The Menopausal Survival Guide

Attitude

According to one of the leading American experts on menopause, Dr. Karen Deighan “a positive attitude and a little preparation” can make a huge difference in the way women experience menopause. Targeting menopausal symptoms before they occur is essential to getting through this stage of life.

“Menopause is not a disease. It is a normal wechseljahre event; a passage from one stage of life to another.”

Menopause is in many cases the time when women enter “the most productive and lucrative stages” of their career, fulfilling their professional aspirations. It is also the time when many children leave home – giving women the opportunity and time to focus on themselves. According to Menopause Signs, “Menopause can be a time of unprecedented self-confidence, freedom and financial liberation for women.”

Also, a recent American study found that stress, a lower income and attitudes toward aging had a significant effect on the way women experienced menopausal symptoms. Having a positive outlook on life changes the way women go through menopause.

Dr. Sheryl Kingsberg, of Case Western Reserve University in Ohio, reveals that life expectancy for western women is more than 82 years of age, which means that a third of a woman’s life can take place after menopause. She reminds women, “Menopause is not a disease. It is a normal event; a passage from one stage of life to another.”

Avoiding menopausal weight gain

Women often struggle to maintain their weight as they grow older.

It is estimated that up to 90% of menopausal women experience some type of weight gain in the period leading up to menopause (perimenopause) as well as during menopause.

Hormonal imbalances in combination with genetic factors, stress and the loss of muscle tissue associated with aging may leave women with a few extra inches on their waistline. Also, menopausal women, especially those experiencing debilitating symptoms, are often times less likely to exercise. In addition to this, “women experience a metabolic slowdown of about 10-15 percent at midlife compared to earlier in life, making our bodies more efficient at taking in and storing fat,” according to Christiane Northrup, M.D., internationally known author and speaker with an empowering approach to women’s health and wellness.

The weight acquired during menopause no longer distributes itself equally, tending to settle instead in the belly area. Many women gradually gain 5 to 15 pounds during menopause and unless they adapt their diet, the weight gain may be even more prominent.

As women grow older, they can expect a change in their bodies. Although a slight weight gain can be expected (and may even ease certain menopausal symptoms, such as hot flashes) excessive weight gain is problematic as it can lead to high cholesterol levels, high blood pressure, increase the risk of type 2 diabetes, and even certain types of cancer. If you are carrying many extra kilos, your menopausal symptoms may also be worse as a result.
According to the Mayo Clinic: “Gaining as little as 4.4 pounds at age 50 or later could increase the risk of breast cancer by 30 percent.”

To avoid or combat this weight gain, it is important to increase the amount of exercise and to be consistent in one’s exercise regime. Crash diets should be avoided at all costs during menopause as they wreak havoc on the metabolism. Women should rather take steps to alter their lifestyle and improve their health. Avoiding refined sugars and opting instead for a rich and varied lower-calorie diet is very important. However, losing too much weight can also be dangerous as it may lead to a greater risk for osteoporosis.

Eating right

A nutritious diet in combination with plenty of exercise leads to better physical and mental health during menopause. Research has shown that women in their 50’s need approximately 200 fewer calories than women 10 or 20 years younger just to maintain their weight, let alone to drop a few pounds. This means women will need to change their eating habits as they will most likely not be able to eat like they used to. Controlling which foods you intake and the portion sizes, rather than calories is the most effective route. Also, do not skip meals, as this will only lead you to overeat later. It is suggested that menopausal women eat three meals a day, rather than skipping breakfast or lunch as the food eaten later in the day is more likely to be stored as fat due to the slowing down of the metabolism. Personal trainer Kristin McGee, a personal trainer who works with menopausal women in their 50’s and 60’s, suggests following the simple rule: “Eat like a queen in the morning, a princess at lunch, and a pauper at dinner!”

Menopausal women should enjoy a diet consisting of plenty of fruits and vegetables, whole grains, lean meats, nuts, seeds, fish, poultry and low-fat dairy products – all in small portions. “Be a grazer, not a gorger!” MedicineNet suggests.

• Whole grains

In addition to plenty of exercise, it is recommended that menopausal women eat whole grain foods, which can reduce constipation, as well as reduce the risk of coronary heart disease.

Whole grains include rye and wholemeal bread, wheat cereal and oats, brown rice or wholegrain pasta, which are rich in nutrients, fibre, vitamin B, minerals and selenium. Whole grains are preferred to white rice, white bread, potatoes and pasta, which are calorie-rich but nutritionally empty.

