Menopause: Definitions and Dietary Tips

THE DEFINITION OF MENOPAUSE

“Menopause is one of the most loaded words in a woman’s vocabulary, conjuring up, as it does, visions of a neurotic, dried-up, rapidly ageing woman struggling with uncontrollable hot flushes, a spreading waistline, mood swings, brittle bones, a softening mind and the threat of a host of dread diseases waiting to take over an increasingly fragile body.”  (A quote from the book: “Menopause: A Complete Guide”).

Here we describe what happens in a woman’s body during peri-menopause and menopause, with recommendations how to micromanage this “often tumultuous time”, enabling women to experience these years as being “fulfilled, healthy and productive”.

Definitions:

Menopause:         is the last day of a woman’s last period ever. From this point one is considered menopausal.

The Climateric:     the transition time period where a woman’s body moves from being fertile, able to produce eggs and bear children, to the moment of menopause when a woman no longer ovulates. (Climateric means: a critical stage in human life; a period which is especially likely to be connected with a change in health).

Peri-Menopause: As one moves during the climacteric, towards the menopause, the changes taking place in a woman’s body cause certain symptoms that occur as the levels of oestrogen start to fluctuate and levels of progesterone start to decline. These symptoms include both physiological and psychological changes.

Peri-menopause describes all the things that are happening in a woman’s body before, during, and after the actual moment of menopause.

Each woman is totally unique in the way in which she experiences these symptoms.

Peri-menopause develops 2-14 years before the actual onset of menopause, depending on the person’s own body chemistry, unless a surgical or chemical menopause has been undergone.

SYMPTOMS

Some of the main symptoms caused by fluctuating hormone (oestrogen and progesterone) levels can include:

  • Hot flushes (sometimes called “hot flashes”)
  • Night sweats
  • Forgetfulness
  • Undefined anxiety
  • Inability to concentrate
  • Mood swings
  • Weight gain
  • Sleep pattern changes
  • Loss of libido )sexual desire)
  • Change in the type of PMS
  • Headaches / migraines
  • Irregular periods – other too often OR with months in-between
  • Change in the type and intensity of menstrual periods
  • Symptoms that often occur in pregnancy as well, such as: ravenous hunger, sore breasts, tearfulness, fatigue.

Symptoms that may persist after other symptoms have abated:

  • Vaginal dryness
  • Persistent loss of libido
  • Urinary problems

A brief description of what happens in a woman’s body from menstruation through to menopause

The Menstrual Cycle:

A woman is born with 2 ovaries containing eggs.

Each egg is surrounded by a sac = primordial follicle.

Egg + follicle = the egg unit (and are in a resting state).

At puberty the ovaries contain about 500 000 eggs; whilst at menopause only 3000 eggs remain.

The menstrual cycle (typically between 24-35 days; ideally 28 days), starts on the first day of one’s period:

  • the pituitary gland in the brain produces FSH (follicle stimulating hormone) which cause the egg units to produce oestrogen which, in turn, causes the lining of the womb (endometrium) to thicken. During this time up to 1000 egg units begin to mature.
  • By Day 9 one of these egg units starts to grow much more quickly than the others and becomes the dominant follicle. The other egg units then start to degenerate.
  • As this follicle matures, its oestrogen production increases to a point when around +/- Day 13 it reaches a level where it tells the hypothalamus (the part of the brain involved with the endocrine system) to send a message to the pituitary gland to reduce FSH production and to secrete LH (another hormone: luteinising hormone)
  • Ovulation: on Day 14 (in an ideal 28 day cycle) the surge of LH causes the ripening follicle to rupture, and then release its egg into the fallopian tube, which leads into the womb. The ruptured follicle = the corpus luteus, now produces small amounts of oestrogen and increasing amounts of progesterone which stabilises the thickened lining of the womb / uterus (so that should the egg be fertilised, the lining will be ready to receive the fertilised egg). If pregnancy does not happen, the corpus luteus starts to degenerate, and the levels of oestrogen and progesterone it starts to produce drop. Since the lining of the womb needs progesterone to sustain it, when the levels of oestrogen and progesterone have dropped far enough, the lining begins to crumble and within a couple of days it  separates from the wall of the womb – and menstruation then starts approximately 14 days after ovulation.
  • This menstrual cycle generally continues in more or less the same way during the fertile years unless the woman falls pregnant, and also until she gets older when things start to change.

Peri-menopause Menstrual Cycle:

  • During the fertile years, the main hormones produced by the ovaries are 2 types of oestrogen (estradiol, and estrone), progesterone and small amounts of androgen.
  • As one approaches menopause, the changing ovaries produce less oestrogen, and increased amounts of androgen. (Testosterone is an androgen). The ovaries are still functioning during this time but less efficiently.
  • From the late thirties onwards, the remaining egg units become progressively less efficient, less responsive and less functional, causing the hypothalamus and pituitary gland to respond accordingly. As the follicles age, their response is poorer, causing the pituitary to pump out increased FSH in an attempt to stimulate the follicles. Some follicles may respond to this, producing excessive oestrogen with resulting exaggerated symptoms of ovulation (sore breasts, heightened emotional responses and sugar cravings). Sometimes ovulation occurs, with a resulting period, which, due to the higher amounts of oestrogen making the womb lining thicker than usual, is very heavy and may be accompanied by large clots. On the other hand, ovulation may not occur, and yet still large amounts of oestrogen are produced, whilst (due to their being no corpus luteum) progesterone (the hormone responsible for controlling menstruation) is not produced, and so there is no period.
  • Furthermore, oestrogen levels may also suddenly drop OR may fluctuate wildly, causing all the symptoms of peri-menopause to occur.
  • As one approaches menopause the drastic changes in hormones level out, whereby one has the same high levels of FSH, LH and oestrogen for the rest of their life, if one leads a balanced life. However, oestrogen levels can be affected by an increase in or loss of weight, by chemicals or stress, and they can fluctuate.
  • If hormonal levels are stable, most of the symptoms of peri-menopause will eventually stop (the only ones that may remain of post-menopause are vaginal dryness, low libido, and sometimes urinary problems).

