While menopause may be inevitable for women, its effects are also highly variable and individual. HFG senior nutritionist Rose Carr investigates the truth behind stories about menopause and what we can do to make the best of it.
Hormones are making me gain weight
During menopause hormones change and many women tell us they experience weight gain — especially around the stomach — which can’t be shifted. Science plays a part, with animal studies showing that oestrogen seems to help regulate body weight. The theory is that oestrogen plays a role in metabolism or that maybe it could influence how we process carbohydrates.
Myth or truth?
The weight of evidence says this is half myth and half truth. There are numerous studies demonstrating an association between weight gain and the time around menopause but it’s now believed the steady weight gain, on average half a kilo a year, is linked to age and not the hormonal changes of menopause.
The fall in oestrogen, however, does influence where that fat goes, and storage in the central abdominal area is now favoured.
The facts
There’s no doubt hormone levels are changing in the years leading up to menopause. Production of the main female hormone oestrogen is declining. Unfortunately, this doesn’t happen in a smooth fashion. The decline can be quite irregular and sometimes we can even produce more oestrogen than we did before this phase in life. Production of progesterone, previously cyclical, stops altogether after the final menstrual period. Testosterone production also declines as we age but it’s not specifically affected by menopause. These hormonal changes are not causing any actual weight gain, but if you are gaining weight, it’s now more likely to head for the stomach area.
What you can do
Let’s think of this as good news! Weight gain is not inevitable around menopause. We can maintain a healthy weight at this time with a healthy diet and exercise. Our metabolic rate will decline as we get older, so we do need to modify our food intake slightly, over time, to keep the balance of kilojoules consumed versus those used.
A study of more than 3000 women in the US aged from 42 to 52 years found increasing girth and weight was not linked to menopause, but rather the amount of physical activity they were doing (or not doing). So the message is to keep on moving. Even gentle exercise such as walking every day is great for health. And don’t forget to include some resistance exercise for muscle tone. Maintaining muscle mass is very important for balance in our older age and a more immediate benefit is that muscle burns more energy than fat.
Menopause has made my skin dry
In their 50s many women notice their skin becoming drier and those wrinkles rapidly gaining ground. Menopause is so unfair!
Myth or truth?
Another half myth and half truth. Hormonal changes, and falling oestrogen in particular, do seem to contribute to drying skin but there are other factors, such as just getting older. The cumulative effects of sun exposure and smoking both have a big impact on skin ageing.
The facts
Skin ageing is different for everyone. It’s affected by our genes, our environment and our hormones, especially oestrogen, as this has a role in the growth and maintenance of blood capillaries within skin. As men age their oestrogen levels also fall, affecting skin ageing, but the fall is less dramatic than for women.
As oestrogen declines, blood flow in the skin is reduced which contributes to slower cell turnover and thinning of the skin. This means the barrier function of skin reduces so that increased water loss through the skin causes skin dryness. At the same time, one of the effects of fat now heading towards the abdomen is a loss of those supportive fat deposits below the skin surface on our face, neck, hands and arms. This means thinning, drying, sagging and wrinkling.
What you can do
We may not be able to stop getting older but we can maximise skin health at any age. Long-chain omega-3 fats found in oily fish are thought to help protect skin from sun damage. Good hydration is vital for skin so make sure you’re getting enough water each day and limit alcohol as this dehydrates the skin and can damage it over time. Exercise also supports skin health as it can improve circulation and boost the immune system.
Protecting our skin from sun damage, balanced with some sun exposure so we get enough vitamin D, is also an important goal at any age.
Menopause increases the risk of diseases
Menopause isn’t just about hot flushes, women are now more susceptible to heart disease as well as osteoporosis.
Myth or truth?
True.
The facts
Heart disease is not just a male issue, it is a concern for women, too, especially after menopause.
Oestrogen helps arteries maintain flexibility and strengthens their interior walls so the lower oestrogen level in post-menopausal women is implicated. The American Heart Association believes lower oestrogen isn’t the only reason for increased risk and researchers are actively searching for more comprehensive answers. Other changes women go through at this life stage include increasing blood pressure and changes in cholesterol and triglyceride levels which can also increase heart disease risk. Some of this is related to menopausal changes but weight gain and simply ageing have an effect as well.
