The most common menopause symptoms are hot flushes, night sweats, sleep problems, mood changes, irregular periods, vaginal dryness and weight gain around the waist. At this stage, a balanced Mediterranean-style diet rich in calcium and vitamin D, with enough protein and fibre, can help protect bone, heart and muscle health and ease some symptoms.
According to the World Health Organization, most women reach menopause between the ages of 45 and 55. Menopause is not an illness but a natural stage of life; even so, the changes it brings can clearly affect daily life. In this article I explain the symptoms and the role of nutrition in this period; treatment options you need to discuss with your doctor.
- Menopause is defined as having no periods at all for 12 months; the transition before it is called perimenopause.
- The fall in oestrogen is linked to hot flushes, sleep problems, bone loss and a tendency to put on fat around the waist.
- Calcium, vitamin D, protein and fibre are the nutrition priorities in this period.
- Alcohol, a lot of caffeine, very spicy food and hot drinks can trigger hot flushes in some women.
- Decisions on hormone therapy and supplements are individual and are made with a doctor.
What Is Menopause and When Does It Start?
Menopause is the complete end of periods as the ovaries wind down, and it is diagnosed when there has been no period for at least 12 months. The stage before this point, which can last several years and when symptoms often begin, is called perimenopause.
The US National Institute on Aging (NIA) states that the transition begins between the ages of 45 and 55 in most women and can last several years. In some women menopause can come earlier as a result of surgery or medical treatments. If your periods have stopped before the age of 45, or your symptoms are making daily life difficult, see your doctor.
What Are the Symptoms of Menopause?
Symptoms vary a great deal from woman to woman; some women have almost no complaints, while in others symptoms can last for years. The most common are:
- Hot flushes and night sweats: A sudden feeling of heat, flushing of the face, sweating and then feeling chilled.
- Sleep problems: Difficulty falling asleep, waking often at night; night sweats can make this worse.
- Mood changes: Restlessness, anxiety, low motivation, forgetfulness and difficulty concentrating.
- Irregular periods: In perimenopause the frequency and amount of periods can change.
- Vaginal dryness and urinary complaints: Discomfort caused by thinning of the tissues.
- Joint and muscle aches, headaches, a feeling of palpitations.
- Changes in weight and body shape: A tendency for fat to collect more around the waist.
Some of these symptoms can be confused with other conditions such as thyroid problems or iron deficiency. That is why it is important to assess your symptoms with your doctor rather than putting them down to menopause on your own.
How Does Menopause Affect Bone and Heart Health?
As oestrogen levels fall, bone density declines more quickly and the risk of osteoporosis and fractures rises. In the same period, blood fats and waist measurement can change, so the risk of cardiovascular disease also rises.
The WHO stresses that the loss of bone density at menopause contributes significantly to higher rates of osteoporosis and fractures. Diet and regular exercise do not remove these risks completely; but they are the most accessible ways of supporting bone and heart health. For nutrition principles for heart health, you can look at my page on nutrition for heart disease.
How Should You Eat in Menopause?
The priority in nutrition at menopause is calcium and vitamin D for the bones, enough protein for muscle mass, fibre and healthy fats for heart and gut health, and portion control to help keep weight in balance. A Mediterranean-style diet is a practical model that meets most of these needs.
| Nutrient | Why it matters in menopause | Good sources |
|---|---|---|
| Calcium | Protecting bone density | Milk, yoghurt, kefir, cheese, sesame, leafy green vegetables, small fish eaten with the bones |
| Vitamin D | Calcium absorption, muscle and bone health | Sunlight, oily fish, egg yolk; a supplement on a doctor's advice if levels are low |
| Protein | Preserving muscle mass, which falls with age | Eggs, fish, chicken, yoghurt, cheese, pulses |
| Fibre | Cholesterol, blood sugar and bowel regularity | Vegetables, fruit, wholegrains, dried pulses, oats |
| Omega-3 and healthy fats | Cardiovascular health | Sardines, salmon, walnuts, flaxseed, olive oil |
| Magnesium and potassium | Muscle, nerve and blood pressure balance | Nuts, pulses, leafy greens, bananas |
Spreading calcium through the day rather than taking it all at once makes it easier to absorb. I described what can be done about falling vitamin D levels in the winter months in the article on vitamin D deficiency in winter. For a comparison of the Mediterranean diet with other approaches, you can look at the article on the Mediterranean diet versus the ketogenic diet.
What Should You Eat and Avoid to Reduce Hot Flushes?
No food completely prevents hot flushes; however, in some women alcohol, a lot of caffeine, very hot and spicy food and very hot drinks can trigger attacks. To work out what affects you, it helps to note your symptoms for a few weeks and what you ate and drank beforehand.