RECOMMENDED DIETARY TIPS

Weight issues

During peri-menopause and menopause, oestrogen (produced in the ovaries AND in the fatty tissues) levels drop. In an effort to conserve oestrogen, the body may react by retaining or even encouraging more fat storage, so it seems that the metabolism slows and the fat is redistributed to the areas where it produces the most oestrogen – waist, bottom, hips and thighs!

In addition, as one ages, metabolism slows as certain hormone levels drop. Also, one’s thyroid is not as efficient; and one is less active.

An essential change in lifestyle is the only way to prevent becoming overweight / obese. Research (a large meta-analysis, done over a period of 4 ½ years) shows that women who made an effort to change their lifestyles did not gain weight, in fact, some actually lost weight. A control group of women who had not been on a low fat, calorie-controlled diet with increased physical activity gained an average of 2.5kg. These results clearly show that one does not need to gain excessive weight after menopause.

A HEALTHY LIFESTYLE:

Follow 5 basic dietary principles to maintain / lose weight:

  • Eat 5 evenly-spaced, balanced meals and snacks per day
  • Choose foods that have a low glycaemic index *
  • Choose low fat / fat-free foods
  • Control portions
  • Drink plenty of water (1 ½ -2l/day)

Do some form of regular exercise that you enjoy, daily.

Have at least 7-8 hours of sleep at night

Do not smoke

Manage time efficiently, planning time for exercise, recreation, food shopping and preparation.

* Low GI foods (have a small portion at each meal/snack):  heavy health breads, and rye bread; porridge such as oats Or Soya Life porridge; cereals such as a muesli with plenty of nuts and dried fruit (yet low in sugar and fat); rice; durum wheat pasta; baby potatoes and sweet potatoes; legumes such as baked beans, butter beans, lentils, chickpeas and soya; all vegetables, and deciduous / citrus fruits.

SOYA: Soya products are low GI and as such assist in stabilizing blood glucose levels, thus preventing insulin resistance, metabolic syndrome and pre-diabetes, all of which occur more easily in menopause.

Soya products are filling, and act as a natural appetite suppressant, preventing one from over-eating at meals.

Soya is low in the type of fats that cause visceral fat gain around the abdomen.

The Soya Life Meal Replacement drink offers a controlled calorie meal, and as such enables one to control overall daily calories better.

The Soya Life porridge is a convenient, filling, instant and tasty porridge that can be used at any meal as a low GI option, sustaining blood glucose and energy

Control of symptoms such as Hot Flushes

Soya products have been directly and positively linked with a reduction in many menopausal symptoms such as hot flushes.

The drop in estrogen levels that occurs in menopause is linked with the onset of hot flushes. Isoflavones found in soya products produce oestrogen-like properties, and may be one reason why western women report having hot flushes to a much greater extent than women in Japan. More than 50 clinical trials have evaluated the effects of isoflavone-containing products on the alleviation of menopausal symptoms. The most recent analysis of this research, which includes 19 studies, shows very clearly that isoflavones are effective. On average, isoflavones produce a 50% decrease in the frequency and severity of hot flushes. The amount of isoflavones found in two servings of traditional soy foods appears to be sufficient to produce this benefit.

Soy Isoflavones and their benefits to menopausal women:

Soy protein which comes from soybeans is a very important dietary supplement because soybeans are rich in calcium, iron, potassium, amino acids, vitamins and fibre. Soy contains all the essential amino acids necessary in a healthy human being.

Soy contains plant-oestrogens (phyto-estrogens), known as soy isoflavones.

2 of the better-known isoflavones in soy are genistein and daidzein. Daidzein is metabolized to an oestrogenic compound called equol. Those women with good amounts of gut flora convert this daidzein better than those with lower levels of gut flora.

Dose: the general recommendation is that between 35-110mg soy isoflavones is both safe and effective.

There are concerns that soy might act like oestrogen on breast tissue and the lining of the uterus (womb). However, recent research has shown that women taking genistein over one year had no effect on the lining of the uterus.

Other studies clearly show that soy isoflavones may protect breast tissue from oestrogens. Some older evidence shows that soy may stimulate breast tissue.

The most recent research, however, is clearly in favour of the use of soy isoflavones to protect against hormonally-driven cancers; as well as significantly minimize the symptoms of menopause.

The recommended guideline therefore is: For those women at risk of oestrogen-related cancers and are sensitive to oestrogen should be very aware of any oestrogen-like symptoms, when taking soy on a daily basis.

All other women should include soy-based foods daily with benefits in menopause such as:

– Reduced occurrence of hot flushes

– Reduction of bad-cholesterol levels

– Strong antioxidant action (prevents all cancers, heart disease, and diabetes)

– May maintain / build bone density

– will help in weight management due to its low GI properties

SOYA LIFE produces 3 useful products, easily applicable in daily diets (found in your local Dischem):

  1. Soya Life Porridge: use at any meal: instant, tasty and low GI thus filling.
  2. Soya Life Soya Milk: comes as a powder: reconstitute and use as a very acceptable cow’s milk substitute
  3. Soya Life Instant Meal Replacement Drink: a balanced, low GI vitamin and mineral enriched meal replacement: ideal in busy lifestyles.
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