Nutrition During Menopause: What You Need to Know

Throughout their lives, almost every woman will experience perimenopause, menopause, and postmenopause. During these phases, collectively known as the menopause, women often notice significant hormonal changes and accompanying symptoms. Unfortunately, these completely natural stages of hormonal development have been taboo in our society for too long. Many women, therefore, are unprepared and have little or no help or advice on how to manage the symptoms of menopause, sometimes with dramatic consequences for their relationships and their physical and mental health.

In addition to the obvious changes, such as the decline in oestrogen and progesterone levels and the resulting irregularities in menstruation, perimenopause and menopause are often associated with weight gain, particularly an increase in body fat and visceral fat, metabolic syndrome, cardiovascular disease, and osteoporosis. Other common symptoms include hot flashes, night sweats, mood swings, sleep disturbances, and generally poor sleep quality. Fortunately, although the progress is slow, there is increasing support and advice for women during menopause. In addition to measures such as hormone replacement therapy, simple lifestyle changes, such as a healthy diet and exercise during this time, can not only alleviate symptoms but also help prevent negative health consequences. In today’s article, we will focus specifically on the aspect of nutrition.

Menopause: Understanding Menopause and Perimenopause

“Menopause” refers to a woman’s last period when no other follows within a year. This usually happens between the ages of 45 and 55, often around age 52. The period before this is called perimenopause, and it can last for many years. Most women experience all sorts of uncomfortable changes and symptoms in their bodies during this time, such as hot flashes and weight gain. Hormonal balance, or the decline in progesterone and oestrogen levels, is a key factor contributing to the onset of symptoms [1]. A gynaecologist should certainly be the first point of contact to monitor, discuss, and navigate these changes. In addition, nutritional counselling can be a great way to effectively reduce risk factors for diseases and promote general well-being.

Why Nutrition is So Important During Menopause

As a direct and/or indirect consequence of hormonal changes during menopause, many women experience a decrease in basal metabolic rate (the calories they burn even at rest) and, consequently, weight gain. The extra pounds often manifest as an increase in so-called visceral fat, which is stored around vital organs in the middle of the body and is harmful to health [2]. In addition, bone density decreases, leading to higher rates of osteoporosis and bone fractures. Hormonal changes also bring a higher risk of certain types of cancer and sleep disturbances. To some extent, a balanced, predominantly plant-based diet combined with regular exercise can help reduce these risks [3].

Basics of a Healthy Diet

So, what does a balanced diet for menopause look like? Dietary guidelines, such as those from the German Nutrition Society (DGE), recommend a diet rich in fruits, vegetables, whole grains, fibre, and healthy fats while emphasising the importance of nutrient-dense foods [4]. A high protein intake is absolutely essential to preserve as much muscle mass as possible, which unfortunately tends to decrease with age [5]. Probiotic foods and fibre support a healthy gut microbiome, which has a positive effect on digestion and therefore health during menopause [6]. A Mediterranean diet, rich in plant-based foods and good olive oil, can help increase the concentration of protective HDL cholesterol and thus reduce the risk of cardiovascular disease. Moreover, it is important to drink enough water to support cellular metabolism and regulate body temperature. For some women, hormonal changes during menopause can affect their sense of thirst, so it may be helpful to monitor fluid intake [7].

Preventing Cardiovascular Disease

We have already learned that many women experience an increase in visceral fat (abdominal fat) during perimenopause and menopause. This type of fat increases the risk of cardiovascular disease, making a heart-healthy diet that reduces saturated fats and focuses more on omega-3 fatty acids even more important. Healthy polyunsaturated fats, such as omega-3 fatty acids, are found in fish like salmon and mackerel, as well as in nuts and seeds. The latter also contain other valuable nutrients and antioxidants that can further support heart health [8].

Preventing Osteoporosis and Bone Loss

For many women, osteoporosis after menopause is a sad reality. To keep bones strong and healthy and slow bone loss, a protein-rich diet containing plenty of vitamin D and calcium is recommended [9]. Ideally, this should be combined with strength training to further support bone density. A protein shake, such as our WAM Protein, can be a convenient way to meet daily protein needs as part of a balanced diet. Vitamin D is produced in our skin when exposed to sunlight, but supplements can be helpful during the darker months or for those with a lifestyle that does not involve much sunlight. Calcium is found in dairy products but also in leafy greens such as spinach and kale. There are also many products like vegan milk alternatives that are fortified with extra calcium.

Cancer Prevention

Certain types of cancer, such as some breast cancer variants, are hormone-sensitive and can occur as a result of changes during menopause. Although there is, unfortunately, no guaranteed way to prevent this, common recommendations for reducing cancer risk include a whole-food diet, maintaining a healthy weight, and avoiding alcohol and smoking. There is a proven link between the consumption of large amounts of processed and red meats and cancer development, so they should only be consumed sparingly [10]. However, eating fish, especially varieties rich in omega-3, can have a protective effect.