- Try drinking hot drinks lukewarm and cutting back on hot chilli and strong spices.
- Limit coffee and tea through the day, especially in the evening.
- Stay away from alcohol, or limit it as far as your doctor advises.
- Drink enough water; sweating can increase fluid loss.
- Because excess weight can make hot flushes worse, balanced weight management can be supportive.
Research results on the effect of foods containing phytoestrogens, such as soy and flaxseed, on hot flushes are inconsistent. These foods can be eaten as part of a balanced diet; but before using concentrated soy isoflavones or herbal menopause supplements, especially if you have a history of breast cancer or a hormone-sensitive condition, ask your doctor. The NHS also advises talking to a doctor before using herbal products and complementary therapies.
What Can You Do to Avoid Gaining Weight in Menopause?
With menopause, the loss of muscle mass and fall in energy expenditure can make weight gain easier even on the same diet. The answer is not to go hungry, but to readjust portions, spread protein across meals, increase high-fibre foods and do resistance exercise to preserve muscle mass.
- Give half the plate to vegetables, a quarter to protein and a quarter to wholegrains or pulses.
- Limit sugary drinks, packaged snacks and pastries.
- Plan resistance exercise on at least two days a week and regular walking; weight-bearing exercise is also important for bone health.
- Take care over your sleep pattern; sleeplessness can increase appetite.
For ways of losing weight without losing muscle, you can look at the article on losing weight without losing muscle.
Can Nutrition Help With Sleep and Mood?
Nutrition alone does not solve sleeplessness or mood changes; but regular mealtimes, eating a light and early evening meal, and avoiding caffeine and alcohol in the evening can support sleep quality. Balanced meals that prevent sudden swings in blood sugar can also have a positive effect on energy and concentration through the day.
If night sweats disturb your sleep, keeping the bedroom cool, choosing thin, layered clothing and avoiding heavy, spicy meals before bed are practical measures. If you have marked low motivation, anxiety or prolonged unhappiness, be sure to share it with your doctor; these symptoms can be treated too.
How Can You Plan a Sample Day in Menopause?
The example below is a framework that spreads calcium, protein and fibre through the day; portions and content should be adapted to your personal health.
- Breakfast: Egg, white cheese, tomato, cucumber, rocket, a few walnuts and wholegrain bread.
- Snack: A bowl of yoghurt and a portion of fruit.
- Lunch: A salad with chickpeas or lentils, vegetables cooked in olive oil and ayran (Turkish salted yoghurt drink).
- Snack: A glass of kefir or milk, a handful of almonds.
- Dinner: Fish twice a week (sardines, salmon, anchovies), chicken or pulses on other days; with vegetables and bulgur pilaf.
For a personal nutrition plan on weight, bone health, cholesterol or blood sugar at menopause, we can work together within nutrition counselling for medical conditions. Hormone therapy and medicine options must always be assessed with your doctor.
Sources
- WHO – Menopause
- NHS – Symptoms of menopause and perimenopause
- NIA (NIH) – What Is Menopause?
- NHS – Osteoporosis
This article is for general information only; please consult your doctor and dietitian about your own situation.
Frequently Asked Questions
How many years do menopause symptoms last?
The length varies a great deal from woman to woman. Symptoms that begin in perimenopause can last several years; in some women hot flushes continue for a while after menopause. If your symptoms are affecting your quality of life, talk to your doctor about treatment options.
Which vitamins matter in menopause?
For bone health, calcium and vitamin D stand out; for the muscles and nervous system, B12 and magnesium. The aim is to get these mainly from food; whether you need a supplement is decided by your doctor by looking at your blood values and diet.
Is eating soy helpful in menopause?
Research has given mixed results on the effect of soy and other sources of phytoestrogens on hot flushes. They can be eaten as part of a balanced diet; but ask your doctor before using concentrated soy supplements or herbal menopause products.
Why do you gain weight around the belly in menopause?
With the fall in oestrogen, the distribution of fat changes and fat tends to collect more around the waist. Falling muscle mass and less movement contribute to this as well. Enough protein, high-fibre eating, portion control and resistance exercise help balance this tendency.
Should I eat dairy products in menopause?
Milk, yoghurt, kefir and cheese are valuable sources of calcium and protein and support bone health. If you are lactose intolerant, you can meet this need with yoghurt, kefir, lactose-free milk or other calcium-rich foods.
Book an appointment for a personalised nutrition plan
The information in this article is general; what you need depends on your age, health and goals. Message us and we will build the plan that suits you together.
This content is for information only. For a personalised nutrition programme, please consult a dietitian.
