Let’s Talk About Menopause and Peri-Menopause – it’s more than hot flushes and mood swings
Most women who come to see me about menopause do so because of mood swings and hot flushes. It’s easy to talk about these symptoms of menopause. Some come because of weight gain.
What women don’t talk about are symptoms like dry vagina, bladder weakness (leakage when you sneeze or cough), and reduce libido. These issues are just as important as hot flushes and mood swings; so important I’ve written a second Blog just on genitourinary changes in menopause.
Quality of life can be impacted by all or any of these symptoms of menopause. We need to get better at talking about all the symptoms of menopause. The more we talk about it, the more normal these symptoms become.
Definitions
Menopause is a natural part of ageing; it represents the end of reproductive years for women. Women usually experience a slow slide into menopause over 4-6 years, starting in their 40s. This period is referred to as peri-menopause.
Perimenopause happens due to variable hormone secretion by the hypothalamus, pituitary and ovaries. As hormone secretions change the ovaries start to function erratically and decline in function.
Signs and Symptoms
The first signs and symptoms women experience relate to regularity of menstrual periods. While signs and symptoms vary between women, most can expect their menstrual period to become irregular and erratic. Some women start having very heavy periods. For some women their cycle becomes haphazard rather than regular.
Most symptoms of menopause relate to falling oestrogen levels.
As well as the symptoms mentioned earlier, women may also experience insomnia, achy joints, new facial hair, and dry skin. Once past menopause, women have an increased risk of osteoporosis and cardiovascular disease. (see my Blog on Cardiovascular Disease in Women)
Treatments
The good news is there is help available.
While there are pharmaceutical interventions for menopause symptoms, many women prefer a more natural approach such as medicinal herbs and nutritional supplements for the management of their symptoms. In my experience, around 95% of women who seek naturopathic help will benefit from the herbs and/or supplements prescribed.
Research has shown that medicinal herbs used in traditional Western, Chinese and Ayurvedic medicine systems can be prescribed to support a healthy transition through menopause. These herbs and supplements are particularly good at assisting in the management of hot flushes,night sweats, mood changes and low libido.
What herbs can assist with doesn’t stop here. Talk to an accredited naturopath or herbalist to find out what medical herbs and supplements will suit your individual needs.
Weight Gain
One of the most frustrating aspects of menopause is weight gain and the difficulty some women experience in losing weight. Weight loss is difficult without the complicating factors of menopause. Recent research indicates that abdominal weight gain is most likely associated with insulin resistance. Seeking assistance from a qualified nutritionist will help you develop an eating plan to help reduce abdominal weight gain.
Regular exercise – a mix of cardio and resistance is essential. If you are unsure of what exercise to do, seek the help of a qualified exercise physiologist, particularly if you have underlying health issues.
What works for one woman may not work for another. There are a number of medicinal herbs and nutritional supplements that can help with insulin resistance.
TATT – tired all the time and Brain Fog
Constant fatigue is more a side effect of a busy lifestyle than menopause. Sometimes lack of sleep due to uncontrolled hot flushes adds to fatigue.
With changes in when women have children, quite often women are managing young or teenage children and ageing parents, along with a demanding job, all while going through menopause. No wonder they feel tired all the time.
Give yourself a break. Find a few minutes every day for yourself.
Brain fog during menopause it most likely related to sleep problems and overall fatigue. Generally addressing night sweats and fatigue will correct brain fog.
Benefits of Menopause
There are benefits to going through menopause. No more worrying about getting pregnant, no need to carry tampons and/or sanitary pads around in case your period pops up unexpectedly.
Some women talk about the extra energy they have post-menopause. Others talk about being more focused on their own goals.
Fatigue
Guide to Pantry Essentials
Guide to Pantry Essentials
I am often asked what I consider to be pantry essentials, i.e. what basics do I have on hand to ensure we are able to eat quite well and follow a healthy diet. Here’s what I see as essentials to have in my pantry.
