The menopause is something most women dread and strangely it appears to be a taboo subject for many. The news recently has been full of not only HRT shortages in the UK but also possible links to a small increase in breast cancer. HRT is a great medication for many women, but some prefer to reduce the symptoms naturally without having to resort to HRT.
Women are controlled by 3 hormones, oestrogen and progesterone are the main players, with a small amount of testosterone, but as we age, the levels of oestrogen and progesterone diminish and become imbalanced.
The early stages of Menopause are called the Perimenopause, which is the time the hormones are fluctuating. As the body ages, women have less follicles remaining in the ovaries. It is during this time that progesterone declines leading to a temporary state of oestrogen dominance but will eventually also lead to a low level of oestrogen. Early signs of Perimenopause include hot flushes, irregular, heavy or painful periods, mood swings, fatigue, anxiety, depression and weight gain.
Menopause typically develops in the late 40’s, however, many women can experience early menopause (occurring before the age of 45). Genetics can play a role in when women move into menopause, typically they follow the path of their mothers and grandmothers. Smoking, poor diet, use of contraception, including Tubal ligation, hysterectomy, damaged ovaries and medication such as Tamoxifen, can all lead to an earlier menopause. The symptoms of menopause (tiredness, dry skin, weight gain, anxiety, mood) can often be confused with thyroid imbalance, so it is worth getting a test to rule out any other possibility.
We have to remember that despite the symptoms of the menopause, it is a very natural ageing process for women. The symptoms can be managed naturally, working with the body and strengthening areas that need additional support. HRT can be good for some, but it does come with an increased risk of cardiovascular disease, breast ovarian and endometrial cancer, blood clots and strokes. Many find benefits from following the natural route.
Skin & Hair
As we start to suffer from the hormonal changes, we lose essential collagen and hyaluronic acid. The result is a thinner, drier skin, that has lost elasticity and is slower to heal. Our hair is also slower to grow and can change in texture to a drier, more brittle texture.
Collagen- Replacing collagen and hyaluronic acid will dramatically help your skin condition. Wrinkles and fine lines are usually a result of a dehydrated skin as well as a breakdown of collagen. 95% of the dermis is made of collagen. Collagen and Elastin makes our skin firm so as this depletes, so, unfortunately, does our smooth skin. Sun expose can seriously damage our skin. The sun’s ultraviolet rays can cause us to produce an abnormal elastin. As the body tries to repair this, it causes scar tissue which helps create more wrinkles. Sun exposure also causes pigmentation which can often appear as brown spots on the skin. There are many collagen/hyaluronic formulas on the market, contact me for more information if you would like my personal recommendations.
Vitamin C & E– This works alongside vitamin E and collagen for skin health and the formation of collagen. Fill up on vitamin C and E, both play an essential role in the formation of collagen and hydration. Eating plenty of nutrient and antioxidant rich foods can also protect you from the damaging effects of the sun. Eat plenty of berries, citrus fruits, nuts and avocados. Citrus fruits also contain Limonene, which has been shown to help reduce skin cancer.
Oils– it is essential to have a good supply of essential fatty acids in your diet for almost every biochemical function in the body, but especially for healthy skin and hair. Women tend to suffer more with hair and skin issues when they follow a low-fat diet. Eat healthy, natural fats such as oily fish, olive oil, flax oil, butter and coconut oil. Avoid industrialised oils such as vegetable oils and margarines.
Sugar & refined carbohydrates– a diet free of sugar and refined carbohydrates can have a dramatic, positive affect on your skin and hair health. It also decreases whole body inflammation and aids detoxification, allowing the cells to function more efficiently.
We may also suffer from vaginal dryness. This is due to the cells getting thinner and losing their flexibility, producing less lubrication, which can contribute to low libido. This can also affect our urethra, increasing our risk of stress incontinence and urine infections.
Probiotics - Keeping a healthy bowel flora using a good quality, high strength probiotic can help maintain the correct bacterial balance in the vagina and urethra, helping to prevent infection. As oestrogen levels fluctuate in perimenopause, you can often have too much oestrogen floating around, a healthy bowel flora can help to detoxify and eliminated an excess oestrogen, preventing enterohepatic recirculation.
Vitamin E– this can help keep everything lubricated. Some women use vitamin e internally to help keep the vagina lubricated.
