Menopause: A Season of Self Reflection
Overview
Whether warmly welcomed or sincerely feared, the fact of the matter is that every woman all the world over will experience menopause at one point in their lives. The experience, however, varies for each woman, with 70-75% of women experiencing the vasomotor symptoms associated with menopause including hot flashes, sweating, anxiety and heart palpitations that can last from 6 months to 2 years.1
Throughout life, hormones dictate the proper functioning of the entire female cycle. Hormones like follicle stimulating hormone (FSH) and luteinizing hormone (LH) stimulate the ovaries to release an egg for fertilization, and secrete estrogen at the same time, followed by progesterone.2 If the egg is not fertilized, hormones begin the dance all over again, with rises and falls throughout the monthly cycle.
As a woman ages, the available potential eggs (follicles) decline and she may note that her cycles change, decreasing in length and varying in heaviness.2 This will diminish until eventually, follicles will cease to be released and a woman will experience her final menstrual period, this being menopause. Medically, menopause is considered to be 12 consecutive months of missed menses as part of a natural progression of a woman’s life.1
As a natural experience in a woman’s life, the event of menopause itself cannot be changed nutritionally, however, the experience of the vasomotor symptoms associated with menopause are influenced by hormones and may vary according to diet. Additionally, as estrogen declines, nutritional needs make up the protective properties these reproductive hormones once provided. Calcium, for example, becomes important as the decrease in estrogen puts a woman at risk for decreased bone density. 2 Fiber intake and its role in lowering LDL cholesterol also becomes more focused as the risk for cardiac disease can rise as a woman goes through menopause.2,3
Therapeutic Foods
A recommended place to begin nutritionally, is with a Detox Food Plan which supports Phase 1 and Phase 2 detox pathways, reducing the toxic load on the liver in support of healthy hormones.1,4 Typical foods consumed might include high quality protein from animal sources, lentils and legumes, nuts and seeds, vegetables, greens and various omega rich oils.1 While studies have shown that detox diets can stimulate enhanced liver function and detoxification in the support and removal of harmful pollutants from the body, study sample sizes and method inconsistencies to be able to identify efficacy of such a diet in a given time frame is inconclusive.5 Initial evidence, however, is promising.
While many women enjoy benefits of medicinal symptom relievers like hormone replacement therapy (HRT), the proposed risk of increases in breast and ovarian cancer can have many women shying away from its use.2 A detoxification diet in support of liver function and hormone health can be a welcome alternative or follow up to HRT, along with supportive nutrition and supplementation.1
One expected negative aspect to the diet, as with any reduction diet, is the difficulty of avoiding favorite foods, particularly comfort foods during the emotional shifts and upheavals that can occur during menopause. A positive suggestion would be to visualize the outcome with guided imagery, or to get engaged in an activity that can bring a level of the same comfort.
Foods that are rich sources of omega 3 fatty acids follow a detox diet and are a reliable source of nutrients to reduce cardiac risk associated with menopause, decrease inflammation, and improve mood symptoms.2 One study of 483 women over 3 randomized controlled trials supplementing with omega 3 fatty acids experienced a reduced frequency and severity of night sweats.6
Fiber foods from vegetables, fruits, beans, bran, prunes, peas and potato skins can be an important part of the menopausal woman’s diet, as fiber has been proven to reduce LDL “lousy” cholesterol.2 A meta analysis of 67 controlled styles were performed to this end. The studies showed that between 2-10 grams per day of soluble fiber was associated with small decreases in total cholesterol, and can be a small addition to a dietary plan in favor of health.
Supplements to Consider
Maca – Maca has been studied as a non pharmacological intervention in the relief of symptoms of hormonal imbalance, reproductive health in both men and women, and in menopause for females.1 A study following women consuming 2 g of maca root powder during a nine month period evidenced a significant increase in luteinizing hormone, while simultaneously decreasing follicle stimulating hormone.7 The women also reported a reduced feeling of discomfort in their menopausal symptoms.7 Maca is generally considered safe.
Black Cohosh – Black cohosh is widely regarded as an effective botanical supplement as an herbal therapeutic for hormone imbalance.2 However, studies have failed to consistently back up its use as to a particular dosage or time frame, possibly due to the difficulty in the natural courses of hot flashes.2 Research suggests that black cohosh may in fact reduce some menopausal symptoms. It is important to note that black cohosh should be used in the short term.2 It is also unclear if it is safe for use in women with hormone influenced cancers, while pregnant, or during breastfeeding.8
Members To Add To Your Team
Menopause is a shifting, processing time in a woman’s life, ripe with emotions due to the change as well as the emotions hormone fluctuations can change. Often times, it is useful for a woman to “reframe” the narrative of what this natural change means for her. A practitioner to collaborate with could include a therapist trained in Cognitive Behavioral Therapy (CBT). One study compared CBT conducted in a group, to self help, to a non treatment control group. Either form of CBT improved hot flashes, mood and quality of life after 6 weeks.9
Conclusion
The season of menopause is a natural process in a woman’s life, and should be regarded with the honor of what this life change signifies: a time of self reflection. The advent of this time frame brings with it a balance of reflection within oneself, and the support of a group or partnership to address physical, mental and emotional concerns so that one can truly flourish through and into all that life has to offer next. Functional Wellness and Lifestyle medicine has a lot to offer through this transition from diet and exercise to emotional processing. Call our office at 329-639-0044 or go to anmcholistichealth.com to learn more.
References
Ross K. Nutritional management of surgically induced menopause: A casereport. Women’s Heal. 2021;17. doi:10.1177/17455065211031492
Rakel D. Integrative Medicine. In: Integrative Medicine. 4th ed. Elsevier; 2018:320-333.
Ross K. Reproductive Hormone Health. :1-41.
Kur P, Kolasa-Wołosiuk A, Misiakiewicz-Has K, Wiszniewska B. Sex Hormone-Dependent Physiology and Diseases of Liver. Int J Environ Res Public Health. 2020;17(8). doi:10.3390/IJERPH17082620
Klein A V., Kiat H. Detox diets for toxin elimination and weight management: a critical review of the evidence. J Hum Nutr Diet. 2015;28(6):675-686. doi:10.1111/JHN.12286
Venter C, Eyerich S, Sarin T, Klatt KC. Nutrition and the Immune System: A Complicated Tango. Nutr 2020, Vol 12, Page 818. 2020;12(3):818. doi:10.3390/NU12030818
Meissner HO, Kapczynski W, Mscisz A, Lutomski J. Use of Gelatinized Maca (Lepidium Peruvianum) in Early Postmenopausal Women. Int J Biomed Sci. 2005;1(1):33. Accessed March 8, 2022. /pmc/articles/PMC3614576/
Black Cohosh | NCCIH. Accessed March 8, 2022. https://www.nccih.nih.gov/health/black-cohosh
Ayers B, Smith M, Hellier J, Mann E, Hunter MS. Effectiveness of group and self-help cognitive behavior therapy in reducing problematic menopausal hot flushes and night sweats (MENOS 2): A randomized controlled trial. Menopause. 2012;19(7):749-759. doi:10.1097/GME.0B013E31823FE835