Alleviating Sleep Disturbances

Due to the decline in the hormone progesterone, sleep disturbances are more common during menopause. Lack of sleep can lead to chronic fatigue and less energy, significantly affecting quality of life and making things like diet and exercise even more challenging, thus setting off a vicious cycle [11]. In addition to certain lifestyle changes, some eating habits can also positively influence sleep. Heavy, fatty meals and stimulants such as alcohol and coffee should be avoided in the evening. On the other hand, foods containing melatonin, such as tart cherries, eggs, and nuts, could promote better sleep.

Further Preventing Menopausal Symptoms

Certain lifestyle changes, such as regular physical activity, stress management, quitting smoking, and limiting or eliminating alcohol, should complement a healthy diet to promote health during menopause. Exercise particularly helps to maintain muscle mass while also strengthening bones, supporting heart health, and promoting mental health. A low-fat diet rich in omega-3 fatty acids and lean proteins can also help. Good protein sources include lean meats, or, for a vegetarian or vegan lifestyle, legumes such as lentils, beans, and peas, as well as soy and soy products. The latter also contain so-called isoflavones, which belong to phytoestrogens that are also found in nuts, seeds, and some fruits. Although these compounds are too weak in their effect to show oestrogenic effects in younger women or men, their intake during menopause is often associated with a relief of symptoms.

Nutrition During Menopause: Conclusion

It is not news that a balanced diet and regular exercise are good for our health. However, their influence becomes exponentially more important as we age and during menopause. Changing one’s diet and cultivating new, positive habits such as daily exercise can be challenging and time-consuming at first. Therefore, it is best to start as early as possible—preferably before perimenopause. At the same time, it is never too late to work on your diet, fitness, and health, and there are many qualified professionals who will be happy to help you. One thing is certain: with a healthy lifestyle, any symptoms experienced during menopause will be easier to navigate!

Summary

• The right diet can alleviate symptoms during menopause and help prevent negative health consequences.
• Your diet should be balanced and contain a high amount of fruits and vegetables, whole grains, protein, and healthy fats.
• Special focus should be placed on omega-3 fatty acids and antioxidants for heart health, as well as protein, vitamin D, and calcium for bone health.
• Red and processed meat should be drastically reduced or avoided to lower the risk of cancer.
• Additionally, regular exercise, stress management, and a smoke- and alcohol-free lifestyle support health during menopause.

Sources

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[2] Lovejoy JC, Champagne CM, de Jonge L, Xie H, Smith SR. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes (Lond). 2008 Jun;32(6):949-58.

[3] Silva TR, Oppermann K, Reis FM, Spritzer PM. Nutrition in Menopausal Women: A Narrative Review. Nutrients. 2021 Jun 23;13(7):2149. 

[4] https://www.fao.org/nutrition/education/food-based-dietary-guidelines

[5] Cailleaux PE, Déchelotte P, Coëffier M. Novel dietary strategies to manage sarcopenia. Curr Opin Clin Nutr Metab Care. 2024 May 1;27(3):234-243.  

[6] Barrea L, Verde L, Auriemma RS, Vetrani C, Cataldi M, Frias-Toral E, Pugliese G, Camajani E, Savastano S, Colao A, Muscogiuri G. Probiotics and Prebiotics: Any Role in Menopause-Related Diseases? Curr Nutr Rep. 2023 Mar;12(1):83-97. 

[7] Stachenfeld NS. Hormonal changes during menopause and the impact on fluid regulation. Reprod Sci. 2014 May;21(5):555-61. 

[8] Gardner CD, Vadiveloo MK, Petersen KS, Anderson CAM, Springfield S, Van Horn L, Khera A, Lamendola C, Mayo SM, Joseph JJ; American Heart Association Council on Lifestyle and Cardiometabolic Health. Popular Dietary Patterns: Alignment With American Heart Association 2021 Dietary Guidance: A Scientific Statement From the American Heart Association. Circulation. 2023 May 30;147(22):1715-1730.

[9] Management of osteoporosis in postmenopausal women: the 2021 position statement of The North American Menopause Society. Menopause. 2021 Sep 1;28(9):973-997. 

[10] Meinilä J, Virtanen JK. Meat and meat products - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res. 2024 Feb 21;68. 

[11] Baker FC, de Zambotti M, Colrain IM, Bei B. Sleep problems during the menopausal transition: prevalence, impact, and management challenges. Nat Sci Sleep. 2018 Feb 9;10:73-95.