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

If you haven’t had a period for the past 12 months, it’s possible you’ve reached the menopause – a natural transition in life, as your body discontinues the menstrual cycle. Typically, the menopause 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 menopause diet is one way to ease the transition. 

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 flushes 

By far the most common symptom of menopause, a hot  flush 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. Several symptoms can arise as a result of decreased oestrogen levels, such as: 

• Pelvic floor muscles weakening 
• Vaginal walls becoming thinner, drier, and less elastic (which can lead to pain during sexual intercourse) 
• Vaginal dryness, itching, discharge and occasionally bleeding. 
• 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. 

Vaginal moisturisers used several times a week, and vaginal lubricant for intimacy can help treat GSM. Most women can safely use vaginal oestrogen and your GP can prescribe this in various forms such as tablets, creams, gels, a pessary or a ring. You can also buy vaginal oestrogen tablets over the counter. Vaginal oestrogen in some cancer patients, however, is not recommended and you should always check with your health care professional. Be sure to keep your pelvic floor strong with pelvic floor exercises to help prevent future incontinence12. 

Other bladder problems 

Bladder issues may include frequency incontinence, urgency incontinence, nocturia and stress incontinence. Try using vaginal oestrogen creams 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. Cutting down on caffeine can help too, as it is a known contributor to urinary frequency. 

Weight gain 

A natural effect of ageing is the loss of muscle mass, which impacts your metabolism, and tends to increase fat storage, especially around the middle. 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. Physical activity also reduces the risk of heart disease, diabetes and many cancers. A weights programme can also reverse the loss of muscle mass called sarcopenia of menopause. 

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 are recommended, as well as exercising –both weight bearing such as walking, and a weights programme, 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. 

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.  

A Mediterranean style diet has been shown in multiple studies to bring the most benefits to your health. The general principles are to eat lots of plant-based foods such as vegetables and fruits, nuts and seeds, beans and wholegrains. Fermented dairy foods, seafood and other sources of Omega 3 oils and unsaturated fats such as those in olive oil are also a key part of this diet. Meat and dairy foods are in smaller amounts and there is very little salt, sugar or processed foods.  

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.  

Other calcium rich foods are green leafy vegetables, nuts, seeds, dried fruit and the soft bones in tinned fish. 

If you are unsure whether you are getting enough calcium in your diet the Royal Osteoporosis Society has an excellent online calcium calculator which you can use to see if you are getting enough.  As well as getting Vitamin D from sunlight, some foods are high in Vit D including oily fish and egg yolks. 

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, but it may also help reduce hot flushes  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. 

Friendly bacteria for your gut 

Many women suffer from bloating, cramps and generalised abdominal discomfort which can be caused by poor gut health. There are millions of friendly bacteria in your gut helping to aid digestion and improve bowel function.  

A healthy gut can improve your emotional wellbeing, increase production of your “happy chemical “serotonin, reduce inflammation, help with weight and improve general health. Gut friendly foods are prebiotic (stimulating growth of good bacteria) and probiotic (containing live bacteria and yeasts) Prebiotic foods are: 

• Bananas  
• Blueberries 
• Apples 
• Garlic 
• Onions 
• Leeks  

Probiotic foods are those such as kefir, live yogurt, kombucha, kimchi and sauerkraut.  

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. However healthy fats are essential such as those found in olive oil, nuts, butter and avocados. It’s the saturated fats you want to avoid. 

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 flushes. 

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. 

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 hormone's oestrogen, testosterone, 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, yoga and meditation can also support your adrenal glands in a good way. 

Many different factors may contribute to incontinence in women, including childbirth, ageing, obesity, overall health, and other physical illness. 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.