Menopause diet: what’s good, and what’s good to avoid

If you haven’t had a period for the past 12 months, you’ve likely reached menopause – a natural transition in life, as your body discontinues the menstrual cycle. Typically, this delicate moment arrives somewhere between your late 40s and early 50s, though it can also happen earlier, or much later. Some of the changes your body experiences during this time may be uncomfortable, but having a good diet is one way to ease the transition.

Hormonal changes and their effects

During menopause, your declining oestrogen level produces several effects. While different women may experience different symptoms, here are some of the most common ones:
 
Hot flashes
By far the most common symptom of menopause, a hot flash is a sudden and brief increase in body temperature. About 75% of all women in menopause experience this symptom1 but the frequency and intensity vary for each woman.
 
Genitourinary Syndrome of Menopause (GSM) 
GSM is a term to describe the changes that affect the vagina, bladder, urethra and pelvic floor tissue that may occur during menopause. As a result of decreased oestrogen levels, your pelvic floor muscles may become weaker, and your vaginal walls may become thinner, drier, and less elastic, which can lead to pain during sexual intercourse. Your level of lactobacilli bacteria also decreases, leading to a higher pH-environment, and a higher risk of urinary tract infection, since the bacteria find it easier to attach and thrive.
 
Other bladder problems
Bladder issues may include frequency-, urgency-, nocturia- and stress incontinence. Try using vaginal oestrogen creams, tablets and inserts to relieve some of your GSM symptoms, and be sure to keep your pelvic floor strong with pelvic floor exercises to help prevent future incontinence.
 
Weight gain
A natural effect of ageing is the loss of muscle mass, which impacts your metabolism, and tends to increase fat storage. Along with lowered oestrogen, this can contribute to weight gain, especially if obesity is already a problem. Obesity itself is also a risk factor for incontinence, and may lead to both stress incontinence and urge incontinence. Lifestyle, ageing, diet, and genetic factors all contribute to your overall weight and health. Keeping physically active, and watching your diet, can help you maintain both your weight level and your body’s ability to resist incontinence. 
 
Bone density
Declining oestrogen production can also impact the calcium in your bones, which can make you more susceptible to hip, spine and other bone fractures, as the bone density decreases. Taking vitamin D supplements, as well as exercising and eating foods with calcium, can help keep your bones healthy.
 
This may seem like quite a long list of changes to deal with, but keep in mind that the frequency and intensity of symptoms are different for each person. Fortunately, there are things you can do to help relieve menopause symptoms. To start with, make sure your diet includes good food for menopause.

Foods to help menopause

While some of the risks associated with menopause can’t be avoided, a nutrient-rich diet can help you prevent or relieve its symptoms. As a basic dietary guideline, make sure you get enough calcium and vitamin D to compensate for the effect that a lower oestrogen level has on your bones. 
 
Dairy products
Milk, yoghurt, cheese, and other dairy products contain calcium, phosphorus, potassium, magnesium, and vitamins D and K. Each of these ingredients either help to protect your bones or improve their health, thus minimising your risk of bone fractures.
 
Whole grains
Whole grains are an excellent source for fibre, and B vitamins and are linked to a reduced risk of heart conditions, type 2 diabetes, and cancer2
 
Fresh fruits and vegetables
A diet that is rich in fruits and vegetables will be packed with vitamins, minerals, fibre, and antioxidants. This is not only good for your general health, it may also help reduce hot flashes3 for some women.
 
Protein and exercise
Foods high in protein include eggs, meat, fish, legumes, seitan, tofu, and dairy products. When oestrogen levels fall off due to menopause, it can affect both muscle mass and bone density. Increasing both your protein intake and your physical activity can help offset these effects4.

Foods to avoid during menopause 5

Certain foods are always good to avoid from a pure health perspective. But for women in menopause specifically, it’s wise to cut down on foods that can easily lead to weight gain, hot flashes, and affect your general well-being.
 
Trans fats
Bacon, potato chips, margarine, cookies, instant soups and sauces, breads and pastries – these foods might taste good, but they increase the risk of weight gain and heart disease. You’re better off with choices like black flour, brown rice, quinoa, or sweet potatoes.
 
