BarcelonaMenopause is a stage in all women’s lives, with over a billion expected to be postmenopausal next year, according to the American Menopause Society. With the end of menstruation, the ovaries stop producing essential hormones, such as estrogen and progesterone, leading to physiological and hormonal changes that until a few years ago were associated with the onset of old age. Some of these symptoms, such as hot flashes, are widely known, but there are others that are not usually associated with menopause and that many women also experience. To enter this new stage in the best way and with good health, it is necessary to make lifestyle changes, such as incorporating physical exercise and following a good diet, and even consulting with experts about whether hormone replacement therapy is necessary.
Diet is, in the eyes of experts, one of the great allies in this new stage to live through all the changes in the best way and minimize their impact. “We must use nutrition as if it were medication to counteract estrogen loss, combat inflammation, insulin resistance, muscle loss, and increased stress,” states the director of the gynecology and obstetrics service at Hospital de Sant Pau, Elisa Llurba, who advocates for a diet based on anti-inflammatory foods.
Therefore, fruit, vegetables, nuts, and oily fish are foods that will provide protection because they will compensate for the lack of estrogen. Foods rich in fiber and a good amount of healthy protein, such as legumes and white meat, are essential for maintaining good muscle mass and protecting bones. It is also important to avoid sugars, processed foods, and alcohol, as well as to moderate fast-absorbing carbohydrates (bread, rice, and pasta) and try to eat whole-grain options.
In her book La teva menopausa en positiu (Rosa dels vents), Llurba argues that a good diet, combined with lifestyle changes such as sport and sleep hygiene, are the basis for facing menopause in the best way. Calcium, magnesium, and vitamin D, found for example in fatty fish, such as salmon or tuna, help prevent osteoporosis, while omega-3, which we get from eating fish, seafood, nuts, and seeds, helps reduce inflammation and combat some of the symptoms, such as hot flashes.
The Mediterranean diet, for example, is rich in foods that help protect the heart, improve skin quality, and also reduce inflammation, muscle loss, glycemic and lipid profiles. In fact, these are products that should be present throughout life to maintain good physical and mental health: quality proteins, whether through lean meats (beef, chicken, fish) or legumes (lentils, beans). As for vitamins, group B vitamins (legumes, eggs, whole grains, dairy, etc.) promote good nervous system function, while antioxidants (A, C, and E, found in berries or citrus fruits) strengthen cellular health.
A person who does not take care of their diet risks gaining weight, losing muscle, and increasing their cardiovascular risk, in addition to feeling worse: “They will be more stressed, anxious, they will feel that they are not getting things done,” assures Llurba. The symptoms that everyone most identifies are hot flashes, insomnia, mood swings, and irritability, but there are others that are often not related to menopause, such as joint pain, urinary tract infections, fatigue, tachycardia, and weight gain, especially in the abdominal area.
The Harvard plate
The expert argues that food should be better planned to help mitigate the impact of estrogen deficiency. This means following a balanced diet of three meals a day, spacing meals between 4 and 6 hours apart, and above all, not skipping breakfast or dinner. “It’s also not good to eat a large amount at once; glucose imbalances, whether up or down, will lead to health problems,” warns Llurba.
In her opinion, the ideal is to follow the method known as the Harvard Plate (referring to the Harvard School of Public Health, Harvard University), which explains the importance of eating vegetables, greens, and fruits and therefore reducing the intake of refined carbohydrates that come from white flours and especially from sugary industrial cereals. According to this strategy, you shouldn’t have two plates, but only one: half should be vegetables, a quarter protein, and a quarter slow-absorbing carbohydrates.
With this method, water is the essential drink, not sugary drinks, not even fruit juices, not even natural ones. Vegetables and greens are a priority, as are fruits. Proteins like nuts, eggs, dairy products, and legumes are also important. In fact, the recommendation is to reduce the intake of animal protein, especially red meat and processed foods (cured meats, sausages, frankfurters…). And, finally, she advises whole foods.
Supplementation and exercise
The rate of sedentary lifestyle in the age group of 45 to 55 years, which is when menopause usually appears, is very high, and more so among women, warns Llurba. Therefore, it is important to incorporate exercise into daily life and be an active person. “It should be a consistent habit and done three times a week. It is not optional,” states the expert. She recommends strength exercises because strong, well-toned muscles protect bones and improve sugar metabolism, as well as walking to places.
Regarding hormonal supplements, the expert maintains that before starting any treatment, one must consult with a gynecologist to see if there are any contraindications. Not all women can receive the same, and once started, it is important to follow up with professionals in case doubts arise. Complementary to therapy, there are supplements that can help improve symptoms and discomforts.
Hormonal treatments are recommended by various scientific societies to improve the quality of life during this stage, as they help reduce the risk of suffering from diseases caused by hormone loss. Depending on each woman’s condition and preferences, a hormone replacement therapy or another will be recommended.
These treatments contain the same hormones as those produced by the ovaries, which are called bioidentical. Those with a higher safety profile are those administered cutaneously in the form of sprays, patches, and gels, and must be combined with natural progesterone. If they cannot be prescribed due to contraindications, there are other local options applied vaginally that are also indicated and safe.
Llurba explains that scientific literature supports that these types of treatments can be followed for at least 10 years, and increasingly, there is more data indicating they can be extended over time because their effects are maintained. “It is very important to preserve health as much as possible if there are no contraindications,” she concludes.
