A Healthier Transition to Menopause
Menopause is a noteworthy signal in a woman’s life, the end of the female reproductive phase, and an opportunity for reassessment of a woman’s health goals and nutritional needs. However, for many midlife women, “going through menopause” is often met with a collection of unwanted physical and emotional changes and unbiased and reliable information is often insufficient. For women who may dread and fear menopause, it can be helpful to understand that these changes are part of a natural process and learn what to do to improve your health as you transition into menopause and beyond.
What is Menopause? Menopause, defined as the final menstrual period (FMP), naturally occurs around 51 years of age. Perimenopause is the period leading up to menopause when hormones produced by the ovaries begin to fluctuate and eventually decline. A woman may notice irregular menstrual cycles along with symptoms such as hot flashes, sleep disturbances, difficulty concentrating, irritability, digestive issues, and weight gain. Postmenopause is defined as the phase in a woman’s life after the FMP and is associated with changes in bone density, vaginal health, and cardiovascular health due to the depletion of estrogen.
Dr. Mary Dolan, Director of Midlife and Menopausal Medicine at The Emory Clinic in Atlanta, Georgia and NAMS (North American Menopause Society) certified menopause practitioner, encourages women to implement health-promoting behaviors during the perimenopausal years to prevent long-term health problems, such as osteoporosis, heart disease, diabetes, and cancer.
What Causes Midlife Weight Gain? During the menopause transition, women may experience weight gain and/or an increasing waistline that often contributes to body dissatisfaction and can become the tipping point for disordered eating and depression. “So many women want to blame their body and loss of hormones for everything that is going awry at this time of life,” adds Dolan. Although shifting hormones influence changes in body fat distribution, research indicates that the reasons for weight gain are more often a result of being less active, eating more, and the natural process of aging. Lifestyle changes (e.g. taking care of aging parents and adjusting to becoming an empty nester) can result in preparing less meals at home, eating out more, traveling and drinking more (or more frequently), and women may be unknowingly increasing their caloric intake at a time when their body needs less.
What Can You Do? Nutrition and exercise are key for preventing or decreasing weight gain; maintaining or restoring lean tissue; and lowering risk of disease.
- Eat regular, balanced meals. A nourishing diet includes a balance of high-quality protein, wholesome carbohydrates, and healthy fats. Skipped meals and restrictive diets often backfire with cravings and overeating. Moreover, meal plans that eliminate foods or food groups may result in nutrient deficiencies and the body’s lessened ability to fight disease. Adequate intake of energy and key nutrients has been shown to have a protective role for aging women.
- Improve diet quality. Rather than focusing on a single nutrient, eating patterns that include nutrient-dense foods, such as fruits and vegetables, whole grains, beans, nuts, seeds, soy foods, dairy foods, poultry, fish, and lean meats take advantage of the beneficial effects of the additive and synergistic nature of nutrients and food in the body. The Mediterranean-style diet is an example of this type of eating pattern linked with improved health outcomes. In a 12-year follow-up study of 25,994 U.S. women from the Women’s Health Initiative, researchers observed that those eating a Mediterranean diet had a 25 percent lower relative risk of cardiovascular disease.
- Stay active. Physical activity helps prevent the loss of lean tissue that occurs with aging and protects bone when muscle-strengthening exercise places a healthy tension on the bone. A combination of aerobic activity (e.g. brisk walking, running, biking, swimming) with resistance exercise (e.g. weightlifting or weight-bearing activities, such as pushups and lunges) is optimal for preventing age-related weight gain, improving strength and balance, and, decreasing the risk for several metabolic diseases.
What About Supplements? Herbal remedies and supplements, such as black cohosh and dong quai, are often sought out by women yearning for a solution for menopausal symptoms, such as hot flashes. Although these may seem “natural” and therefore safe, there is limited evidence supporting efficacy and long-term safety. Soy foods and isoflavones are another nutritional remedy often found in over-the-counter supplements for relief of menopausal symptoms. Isoflavones are compounds found in soy foods which can bind to estrogen receptors in the body, but only after being converted to a biologically active form by specific gut bacteria. Current research has shown that about one-third of North American women have this type of bacteria and consequently data is inconsistent about who may benefit. Nevertheless, soy foods are an excellent source of plant-based protein and provide other non-hormonal benefits.
The Bottom Line. Menopause is a health milestone, and the transition from the reproductive years into postmenopause brings with it numerous physical and emotional changes. A final thought from Dr. Dolan is “there isn’t one approach to weight maintenance and health, but rather the combination of diet, exercise, sleep, mental health, social health, spiritual health, and personal motivation, that is needed to maintain health in menopause and beyond.”
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