Step one: peri-menopause Step three: post-menopause Food to fight osteoporosis
The menopause is actually the moment that women stop menstruating, but we commonly think of it as a longer transition phase. There is no set pattern as each women is individual - some women will stop menstruating overnight, while others can take ten years
Some will experience strong symptoms while others sail through. Many women view this time of hormonal change as an opportunity to enjoy life unfettered by monthly cycles and others fear it as a loss of their youth. Either way, the menopause is a natural stage of life.
This is the pre-menopausal stage during which hormone levels are changing. Oestrogen gradually declines, progesterone is often produced erratically and only during cycles when an egg is released, and follicle stimulating hormone (FSH) is triggered by low oestrogen causing hot flushes. Usually the peri-menopause starts in a woman's mid-40s. For some it is much earlier and can follow a mother's pattern. During this phase some cycles are 'anovulatory', meaning an egg is not produced, while other cycles produce more than one egg making twins more likely if conception does take place.
Signs of peri-menopause
Early signs of the peri-menopause might be the length of time between periods altering or periods becoming heavier or lighter. Here are some other telltale signs:
These can be very troublesome for women who experience them several times daily, and they can be worse at night. To reduce their severity, eat a diet which features soya products and wholewheat foods - studies show an effect after four to eight weeks. Hot flushes are less of a problem in vegetarian societies, so a diet high in pulses and vegetables may help. Caffeine and alcohol can be frequent triggers. Regular exercise has a short-term worsening effect but a longer-term dampening effect on hot flushes. High levels of vitamin E have been reported to help, but avoid this if you are taking blood thinning medication such as warfarin.
Sage is a prime herbal remedy for reducing night sweats. Drink a sage tea made from sage leaves steeped in boiling water for five minutes, three times daily. Black cohosh and dong quai are the herbs most frequently taken during the peri-menopause which have a wide range of beneficial effects on symptoms. As with all herbs it is best to seek professional advice from a herbalist, especially if you are taking other medications.
Balancing blood sugar levels by eating fibre-rich food can help your mood. St John's Wort is well-known for its effectiveness against mild to moderate depression but it must not be taken with other medications and can increase sensitivity to sunlight. Avena sativa, known better as porridge oats, is used traditionally as a relaxant herb and can be taken in tincture form.
Many women complain of a worsening memory at this time. B-vitamins are important for mental function and are found in cereals, or try a Brewer's yeast supplement. The herb ginkgo biloba can improve circulation and help short-term memory problems.
These often start, or get worse, during the menopause. Caffeine is a frequent trigger as are amine-rich foods and drinks such as wine, beer, chocolate, cheese, pickles and salami. Ginger can help to reduce headaches and migraines by dilating blood vessels that lead to the head.
Step two: the menopause
This is the moment when periods cease completely and the ovaries are no longer producing eggs. It is advised that contraception is continued until a year after periods cease - just in case! Conditions linked to high oestrogen levels, like fibroids and endometriosis - decrease at this time as hormone production stops. Some other common changes include:
This can begin to be a problem in the peri-menopause but is worse after periods cease (oestrogen keeps tissues 'plumped out'). Many lubricants are available including those enriched with oestrogen, for short-term use from your doctor. Again, a diet which features soya may help. The popular menopausal herbs black cohosh and red clover can alleviate dryness.
There can be anxiety about decreasing libido. For women, sorting out problems with vaginal dryness certainly helps. Some herbs might be helpful - horny goat weed, an aptly named herb, can be a tonic. It is thought to stimulate sensory nerves and so improve sexual desire and satisfaction. The herb damiana works by stimulating oxygen flow to the sex organs and is useful when depression or decreased physical sensitivity is linked to low sex drive. Ginkgo biloba is also known to improve blood flow to the sex organs and can improve sex drive in those whose libido has been affected by antidepressants.
By this stage a woman's hormone patterns have changed significantly. The ovaries are no longer producing oestrogen or progesterone. However the adrenal glands and fat cells continue to produce oestrogen at around 40 per cent of previous levels. Hormone pattern changes mean that central weight gain (fat around the tummy instead of the hips) is more likely, and risk-factors for certain diseases become similar to men's. Osteoporosis becomes more of a risk affecting one in three women. Now might be the time for an overall health check, including an assessment of cholesterol, blood pressure and bone density.
Menopause and your diet
A healthy, balanced diet can help you through the menopause. Concentrate on the following areas of your diet:
High intakes, that is about seven to ten portions daily, can be highly protective of bone health, cardiovascular complications and breast cancer. To achieve this level make sure you eat two portions with each of three meals and add in a couple as snacks between meals.
Soya protein has been shown to be protective against heart disease. The plant oestrogens in soya foods are also believed to help against osteoporosis as a gentle form of oestrogen replacement. Soya protein may help breast cancer, as mild plant oestrogens are thought to block the damaging effects of potent forms of the oestrogen involved in breast cancer. Around five portions a week should be beneficial. (Try soya milk, soya yoghurts, soya snacks, tofu and other soya based foods available in health food shops).
Fibre helps protect against digestive and bowel problems, but also may be effective in protecting against heart disease, weight gain and breast cancer. Fruit, vegetables, pulses and beans, whole grains (oats and rye are particularly beneficial), nuts and seeds are fibre rich. Linseeds have compounds called lignans in them which may help protect against breast cancer.
Eating to help cardio-health
Suzannah Olivier is the author or Natural Hormone Balance (Simon & Schuster) and The Breast Cancer Prevention and Recovery Diet (Penguin).