Menopause is a transition period lasting 2-8 years where the production of female sex hormones – oestrogen and progesterone from the ovaries declines and other systems step in to compensate. If these systems aren’t healthy then it’s likely to result in a difficult transition and symptoms long into the postmenopausal years. Many of these symptoms are not the direct effect of low sex hormones, but their interaction with other hormones – hormones don’t operate in isolation but as part of a network, so lets have a look at some of the key players and how to balance them.
Prior to menopause most oestrogen production comes from the ovaries. After menopause the adrenal glands step in and make a precursor hormone called androstenedione which is then converted into oestrogen in the peripheral fat tissue. Androstenedione is a steroid hormone, meaning it is made from cholesterol – the building block for all steroid hormones. With the increased need for oestrogen the body will respond by producing a sudden rise in cholesterol. It’s well documented that cholesterol levels rise in women at this time and that leads to concerns over increased risk of heart disease, but by understanding how the body works you can address this at the cause. We know that men have higher risk of cardiovascular disease compared to pre-menopausal women but after menopause women find themselves with equal risk. The old way of thinking was that the increase in cholesterol was the problem. The new way of thinking understands that the body is intelligent and that it has good reason for increasing cholesterol, and that what’s really happening is that in all those pre-menopausal years the higher levels of oestrogen exerted an anti-inflammatory effect (as steroid hormones commonly do) and as heart disease is an inflammatory disease this lowered the risk for pre-menopausal women. Then once menopause hit this protective effect disappeared and the risk of inflammatory diseases jumped to match that in men – the real issue here is to reduce inflammation, not lower cholesterol. Without cholesterol you can’t make oestrogen.
Fortunately for women, nature has the answer in the form of phytoestrogens – ‘phyto’ means plant – these are compounds in plants that exert a similar effect in the body to oestrogen. There are three main categories of phytoestrogens: isoflavones, lignans and courmarins. Isoflavones are found in soybeans, but to benefit from these a process needs to take place in the gut where certain bacteria convert isoflavones into active forms so a health gut is key. For this reason fermented soy products such as tamari suace, miso and tempeh are most beneficial. The best source of lignans is flaxseed, which is also high in omega 3 oils that have a beneficial anti-inflammatory effect. Other good sources of lignans are sesame seeds, kale, broccoli, apricots and strawberries. Coumestans are found in alfalfa and bean sprouts.
Tips to support oestrogen levels:
optimise adrenal health
don’t worry about the cholesterol, instead address inflammation
enjoy fermented soy products such as tamari, tempeh and miso
add flaxseeds and sesame seeds to meals
eat more alfalfa and bean sprouts
address issues with your gut flora to get maximum benefit from phytoestrogens
Stir-fired broccoli and beansprouts with tamari sauce sprinkled with sesame seeds.
Progesterone has an effect on the brain, and many menopause-associated symptoms are linked to the brain, including sleep problems, insomnia, anxiety, depression, memory and cognitive function. Due to the way hormones interact with each other it’s important to look at ratios as well as total amounts. Oestrogen has an excitatory effect on the brain, while progesterone has a calming effect. So if you’re looking to improve anxiety or promote normal sleep patterns it may be progesterone that you need. Progesterone is also a natural antidiuretic, so it helps control water retention and cellulite.
There are no foods that contain progesterone so the key is to support your body in making it. Before menopause it was the eggs released from the ovaries that made progesterone. After menopause it is the job of the adrenal glands. From the building block of cholesterol, the adrenals make a hormone called pregnenolone. From here pregnenolone can become either progesterone or cortisol. Cortisol is the ‘stress hormone’ and it always takes precedence over other hormones. If you have a high demand for cortisol then this is at the expense of progesterone.
Cortisol – the progesterone thief
Many of the symptoms associated with menopause are actually due to adrenal dysfunction and as the adrenal are the main source of oestrogen and progesterone after menopause it’s clear that supporting the adrenals is a good place to start. The main hormone made by the adrenals is cortisol and this will take priority over other hormones. Cortisol is produced in response to stress,
and not just the obvious types of stress you automatically think of – it could be the stress of chronic infections, toxins, blood sugar imbalances, nutrient deficiencies, lack of sleep, emotional stress and mental stresses. Knowing what distresses your body and working to reduce those things will take a massive burden off your adrenals. Thyroid dysfunction also leads to cortisol problems, so any thyroid issues you have may need to be addressed also. It also helps to support your adrenals with the specific nutrients they need to function, which are magnesium, vitamin C, vitamin B5, tyrosine and vitamin B6.
Foods to support the adrenals
Vitamin C – berries, citrus fruits, bell peppers, papaya, kiwi fruit, broccoli
Magnesium – dark chocolate, broccoli, spinach, chard, kale, pumpkin seeds, sesame seeds, sunflower seeds, cashew nuts
Vitamin B5 – liver, shittake mushrooms, crimini mushrooms, avocado, sweet potatoes, strawberries, sunflower seeds, cauliflower, broccoli, sweetcorn
Vitamin B6 – spinach, peppers, garlic, cauliflower, bananas, broccoli, lentils, sunflower seeds, walnuts, hazelnuts, salmon, halibut, sweet potatoes
Tyrosine – spirulina, eggs, cottage cheese, pumpkin seeds, sunflower seeds, pine nuts, flaxseeds, pistachios, turkey, chicken, pork
Tips to reduce cortisol
get to bed by 10pm
balance blood sugar levels by including protein and health fats with each meal
avoid blood sugar spikes by not snacking on carbohydrate and sugary foods
limit whatever stresses you can
avoid skipping meals as it can lead to hypoglycaemia
reduce stimulants such as coffee and alcohol
Baked sweet potato with cottage cheese and steamed broccoli
Serotonin and melatonin – for good mood and good sleep
When oestrogen drops, brain levels of serotonin, the ‘feel good hormone’, drop too leaving you with more unstable moods. Fortunately 95% of serotonin is produced in the gut – the second brain – so diet can really help here.
From serotonin we make melatonin, the sleep hormone which helps us get a good night’s sleep. melatonin also plays a role in body temperature control, especially keeping cool at night. Melatonin is mostly associated with the pineal gland, but in fact 400 times more melatonin is made in the gut than the pineal gland.
This explains how the downstream effects of oestrogen on serotonin leads to many symptoms associated with menopause such as mood instability, anxiety, insomnia and night sweats.
To ensure good production of serotonin and melatonin look to the health of the gut microbiome – the community of beneficial bacteria that supports our health. These bacteria thrive on fibre from fruits and vegetables – which are known as prebiotic foods. Certain fibres feed certain strains of bacteria, so variety is best. Some of the best prebiotic foods are asparagus, onions, leeks, garlic, artichoke, apples, bananas, root vegetables, cabbage and legumes. You can also support healthy bacteria using probiotic foods – foods that actually contain live beneficial bacteria such as raw sauerkraut, kimchi and kefir. Don’t buy pasteurised versions as all the beneficial bacteria will have been destroyed.
How to support healthy melatonin production:
cherries and goji berries provide melatonin
foods rich in tryptophan provide the building blocks for serotonin and melatonin – these include turkey, chicken thighs, nuts, seeds and bananas
Get bright sun exposure during the day
Sleep in darkness at night – it’s the contrast between day and night that works
Turn off the wifi at night – EMFs disrupt the pineal gland, which makes the melatonin at night
Turn off blue-light emitting screens an hour before bed as those light spectrums inhibit melatonin
Use soft orange and red lights at night as these don’t interfere with melatonin production
Registered Nutritional Therapist, Functional Medicine Practitioner
BA (Oxon), DipION, mBANT, CNHC, CFSP