The United States Department of Agriculture suggests “It’s important to substitute the whole-grain product for the refined one, rather than adding the whole grain product.” Women should look at the food label to ensure that the product names “one of the following whole-grain ingredients first on the label’s ingredient list: ‘brown rice,’ ‘bulgur,’ ‘graham flour,’ ‘oatmeal,’ ‘whole-grain corn,’ ‘whole oats,’ ‘whole rye,’ ‘whole wheat,’ ‘wild rice.'” However, Dr Christiane Northrup warns that even women who “have eliminated refined grains […] may still have problems with whole wheat, whole rye, whole oat, or millet flour” due to a high carbohydrate sensitivity.

• The ‘good fats’

Substituting certain types of fats and oils for others can make a huge difference to how you feel, as well as reducing cholesterol levels and improving heart health and slowing the hardening of the arteries. Dr Christiane Northrup saw her female patients “complain of sallow skin, brittle hair and nails, susceptibility to infection, inability to concentrate, and weight gain despite their rigid diets. None of these women were getting enough healthy fat.”

It is suggested that women limit their intake of saturated fats, which are known to raise blood cholesterol and increase the risk of heart disease. Saturated fatty acids include butter, whole milk and cream, eggs, chocolate and red meat. The USDA suggests a limited consumption of these foods. Trans fats, contained in fried foods, crackers, cookies and snack foods also increase LDL cholesterol levels and the risk of heart disease.

Monounsaturated fatty acids are preferred to saturated fats as they may lower cholesterol levels and lower the risk of coronary heart disease. Foods with a high content of these fats include avocados, nuts, olive oil and canola oils.

Omega-3 fats have been linked to reducing the severity of menopausal symptoms, especially psychological stress, mood swings and depression.

Omega-3 fatty acids could reduce the ‘psychological distress’ and depression associated with menopause.

Although more research is necessary, a Canadian study recently found that omega-3 fats had a positive effect on women’s mental state. Omega-3 fats are contained in fish, including salmon, halibut, cod, catfish, trout, sardines, and herring, as well as in krill, shrimp and clams, green-lipped mussel, raspberries, flaxseed, walnuts, pecan nuts and hazelnuts.

• Fruits and vegetables

Menopausal women benefit from a diet rich in fruits and vegetables, as they are naturally low in fat and contain vitamins, minerals, antioxidants and fibre. Fruits such as plums, strawberries, apples, pears, grapefruit and raspberries contain boron, a mineral that seems to increase estrogen levels in middle-aged women. Some fruits and vegetables also contain phytoestrogens, a plant form of estrogen, which may “potentially diminish some of the discomforts caused by lower estrogen levels during menopause,” according to Medicine Net. More research is needed to confirm these positive effects.

Dr Christiane Northrup suggests women choose fruits and vegetables that are rich in colour as “the deep pigments in these foods contain powerful antioxidants. Go for broccoli, green leafy vegetables, berries, red, yellow and green peppers, and tomatoes, and vary your choices through the seasons, ” she suggests. “Antioxidants combat cellular damage from free radicals, which are known to be a cause of chronic conditions such as heart disease, cataracts, macular degeneration, and cancer,” she confirms.

Substituting high-calorie foods with fruits and vegetables can also be part of a successful weight loss strategy.

• Protein foods

Lean meat, poultry, fish, beans, peas, eggs, nuts and seeds are all high in protein and should be an integral part of a menopausal women’s diet, eaten at almost every meal. Women should choose the leanest cuts of beef (and at least 90% lean ground beef), pork and skinless chicken and turkey. Some organ meats such as liver are fairly high in cholesterol, as are egg yolks. Processed meats may have a higher sodium content.

Beans, peas, lentils, soy, carob and nuts are all legumes, known as sources of plant protein, as well as nutrients like iron and zinc and dietary fibre. Beans are an excellent choice for menopausal women as they are a low-fat source of protein and they contain fibre and many vitamins and minerals. They also keep women feeling fuller for longer and contain plant-based estrogens, phytoestrogens.

Soy has been praised for its role in lowering the risks of heart disease and its positive effects on bone health. Recent studies have shown that the phytoestrogens contained in soy products such as soy milk, tofu or soy nuts may also ease problematic menopausal symptoms, especially hot flushes. According to HealthCastle Nutrition:

“In Japan, where soy foods are commonly consumed daily, women are only one-third as likely to report menopausal symptoms as in the United States or Canada. In fact, there is no word in the Japanese language for ‘hot flashes.'”

“Soy products have been taken by women and promoted for relief of menopausal symptoms,” according to Australian women’s health expert Dr Jane Elliott. The results obtained from research studies are limited but “new research currently being undertaken is looking at a compound derived from soy,” she confirms.

