Menopause is an innate biological process that marks the end of a woman's reproductive years. It is defined as the cessation of menstruation for 12 successive months, indicating the end of ovarian follicular function.
Menopause is of biological significance because of the hormonal changes accompanying it, particularly the decline in estrogen and progesterone levels, which can affect a woman's overall health and well-being.
The menopausal transition generally occurs between the ages of 45 and 55, with the average age in the United States being 51.
Menopause is a gradual process that can be divided into the perimenopausal phase leading up to menopause and the postmenopausal phase that follows.
In addition to a brief review of menopause and associated symptoms, this article explores the roles of crucial vitamins and minerals in women's health, how the demand for these micronutrients changes as a woman ages, and how to employ micronutrients to address challenging symptoms associated with menopause, improve quality of life, and reduce chronic disease risk.
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Understanding Menopause and Its Symptoms
Considering that the female body takes 8-10 years to prepare for menopause, it is essential to start our review of this transition with a discussion of perimenopause.
Perimenopause represents the time during which the female body begins to transition to menopause naturally. In some women, perimenopause starts in their 30s but most often occurs between ages 40 to 44.
This period is accompanied by changes in the menstrual cycle, including flow and the cycle length. These changes result from a reduction in ovarian hormone production, with levels of estrogen and progesterone rising and falling unevenly, causing the menstrual cycle to become unpredictable or irregular. Menstrual cycles can become a challenge during this time, but this is a natural and expected progression in a woman's reproductive cycle.
During perimenopause, women often start to experience hot flashes and vaginal dryness, which are among the most common and bothersome symptoms. Once a woman has gone 12 consecutive months without a menstrual period, she is considered to have reached menopause, marking the end of the perimenopausal phase.
However, hormone levels can continue to shift and decline for ten years beyond menopause. Signs and symptoms of menopause can continue as well:
- Irregular periods or skipping periods
- Shifts in menstrual flow
- Hot flashes or night sweats
- Vaginal dryness and discomfort with intercourse
- Changes in mood, including anxiety, depression, irritability, and mood swings
- Urinary urgency
- Sleep disturbance
- Weight gain
- Decreasing fertility
- Changes in sexual function
- Loss of bone mass
- Changes in cholesterol levels (increase in LDL)
The Role of Micronutrients in Menopause
A micronutrient is a vitamin or mineral used by the body for critical processes. They are required in small quantities for our biochemistry to run optimally. There are nearly 30 essential micronutrients, vitamins and minerals that the body cannot produce in adequate amounts on its own.
They are derived from dietary or supplement sources and are involved in many functions throughout the body to support average growth, development, and health maintenance. A woman's nutrient requirements change as she enters perimenopause to support the changes in hormones, cardiovascular function, and bone health.
The most essential micronutrients during menopause vary between individuals. However, the following are of particular value, and if dietary sources are not reliably sufficient, supplementation is a consideration. Adequate levels of each support the female body as hormone production declines.
Vitamin D
Vitamin D positively influences several factors affecting health throughout menopause, including:
- Bone mass and muscle mass: D3 supports calcium absorption from the intestine, encouraging bone production. D3 receptors are present in bone and skeletal muscle, positively influencing muscle function, strength, and balance as a woman ages.
- Cardiovascular health: Vitamin D has anti-inflammatory and antioxidant properties, reducing the risk of cardiovascular and metabolic diseases. A 2021 study found that higher vitamin D3 levels were linked to lower fasting glucose and insulin levels in postmenopausal women with type II diabetes.
- Immune function: Vitamin D and metabolites cast an antiproliferative effect on tumor cells, reducing the incidence of many cancers, including lung, ovarian, and breast.
- Mood support: During menopause, women are significantly more vulnerable to depression and anxiety as estrogen levels fall. Vitamin D protects the brain's dopamine pathway, providing an antidepressant-like effect supporting a more positive mood.
B Vitamins
The family of B Vitamins is essential throughout life, especially during menopause. They play many roles in the body, including:
- ATP production: The body relies on B2, B6, B12, and folate to metabolize carbs, proteins, and fats into energy.
- Nervous system support: B vitamins are necessary to metabolize and detoxify hormones, medications, and neurotransmitters.
