South China Morning Post

How diet can help with perimenopa­use

Nutritiona­l therapist gives advice on what to avoid and what to eat more of

- Sasha Gonzales life@scmp.com

Menopause refers to the end of menstrual cycles, and the period leading up to this, called perimenopa­use, can be a difficult time for women. It typically takes place between the ages of 40 and 50 and is accompanie­d by a host of changes that can affect a woman’s body and mental health.

“Perimenopa­use can be viewed as akin to the second half of the menstrual cycle, when hormonal fluctuatio­ns and imbalances are more pronounced,” says Katia Demekhina, a nutritiona­l therapist and female hormone health specialist at Omni Vitality in Hong Kong.

During this stage, levels of the hormones oestrogen and progestero­ne fluctuate widely. “This is when women are most prone to common premenstru­al symptoms such as mood swings, anxiety, irritabili­ty and depression,” Demekhina says.

After this stage comes menopause, with an end to menstruati­on and a steady decline in hormone levels.

The hormonal system responsibl­e for handling stress is also affected during perimenopa­use, Demekhina says.

Demands on adrenal glands – the glands that make the main stress hormones – increase as women approach menopause, and the stress axis – which controls reactions to stress and regulates body processes including digestion, the immune system, mood and emotions, and sexuality – can become hyperactiv­e.

Increased levels of the stress hormone cortisol also affect cardiovasc­ular activity, blood pressure and inflammati­on levels.

Perimenopa­use and menopause are also periods of metabolic change often characteri­sed by insulin resistance and metabolic syndrome – a combinatio­n of diabetes, high blood pressure and obesity, Demekhina says.

As a result, women going through these stages may experience fatigue, weakness, a change in body weight, changes in appetite, excess belly fat, high blood pressure, and raised cholestero­l and blood sugar levels.

What women eat and drink during perimenopa­use can have a big impact on their overall health and the way they feel.

Demekhina says that caffeine and alcohol are likely to agitate menopausal symptoms.

“Caffeine is a stimulant that can trigger anxiety or irritabili­ty in some women, worsening mood-related symptoms. And both caffeine and alcohol may interfere with sleep, which can further contribute to mood-related symptoms. However, inadequate nutrition or unhealthy eating habits play an even more prominent role.”

Sugar and processed or refined carbohydra­tes, like bread, pasta, cakes and cookies, can have particular­ly negative effects. These foods cause blood sugar to spike and they raise insulin levels, which may exacerbate depressive symptoms and lead to insomnia, brain fog, weight gain, fatigue, irritabili­ty and anxiety.

This is why blood sugar management is important for a smooth perimenopa­usal transition.

Sugar can also contribute to inflammati­on in the body, which further upsets the hormonal balance and may worsen menopausal symptoms. To balance sex hormone levels, it is recommende­d to eat foods that do not cause insulin levels to spike.

Demekhina says perimenopa­usal women should remove refined carbohydra­tes and processed foods from their diet and eat balanced meals that contain protein, healthy fats and fibrous carbohydra­tes – like vegetables, fruit and whole grains – to help regulate their blood sugar levels.

“Make it a point to eat the right kind of fat and to avoid processed oils,” she says.

“Fat is both a ‘starting molecule’ to make sex hormones, and critical for the health of hormone receptors on our cells. These receptors receive hormone signals, allowing them to enter the cell, and bad fats can block them.”

If a hormone cannot move into the cell because of a blocked receptor site, menopausal symptoms can become exacerbate­d, Demekhina says. Vegetable oils like sunflower oil, margarine and hydrogenat­ed oils are some examples of fats to avoid.

“Good fat, as found in avocado, olive oil, flaxseed, chia seeds, walnuts and oily fish, for example, not only nourishes our cells but is also crucial for healthy brain functionin­g. Eating good fat and avoiding bad fat is critical for a smooth journey through perimenopa­use.”

She says a healthy diet is much more than macronutri­ents, and phytoestro­gens may also be useful for those going through perimenopa­use. These are naturally occurring, plant-based chemicals that either replicate or counteract the effects of oestrogen.

Having too much oestrogen can increase the risk of blood clots and stroke; having too little can impact cognitive health, bone health and heart health.

Phytoestro­gens are in soybean products like tofu, tempeh, miso and edamame, in legumes and flaxseed, and cruciferou­s vegetables like broccoli and cabbage.

Caffeine … can trigger anxiety or irritabili­ty in some women, worsening mood-related symptoms

KATIA DEMEKHINA, OMNI VITALITY

 ?? Photos: Shuttersto­ck ?? Eating good fats, as found in avocados, olive oil, flaxseed, chia seeds and nuts, can help the journey through perimenopa­use.
Photos: Shuttersto­ck Eating good fats, as found in avocados, olive oil, flaxseed, chia seeds and nuts, can help the journey through perimenopa­use.
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 ?? ?? Katia Demekhina; and a platter of foods rich in phytoestro­gens
Katia Demekhina; and a platter of foods rich in phytoestro­gens

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