Menopause is a stage in a woman’s life when her reproductive years come to an end and her monthly period stops for at least twelve consecutive months. It's a time when estrogen and progesterone levels, the hormones that regulate menstruation, decline. Menopause occurs in women, on average, at age 51, and often between ages 45 and 55.
The term “perimenopause” refers to the phase of life that precedes menopause — a time when women's bodies naturally transition into menopause. Many women experience this in their 40's, but some may experience perimenopause as early as their 30's. You may notice perimenopause or menopause when mood swings unexpectedly arise, weight gain creeps around the middle, muscle tone seems to soften, hot flashes come out of nowhere, and sleep is disrupted.
The transition of perimenopause into menopause is also a time when the risk of heart disease and cognitive decline increase.
While this all may sound like doom and gloom, perimenopause and menopause may be ideal times to reassess health habits. This time can be an opportunity to better understand what is happening in the body and embrace good nutrition, regular movement, stress reduction, breathing techniques, and other lifestyle habits that can help you feel your best and reduce the risk of lifestyle diseases.
Many women approaching menopausal age believe that the accompanying symptoms are expected and a part of the natural process. Whether you are experiencing perimenopause or menopause, or you know someone experiencing this transition, my hope is that this series of articles on menopause can help to shift the menopause mindset from one of taboo to one of celebration and empowerment.
What's interesting is that, in many cultures around the world, menopause is considered a time of triumph and renewal...
Menopause Experiences Around the World
Western cultures have traditionally treated menopause as a dreaded time when childbearing ends and old age begins. However, this is not the case in many areas around the world, where menopause is welcomed as a transformational experience where the old self is left behind and the new, more powerful self emerges — how awesome is that?
For example, in China, menopause is considered a "rebirth." Women in some regions of China report having no symptoms of menopause. Researchers feel this may be because post-menopausal women in these regions are well respected and have the highest valued family status. Another study reported that women of the Rajput caste in India also don't experience menopause symptoms. It's believed that it may be because they are rewarded for reaching the menopause phase of their life and have a high social and family status. It also may make you wonder if the positive mindset is delegating what happens in the body for women who have a positive perception about menopause. After all, we know that stress can lead to negative physiological effects in the body. So, perhaps less stress equates to less symptoms?
The word for menopause in Japan is konenki — ko means “renewal and regeneration,” nen means “year” or “years,” and ki means “season” or “energy.” I don't know about you, but the year of renewed energy or a renewed season sounds lovely to me!
Postmenopausal life for women in the Middle East is also viewed as a time of renewed life, greater inclusion, and higher position in society.
First Nations' women are seen as wise because of their lived experiences.
A common belief among traditional shamanic cultures, like Mayan women, is that they must enter menopause to access their shamanic and healing powers. Finding your inner superhero through healing menopausal powers sounds pretty cool.
While hormonal fluctuations can occur in all women, it appears that social support and perception may guide how this important transition in a woman's life is experienced in some cultures. By normalizing the menopause experience, perhaps women around the globe can feel empowered to shift their mindsets from one of dreading the transition to one of welcoming these changes that may mark new empowered beginnings.
“Perimenopause and menopause should be treated as the rites of passage that they are,” she continued. “If not celebrated, then at least accepted and acknowledged and honored.”
—Gillian Anderson
Hot Flashes
Hot flashes are one of the most notable symptoms of menopause in the Western world. The exact cause of hot flashes is not completely understood, but it's thought to be a result of decreased estrogen, which leads to changes in the hypothalamus, the part of the brain that regulates the body’s temperature. If your hypothalamus senses that you're too warm, it will attempt to cool you down by sending signals throughout your body to dilate blood vessels and increase blood flow in effort to dissipate body heat. This may lead to a red, flushed look in the face and neck in light-skinned women and cause perspiration in an attempt to cool down the body. You may also experience a faster heartbeat and a cold chill following the hot flash.
