Sharona Gabai, clinical dietitian, B.Sc RD
Hot flashes, night sweats, irritability, low mood, mood swings, irregular periods, reduced sexual desire, weight gain, fluid retention, fatigue, sleep disturbances and osteoporosis are only some of the physical and psychological effects a woman may experience for several years before menstruation stops. Known as “menopausal symptoms,” they generally appear in the fifth decade of life and are associated with the natural, gradual decline in female sex hormones, estrogen and progesterone. They can accompany a long period of hormonal adjustment and substantially impair quality of life, but appropriate nutrition can moderate their severity.
Why does your body undergo extreme hormonal changes?
Menopause involves hormonal changes and the end of menstruation.
Symptoms often appear about five years before periods actually stop, as ovarian estrogen and progesterone production gradually decreases. They are also associated with increased risk of breast or endometrial cancer and higher cardiovascular and osteoporosis risk after menopause.
Many symptoms arise from altered hypothalamic function. The hypothalamus controls numerous functions, including body temperature, metabolism, sleep patterns, libido and pituitary hormone secretion.
What does your body need during this period?
As estrogen and progesterone decrease, metabolic rate and energy needs gradually decline, so fewer daily calories are needed. At the same time, varied nutrition rich in vitamins and minerals becomes more important for optimal body-system function. Iron requirements decrease as blood loss diminishes, while requirements for calcium, vitamin D and magnesium increase. Calcium-rich foods are recommended, including small fish eaten with bones, such as sardines and anchovies; leafy vegetables such as cabbage and broccoli; seeds; and sesame in tahini and halva.
Treatment and symptom relief:
Conventional treatment, hormone replacement therapy (HRT), uses synthetic or natural hormones. It usually combines estrogen and progesterone in tablets, patches or cream.
HRT has become controversial in recent years. Many experts believe its risks exceed potential benefits. In 2002, the World Health Organization stated that combined treatment may increase the risk of blood clots, stroke, heart attacks, bladder diseases and dementia, and raise breast-cancer risk by tens of percent. Studies showed substantial risks even in women who had undergone hysterectomy and therefore took estrogen alone. The medical community does not recommend long-term hormone use. Nevertheless, the prevailing view is that short-term treatment may be relatively effective and safe for women needing immediate relief from menopausal symptoms.
Because contradictory research has prevented the medical community from reaching a decisive and unambiguous view on safety and efficacy for over a decade, many women choose alternative approaches.