Issue 128: Boo! It's Menopause!

Happy Halloween! 🎃👻 Snuggle up with some popcorn and watch a scary movie! Enjoy your candy! (Also, in case you wonder where I stand on candy, watch this from The Nutrition Tea on Instagram. She captures my own thoughts exactly).

My friend Amy and I were talking the other day, and she observed, “I don’t think there’s enough info out there for women. I’d like to hear more about navigating women’s health in your 60’s. What foods help at this time of life?”

It’s a great question! Time for some insights for your 60’s and beyond. And if you think this is just for women of a certain age, think again! Everyone will learn something important from this issue.

In Wellness, Mary Virginia

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Women who are in perimenopause and menopause are often blindsided by a bunch of pretty well known symptoms: hot flashes, night sweats, sleep disruptions, mood swings, an increase in headaches, brain fog, and other uncomfortable features of hormonal shifts.

As we move into our late 50’s and 60’s, we might experience other changes. Bones become a bit more porous. We lose strength and muscle. Our hair and skin seem to dry out overnight. Our bodies change shape and begin to deposit padding where we might prefer it not reside.

And then there are those kind of shocking surprises that no one mentioned: Our cholesterol often rises. Our tendons change, putting our hips, knees, and shoulders at risk for pain and injury (check out this article on gluteal tendinopathy). Food doesn’t digest as well. Ears might start to ring with tinnitus. Our heart feels like it beats harder. We develop phobias and anxiety that never existed before. And, irritatingly, sometimes we can’t hold our urine. I suppose the good part is that we don’t have to deal with periods anymore!

The Change

Sometime in our 40’s/early 50’s, estrogen and progesterone levels drop. By the way, this is true for all genders and sexes. Most of us know that these hormones play important roles in reproduction, but we didn’t know they affected so many other aspects of our bodies! I’m not going to give a whole science lesson on this, but here are a few fun facts to understand it better.

Definition of Menopause: The cessation of menstruation for 12 months, not caused by reversible illness, overexercise, inadequate weight, or nutritional depletions.

Cholesterol: The sex hormones DHEA, testosterone, estrogen, and progesterone are made from cholesterol. The liver keeps making cholesterol as we age, but as the ovaries and other tissues decrease in hormone production, cholesterol begins to rise. Notably, a higher total cholesterol as we age appears to be brain protective (the brain is 60% fat and the myelin sheath that protects the neurons of the brain is made from cholesterol).

DHEA (dehydroepiandrosterone) is made in the adrenal glands and is the precursor to all the other sex hormones.

Testosterone is produced by every gender and sex. In those with ovaries, nearly half of available testosterone is made there. In menopause, women can show signs of testosterone deficiency: low energy, increase in fat storage, loss of strength/muscle tone, depression/anxiety, thinning hair, etc. Read more here.

Estrogen is also produced in all sexes: gonads, ovaries, adrenal glands, and fat cells.
In everyone, estrogen is required for sex drive. Low estrogen tanks it.

The Cleveland Clinic writes this about the “non-reproductive function of estrogen”:
“Estrogen regulates important processes in your skeletal, cardiovascular, and central nervous systems that impact your overall health. Estrogen affects:

• Cholesterol levels.
• Blood sugar levels.
• Bone and muscle mass.
• Circulation and blood flow.
• Collagen production and moisture in your skin.
• Brain function, including your ability to focus.”
  

Estrogen receptors are not just found in reproductive organs and breasts. They are also found in bone, brain, liver, colon, skin, and salivary glands.

Progesterone is a calming hormone. It supports duration and quality of sleep and a balanced mood. Our adrenal glands (think stress response) are a primary producer of progesterone. You can connect the dots about what this means for stress resilience, mood, and sleep during perimenopause and menopause as progesterone levels fall. Read more about progesterone here.

I mean, this part of life sometimes is no joke. It’s time to adapt our choices to our more mature needs!

The New Normal

As our bodies move into the next stage, they do a lot of rearranging and resettling. Luckily, we have nutrition science and clinical experience to support our next steps!

From here on, I’m just going to give you nutrition and some lifestyle tips that will support you feeling your best as you live into your fabulous menopausal status. These will improve both physical and mental health.

HCl, aka Stomach Acid

We produce less stomach acid as we age. Stomach acid is necessary to digest food and absorb nutrients well, especially animal protein and fats. We also need it to kill pathogenic microorganisms we incidentally swallow along the way so we don’t get sick.

Eat these to support appropriate stomach acid:

• Lemon water or lemon in tea before and/or with your meals.
• Add raw apple cider vinegar to your salad dressings or otherwise use as a condiment, or drink some mixed in water in place of the lemon.
• Bitter greens and vegetables, like spinach, kale, collards, mustard greens, and cruciferous vegetables, like arugula, bok choy, broccoli, Brussels sprouts, cabbage, and cauliflower.
• Cook with bitter herbs, like chervil, ginger, fenugreek, thyme, marjoram, rosemary, tarragon, sage, oregano, coriander, and turmeric (not a complete list). This looks like a good article about them.
  
  

Read more about this Secret Sauce to Good Digestion. Remember, low stomach acid mimics the symptoms of much more rare high stomach acid. Don’t take an acid blocker. See a nutritionist.

