A holistic approach to tackle peri/menopausal symptoms

Our resident Nutritionist, Magdalena Marvell, returns to provide expert advice on the menopause and how a nutritionally balanced diet may help to manage some menopausal symptoms and reduce the risk of cardiovascular disease and osteoporosis.

Although discussion around the menopause has largely remained a taboo for many years, females have finally started using this natural transition to their advantage rather than treating it as medical condition.

Scares of breast cancer and other side effects have driven some females towards exploring more holistic approaches to treat some of the symptoms.

Perimenopause usually begins between the ages of 45-55 years. Most females start experiencing the symptoms four years before their last period. Perimenopause phase begins after a females is in her mid forties and can last from a few months to a few years. Some females don’t undergo perimenopause and directly enter menopause. The menopause begins when the ovaries start reducing their production of reproductive hormones.

Most females experience some or all of the following symptoms during menopause: hot flushes, weight gain, insomnia, night sweats, fatigue, vaginal atrophy and osteoporosis. Keeping fit and following a healthy nutritionally balanced diet may help to manage some menopausal symptoms and reduce the risk of cardiovascular disease and osteoporosis. But how can we improve other symptoms?

Lowered serotonin activity is linked to reduced estrogen levels as a result of the menopause which could explain poor temperature regulation including hot flashes and night sweats. Hot flashes is one the most common symptoms experienced during the menopause. Approximately 75% of females will experience menopausal vasomotor symptoms including hot flashes and night sweats.

Supplementing ones diet with black cohosh root appears to have some effects similar to the female hormone oestrogen which may help to improve hot flashes, excessive sweat and sleep disturbances, although more extensive research is required to confirm it efficacy and side effects¹.

Black Cohosh (Actaea racemosa, formerly Cimicifuga racemes) is an herb which some females use as an alternative to hormone replacement therapy (HRT). One randomised placebo-controlled trial in 80 menopausal females compared 8mg/day of a black cohosh extract with placebo or estrogen treatment (0.625mg/day). At the end of a 12 week trial it has been established that Black cohosh significantly helped to decrease symptoms of hot flashes and symptoms of anxiety (according to the scores of Kupperman and the Hamilton anxiety scale) in the black cohosh group².

Some studies suggest significant effect of black cohosh on the menopausal symptoms, and some remain uncertain. Further research needs to be carried out to establish the correct data and safety of long term black cohosh use. Black Cohosh should not be used as a replacement of medication prescribed by a medical provider³.

Black cohosh is also believed to show protective effects against bone mineral loss which many post-menstrual females suffer from. Supplementation with black cohosh may help to maintain the bone mineral density and prevent the risk of osteoporosis. According to studies carried out by Chan and co-workers, Black cohosh extracts effected the formation of bone nodule in the osteoblast. A trail performed on rats also confirmed that at high doses ethanolic extract of black cohosh contributed to suppression of osteoblast multiplication⁴.

This underlined the possibility of a black cohosh providing a protective effect against osteoporosis common in postmenopausal females⁴.

According to some studies black cohosh may also have cholesterol lowering properties, however the research outcomes are mixed and contradictory.

Peri-menopausal females with high cholesterol should reduce their alcohol intake. Alcohol can increase the (LDL) cholesterol and triglyceride levels leading to increased blood pressure. Hot flashes appeared to be associated with an increase in both LDL and HDL cholesterol⁵.

Reducing alcohol intake and eliminating high levels of saturated fats can help to lower cholesterol level and stabilise blood pressure.

Refined carbohydrates and sugar contribute to depression and mood swings. Reducing sugary foods and eating regular meals throughout the day may help to control blood sugar and keep energy levels stable.

Depression/mood swings and low concentration in peri/menopausal females is often linked to deficiency of vitamins B12 and B6 which contribute to the production of neurotransmitters such as serotonin and chemical molecules helping to control moods. Including products rich in vitamin B12 such as: Dairy, eggs, meat, poultry, and shellfish and vitamin B6: potatoes, carrots, peas, spinach may help to improve mood swings⁶.

It is also believed that St.John’s Wort may help to relive some peri- and menopausal symptoms such as mood swings and mild depression. Adaptogenic properties of St.John Wort is believed to increase the sensitivity of serotonin receptors which increases chemical messengers in the brain⁷. Studies suggest that St. John Wort also has a positive impact on reducing the severity of hot flashes and night sweats in peri-menopausal females⁸.

Decreasing oestrogen levels in peri-menopausal females is linked with vaginal dryness. Eating plenty of Omega 3 essential fatty acids found in flaxseeds, walnuts and fatty fish (salmon and Sardines) may improve skin and body tissue condition and help to support the overall health of cell membranes.

Evening Primrose oil is a good source of gamma linoleic acid (Omega 6). Linoleic acid is believed to help with vaginal atrophy however further research is required to confirm its efficiency⁹. Research suggests that severity and duration of hot flashes improved after oral supplementation of evening primrose oil¹⁰.

According to some clinical trials the Pueraria Mirifica (Kwao Krua Kao) plant rich in phytoestrogens (components mimicking body’s own oestrogen) which grows in Southeast Asia may also be beneficial in treating peri and menopausal symptoms such as vaginal dryness and the bone loss caused by oestrogen deficiency. Soy isoflavones have been wildly used as a safer alternative to HRT. Studies suggest that soy isoflavones supplementation may contribute to the improvement of symptoms such as hot flashes, libido and bone health (osteoporosis), although more extensive research is needed to confirm this finding¹¹.

We are all unique individuals and what works for one may not be effective for another. Before undertaking any alternative treatment it is always recommended that you first discuss this with your doctor and a registered nutritional therapist.

Magdalena Marvell is a Nutritional Practitioner and Founder of the Persea Clinic which helps support clients who want to optimise their health in areas such as gut health, hormonal balance, skin conditions, weight management, family nutrition. To find out more about her work please visit www.persea.clinic.

References: 

1. https://www.webmd.com/vitamins/ai/ingredientmono-857/black-cohosh
2. https://ods.od.nih.gov/factsheets/BlackCohosh-HealthProfessional/
3. https://www.drugs.com/drug-interactions/black-cohosh.html
4. http://www.thebonejournal.com/article/S8756-3282(08)00229-9/abstract
5. http://www.webmd.com/menopause/news/20110921/hot-flashes-may-be-linked-to-higher-cholesterol
6. https://www.ncbi.nlm.nih.gov/books/NBK92750/
7. http://www.healthline.com/health-blogs/hold-that-pause/b-well-why-women-perimenopause-need-b-vitamins
8. https://pubmed.ncbi.nlm.nih.gov/20216274/
9. https://www.rcog.org.uk/globalassets/documents/guidelines/scientific-impact-papers/sip_6.pdf
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868221/
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5713750/