Prevalence and Frequency of Hot Flashes
Approximately 75% of women in the United States experience hot flashes, whereas Asian women experience significantly less — 31% of Filipino, 26% of Japanese, 25% of East Indian, and 18% of Chinese women report having hot flashes or night sweats. Only twenty-six percent of Hispanic women report experiencing hot flashes. Many Japanese women report feeling only chills instead of hot flashes. Researchers feel this is due to higher soy intake in Japanese women.
Of the 75% of American women who experience hot flashes, about one quarter of them seek medical treatment because of the severity. Others may find hot flashes easy to tolerate or moderate to severe, but they do not seek treatment. Every woman's experience of menopause-related hot flashes is unique. Most experience hot flashes for 6 months to 2 years, while a small number of women report experiencing hot flashes as long as 10 years.
Mitigating Hot Flashes Through Diet
Nutraingredients recently reported about a new study, soon to be released, that looked at 120 Japanese women between the ages of 50 and 65 years of age. The researchers found that walking and strengthening exercises, as well as a diet rich in phytoestrogens (found mostly in soy foods) and calcium significantly reduced hot flashes, body fat, and blood pressure. After just 12 weeks of phytoestrogen-rich foods, 1500 mg of calcium*, and eight glasses of water daily, the participants noticed significant changes in hot flashes, mood, energy levels, and motivation. *Please note that it's important to obtain sufficient calcium through diet. If considering calcium supplementation, please discuss with your healthcare provider. Calcium supplementation has been shown to reduce bone loss in menopausal women, but it's also associated with cardiovascular issues. Please discuss calcium with your healthcare provider before supplementing and to determine is supplementation is warranted. Get a list of calcium-rich plant-based foods here.
Another study published by the North American Menopause Society in the journal Menopause, found that a plant-based diet that included whole soybeans daily reduced moderate-to-severe hot flashes by 84% in women who experienced two or more hot flashes a day. Hot flash frequency decreased from nearly five a day to fewer than one a day. Almost 60% of the women in this study became totally free of moderate-to-severe hot flashes after 12 weeks of the diet intervention. The diet consumed was a low fat, vegan diet that included lots of fruits, vegetables, beans, and whole grains plus 1/2 cup of cooked soybeans daily.
What's extra interesting is that researchers found that the low fat, plant-based diet rich in soy was as effective as hormone replacement therapy for reducing hot flashes. By comparison, hormone replacement therapy has been associated with a 70–90% reduction in hot flashes.
Also notable, for those experiencing unwanted weight gain as one of the symptoms of menopause, is that the participants in this study also lost weight.
While the researchers didn't understand the exact reason behind the significant reduction in hot flashes they suggested the following points were key to reducing symptoms:
avoiding animal products
reducing overall fat intake
including a daily serving of soybeans
Of note, participants with fewer hot flashes also ate significantly more fiber. One study showed that low blood sugar experienced between meals was associated with hot flashes. We know that fiber-rich plant-based foods can help to keep blood sugar stable.
In addition to the above, if you're experiencing hot flashes, you may want to avoid foods and beverages that may trigger hot flashes, like ultra processed foods, sugar, meat, dairy, spicy foods, alcohol, and coffee.
Putting This Into Practice
Simply adding more plant-based foods to your plate can help to boost fiber intake, which may be helpful for hot flashes due to its ability to stabilize blood sugar. And, it's certainly helpful for other things associated with menopause like managing weight, preventing heart disease, reducing blood pressure, and boosting mood. Learn more about increasing fiber intake here.
While whole cooked soybeans were used in the study mentioned above, other soy foods can also provide isoflavones (phytoestrogens), which may be the compound responsible for mitigating hot flashes. Consider using soy milk in oatmeal, swapping out meat for tofu or tempeh, or enjoying edamame in stir fries or as a snack. Beans, peas, and lentils are also rich in isoflavones (as well as fiber!). The one caveat with soy is to choose organic whenever possible since most of the soy in the United States is GMO, which means it's genetically modified and is likely to contain lots of glyphosate, the pesticide associated with disrupting hormones and causing certain types of cancer. Learn more about soy and get tasty tofu and tempeh recipes here.
Stay tuned for the next article on menopause: How Movement and Stress Reduction Can Decrease Hot Flashes
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