DIET

Similar to physical activity, having a healthy, balanced diet can help with menopausal symptoms, as well as keep you healthy during and after the menopause transition.

Why is a healthy diet important in managing my symptoms?

1. To protect bone health

• Try to get 2-3 portions of food rich in calcium per day e.g. milk or yoghurt
• Get some sunlight on your skin as this helps to produce vitamin D. It is recommended to expose your skin to direct sunlight for around 10 minutes, once or twice per day, but avoid burning. Use at least factor 30 suncream and spend time in the shade between 11am and 3pm.
• Consider taking a daily supplement containing at least 10 micrograms of vitamin D, particularly during autumn and winter. Consider taking it all year round if you are over 65 years, have dark skin from African, African-Caribbean or South Asian background or if you have low sunlight exposure.

2. To protect heart health:

• Try to maintain a healthy weight. Being mindful of portion sizes can help to control the amount you eat.
• Reduce your intake of refined sugar and carbohydrate e.g. cakes and soft drinks
• Reduce salt by limiting ready meals and salted snacks
• Eat at least 5 portions of fruit and vegetables which can be fresh, frozen, canned, juiced or dried.
• Reduce foods high in saturated fat e.g. red meat, fried foods. Healthy fats include oily fish and nuts.
• Eat high fibre foods e.g. wholegrain breads, brown rice and pulses.

3. To maintain muscle

• Ensure you have good quality protein (either plant or animal based) as part of your meals e.g. fish, lean meats such as chicken, eggs and legumes (beans, chickpeas, lentils).

4. To help menopausal symptoms

• Limit the amount of caffeine, spicy foods and alcohol you have which can increase hot flushes
• Oestrogen falls sharply in menopause, causing a host of symptoms, such as hot flushes, mood swings and fatigue. Food high in phytoestrogens are thought to have a balancing effect on hormones, combating low oestrogen, and supporting your health during this time. Some examples include: soyabeans and edamame, flaxseeds, legumes, dried fruit (particularly prunes apricots and dates), garlic, grains, sesame seeds, and cruciferous vegetables.
• Start small if it feels overwhelming, such as a handful of flaxseeds on your porridge, some dried fruits in a smoothie, or throw some edamame and garlic in with your stir fry!

Prescribed treatments include hormone-based therapy and non-hormonal treatment.

• Hormone replacement therapy (HRT) aims to treat the symptoms of menopause and replaces the hormones which are low including oestrogen +/- progesterone replacement. Testosterone can also be used for improving cognition, concentration and fatigue, as well as improved libido.
  • There are different types of HRT, and some people may not be suitable for HRT due to health problems.
• Non-hormonal medical treatments which have been shown to help with hot flushes include clonidine (a blood pressure medicine), gabapentin (an epilepsy medicine) and some antidepressants (9).

Here are some tips for talking to your healthcare professional about menopause:

• Some GP practices have healthcare professionals with a specialist interest in menopause (including nurses, pharmacists, paramedics) who you can ask to speak with.
• Discuss your main symptoms and how these are affecting your life.
• A symptoms chart or tracker can be useful to bring along to any appointments (see 'Useful Resources' section at the bottom of this page).
• Check the NICE guidelines to see what is recommended for menopause.
• Research some of the treatment options yourself and think about what treatments you would like before the consultation.

Non-prescribed or 'complementary' treatments could include:

• Herbal remedies such as black cohosh, red clover or isoflavones (soya). Some women find these helpful however there are some considerations before starting (9):
  • There is no strong evidence that they work for menopausal symptoms.
  • Their quality, purity and ingredients are not regulated and may be unknown
  • Some can interact with other medicines and cause side effects. Consult with your pharmacist or GP if you are considering starting any herbal remedy
• Compound bioidentical hormones
  • These are unregulated in the UK and their safety is unknown (9)
• Cognitive behavioural therapy (CBT) is a type of talking therapy. It may help with:
  • Low mood or anxiety due to menopause
  • Dealing with menopausal symptoms (9)
• Alternative therapy e.g. acupuncture (10), mindfulness or meditation

There is some evidence for these therapies in helping with menopausal symptoms.