Evening Primrose Oil– EPO synthesises prostaglandins, which play a vital role in the regulation of hormones. EPO has high levels of GLA (gamma linoleic acid), which helps balance hormones and increase blood flow, so can help increase libido in women
When we experience low levels of oestrogen, we become more prone to heart disease, an increased risk of oxidative stress, which has a detrimental effect on our cholesterol. We also have lower levels of nitric oxide, which helps prevent fatty deposits sticking to the arterial walls. Menopausal weight gain (caused by low levels of leptin, slower metabolism and declining testosterone levels), especially around the middle increases our risk of cardiovascular disease.
Lycopenehelps increase the flexibility of the arteries and the sensitivity of blood vessels to nitric oxide, which is a powerful vasodilator, helping increase blood flow and flexibility of the blood vessel walls.
CoQ10, especially from the active form Ubiquinol, has shown significant reduction in LDL cholesterol (CoenzymeQ10 plays a vital role in the production of energy, which the heart requires to function effectively. Those taking Statins will see a dramatically lower plasma level of Ubiquinol, so it is important to supplement your diet by eating meat, eggs and fish, which contains high levels of CoQ10. A diet rich in antioxidants such as Lycopene, vitamin C, E and CoQ10, can protect us from oxidising LDL cholesterol which can contribute to arteriolosclerosis
Bowel Flora – Good bowel flora not only boosts the immune system and aids digestion, it also helps to break down unwanted cholesterol, preventing it from being reabsorbed, so it is vital to keep a good healthy bowel. Stress, ill-health and poor diet, low oestrogen levels, can upset your natural bowel flora, so opt for a good quality probiotic to keep your gut healthy and balanced.
Our bones can also suffer due to the hormonal change; the incidence of osteoporosis trebles as we move into the menopause. Our bone cells consist of Osteoblasts and Osteoclasts. Osteoblasts help build the bones, and Osteoclasts break down the bone. Oestrogen controls the osteoclasts whilst allowing the osteoblasts to produce new healthy bone. As oestrogen and testosterone decline, so does our bone density, leading to thin and brittle bones.
Diet- A diet rich vegetables, nuts and seeds, especially in green leafy vegetables which is rich in usable calcium, magnesium, vitamin K and B vitamins. You also need foods rich in zinc, such as pumpkin seeds as well as oily fish. Vitamin D (from sunlight or a daily good quality D3 supplement) can all help keep enhance your bone health supports your immune system, balances moods and helps ease inflammation.
CoQ10, which has a prime role in energy production and cholesterol, also regulates osteoclasts and osteoblasts. This is especially crucial if you are taking statins, as statins block CoQ10 manufacture.
Isoflavones- You can also opt for Soya Isoflavones in supplement form. Soya Isoflavones contain Genistein and Daidzein. Genistein inhibits bone resorption whilst also stimulating the osteoblasts (strengthening and building new bone). Some women find that soya products can help, but these can be highly processed and unhealthy. If you want to opt for this, buy only organic fermented soya foods such as tofu and tempeh.
Evening Primrose Oil– When taken with a good quality fish oil, EPO has been shown to decrease bone loss and improve bone density. I would recommend a high quality product such as Effamol’s Evening Primrose Oil, available from Boots pharmacies. http://www.nlm.nih.gov/medlineplus/druginfo/natural/1006.html
Exercise– we must keep active. Our bones and muscles adapt to the way we use them, so it is the case of use it or lose it. The more exercise, particularly weight bearing, the stronger our bone density and the less muscle wastage as we age.
Omega 3 Fish Oils – We know how important it is to consume a diet rich in oily fish, nuts, seeds and avocados to ensure a good range of omega 3 fatty acids, but most of us could also benefit from taking a good quality omega 3 fish oil. Omega 3 fish oil contains both docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) which help to protect the heart and joints. In clinic I use a good quality Krill Oil as well as a high potency fish oil. It is also important to limit Omega 6 – High levels of omega 6 (such as vegetable oils and spreads) can promote inflammation and increase pain. Replace these with omega 3 rich foods such as oily fish, nut oils, avocado oil, coconut oil and butter.
Sulphur-rich foods/MSM - To keep your joints and muscles in tip top condition, eat plenty of sulphur- rich foods such as meat, eggs, cauliflower and sprouts, which is a great way to help heal and repair connective tissue as well as acting as an anti-inflammatory. Combine the sulphur-rich foods with foods that aid the formation of collagen such as green leafy vegetables, fruit and veg such as berries, carrots and sweet potatoes as this will help maintain lean muscle mass and keep both joints and bone health in good condition. If all that seems too much, you can get your sulphur from a supplement called MSM (Methysulfonylmethane).