Dried beans/pulses like borlotti beans, chickpeas, black beans, lentils and moong dahl. Dried beans can be soaked overnight and cooked the next day. Beans/pulses are a great source of protein and fibre, which helps slow glucose absorption and keeps blood glucose levels stable. Dried beans/pulses can be used to make lots of delicious meals e.g. beans and rice, and dahl, or pulses can be added to a meat based casserole.
Rice – I have brown rice, black rice, white rice, red rice and wild rice, as well as gluten free grains quinoa and buckwheat. When I cook rice, I often add quinoa, buckwheat and chia seeds to add extra fibre. I use leftover cooked rice to make one of my favourite Thai dishes – Andaman fried rice – I add extra vegetables, to make sure we get our daily serves of vegetables, and top with nuts and a fried egg for protein.
Nuts and seeds are good sources of healthy fats, fibres, and a range of essential vitamins and minerals. Sometimes I’ll add nuts to vegetarian meals for extra crunch and additional protein.
Add Herbs and Spices
For me a good range of dried herbs and spices is essential for adding flavour to food. With the right herbs and spices you can make really tasty food from basic ingredients e.g. curries, Asian and Middle Eastern inspired food, add flavour to a salad. I’m a little hard core when it comes to curries etc, I like to mix my own herbs and spices together to make the spice mix. Having said that, a good quality curry powder is essential to my pantry.
Dried Fruit
Dried fruit can be used in sweet and savoury meals. Dates, prunes, apricots, raisins, cranberries and figs are not only sweet, they provide essential fibre and antioxidants. Don’t overdo the dried fruits, while delicious dried fruit is high in sugar and quickly adds calories to what you eat.
Canned and Frozen Foods
While I do have dried beans/pulses, I also have canned ones on hand for a quick addition to a meal.
Canned food is comparable to fresh or frozen food. Canned lentils can be used to make a delicious lentil salad, or added to soups and stews. One of my favourite super easy soups to make has one can of mixed beans, 2 cups of fresh or frozen mixed vegetables, and 1 litre of stock; plus fresh or dried herbs for flavour. Always drain canned beans/lentils and rinse well before use.
Canned tomatoes, canned salmon, and baked beans all make great additions to your pantry.
In the freezer I usually have some frozen vegetables and frozen berries. (I also have frozen meals I prepared and froze earlier for those busy days when I don’t have time to cook).
Good Oil
Good quality oil is essential for both cooking and making your own salad dressings. I always have extra virgin olive oil, good quality vegetable oil and a selection of different vinegars in my pantry.
Fresh is Best
Every week I buy a range of fresh vegetables and fruits to include in our weekly meals. Local Farmers Markets, and/or fresh food markets are great places to buy fresh produce. Add to small amounts of animal protein and you have the ideal plant based diet.
Fibre and Gut Health
Fibre and Gut Health
Over the past 5-10 years research into the human gut microbiome has increased exponentially. While we continue to learn more about our gut bugs, one thing experts agree on is that a diet high in a variety of plant fibre is essential to having a health gut microbiome, a healthy gut, and a healthy you.
What is Fibre?
Fibre is derived from structural parts of plants – fruit, vegetable, wholegrains, legumes. Fibre cannot be broken down by digestion and therefore contributes little to energy needs.
Soluble fibre dissolves in water and forms gels and are digested (fermented) by gut bugs in our gut, adding to energy. Soluble fibre is found in oats, barley, legumes and citrus; it helps to lower blood glucose and cholesterol.
Insoluble fibre is found in whole grains and vegetables, and adds bulk to faeces.