Oestrogen also helps control bone loss so falling oestrogen means women now lose more bone than is replaced. In time, Bones can become weak and break easily, a condition called osteoporosis.
What you can do
Observing a heart-healthy diet and lifestyle minimises our disease risk at any stage of life. And it’s never too late to improve our health if we need to quit smoking, lose a bit of weight or up the exercise.
Getting enough calcium and vitamin D to support bone health is also important throughout life and after menopause women’s needs for these increase.
Menopause causes depression
Many women report extreme mood swings, even feeling depressed around menopause.
Myth or truth?
Myth. Menopause does not cause depression. It’s true hormonal changes can contribute to mood changes at this time but moderate to severe depression is no more common in women around menopause than at any other life stage.
The facts
There are a couple of theories about mood swings at this time of life. The oestrogen withdrawal theory says in women at risk of depression, reduced oestrogen drives worsening mood swings. Supporters of this theory point to oestrogen’s links with brain levels and metabolism of neurotransmitters which can affect emotional pathways.
Alternatively, in the domino theory, symptoms such as hot flushes and night sweats disturb sleep and the lack of sleep causes mood changes during the day. Of course both of these could be working at the same time.
What you can do
It’s important to seek help for depression and your GP will know how to find appropriate help. But for those who are just moodier than usual, some small changes might help. For most of us a lack of sleep affects our mood and general ability to cope, so doing everything we can to get enough sleep is a good place to start. Exercise, which can be as simple as a lunchtime walk, has both immediate benefits in terms of lifting our mood as well as helping release tension and aiding sleep later on. Progressive muscle relaxation, meditation, breathing techniques, t’ai chi and yoga are just a few stress-relief methods we can use. Or try listening to relaxing meditations or music. It’s a matter of finding something that appeals and works for you.
Menopause causes sleep problems
Sleep disruption is one of the most common complaints reported around menopause.
Myth or truth?
True. It’s certainly true that hormonal changes at this time can cause disrupted sleep, possibly affecting up to 60 per cent of women. Remember though, there are many factors that affect the quality of our sleep, so if this becomes a problem for you be sure to review all possible causes. There may be more than one.
The facts
Hot flushes and night sweats, the most common symptoms of menopause, are often severe enough to wake women while sleeping and some can be woken many times during the night. Remember: oestrogen levels are not falling smoothly so the occurrence and severity of these symptoms can be erratic.
And that body fat that’s now directed to the abdomen means women are also more susceptible to abnormal breathing while sleeping. Hormonal changes may also restrict air flow in the upper airway, in some cases causing sleep apnoea (which can be serious), typically accompanied by snoring.
While the role of hormonal changes is not fully understood, restless legs (also common during pregnancy) is frequently reported as a cause of sleep disturbance for women during menopause.
What you can do
The night sweats might be beyond our control but there are some things we can control. Both caffeine and alcohol can impact the quality of sleep. For people especially sensitive to caffeine, it’s advisable not to have any caffeine-containing food or drinks six to eight hours before going to bed. That includes coffee, tea, chocolate, chocolate drinks, cola and energy drinks. And while a large glass of wine might help us get to sleep, any more can wake us in the night as the breakdown products of alcohol disturb the quality of our sleep. Regular exercise helps promote sound sleep as it releases tension and helps the body relax.
Five things to include in your diet to keep yourself feeling great
- Loads of colourful veges: It’s never too late to up the ante on low-kJ, high-nutrient vegetables.
- Three to four serves daily of low-fat dairy: Increased calcium needs are most easily met by including more low-fat dairy. Try a glass of trim milk at breakfast, snacks of reduced-fat cheese and crackers and a pottle of low-fat yoghurt, and for dessert a low-fat ice cream with fruit.
- Oily fish such as salmon, sardines, tuna, mackerel and kahawai is our best source of long-chain omega-3s. Aim for at least two to three serves each week.
- Water, whether plain or in herbal teas, is the best way to stay hydrated. Aim for around eight cups each day, more in hot weather.
- Nuts and seeds contain heart-healthy fats. Try snacking on a small handful of nuts each day and add seeds to salads.
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