Sugar and gluten
Too much of these substances can destabilise your blood glucose levels and elevate your insulin response. For healthy sweeteners try things like organic honey or coconut sugar.  
 
Artificial sweeteners 
Used in products such as diet sodas and chewing gum, common sweeteners like Aspartame have no real health benefits, and may actually be harmful. Refraining from sweet things all together is the best choice, if you can manage it. Especially if you’ve struggled with sugar addiction. A sweet tooth is just a habit that will disappear quickly if you give it a chance. Water is the best drink with meals, and an unbeatable thirst quencher.
 
Alcohol
In women’s bodies, alcohol blocks the oestrogen receptors. This is no good since your hormone levels are already declining and you may experience mood swings. Also keep in mind that alcohol is high in calories per gram and stimulates your appetite, which might lead to weight gain. Staying away from the drinks can also have a positive effect on your sleep, since this is the time when your brain and body recover to get ready for the next day. Even small amounts of alcohol before you say goodnight affect this recovery process in a negative way.
 
Spicy foods
It is often suggested for women in menopause to avoid spicy foods. The effects are highly individual, but hot/spicy foods stimulate nerve endings which can dilate blood vessels and trigger hot flashes6.
 
Foods that might trigger a reaction 
If you’re already sensitive to certain foods, you may need to avoid them during menopause as well. You may also experience latent food sensitivities that manifest during menopause for the first time, with symptoms such as bloating, nausea, gas, or constipation. Common examples of foods that can trigger these types of sensitive reactions are dairy products, eggs, or tomatoes. Keep a watchful eye on any new reactions, and avoid foods that activate them.

Supporting your adrenal glands

Your adrenal glands sit just above your kidneys, and their job is for example to produce the stress hormones cortisol and adrenaline. The adrenal glands also produce small amounts of the hormones oestrogen and progesterone, but the levels of these decrease during menopause.
 
When your body is under stress, the production of stress hormones is prioritized over the production of oestrogen and progesterone. And since the symptoms of hormonal change can be stressful, this can be an issue for women going through menopause who need these hormones for their wellbeing.
 
There are supplements available that can support the function of the adrenal glands, such as B vitamins which are involved in multiple processes in the nervous system. Magnesium, selenium, and vitamin C and D are also frequently recommended.
 
There are some things you can do yourself to help keep your adrenal glands in balance. Try to minimize stress through choices like regular sleep, a balanced living, exercising, a healthy diet, eating regularly and keeping your blood sugar levels stable. Relaxing and meditation can also support your adrenal glands in a good way. Cutting down on caffeine can help too, as it is a known contributor to urinary frequency.

The effect of menopause on incontinence

Many different factors may contribute to incontinence in women, including childbirth, ageing, overall health, and other physical issues. Nevertheless, there is evidence of a peak in incontinence at the time of menopause.
 
As oestrogen levels drop during menopause, so do the elasticity and strength of the pelvic floor muscles. Decreased oestrogen levels can also cause the vaginal and urinary tract tissues to become drier, thinner, and less elastic. All these changes can contribute to incontinence.
 
For these reasons, it’s important to maintain good skin health, and to use incontinence products that are comfortable and keep the skin dry. Doing pelvic floor exercises can also help you strengthen the pelvic muscles and prevent incontinence.
3 A study of more than 17,000 menopausal women showed a 19% reduction in hot flashes for those who ate more vegetables, fruit, fiber, and soy compared to the control group. https://pubmed.ncbi.nlm.nih.gov/18328014/
5 Lundin, Mia. The Hormone Balance Cookbook. Skyhorse Publishing, 2018:64–65.

Eat well, live well

On the whole, if a food comes with a long list of ingredients, it’s probably not the healthiest option. Try instead to get the majority of your carbs from whole, single-ingredient foods. And remember, menopause is a natural part of your life cycle. Yes, your body does go through changes, and some of these may be unpleasant, but a good diet plan and regular exercise can help you feel like yourself well into your mature years, and beyond.