Menopause is a natural and significant stage in a woman's life, marking the end of her reproductive years. However, this transition is often accompanied by uncomfortable symptoms, including hot flashes, mood swings, and weight gain. Many women are taking a holistic approach to support their well-being during this transformative phase. Integrative nutrition recognizes the profound impact of food and lifestyle choices on hormonal balance and overall health. This article will explore using food and other complementary strategies to help manage menopausal symptoms and support women during this transition.
[signup]
Understanding Menopause
Menopause is a natural biological process that signifies the end of a woman's menstrual cycles and fertility. In the United States, an estimated 1.3 million women enter menopause. The menopausal transition occurs in most women between ages 45 and 55 and usually lasts seven years. (1)
Menopause is generally recognized to have three stages: perimenopause, menopause, and postmenopause. Perimenopause, the earliest stage, can start several years before menopause and is marked by irregular periods and hormonal fluctuations. Menopause is the absence of menstruation for 12 consecutive months, signaling the permanent cessation of ovulation and fertility. Postmenopause refers to the years following menopause, where most menopausal symptoms tend to diminish, although hormonal changes and symptoms can still impact overall health and well-being. (2)
Common Symptoms and Challenges Associated With Menopause
Symptoms of menopause typically begin during perimenopause, related to the natural decline in estrogen (3). The most common symptom of menopause is hot flashes, periodic increases in body temperature experienced by 75% of all menopausal women. Hot flashes that occur at night are called night sweats.
Mood disorders, encompassing emotional changes and mood swings, are also more likely for women at the onset of perimenopause than at any other point in their life. Fluctuations in estrogen and progesterone and the effects this has on neurotransmitter synthesis, memory, and brain structure account for irritability, rage, anxiety, and depression.
The average woman gains 5-8 pounds during the menopausal transition. Studies suggest that fluctuations in reproductive hormones may influence ghrelin, leptin, and neuropeptide Y, hormones that help control appetite and satiety signals, potentially contributing to changes in metabolism and weight during this life phase. (4)
Other common symptoms associated with menopausal hormonal changes may include vaginal atrophy, low libido, sleep disturbances, urinary incontinence, and hair loss (2, 5). Postmenopausal women may also experience changes in heart and bone health as estrogen levels decrease, potentially affecting cardiovascular and bone health (6, 7).
What Are the Principles of Integrative Nutrition?
Integrative and functional nutrition operates on principles that prioritize a holistic approach to nutrition, understanding that a healthy diet is foundational for all aspects of health. Adopting a holistic approach, integrative nutrition emphasizes that nutrition is not just about isolated nutrients. Instead, it encompasses the complex interactions between an individual's unique circumstances (i.e., lifestyle, genetics, environmental factors) and the foods they eat.
Placing a strong emphasis on nutrient-dense, whole foods that provide essential vitamins, minerals, antioxidants, and phytochemicals that support the body's physiologic processes and nourish the body, nutrition can be a cornerstone to achieving optimal wellness. Functional nutrition embraces the concept of bio-individuality, meaning that each person has specific needs when it comes to nutrition, and what works for one person may not work for another. A tailored, individualized nutritional approach ensures that dietary plans are enjoyable, sustainable, and effective in meeting health goals and supporting wellness.
Common Functional Medicine Labs That Can Help Individualize Integrative Nutrition Options for Menopause Patients
Functional medicine labs can play a role in tailoring integrative nutrition approaches for menopause patients by providing insights into individual biochemistry, hormone levels, nutrient levels, and overall health markers.
Comprehensive Hormone Panel
A comprehensive female hormone panel is one of the first go-to labs for a baseline hormone assessment to gauge the menopausal transition. The DUTCH Complete is a popular lab amongst functional providers because it assesses the balance of estrogen, progesterone, testosterone, and their metabolites to determine how the body makes and processes sex hormones. In addition, it also measures cortisol, melatonin, and various organic acids, which provide additional insight into the reason behind the physical and emotional symptoms of menopause.
Nutritional Assessment
The Metabolomix+ is an advanced panel that combines a variety of tests to analyze essential vitamins, minerals, amino acids, organic acids, and oxidative stress markers. This evaluation goes beyond simply screening for nutrient levels and provides in-depth insight into total-body nutritional status, helping to stratify health risks for preventive healthcare. Using this information to guide dietary recommendations can support a holistic plan that promotes overall wellness.
Comprehensive Stool Test
Specific bacteria within the intestinal microbiome, called the estrobolome, may play a role in metabolizing and modulating the body's circulating estrogen. Additionally, studies show a reduction in gut microbiota diversity and increased potential for gut permeability ("leaky gut") in menopausal women (3). Given this, a comprehensive stool analysis helps assess gut health and function by measuring intestinal biomarkers related to the abundance and diversity of the microbiome, the integrity of the gut barrier, and digestive efficiency.
Food Sensitivity Testing
Sometimes, food sensitivity testing is appropriate to identify foods that may be problematic for an individual, contributing to digestive symptoms. These test results can be used to create a personalized, therapeutic elimination diet to help manage gut health.
