Post-menopause is a phase that makes up a significant portion of a woman’s life, yet it doesn’t always get the attention it deserves or requires. During this life stage, you may find yourself adjusting to a new ‘normal’ in a multitude of ways—aside from the hormonal shifts that occur as we enter this phase, there may be career changes or changes in family dynamics, with children growing up and moving away to study or work, for example. As you move into this next phase, more opportunities for you to focus on yourself may arise—to prioritise your own health and happiness—and it’s important you feel supported to do just that.
If you’re familiar with my work, you’ll know that I examine health using three pillars—the nutritional, biochemical and emotional. So, let’s explore post-menopause through these lenses.
Vitamins and minerals
Post-menopause, there are a few nutrients that we need in greater amounts than we did prior to this life stage. Most women are aware of the importance of adequate calcium intake, given that health messages for post-menopausal women are commonly focused on bone health—you can read my blog on bone health here for more information on this. But our requirements for some other nutrients change too—we require more vitamin D and vitamin B6, and less dietary iron, for example. Because we no longer lose some iron via menstrual bleeding, it’s especially important not to supplement this mineral unless you have confirmed that this is necessary via a blood test (the blood test to have your iron status assessed by your GP is called “iron studies”).
A nourishing way of eating that focuses on mostly whole foods—aiming for at least five serves of vegetables every day—is especially important, to help prevent the development of chronic diseases and to maintain an excellent quality of life, with great energy and vitality. Including plenty of colourful plant foods will provide your body with a plethora of antioxidants that help to reduce oxidative stress, preventing damage from free radicals which can accelerate ageing and degeneration from the inside out. As we continue to age, the body’s thirst signals can also become less pronounced, so setting up a habit of drinking plenty of water each day can be really beneficial, as is adding electrolytes to some of your glasses of water.
After menopause, our levels of estrogen and progesterone are significantly lower. This is completely normal – it is supposed to be this way – and it’s your body’s wisdom deciding that high circulating estrogen levels are no longer right for you. However this shift in our hormonal pattern does alter our biochemistry, and we lose some of the gifts that the higher sex hormone levels provided us with during the menstruation years, such as the anti-anxiety effects of progesterone, the utilisation of cholesterol for the creation of sex hormones and estrogen’s positive effects on our cardiovascular system. We also obtain benefits from these lower levels of sex hormones, such as freedom from the ebbs and surges of estrogen that can have caused myriad challenges such as heavy blood loss and a low mood.
Some of the key body systems and organs that we want to take extra special care of post-menopause include the brain, heart (and vascular system), bones, liver and endocrine system—particularly the adrenals, thyroid and pancreas.
After the ovaries cease their production of estrogen and progesterone, one hormone whose levels are not significantly altered post-menopausally is testosterone (although it does gradually decline with age). The adrenal glands continue to produce testosterone (some studies postulate that the ovaries continue to make it too, but a consensus is yet to be reached) which the body can convert into estrogen. An enzyme called aromatase catalyses this conversion, however, we don’t want too much estrogen (or aromatase) post-menopausally, because of the risks of estrogen-receptor-positive reproductive cancers. One of the most important health steps we can take post-menopausally is to ensure we are not making excessive amounts of aromatase.
Most of the aromatase inhibitors in nature are found in plant foods. The class of antioxidants known as flavonoids are particularly potent and are important inclusions in how we eat. One of the challenges we face however, is that plants primarily produce their flavonoids as a mechanism of defence in response to attack by pathogens. So, when plants are sprayed with herbicides, they don’t need to switch on their innate production of these protective substances (as much, or possibly at all). This means that we can end up with foods on our plate that are supposed to be rich in protective flavonoids, which are not. This is a major reason why choosing biodynamically or organically grown, or spray-free food is so important, as is ensuring we are eating our “7-a-day” (a minimum of five serves of vegetables and two serves of fruit per day).
