- The menopause occurs when ovulation ceases and oestrogen production decreases; it usually happens at an average age of 51 (range 40–58).
- Approximately 75–80% of women suffer some menopausal symptoms; it normally lasts for 2-5 years but sometimes longer.
- The most common menopausal symptoms include hot flushes, night sweats, vaginal dryness, sleep disturbance, mood swings, forgetfulness and lack of concentration.
- Lean body mass and metabolic rate decrease during the menopause and this can result in weight
- Weight is more likely to be deposited round the middle, Weight here increases the risk of diabetes, raised blood fats and heart disease,
- Weight gain, especially abdominally, can exacerbate hot flushes and night sweats
- Being physically active is associated with fewer menopausal symptoms and may help to reduce weight around the abdomen.
- Following a Mediterranean style diet has been shown to reduce weight gain
The symptoms and their management
Heart disease and related conditions
- Lowered oestrogen levels, which starts in the perimenopause before periods actually stop, increases the risk of heart disease, diabetes, harmful blood fats and blood pressure.
- Consuming Soya based foods and following a more Mediterranean style of diet may help improve cholesterol levels and protect the heart
- Reducing the glycaemic load (GL) of the diet has been shown to increase HDL (good cholesterol levels) in postmenopausal women
- Women with Type 2 diabetes tend to have an earlier menopause and so have an even higher risk of heart disease
- Postmenopausal women are at risk of osteoporosis because the rate of bone calcium loss is escalated during the menopause, especially if vitamin D status is low
- The National Osteoporosis Society recommends a daily intake of 700 mg of calcium in postmenopausal women, which should be increased to 1000–1200 mg in women with
- Women with low blood levels of vitamin D should be given a vitamin D supplement.
New advice from public health England was released in July 2016: adults and children over the age of one should consider taking a daily supplement containing 10mcg of vitamin D, particularly during autumn and winter.
People who have a higher risk of vitamin D deficiency are being advised to take a supplement all year round
- Vitamin A is associated with an increased risk of osteoporosis; therefore, vitamin A or retinol supplements should be used with caution
- Weight loss of as little as 5% of body weight is associated with increased risk of bone loss, so ideally weight loss programmes should be combined with high impact exercise.
- There is an increased risk of developing hormone sensitive cancers, including breast cancer, during and after the menopause
- To help reduce the risk it has been found that increased consumption of brassicas and fibre and avoiding excess weight gain can help.
- Hot flushes are one of the most common symptoms of the menopause.
- Reducing the intake of alcohol, spicy food and caffeine, and losing weight if overweight or obese
- Those with diabetes or at risk of it and those with high harmful blood fats may be at increased risk of hot flushes.
- Hot flushes are less prevalent in countries where soya intake is high probably due to higher isoflavone (plant oestrogen,) soya and soya products being the most common source
- A 20mg/d supplement of the potent isoflavone genistein, or 400ml soya milk or 80g soya mince a day, may be effective in reducing hot flushes.
- The daily consumption of probiotic bacteria milk and prebiotic fibres may increase the bioavailability of soy isoflavones
References available on request