Integrative Nutrition Strategies for Menopause Symptom Management
The fundamental goals of an integrative nutrition strategy include providing support for common menopausal symptoms and including foods rich in nutrients that may help maintain bone health, cardiovascular health, and gut health. In general, women going through menopause might consider adopting dietary practices, such as those emphasized by the Mediterranean diet guidelines. Research has suggested that a Mediterranean diet may support bone health, reduce the risk of cardiovascular issues, and support healthy aging.
Any meal pattern constructed around whole fruits, vegetables, unsaturated fats, whole grains, legumes, lean protein, herbs, and spices is considered supportive of overall health. By incorporating these nutrient-dense foods into the diet and simultaneously limiting ultra-processed foods high in saturated and trans fats and sugars, we can observe general shifts in health associated with improved wellness. Balancing macro- and micronutrients through healthy eating patterns may help maintain balanced blood sugar, support gut health, and reduce systemic inflammation - potentially supporting hormone metabolism and managing menopausal symptoms. (8)
Key Nutrients and Foods for Menopause Support
Beginning with perimenopause, nutrient requirements may change for women to support hormonal changes, bone health, and cardiovascular function. Vitamins and minerals of significant importance for women aged 40 and older include vitamin D and Bs, calcium, zinc, and magnesium. A perimenopausal diet may help prepare the body to cope with hormonal fluctuations, prevent nutrient deficiencies, and support overall wellness.
Protein
According to research, adequate protein intake is associated with improved weight management, prevention of muscle loss, and better physical performance in perimenopausal, menopausal, and postmenopausal women. Guidelines suggest eating 0.8-1.5 grams of protein per kilogram of body weight daily to help maintain muscle function. High-protein foods include meats, poultry, seafood, eggs, soy, beans, nuts, and seeds. (9, 10)
Phytoestrogens
Phytoestrogens are plant-derived substances that may interact with estrogen receptors. They may exert weak estrogenic effects in some parts of the body while having antiestrogenic effects in others. Isoflavones are the most common phytoestrogenic compounds. Isoflavones may express estrogenic effects in the central nervous system, blood vessels, bone, and skin without stimulating breast or uterine tissues. Phytoestrogen-rich foods include soy, beans, flaxseeds, and whole grains. (11, 12)
Omega-3 Fatty Acids
Omega-3 fatty acids are essential polyunsaturated fats found in high concentrations in fatty fish. Adequate intake of these essential fatty acids is important for modulating systemic inflammation and may help support bone health, heart health, and cognitive function. (9)
Fiber
Ensuring adequate fiber intake, at least 25 grams daily, by eating whole grains, fruits, vegetables, and legumes is important for supporting cholesterol and blood sugar levels, maintaining a healthy weight, normalizing bowel habits, and supporting the intestinal microbiome.
Supplements and Herbs Commonly Used for Menopause Support
The following supplements are commonly used alongside diet and lifestyle modifications to support menopause symptoms.
Black Cohosh
Black cohosh is a well-researched botanical supplement often used for managing menopausal symptoms, predominantly hot flashes and night sweats, due to its potential phytoestrogenic effects. Additionally, black cohosh may interact with serotonin receptors, which could help with the psychoemotional symptoms of menopause. (13, 14)
Maca
Maca root is an adaptogenic herb that may support a healthy stress response by influencing the hypothalamic-pituitary-adrenal (HPA) axis. Adaptogens have been found to improve the subjective experience of stress, potentially enhancing energy levels, sleep quality, cognitive function, and emotional stability. Some research suggests maca may be helpful for hot flashes, night sweats, mood swings, and low libido.
St. John's Wort
Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressant medication sometimes prescribed for managing hot flashes and mood disorders related to the menopausal transition. St. John's wort is sometimes considered a potential alternative to SSRIs in managing mild-to-moderate depression. Some trials have also suggested that menopausal women using St. John's wort may experience improvements in hot flashes, fatigue, and sleep.
Integrative Nutrition and Hormone Replacement Therapy (HRT)
Integrative nutrition and hormone replacement therapy (HRT) are complementary approaches to addressing menopausal symptoms and promoting overall well-being. Producing (or administering) hormones is just one part of the equation when considering hormonal imbalances; integrating diet therapy into a menopausal plan can address other essential aspects required to support hormonal balance. While administering HRT, using food to support thyroid, adrenal, liver, and gut health can optimize the interconnected workings of the body's endocrine and detoxification systems, potentially enhancing symptom management, often with lower hormonal doses.
[signup]
Summary
Menopause is a transformative phase of a woman's life. Unfortunately, menopause is often associated with undesirable symptoms related to the decline in ovarian function and reproductive hormones; however, this transition doesn't need to be uncomfortable. Women can navigate this life transition by utilizing an integrative approach to supporting women's health and hormonal balance. Integrative nutrition is an essential aspect of supporting women through menopause. An individualized dietary strategy can be effective in supporting the body's endocrine system, managing menopausal symptoms, and setting a solid stage for healthy aging.
%201.svg){kind=logo}
