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MENOPAUSE



Nutrition and Training



Menopause starts exactly a year from your last period and the UK average age is 51yrs.


Premature Menopause is starting menopause below the age of 40.


The frequency for starting Premature Menopause can be seen below:


1 in 100 start before 40yr


1 in 1000 start before 30yr


1 in 10,000 start before 20yr


A good way to indicate when you may start menopause is to discuss it within your female family history and asking older generations.


The female body holds enough eggs for about 40 years. If you ovulate less for example during pregnancy and those that have had children may find they enter menopause slightly later (roughly a year).


Perimenopause describes the period leading up to menopause roughly 40-51yrs.


During these years many notice changes in their cycle length and symptoms. Some may become more increased as Oestrogen levels can fluctuate largely and some experience a gradual cessation of the cycle and symptoms.


The leading most common symptoms are:


You may experience the following:


  1. Mood changes

  2. Weight gain

  3. Lack of energy

  4. Hot flushes

  5. Changes in appetite

  6. Sleep Disturbances

  7. Vaginal dryness.



It is hugely important to go into menopause at an advantage from certain lifestyle factors. 20% of women going through menopause don’t notice any symptoms so please take into account how personal variance matters.


Lifestyle factors


  1. Reducing stress and remaining active: It is greatly beneficial in helping to relieve certain menopause symptoms.


  1. Exercise: Starting yoga and pilates can make a difference in altering your Autonomic Nervous System and remaining in a “rest and digest” state .


  1. Asking yourself “What have you done for you today?”, aspects of self care can improve these symptoms greatly.


  1. Smoking has shown females go through the menopause roughly 2 years earlier. Which in turn increases the risk of heart disease and osteoporosis.


Once menopause happens females are in an Oestrogen deficient state and the risks of the following are increased:


  • Heart disease (oestrogen is cardio protective which is why men are more at risk)

  • Dementia

  • Osteoporosis


*More than 6 months of no menstrual cycle must be investigated. There can be many causes as to why a menstrual cycle may have stopped e.g hypothalamic amenorrhea as well as early menopause.


It is worth noting that just because there is absence of a cycle, you can still get pregnant (1 in 10 can randomly ovulate again so contraception is still important).


We need our bone mineral density to be good BEFORE we lose the protective effect that Oestrogen has on them. Oestrogen promotes the activity of osteoblasts (bone forming cells). Everytime you bang down on the floor you cause microdamage to your bones making them stronger.


(Hormone Replacement Therapy)- HRT


This is the replacement of the female sex hormones Progesterone; Oestrogen and potentially Testosterone.

There is currently no added risk of taking HRT until the age of 50 (within the early menopause period).


In 2000 there was a study highlighting some risks; showing there has been a change in guidelines according to this research.


Oestrogen and progesterone must be taken if you have a womb. This is to prevent womb cancer as progesterone can minimise these risks. .


23/ 1000 women of 50-59yr of age have a risk of breast cancer regardless of HRT.


To show the risk comparatively to that of the average female on the contraceptive pill it is 27/ 1000.


Obesity shows an increased risk of x2 at 46/1000.


Currently to summarise risks


50-60yr the benefits outway risks


60-70yr are equal risk/benefits


After 70yr risks are outweighed.




Nutrition and Supplements


Vit D


To optimise calcium absorption ensure you get enough Vit D.


It is very hard to ensure you get enough Vit D from food to reach the daily RNI. (reference nutrient intake). You would need 6250ml of whole milk or 143 Large Eggs. Which is why some may consider supplementing.


*20 minutes of sun exposure during summer months or supplement with 2500IU/ day.


PRO TIP: As it is a fat soluble vitamin you can take your weekly dose on a Monday for ease.


Vitamin D rich foods are salmon, mushrooms, milk and eggs.


Calcium


Aim for two to three portions of calcium-rich foods every day which can include:


200ml milk

matchbox size piece of cheese,

small yoghurt or

milk-based pudding like custard or rice pudding.