Nuts and seeds such as sunflower seeds, almonds and hazelnuts contain vitamin E, which women have also reported as helpful for certain menopausal symptoms, including hot flashes. Flaxseed, which contains both omega-3 fatty acids and lignans, has also shown promising results in treating menopausal symptoms such as hot flashes and mood swings. According to dietician Jane Reinhardt-Martin, “Cross-cultural research shows that women whose traditional diet features a high intake of soy and flax have, on average, a milder menopausal experience.”

• Dairy products

A menopausal woman’s dairy intake should be composed of mainly low-fat sources. The USDA warns that cheese, cream and butter do not retain their calcium content but dairy products, as well as dark leafy greens are good sources of calcium. A range of calcium-fortified juice and soy beverages are also available. According to Menopause Matters, “During menopause an adequate daily calcium intake is especially important to help protect and maintain bone density as bone loss accelerates.”

•Which foods to avoid

During menopause, it is best to limit or avoid processed foods, canned soups, salted nuts, margarine, processed baked goods or ketchup, as well as high-sugar foods. High-sugar foods include soft drinks, syrups, jams, sweetened coffee beverages, cookies, cakes, pies, pastries, frozen desserts, ice-cream and sweet yogurts and should mostly be avoided. Menopausal women are at a stage in their lives where they must be more conscientious about calorie intake than ever in order to prevent weight gain.

Drinking right

Menopausal women should be drinking 8 to 10 glasses of water a day. In addition to keeping you hydrated, drinking more water can reduce food cravings. Menopausal women can enjoy diluted fruit juices, vegetable juices, herbal teas, low fat milk and mineral water but it is best to avoid sweet sugary drinks.e

•Drinking tea

Green tea contains strong antioxidants and has anti-cancer properties. Similar claims have also been made about black tea. Although more research is still necessary, studies have shown that several cups of green tea a day could be effective in relieving hot flashes and sleep disturbance for menopausal women.

•Drinking coffee

Menopausal women should limit their intake of caffeine, which may improve their hot flushes and stabilize sleeping patterns. It has been suggested that a high caffeine intake during menopause may trigger night sweats.

•Reducing alcohol

Alcohol should be consumed in moderation amongst women undergoing menopause. Alcohol, as well as spicy foods, has been labeled as of the triggers of hot flushes. “Research indicates that menopausal women who drink excessively are at much higher risk for the common types of cancer, especially post-menopausal breast cancer, GynOb reports.

“One serving of alcohol can increase the risk of cancer by 7%. However, three servings of alcohol per day increases the risk by 51%.”

Exercise and Fitness

• Staying active

Staying active is one of the most important aspects of getting through menopause. Dr Jane Elliot stresses the importance of “a healthy lifestyle, including exercise” for menopausal women.

Research has shown that women who undertake regular physical exercise enjoy better health than women who are sedentary.

•The benefits of exercise

There are numerous benefits to exercise during menopause: regular exercise can help women lose weight or prevent menopausal weight gain, strengthen bones and reduce the risk of breast cancer. In addition to this, exercise improves the function of the immune system, decreases the risk of heart disease, improves moods, may have a positive effect on depression or anxiety, regulates sleep patterns, increases self-esteem, boosts the metabolism and results in more energy and a better outlook on life.

•How much exercise is enough?

According to the Mayo Clinic, healthy menopausal women should undertake “at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week” as well as “strength training exercises at least twice a week.” Dr Jane Elliott suggests that women do more: “At least 30 mins of exercise a day. The best exercise is the one you will keep doing regularly.” Her advice is choosing an activity you enjoy. “So if you hate the gym, don’t go there. For many women 30 mins brisk walk daily is a very good start.”

Exercising with a friend can be a great way to keep up your fitness regime. It’s fun!

•Which types of exercise

According to personal trainer Kristin McGee, it’s important to work the core muscles with exercises such as the plank, especially since fat tends to settle in the belly area. McGee also suggests mixing up the types of exercises you do, such as yoga and swimming. The Women’s Menopause Health Center suggests enjoying other calorie-burning day-to-day activities such as mowing your lawn, taking dance classes, abnehmen in den wechseljahren or playing catch with your children or grandchildren.

A healthy lifestyle is the key to overcoming the obstacles that may arise during the menopausal transition. A recent American study explored “how and why midlife women think about health in general” and the various influences which contribute to a healthy lifestyle during menopause. It found that a majority of the menopausal women associated guilt with not making enough effort on healthy lifestyle choices such as their exercise and diet regime. It’s never too late to start!