Sources of Fibre
You need to eat 6-9 cups of vegetables and fruits every day to get the amount of fibre your gut needs. Choose a range of different vegetables and fruits each day – preferablyseasonal vegetables and fruits. Variety is the key. For example: artichoke, asparagus, bok choy, bean sprouts, broccoli, brussel sprouts, beetroot, cabbage, cauliflower, carrot, chives, celery, cucumber, endive, fresh herbs, garlic, ginger, green beans, Jerusalem artichoke, lettuce, leeks, leafy greens, mushrooms, okra, onions, parsley, radish, rocket, shallots, spinach, snowpeas, sprouts, turnip, watercress, zucchini, apples, apricots, berries, cherries, grapefruit, kiwi fruit, lemon/lime, mandarin, melon, papaya, peaches, pears, pineapple, plums, rhubarb, rockmelon, strawberries.
Resistant Starch – gold for your gut bugs
Resistant starch is a type of insoluble fibre that behaves more like a soluble fibre – it feeds your gut bugs.
By feeding your beneficial gut bugs, resistance starch supresses potential pathogens and is important for metabolic and heart health.
Sources of Resistant Starch
Foods high in resistant starch included legumes (e.g. red kidney beans, butter beans, adzuki beans, lentils, black eyed beans, chickpeas); whole grain cereals e.g. brown rice; cooked and chilled white rice, potatoes, sweet potato and pasta (cooking and chilling causes modest rises in resistant starch); cashews, green peas, green banana flour, unripe bananas. Regularly include foods high in resistant starch in your daily diet – your gut bugs will thank you.
If you need help increasing fibre in your diet two of my favourite healthy eating books are The CSIRO Healthy Gut Diet and the Women’s Weekly The Good Gut Diet. Both books include recipes for breakfast, small meals and large meals (main meals), with some snacks and sweet treats. There are vegetarian options, gluten free options, soups, salads, food you can prepare and keep in the fridge for taking to work, or a quick reheat. I like the science in the CSIRO book – it helps you understand why you need to eat certain foods. Once you understand what foods are best for you, you can make better food choices on a regular basis.
Cardiovascular Health in Women
Cardiovascular Health in Women
Cardiovascular (CVD), including heart disease, is under-diagnosed in women. This is because symptoms in women are often non-specific, and they develop these symptoms later than men. Sadly this has led to around 50 women in Australia suffering a heart attack every day, with around 24 women dying of heart disease daily. Sad statistics to say the least.
One of the key Principles of Naturopathy is to educate patients so disease can be prevented, or, at least, risks minimised.
Risk factors for CVD in women include gestational diabetes and hypertension in pregnancy, early menopause, depression, smoking, obesity, low physical activity, hypertension and high cholesterol.
Food as Medicine
Including foods in your daily diet like leafy greens, beetroot, high quality chocolate or cacao, berries, raw garlic, green tea, and herbs and spices like ginger and turmeric will help to reduce your risk of developing CVD.
The Mediterranean Diet is the most researched diet and probably the most recommended for managing risk factors associate with CVD. The Mediterranean Diet is mostly plant based with high amounts of vegetables and fruits and good oil eg olive oil (there is emerging research showing that as little as 20ml of good quality olive oil every day can reduce the risk of developing serious CVD).
Essential Nutrients
While there is a range of nutrients essential to cardiovascular health, perhaps the most important to women who are peri or post-menopausal is Vitamin K2.
Vitamin K2 is synthesised in the gut, by gut microbes from Vitamin K1, which is found in foods like broccoli, kale, cabbage, eggs and asparagus to name a few.
Simply put, Vitamin K2 keeps calcium in bones and out of blood vessels. Calcification of blood vessels is linked with vascular diseases like aortic stenosis.
Medicinal Herbs
There is a range of medicinal herbs that can assist with lowering cholesterol, reducing hypertension, stabilising arterial plaque, and reducing other risks associated with CVD. Which herbs are best for you will depend on factors like your overall health, which CVD you have, and your risk factors. For example, someone with elevated cholesterol would be prescribed different herbs to someone with high blood pressure.
Key Message
Eat a mostly plant based diet, manage any CVD risk factors you have, and seek professional advice when needed.