Plant Oestrogens

  • Plant oestrogens (also called phytoestrogens) are very similar to human oestrogen. If eaten regularly and in sufficient quantities, they can start to have mild oestrogen-like effects – which is useful as oestrogen levels decline.

For some women these effects could be sufficient to help relieve menopausal symptoms, particularly hot flushes. It is worth knowing that:

  • It can take 2-3 months for benefits of plant oestrogens to be seen

  • they seem to work better for some women than others which might be down to differences in gut bacteria

  • consuming plant oestrogens several times a day appears to be more effective compared to one larger dose

  • Foods containing plant oestrogens (such as soya and linseeds) are also heart friendly so it’s worth trying to include calcium-enriched soya products like milk, yoghurts, soya and linseed bread or edamame beans 2-3 times each day before opting for supplements.

Red Clover


There is minimal research around the use of red clover. It is a herb that contains natural plant oestrogens but some may find relief from symptoms such as hot flushes with it. There is no reference nutrient intake (RNI) for red clover so follow the advice from the specific brand.


Caffeine and Alcohol


Both caffeine and alcohol can make hot flushes worse so try to moderate intake of caffeine from drinks like coffee, tea and diet coke.


Keep to sensible alcohol limits – no more than 2-3 units per day, avoid altogether if you feel it makes symptoms worse.


Breasts and changes


The female sex hormones for reproductive purposes lay down fat around the breasts and the hips. When this changes with low oestrogen the fat adopts that of a male pattern around the abdomen.


It can change how your breast tissue feels as oestrogen is no longer there. Change in shape and size can be noted.


Skin


Oestrogen affects collagen and the elasticity of it so more females are likely to have wrinkles and be at risk of sun damage. Further reiterating the importance of SPF.

IBS (Irritable Bowel Syndrome)


A lot of women report excessive and uncomfortable levels of bloating during this transitional stage. Hormonal fluctuations can be a huge cause of this and it is important to practice a level of self kindness and track your symptoms so you can discuss them if needed with your GP.


The bloating can be quite dramatic and affects you not only mentally but physically. Gentle exercise, staying hydrated and knowing these symptoms will go in time can be comforting.



Reasons why you gain weight?


Many females report when going through menopause they suddenly wake up with a “spare tyre” or abdominal fat that wasn't there before. The change in fat storage as highlighted above is one of the reasons why this occurs.


It is also largely due to decreased Insulin Sensitivity which means there is higher amounts of glucose in circulation. A reduction in Insulin sensitivity means your body isn’t able to utilise carbohydrates as it should.


Dietary fat also helps absorb and transport fat soluble vitamins, many of which aid in minerals being used in your body. This is a key function for building and maintaining bone density, one of the more prominent negative effects of menopause is that it causes reduction in this. This means dietary fat is not something to be avoided.


Bone mineral density is hugely important and you can maintain this with a high protein intake and resistance training. It is why you should enter this period of your life with it already as a preventative measure.


Menopause means many big changes for your body. But menopause also offers the opportunity to deepen your relationship with your body and bring your commitment to health and wellness to an all-time high.





Training


The exercise program for postmenopausal women should include endurance exercise (aerobic), strength exercise and balance exercise; it should aim for at least two hours and 30 minutes of moderate aerobic activity each week


Every woman should be aware of her target heart rate range and should track the intensity of exercise.. Other deep breathing, yoga and stretching exercises can help to manage the stress of life and menopause-related symptoms


Sleep


Many women report sleep disturbances during menopause due to the change in hormones. Addressing sleep problems is imperative for optimal health. Poor sleep quality becomes more common during menopause, and this can compound problems with weight gain.


A lack of sleep affects your weight in much the same way as hormonal shifts, making you want to eat more and affecting your appetite hormones. If you are experiencing disturbed sleep, practice good sleep hygiene: remove all electronic screens from the bedroom for at least an hour before bedtime, go to bed and get up on the same schedule each day, and ensure a restful sleep environment. If sleep quality doesn't improve, seek help from your doctor or a sleep specialist.


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