Foods to support health through menopause
Originally written by Julie Gough, a nutritionist specialising in women's health. Updated by femme to separate useful nutrition advice from claims that are stronger than the evidence.
Food can support bone, heart, gut and general health through perimenopause and menopause. What it cannot reliably do is “balance” reproductive hormones or replace treatment for troublesome menopause symptoms.
What changes during perimenopause and menopause?
During perimenopause, ovarian hormone levels fluctuate and periods often become less predictable. Menopause is reached after 12 months without a period when this is not caused by another condition or treatment.
Symptoms can include hot flushes, night sweats, sleep problems, mood changes, vaginal symptoms, joint or muscle pain and sexual difficulties. The experience varies widely.
Build the diet around long-term health
Vegetables, fruit and wholegrains
These provide fibre, vitamins, minerals and a wide range of plant compounds. Variety matters more than a particular “detox” vegetable.
Protein
Regular sources such as fish, eggs, dairy, tofu, beans, lentils, meat or alternatives can support muscle maintenance as we age.
Calcium and vitamin D
Bone health becomes particularly important after menopause. Include calcium-rich foods and follow current UK vitamin D guidance.
Unsaturated fats
Olive oil, nuts, seeds and oily fish can form part of a heart-healthy eating pattern.
What about phytoestrogens?
Foods such as soya, tofu, tempeh, beans and flaxseed contain phytoestrogens. NICE notes that there is some evidence isoflavones may relieve vasomotor symptoms, but preparations vary and interactions can occur.
Eating soya foods as part of a balanced diet is not the same as taking a concentrated supplement, and phytoestrogens should not be described as a direct natural replacement for HRT.
HRT and diet are not competing options
Current NICE guidance recommends offering HRT for vasomotor symptoms associated with menopause, with benefits and risks discussed for the individual. Menopause-specific CBT is another evidence-based option for some symptoms, including when HRT is unsuitable or not wanted.
Diet can support health whether or not somebody uses HRT. It does not need to be framed as an “alternative” capable of producing the same effect.
Gut health without the hormone claims
Fibre-rich foods, fruit, vegetables, wholegrains, pulses and fermented foods can support a varied diet and gut microbiome. Research into the gut microbiome and hormone metabolism is developing, but claims that a particular food “detoxes oestrogen” or prevents breast cancer through gut enzymes go beyond what this article can responsibly promise.
A Mediterranean-style pattern
A Mediterranean-style diet rich in vegetables, fruit, wholegrains, pulses, fish, nuts and olive oil is associated with cardiovascular and metabolic benefits. It is a sensible pattern for long-term health through midlife.
It should not be advertised as the proven “best diet” for eliminating menopause symptoms. Individual symptoms may still need medical treatment.
The bottom line
Use food to nourish your body through menopause, not to create another set of rules. Prioritise variety, protein, fibre, calcium-rich foods and unsaturated fats. If symptoms are affecting daily life, discuss HRT and other evidence-based treatments with a healthcare professional.
Current guidance
NICE: Menopause – identification and management
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