Cholesterol/Blood Sugar

I put these two together because spikes and dips or steadily high blood sugar has a profound impact on cholesterol balance, especially LDL and triglycerides.

Eat these foods to support healthy cholesterol and blood vessels, and to keep your blood glucose balanced and your energy steady all day:

• Eat your veggies!
  
• Minimum 2 cups (raw) of leafy greens daily and 1 cup of cruciferous veg daily.
  
• Unlimited: Every color of the rainbow of other vegetables. The phytonutrients and fiber of colorful veg help reduce inflammation, LDL, and triglycerides.
  
• 1-2 servings of whole grains daily, especially whole grain oatmeal and/or barley. The beta-glucans in these grains trap excess cholesterol in the stool and remove it before it can be reabsorbed into the body.
  
• (Incidentally, these will keep your bowel habits regular, which you also need more right now. Remember: fiber, fiber, fiber!!).
  
• 2-3 servings of healthy fats daily.
  
• Protein, complex carbohydrates, healthy fat every time you eat for blood sugar balance and steady energy. Go deep on this here.
  
• Take a 5-10 min walk after you eat.
  
  

Bones

Most of the women I know are clear that they need to keep up their calcium to assure strong bones into their older age, but it’s a bit more complicated than most people realize. We need vitamin D to help us absorb calcium and vitamin K to drive the calcium into our bones rather than our soft tissues, like the heart muscle. For this reason I recommend food, not calcium supplements. It’s really easy to get the nutrients we need for bone health.

Eat these foods to get the balance of vitamins D and K and the mineral calcium:

• Vitamin D
  
  • Mushrooms
    
  • Egg yolks (always eat the whole egg. So much nutrition!)
    
  • Liver
    
  • Salmon, sardines, tuna, herring, halibut, cod (all wild caught for the most vit. D).
    
  • Fortified milks, non-dairy milks, and orange juice.
    
  • Also, expose skin to midday sun for 5-30 minutes.
    
• Vitamin K
  
  • Check out the leafy greens and cruciferous vegetables list above. No, really! These are such incredible powerhouses of nutrition!
    
• Calcium
  
  • Leafy greens and cruciferous veg - again! Point made, right?
    
  • Dairy products (milk, cheese, yogurt, etc.), non-dairy milks, some fortified orange juice.
    *Note for those who are dairy free: some non-dairy milks are great sources of calcium, such as Califia Farms Complete and Ripple Plant Based Milk. These both have the same or more calcium than cow’s milk and the same amount of protein, plus other nutrients.
    
• Weight lifting reliably strengthens bones. Get a trainer.
  
  

Tendons

Collagen is what builds and maintains connective tissues like tendons and other tissues like hair, skin, and nails. And what do you need to make collagen? Vitamin C and protein. If you are eating adequate vitamin C rich foods and protein, I don’t see the need for a collagen powder supplement.

Eat these vitamin C rich foods to support collagen production:

• Bell peppers, especially red and green ones.
  
• Oranges and other citrus fruits.
  
• Berries, bananas, kiwi, cantaloupe, mango, and other fruits.
  
• Broccoli, cabbage, cauliflower, kale, spinach, etc. (seeing a trend here?).
  
• Tomatoes and tomato products.
  
  

Muscle/Strength

Protein becomes even more essential as we age because all of our tissues need the amino acids to build, repair, and maintain them.

Eat these protein-rich foods to support muscles and strength:

• Poultry, beef, lamb, shellfish, fish, eggs - as close to grass fed/pasture raised/wild as you can.
  
• Beans/legumes paired with a whole grain to make a complete protein.
• Tofu, tempeh.
• Nuts and seeds, esp. pumpkin, sunflower, walnuts, almonds, pistachios.
• Dairy, such as Greek yogurt and cheese, if you tolerate it.
  
  

Increase the amount you move your body to 150 minutes of moderate exercise a week or 75 minutes of vigorous exercise a week. Mix up aerobic workouts (like walking, jogging, dancing, biking, etc.) with weight bearing exercises like weight lifting and movement that uses your own body weight, like yoga.

Sleep

Adequate sleep is critical for every function of your body. It washes metabolic breakdown products from your brain and repairs and rejuvenates your cells. Try these to enhance your sleep:

• Move your body! Regular exercise supports quality sleep.
  
• Expose your eyes to morning sun for 5-10 minutes. Morning sun triggers the wakeful hormone cortisol in the morning and the sleep hormone melatonin at night.
  
• Take a hot bath before bed with epsom salts, which are rich in magnesium.
  
• Take a magnesium glycinate supplement, 200-400mg nightly. Start low and gradually increase. Glycine is calming and magnesium relaxes tight muscles.
  
  

Live Your Best Life

Menopause and our 60’s can actually be a really great time for our bodies! We will certainly take stock of how the life we have lived is showing up in what our bodies are doing and our health status. But we are not static. Our health future is not a given. We have neuroplasticity in our brains long into our old age, which means we can learn new things, take on different perspectives, and rise to new challenges. We are adventurers!

Our bodies are showing us that they are in a new phase, and in new phases they will change. This is normal and to be expected. We are not losing some mysterious game by having a rounder middle, and there’s absolutely nothing true about healthy older people naturally losing our memory.

Step into this evolving iteration of yourself. Embrace it, nourish it, love and admire it. Change is the only given. Decide what you want your future to be, and go for it!
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