Body fat storage
When estrogen levels reduce significantly (which naturally occurs as we transition into the post-menopausal phase) this alters where the body stores fat and can contribute to a change in our body shape. During the menstruation years, higher levels of estrogen promote body fat storage around the hips and thighs, and when estrogen levels drop lower around menopause, our fat storage pattern shifts, and body fat tends to be stored around our middle instead. This increases the risk of what is known as metabolic syndrome – elevations in blood fats and cholesterol, as well as blood glucose and blood pressure. Body fat levels don’t have to increase across the menopause years, yet this has become quite common. The nine factors that influence whether the body gets the message to store fat or use it as fuel, such as stress hormones, thyroid function and insulin, become even more important to understand as time goes by. You can learn more about the nine factors here.
The reduction in estrogen and potential increase in abdominal body fat, along with other factors, can increase our susceptibility to insulin resistance. In an insulin resistant state, insulin production increases in an attempt to overcome the resistance—picture the body having to start to shout to make sure its message is heard, rather than simply expressing its message at a normal volume. Insulin is a vitally important hormone involved in blood glucose regulation, but it is also an energy (glucose and fat) storage hormone, and consistently elevated insulin levels can ultimately lead to deteriorating metabolic health and difficulties shifting excess body fat. Some key things to focus on to support insulin sensitivity include prioritising restorative sleep, implementing stress management practices and moving your body regularly. Focusing on a whole food way of eating and minimising (or omitting) highly processed foods and drinks is crucial, too.
After menopause, the levels of fats (lipids) in our blood—such as cholesterol—also commonly tend to move in a direction that isn’t ideal. This is due to a variety of biochemical changes that occur post-menopause – one being that you no longer need to convert nearly as much cholesterol into estrogen. Blood lipid increases also tend occur at this stage, as over time, and as a result of too many poor-quality food choices, fat accumulation in the liver can start to disrupt some of the liver’s vital tasks, including those involved in estrogen clearance from the body and blood glucose regulation. Again, regular movement is helpful, as well as supporting the liver by focusing on choosing predominantly whole foods (particularly plenty of plant foods).
Movement and food choices
If you are feeling a little overwhelmed with where to start when it comes to supporting your health, remember that nothing in the body stands alone. So, one strategy or action you take is going to have a ripple effect and will support a number of different body systems simultaneously. A good example of this is regular movement—particularly resistance exercise such as weights or any type of movement where your own body weight is resisted, such as yoga, Pilates, farm work, gardening, etc. Not only is this helpful for maintaining our muscle mass and strength, it’s also great for our metabolic rate, bone health, mood…the list goes on. Similarly, choosing more whole foods and fewer highly processed foods is going to offer your body a long list of benefits.
Fill up your cup
So often the focus is on the more challenging aspects of menopause which can lead us to forget that this can be such a wonderful time. In cultures or circles where connection has been maintained or re-established with traditional values and practices, menopause is recognised as a time when the flow of wisdom is no longer disrupted, the way it tends to be across the menstruation years. It can also be a time where, after many years of prioritising the care of others, we may feel that it’s time to fill our own cup, with respect to our health and happiness.
Aim to stress less
Stress can stem from our responses to such a wide range of situations, it is rare for people today in Western countries to have much space without the stress response switched on, with adrenaline and/or excess cortisol coursing through their blood. Produced by the adrenal glands, stress hormone production is a top priority because to the body, stress equals danger. Post-menopause, the adrenal glands are also a key site for sex hormone production, so these tiny glands have some big tasks! There are numerous techniques that can be helpful for managing stress, including meditation, tai chi other breath-focused practises, however, we tend to benefit even more when we also consider what stress really is for us. Exploring your emotional landscape can be incredibly rewarding to your health, as it can help you start to turn the tap off on your stress response, rather than simply trying to manage it.
A final note on menopausal symptoms
For some, entering the post-menopause phase brings welcome relief as any turmoil experienced during perimenopause has now eased. For others, symptoms relating to the menopausal transition such as hot flushes, night sweats or mood-related symptoms, persist into post-menopause, and they’re left wondering when things will improve for them. If this is you, know that support is available and there are things you can do to support your body and ease your suffering during this time. You might also like to check out this blog post for more ways that you can support yourself post-menopausally.