During perimenopause, estrogen levels go on a roller coaster ride, rising and falling at an unpredictable rate and then eventually start to decline. Progesterone and testosterone levels gradually decline at a slower rate than estrogen. In menopause, all three hormones are at low levels and remain there. The main source of these hormones are the ovaries but the regulation of these hormones is not solely controlled by the ovaries. Our gut also plays an important role in regulating the amount of hormones circulating in our bodies, which means it’s another system in the body we should be aware of and tend to as we move through the menopause transition.
Some experts have referred to our hormone-regulating gut as the “estrobiome.” You can think of it as the soil to a garden — a garden needs healthy soil and microorganisms to create good health.
This gut microbiome plays an integral part in the appropriate function of many body systems including the metabolism and elimination of estrogen. It contributes to the regulation of estrogen levels in our body. A healthy gut needs a collection of different kinds of bacteria for optimal hormonal balance. An unhealthy gut leads to reabsorption of higher amounts of estrogen therefore lesser amounts are being eliminated which causes an imbalance between estrogen and other hormones. This results in “estrogen dominance” which ultimately can lead to menopausal symptoms, fibrocystic breasts, obesity, and premenstrual syndrome (PMS).
Given this, it’s important to eat foods that support our gut health while avoiding foods that promote unhealthy bacteria. There are foods that work for us and foods that work against us as we enter perimenopause and subsequent menopause. Sugar, the processed kind, is definitely one that works against us when ingested in excessive amounts. Processed sugar and added sweeteners are not very sweet to the inside of your body or to your overall health. Excess consumption of sugar can lead to acne, weight gain, and heart disease. And it can make menopausal symptoms worse. Recent studies suggest sugar can make hot flashes more intense and more frequent. Eating refined carbs can also cause a rapid rise in sugar levels which can worsen perimenopausal symptoms. Some people report experiencing an increase in hot flashes after ingesting alcohol, particularly wine. There are studies that suggest alcohol worsens hot flashes and night sweats. Other studies suggest alcohol intake can actually decrease the amount of hot flashes. In my own clinical experience, I have seen patients experience more or more intense hot flashes after drinking alcohol. Remember, every person is different.
In order to ease the discomfort of the menopausal transition or perimenopause and subsequent menopause, I advise my patients to avoid or minimize in their diet the following:
- Processed sugar like white sugar, added sugars
- Refined Carbs like all things white-bread, pasta, and rice
- Processed foods
- Trans fats found in crackers, baked goods, and fried foods
To support a healthy menopausal transition, you should eat the following:
- Healthy fats like avocado and omega-3 fatty acids found in fatty fish like salmon, walnuts, flax seeds, chia seeds.
- Dairy or nondairy sources of vitamin D, calcium and magnesium like milk, cheese, green leafy vegetables such as kale and spinach.
- Fiber found in whole oats, black beans, nuts, prunes, fruit skins.
- Whole grains like brown rice or quinoa.
- Cruciferous vegetables like broccoli, collard greens, arugula.
- Dark berries like blueberries and blackberries.
- Protein-rich foods like eggs, meat, fish, nuts, legumes. Plant sources of protein are ideal. Limit red meat to once or twice a week.
- Fermented foods/drinks like sauerkraut, kefir, kombucha, miso, yogurt.
I cannot overestimate the power of food in helping you maintain your health during the menopause transition. Healthy food has a significant impact on our wellness while unhealthy food can increase our risk for worse menopausal symptoms and even illness.
So is there a “menopause diet”? It’s not a “diet” but a lifestyle that involves us being intentional about what we put in our bodies, both food and drinks. So eat the rainbow! We need colorful whole-food, plant-based meals because plants support a healthy gut environment and have phytoestrogens which have estrogen-like activity. And don’t forget water, aim to drink half your body weight in ounces! We need water for hydration and appropriate detoxification. Be intentional about what you eat and drink in order to support your mind and body from the inside out as you enter the menopausal transition.