Glucosamine works really well alongside MSM. It aids joint problems and keeps the joint hydrated and prevents enzyme damage. Get busy with the spices as they have some amazing healing properties.
Curcumin is the active ingredient found in Turmeric, it is a very powerful anti-inflammatory, but also helps to detoxify the system, aiding repair and improving circulation. I recommend it it for a wide range of conditions, including joint health but also auto-immune conditions. Ginger and chilli, both stimulate the body to repair as well as another anti-inflammatory.
Magnesium is a really important supplement for joint health. Magnesium helps relax the muscles, it helps to keep the body in a more alkaline state, therefore avoid inflammation. Opt for a magnesium citrate as this is the most usable, bioavailable form – avoid cheap forms such as magnesium oxides and carbonates which we cannot absorb fully.
Hot flushes and Night Sweats
These can be one of the most troublesome symptoms of the menopause. It can really make women’s life a misery. Food can trigger attacks, such as spicy food, caffeine and alcohol, as can stress, exhaustion and anxiety.
Evening Primrose Oil, more commonly used for PMS symptoms, can also help ease hot flushes, help balance moods and ease bloating. Evening Primrose oil has also been shown to help control pain and inflammation, so good for those who may also be suffering from joint conditions including arthritis. [The effect of oral evening primrose oil on menopausal hot flashes: a randomized clinical trial, Farrah Farzaneh et al., Archives of Gynecology and Obstetrics, 2013, volume 288, number 5, pages 1,075-1,079, doi: 10.1007/s00404-013-2852-6,]
Aloe Verais an excellent cooling herb but you need to buy a good quality brand that uses the whole leaf and contains at least 8% bioactive polysaccharides. It also enhances the growth and proliferation of beneficial gut bacteria, promotes healing, is anti-inflammatory and a powerful immune booster. It also enhances the absorption of many nutrients including vitamin E and C (which are powerful antioxidants that help to combat oxidative stress caused by low oestrogen levels).
Vitamin Eis a powerful antioxidant but can also help ease hot flushes, aim for 400iu per day.
Soya Isoflavones– taken in supplement form, the Isoflavones, despite being weak oestrogens, appear to help ease the symptoms of flushes and night sweats when used in conjunction with vitamin E & C. It also helps support bone health during the menopause. I would recommend Nutrigold’s Menopause Support Formula.
Sage – this has been shown to help with night sweats, hot flushes and even helps to balance mood swings. It is a powerful antioxidant and anti-inflammatory.
Black Cohosh (around 160mg per day)can be used to help balance blood sugar as well as female hormone imbalances. Some women find it useful to help reduce hot flushes and night sweats.
As we approach menopause, we may be juggling a career whilst dealing with children in their teens, we may also have the added complication of dealing with elderly parents. Stress can dramatically affect our health, particularly our hormonal health. High cortisol levels impair oestrogen production and can also affect our thyroid and insulin function. A supplement of B vitamins can help enhance mood, aid depression and can help combat stress. I would also advice adaptogens such as Ashwagandha or ginseng. Exercise is also really important as this not only helps over overall health, strengthens bones helping to avoid oestoporosis and helps maintain good weight, but also increases our feel good endorphins
There are many changes we can make to our diet to improve the symptoms of the menopause and to help balance our hormones.
A diet rich in antioxidants, including plenty of green leafy vegetables, will also help to provide potassium, magnesium, usable calcium and vitamin K and B vitamins helps balance hormones whilst also providing essential nutrients that can support the symptoms of the menopause.
Avoid too much caffeine and alcohol as this can affect our adrenal function.
A diet rich in sugar and refined carbohydrates increase whole body inflammation, making you more prone to a whole host of problems, including a higher risk of cardiovascular disease. Opt instead for real food, avoiding processed foods and sugars.
Increase your healthy oils in your diet by eating plenty of omega 3 rich foods such as oily fish, flax oil, nuts, seeds and avocado’s (omega 9). Avoid too many omega 6 foods such as vegetable oils and industrialised margarines. Opt instead for butter and a very good quality olive oil. The British diet is rich in linoleic acid, the most common Omega-6 acid (think of vegetable oils and margarines) but many people today cannot convert it efficiently into the eicosanoid hormones normally derived from Omega-6. This problem may be overcome by using Evening Primrose Oil rich in gamma- linolenic acid (GLA), a special form of Omega-6 that is more easily utilised.
Add phytoestrogen rich foods which exert an oestrogen affect, such as organic tofu, miso and tempeh, ground flax seeds and alfalfa sprouts.