be a more effective nutritional remedy, but only for some women. Because hot flashes are much less common among women in Asia compared with North American women, researchers theorized that the isoflavones in soy foods — consumed regularly in traditional Asian diets — might serve as a sort of “natural” hormonal therapy. Isoflavones are phytoestrogens, plant-based compounds that can behave somewhat like estrogen.

That said, current research suggests that soy isoflavones only benefit women who have gut bacteria that can convert daidzen — an isoflavone found in soy as well as in most plant foods — into its more active form, equol. About 30 percent of women living in North America have this gut bacteria. The bottom line is that while soy is a healthful, plant-based source of protein, it won’t help all women reduce hot flashes.

Protecting bone and muscle

According to the National Osteoporosis Foundation, the sharp decrease in estrogen during menopause can cause bone loss and increase the risk of osteoporosis, with one in two women over the age of 50 breaking a bone because of it. In some women, this bone loss can be rapid and severe, with a loss of up to 20 percent of bone density during the five to seven years following menopause. Women who experience menopause before age 40 also have a greater risk of developing osteoporosis.

What can you do? Start with nutrition.

“Women should check their vitamin D levels and supplement to reach an adequate level to promote bone health,” said Judy Simon, MS, RDN, owner of Mind Body Nutrition in Bellevue. “Be sure to include healthy sources of calcium, vitamin K and magnesium.” After menopause or age 50, women need 1,200 milligrams of calcium from food and/or supplements each day. Food sources include dairy foods, canned salmon and sardines with bones, dark leafy greens, and fortified foods and beverages. Aim to get 1,000 IU of vitamin D from supplements, fortified foods or fatty fish. Getting adequate protein is also important to protect bones and prevent the muscle loss that can also accelerate around menopause. Current evidence recommends 1-1.2 grams of protein per kilogram of body weight for older adults.

As important as nutrition is for strong bones and muscles, it’s not enough. Staying physically active is also key. Include weight-bearing, muscle-strengthening types of physical activity to stress your bones and muscles in a good way. Dancing, jogging, brisk walking, jumping rope and jumping jacks are options, as well as lifting weights with machines or free weights (dumbbells and barbells), using resistance bands, or doing body weight exercises like push-ups, squats and lunges. Simon also recommends Pilates and forms of yoga that require more strength.

Preventing heart disease and cancer

A woman’s risk of cardiovascular disease increases after menopause, as the protective effects of estrogen fade. Women who start menopause after age 55 have an increased risk of breast, endometrial and ovarian cancers. A 2018 study out of Harvard University found that eating a Mediterranean-style diet was associated with a 25 percent lower risk of cardiovascular events — including heart attack and stroke — over the study’s 12 years of follow-up. Research out of the Fred Hutchinson Cancer Research Center for the Women’s Health Initiative — which randomly assigned 48,835 postmenopausal women to a low-fat diet (20 percent fat) or their usual diet — found that women in the low-fat diet group were more likely to survive if they were diagnosed with breast cancer. A high-quality diet is also associated with increased survival after an ovarian-cancer diagnosis.

Protect yourself by building a diet rich in vegetables and fruit, protein that comes at least partly from plants (soy, beans and lentils) and seafood, whole grains, healthy fats (nuts, seeds, olive oil, avocados and fatty fish), and lower-fat milk, yogurt and other dairy. Keep alcohol intake moderate and intake of sugar, salt and refined flour low.

Managing metabolism

“I frequently see women in perimenopause, menopause and post menopause who are unhappy with their bodies,” Simon said. Metabolism tends to slow during menopause, especially if muscle loss is also occurring. At the same time, the drop in estrogen contributes to distribution of excess body fat around the abdomen, even in women who have always carried most of their body fat around their hips and thighs. “I encourage mindful eating and becoming attuned to their body’s signs for hunger and fullness rather than a calorie-restricted diet,” she said.

Simon said that in addition to weight gain, digestive issues, fatigue and depression are other concerns she hears from women going through menopause. In addition to discussing food and movement habits, she talks to them about sleep habits and self-care. That matters, because excess stress — and the stress hormone cortisol — contributes to unhealthy shifts in body composition, including loss of muscle and increase in fat around the waist. “Most importantly, I share they are not alone and there are lifestyle changes they can make to improve their health and wellness,” she said.