4 Nutrition Considerations for Patients in Menopause

Who else wishes they got more menopause training? 🙋 Patients often share that menopause feels like a medical blind spot—a stage of life that is rarely discussed during consultations.

Let’s face it: menopause has a negative stigma. With health concerns compounded by life transitions (hello aging parents and empty nests!), most of us aren’t excited about this phase. I’m here to reframe menopause as a new chapter: a nudge to lean into nutrition as self-care.

Let’s dive into how to handle menopause conversations with sensitivity and clarity. Because YES, nutrition can make a difference!

{this article was written by Amy Corcoran, Registered Dietitian and Health Writer}

The Impact of Hormonal Changes on Nutrition Needs

The most significant change during menopause is a decline in estrogen production, primarily from the ovaries.

This decline in estrogen leads to the oh-so-lovely hot flashes, irregular periods, and mood changes we associate with this transition. We also see an increased risk of disordered eating, osteoporosis, heart disease, and muscle loss.

The good news? Nutrition can play a key role in managing menopause symptoms. Read on for insights on navigating weight discussions, bone health, cardiovascular health, and muscle mass.

Navigating Weight Discussions

Because of declining estrogen levels and aging, many women experience weight gain and changes in fat distribution during menopause.

These body changes often lead to patients seeking weight loss. When we add societal pressures around aging and body image, we have the perfect storm for disordered eating.

Instead of immediately jumping into weight loss discussions, try to shift the focus toward promoting healthy behaviors.

1. Dietary Adjustments: Encourage a diet rich in whole foods—fruits, vegetables, lean proteins, whole grains, and healthy fats–for nutritional adequacy and optimal metabolic health.
2. Physical Activity: Regular exercise, combining both aerobic movement and strength training, can help maintain muscle mass and support metabolic health. Ask patients to consider what movement brings them joy.
3. Lifestyle Changes: Beyond nutrition and movement, consider exploring stress reduction and sleep hygiene with your patients.

While we always respect our patients’ goals, gently reframing food as a friend rather than an enemy can help foster a healthy relationship with food.

Supporting Bone Health

Menopause reduces bone density due to declining estrogen levels. This is of particular concern during the early postmenopausal years and in patients of lower body weights. Here are some quick pointers to integrate into visits:

1. Calcium and Vitamin D: The calcium RDA increases from 1,000 to 1,200 mg for women over 50, which can be reached through supplementation, dairy, leafy greens, and fortified foods. To maximize calcium absorption, ensure adequate vitamin D intake (RDA 600 IU) from supplements, fatty fish, and fortified foods.
2. Physical Activity: Weight-bearing exercises, such as walking, stair climbing, or resistance training, can promote bone density.
3. Bone Density Screenings: Encourage regular screenings to monitor bone health and guide supplementation or dietary changes.

--------------------------------------------------------------------------

Imagine if you felt confident answering your patient's nutrition questions?

And you could provide advice that actually improved their health outcomes?

Right now you're reading a small part of the Nutrition Wrap-Up newsletter.

I release a NEW issue like this each Sunday.

Join 1,000+ smart clinicians who read the Nutrition Wrap-Up weekly.

Subscribe today to get the latest issue (plus a few helpful freebies)

---------------------------------------------------------------------

Managing Cardiovascular Health

During the menopause transition, many women experience higher rates of high blood pressure, lower HDL levels, and elevated LDL and triglycerides.

These changes are because estrogen has a protective effect on heart health, and menopause can lead to changes in the vascular system. These changes point to a greater need to implement a heart-healthy diet rich in:

1. Omega-3 fatty acids: Found in fatty fish (like salmon and mackerel), walnuts, and flaxseeds, these healthy fats help reduce inflammation and lower triglyceride levels.
2. Soluble fiber: Soluble fiber, found in oats, beans, lentils, fruits, and vegetables, can help lower LDL cholesterol.
3. Antioxidants: Found in fruits and vegetables, particularly berries, dark chocolate, and leafy greens, antioxidants help combat oxidative stress and inflammation.
4. Potassium: Found in bananas, sweet potatoes, spinach, and avocados, potassium helps regulate blood pressure by balancing sodium levels.

Encourage swaps for foods high in saturated fat, such as using olive oil instead of butter or choosing lean proteins like chicken breast or legumes instead of fatty cuts of red meat; and encourage whole grain products instead of refined grains.

Maintaining Muscle Mass

Menopause may accelerate age-related muscle loss as estrogen levels decline. Focus conversations on prioritizing protein intake and implementing strength training.

Encourage protein sources such as poultry, fish, legumes, and low-fat dairy products.

• Start the day off with protein-packed oatmeal, smoothies, or eggs.
• Try protein-rich snacks like Greek yogurt, cottage cheese, nuts, or protein bars.
• Try adding silken tofu to soups and smoothies.
• Choose higher-protein grains like quinoa or farro instead of white rice or pasta.

Encourage regular strength training exercises to combat muscle loss. Highlight activities like weightlifting, resistance bands, or even bodyweight exercises.

FAQs

What about phytoestrogens?

Phytoestrogens (e.g., isoflavones, lignans, coumestans) are plant-derived compounds that mimic estrogen in the body. Common sources include soy, lentils, legumes, flaxseeds, whole grains, vegetables, and sunflower seeds.

As estrogen levels decline, phytoestrogens may help alleviate menopause symptoms by binding to estrogen receptors. A 2021 review found limited evidence they could enhance bone mineral density, reduce hot flashes, and lower cardiovascular risk.

Advise patients to add half a cup of soybeans, lentils, or chickpeas to salads, soups, or pasta dishes; sprinkle flaxseeds or sunflower seeds into smoothies and salad dressings; and choose whole grains like barley, buckwheat, and rye.

Are there specific foods that can help with hot flashes?

While no specific foods can help with hot flashes, there is research to support plant-based diets, as seen in this 2016 JAMA review and a small, 12-week randomized controlled trial of a plant-based diet and whole soybeans. This is likely due to phytoestrogens found in plants.

Should I take supplements during menopause?

Some patients may benefit from supplements, such as calcium, vitamin D, or omega-3 fatty acids to support bone and cardiovascular health.

Bottom Line

Many of my patients are surprised to learn that nutrition can play a role during menopause. As healthcare providers, our goal is to support patients in embracing this transition with confidence.

Let’s reframe menopause as an opportunity to use nutrition as self-care. In doing so, we empower our patients to take charge of this phase of life.

Connect with the author:

Amy Corcoran is a dietitian at Dietitian Driven LLC and a health writer driven to bring more peace, understanding, and evidence-based practices to nutrition.