- Cardiovascular health: Insufficient intake of B vitamins is associated with higher homocysteine levels, increasing the risk of stroke by 19-24%.
- Cognitive function: The incidence of dementia and Alzheimer's correlates with insufficient B vitamin intake.
Calcium
Calcium is essential for multiple bodily functions, including:
- Muscle contraction
- Blood clotting
- Nerve function
- Bone health, especially in an aging female
Most calcium exists in the skeletal system; however, calcium is pulled from the bones when the plasma concentration is low. Since estrogen aids in maintaining strong bones, reduced estrogen during menopause leads to more bone loss.
Net absorption of dietary calcium declines to nearly 25% in adults and continues to decrease as we age, making calcium supplementation especially important in postmenopausal women.
Research reveals that supplementing calcium with vitamins D3 and K provides some assurance that the calcium will support bone health and deter blood vessel deposition.
Zinc
Zinc is well known to support many different processes as we age, including:
- Immune function
- Integumentary health
- Vision: Zinc, in combination with antioxidants from a nutritious diet, is shown to reduce the risk of macular degeneration.
- Cognition and emotional health
- Body composition: Zinc deficiency in postmenopausal females correlates with a tendency to gain fat mass, as it is involved in energy metabolism and regulates leptin, satiety, and body weight.
Magnesium
Low serum magnesium correlates with low bone density and is lower in postmenopausal women with an osteoporosis diagnosis than those without. It is also critical for:
- Insulin sensitivity
- Healthy blood pressure levels
- Improved muscle recovery after workouts
- Mood support
- Quality sleep
Dietary Sources of Key Micronutrients
Oily fish, including salmon, sardines, and mackerel, are the richest dietary sources of vitamin D, along with fortified foods such as dairy and orange juice.
As a group, B vitamins are most predominant in animal proteins such as poultry, meat, fish, and dairy. Vegetarians and vegans are more vulnerable to B vitamin and folate deficiency.
While dairy is a solid source of calcium, legumes, dark leafy greens, nuts, seeds, and whole grains provide an impressive amount of calcium, zinc, and magnesium.
The foundational components of the Mediterranean diet include fish, legumes, fruits and vegetables, whole grains, nuts, and seeds. This makes it rich in micronutrients and a solid recommendation for menopausal females. The high phytonutrient content in the Mediterranean diet provides protective anti-inflammatory and antioxidant actions as we age.
Several studies have revealed that a Mediterranean-focused nutrition plan aids in weight control during menopause, thereby reducing the risk of obesity and cardiometabolic disease.
A study reviewing the value of the Mediterranean diet in reducing hot flashes and night sweats during menopause found a 20% reduction in vasomotor symptoms in women who followed the diet.
Supplementation During Menopause
Many adults in the US are deficient in several micronutrients, mainly due to the increased consumption of low-nutrient, high-calorie processed foods and high sugar intake. These foods require the body to metabolize more nutrients like B vitamins and magnesium.
Agricultural practices that deplete the soil of nutrients influence the development of nutrient deficiency. Several deficiencies can also result from chronic diseases, influencing biochemistry and the body's nutrient demands.
However, even with good health and a balanced diet, maintaining adequate micronutrient levels is essential for optimal biochemistry, especially during menopause. This is similar to keeping a bakery's pantry well-stocked. Just as a bakery needs all its ingredients on hand to efficiently fulfill orders, the body needs sufficient nutrients to meet its demands, effectively supporting overall biochemical function.
Choosing which nutrients to supplement, products, and dosing can feel overwhelming. Awareness of quality products and safe, therapeutic dosing is essential. Working closely with a provider specializing in functional medicine who understands the importance of high-quality absorbable nutrients and proper dosing offers a way to safely and confidently design an effective supplement regime.
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Key Takeaways
- Studies have found that the employment of supplemental micronutrients helps alleviate several menopause symptoms, including hot flashes, night sweats, insomnia, depression, and fatigue.
- Research reveals that long-term treatment with micronutrient supplementation effectively relieves symptoms related to menopause while also improving overall health.
- Optimizing micronutrient levels can satisfy the body's nutrient demands, reduce the risk of several chronic diseases, and improve quality of life.
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