I AM 56 and in the menopause. I eat healthily — organic fruit and veg, seeds, nuts, chicken, red meat once or twice a week, fish, including organic salmon, mackerel, sardines and tuna — take care of myself by walking, yoga and going to the gym, and do not take HRT, yet I still seem to suffer from hot flushes. I eat quite a lot of chocolate and also, now, cakes, which I never used to. I understand that a lack of progesterone causes a very sweet tooth and extra weight on the waist and hips, although I weigh around 9st (65kg) and am 5ft 2in (1.57m) tall. I drink two litres of water a day. Name and address supplied
Concerns about conventional HRT have made many women look to eating and lifestyle to help them to ride the waves of the menopause.
The first symptom that many women experience is hot flushes, or flashes, which can come out of the blue, are embarrassing, and mean they have to change the sheets at night. The first tip is to give up caffeine — I find that women who switch to good water-processed decaffeinated coffee or tea, or to herbal tea, find that their flushes become warm, not hot. You might have a headache for a day or two when you stop caffeine, but this passes, especially if you drink plenty of water to flush out the residues. I’d still have milk in tea and coffee — if you’re worried about the increased weight that often occurs with the the menopause, choose semi-skimmed or skimmed, both of which contain as much calcium.
You should also keep up your calcium intake so that your bones remain strong — weakening is more likely during the menopause because of the reduced oestrogen levels. Other good calcium sources include almonds, seeds (poppy, sesame), cheeses (parmesan, which is easy to digest and high in protein, gruyère and edam), oily fish (tinned sardines, etc), tofu, seaweed if you’re a fan of Japanese food, figs, yoghurt, Brazil nuts and leafy vegetables (kale, purple broccoli).
Soya is popular among menopausal women — it contains powerful phyto-oestrogens, natural substances that mimic the effects of oestrogen. Many find that soya milk, soya-based foods such as tofu, and other foods with oestrogen-like properties such as pulses (chickpeas, beans, etc), beansprouts, yams, most fruit and vegetables — can help to alleviate hot flushes. I’d recommend organic soya, which isn’t genetically modified, and try to stick to the unsweetened variety, as the others can be high in sugar. It’s thought that two glasses of soya milk a day provide enough phyto-oestrogens to make a difference. Miso and tempeh, a bean curd like tofu, are two other soya-rich foods to try. If you don’t want soya, a diet high in fresh fruits and vegetables of all sorts can also help you to ride the waves.
Vitamin E can also minimise menopausal symptoms, but don’t reach for supplements: you can glean enough vitamin E from plant oils (hemp, olive), seeds (linseeds, hemp seeds, sesame), wholewheat products (wholemeal bread, cereals), tinned tuna and asparagus. I’m a big fan of boosting omega 3 intake, as this can help to protect your heart — the Food Standards Agency says that unless we are of childbearing age we can eat up to four (140g) portions of oily fish a week — such as fresh tuna, salmon (organic), sardines, mackerel and herrings.
Oily fish are a great source of omega 3 fatty acids, otherwise look to nuts such as walnuts, and hemp oil (try Good Oil from Waitrose, which I think has the best taste). If you’re interested in herbal medicine, black cohosh, sage, agnus castus and red claw seem to be the ones to head for — available from health-food stores.
I noticed about four months ago that my scalp was dry and flaky, leaving horrible dandruff on the shoulders of my clothes. I have also lost some hair over the past nine months, which is distressing. My hair is fine but I had enough to ensure that it always looked good. I have now had a lot cut off. I started to use an organic natural shampoo about six weeks ago — the scalp has improved but the hair is still dry. Is something dietary amiss or is this hormonal? Name and address supplied
Many bald men take pride in the link that is often made between a balding head and high testosterone, but it’s different when women lose their hair. They find it extremely distressing, especially if it happens suddenly and their hair falls out in clumps, typically after a shock or illness. If you can attribute your hair loss to a traumatic event, illness or extreme weight loss, such as that caused by anorexia, your hair may grow back once your body has recovered. But if one of these triggers is not to blame, or you are losing your hair gradually, which can happen during the menopause, then although hormonal changes such as lowering of oestrogen have a strong influence, nutritional factors may play a part.
The most common nutritional cause of hair loss in women is low ferritin levels — ferritin being iron that is stored in the body rather than in the blood in the form of haemoglobin (which contains haem, or ferrous iron). Hugh Rushton, a trichologist, suggests that women should aim for a ferritin level of 70micro g/L to keep their hair. If a doctor’s test confirms that your ferritin is too low, you can either take an iron supplement (this may be essential) or eat more iron-rich foods such as lean red meat, green leafy vegetables, game, offal and pulses. But iron supplements are notorious for their negative effect on the gut and can cause it to contain too much “free iron”, increasing your risk of certain cancers. (If you are on iron supplements to correct low ferritin or haemoglobin, or proven iron-deficiency anaemia, don’t be alarmed — the warning is more against taking them as a self-prescribed remedy.)
By contrast, the iron that your body derives from foods has not been shown to increase cancer risk unless your diet includes too much red meat, and this is an issue only if it also lacks fruits and vegetables. A good compromise is to correct your ferritin level by eating more red meat (organic if possible) on a short-term basis, then to return to a diet based on fish and chicken. If you suffer from heavy periods, and therefore lose large amounts of iron every month, you may need to eat a lot of red meat regularly.The amount will depend on the level of loss and your body’s ability to absorb iron, but increase your antioxidant levels, thus protecting your body from cancer, by eating plenty of fruit and vegetables as well.
Many vegetarian women worry that their diet may not contain sufficient iron to balance their monthly losses, and it’s true that the body can’t absorb non-haem (non-animal) iron as efficiently as the iron in red meat and game, which is why vegetarians should eat lots of pulses and green, leafy vegetables such as spinach, kale and dark cabbage. But at least the vegetarian diet is based on fresh fruit and vegetables, and the vitamin C and other nutrients with which they are packed increase the amount of iron that the body absorbs.
According to Eastern medicine, kidney energy influences hair growth. As patients of mine who have suffered hair loss have told me, massaging your kidneys with your fists, using a circular motion, 18 times in each direction, and then applying a hot-water bottle to your lower back 18 times, preferably in the evening, at the same time as visualising thick hair on your head, is, if nothing else, a relaxing strategy. It’s worth a try.
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