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Can a vegan diet help during menopause?
Towards the end of the 40th year of life, a woman’s life enters a new phase, which is often characterized by typical symptoms such as hot flushes, mood swings or even sleep disorders. These symptoms are caused by a hormonal transformation process, which at the same time reduces health protection against certain diseases. Women enter menopause at this stage of life. Diet and lifestyle have a significant impact on well-being during this time, and it makes sense to pay attention to a few factors, not least to prevent disease. But what exactly happens during the menopause? What about a vegan diet during menopause? What about soy during menopause? Below you will find answers to all these questions.
Menopause: What Happens?
Menopause, also known as the climacteric, is the time when a woman loses her period and, at the same time, her fertility due to a decrease in estrogen levels and, consequently, a decrease in ovarian function. The reason for this is that the supply of eggs, in which the “female hormones” (estrogens, progestins) are formed, is naturally limited and cannot be replenished at a certain point.
German women are on average 51 years old when they enter the menopause, which is defined as the last natural menstrual period followed by 12 months without a natural menstrual period. Postmenopause refers to the period after the last period (menopause) (VDD, 2008).
For most women, this special time marks the beginning of a new, sometimes transformative phase of life. Both the body and the mind, the psychological and emotional state, are affected by the hormonal changes. It is also a phase of life that often brings social changes in addition to biological ones, such as raising one’s own children, the birth of grandchildren, the death of parents, and changes in marriage. Thus, many women are faced with a major process of change, not only in themselves and their bodies, but also in their environment (Ehsanpour et al., 2007). This phase of life is also an opportunity to reorganize daily life and to become more aware of oneself.
Menopause is characterized by typical symptoms that occur at the metabolic and psychovegetative levels. Classic examples include hot flushes, headaches, mood swings, sleep disturbances, sweating, irritability, nervousness, and dry skin and mucous membranes. However, the manifestation of these symptoms varies greatly from person to person, as do the ways in which they are dealt with.
Menopause can be compared to other stages in a woman’s life, such as puberty or pregnancy. All of these periods in a woman’s life are due to hormonal changes (Groeneveld and Hofmann, 2011).
With the decline in estrogen production, women lose not only fertility, but also some health protection.
From about the age of 20, muscle mass declines (sarcopenia) unless counteracted by strength training and adequate protein intake. Contrary to popular belief, energy metabolism does not necessarily decrease during menopause. The reason why many people see an increase in body weight is because of sarcopenia and the reduction in physical activity during this time. This is the only reason that energy metabolism decreases. It is not until after the age of 60 that energy turnover also decreases, regardless of lean mass (Pontzer et al., 2021).
Scientific studies show that women are more affected by the metabolic syndrome at the onset of menopause than before (Janssen et al., 2008; Groeneveld and Hofmann, 2011). This includes obesity, hypertension, insulin resistance, and elevated or altered blood lipid levels. This constellation in turn favors vascular disease (atherosclerosis), which can lead to vasoconstriction and subsequent cardiovascular disease due to plaque buildup. Compared to men, women with these classic risk factors are significantly more susceptible to cardiovascular disease and are statistically more likely to be affected (VDD, 2008).
On the other hand, low estrogen levels lead to increased bone resorption, which increases the risk of osteoporosis because estrogen is a bone building hormone. Although bone loss cannot be stopped completely, it can be slowed down with appropriate measures. These include a diet rich in micronutrients, with adequate protein and calcium, vitamin D blood levels within the reference range, and sufficient physical activity, including muscle-building exercise (Groeneveld and Hofmann, 2011).
Menopause: Vegan Diet and Lifestyle
Entering menopause is a good time to make conscious choices about diet and lifestyle. Those who follow a vegan diet can support their health and quality of life during this time in several ways.
Meeting Nutritional Needs During Menopause on a Vegan Diet
As always, adequate energy intake is very important during menopause, especially with regard to the increased risk of metabolic syndrome and osteoporosis. Overweight and underweight should be avoided. If you find that you are having difficulty maintaining your weight, pay attention to exercise and daily activity and focus more on foods that are filling and low in energy density. These include vegetables, fruits, legumes, and whole grains.
In terms of bone health, vitamin D, calcium, and protein play an important role in a vegan diet during menopause. You can improve your vitamin D intake with supplements tailored to your blood levels, calcium with mineral water and fortified products, and protein with tofu, tempeh, a variety of foods, and protein powders if needed.
The need for iron is slightly less than before menopause (10 mg instead of 15 mg per day) because of the absence of monthly blood loss due to menstruation. However, because many premenopausal vegan women do not get enough iron, you should still be aware of this and consume iron-rich plant foods regularly in combination with vitamin C-containing foods. If you are taking iron supplements, you may want to talk to your doctor about reducing the dose or stopping altogether.
It is also important to take vitamin B12 supplements. Drops or lozenges are ideal because they are absorbed through the oral mucosa. With age, absorption through the intestinal mucosa may be limited.
So continue to pay special attention to the potentially critical nutrients in a vegan diet. The Vegan Food Pyramid can also be a good guide for your needs during and after menopause.
Studies on a Vegan Diet And Menopause
Several studies have examined whether a plant-based or vegan diet can reduce menopausal and postmenopausal symptoms.
In a recent randomized control trial, a targeted vegan diet for 12 weeks had a beneficial effect on menopausal symptoms (hot flashes, vasomotor, psychosocial, physical, and sexual factors) in 18 postmenopausal women compared with a control group. The vegan diet was designed to be low in fat and included 86 g of cooked soybeans (containing approximately 55-60 mg of isoflavones) per day and mandatory vitamin B12 supplementation (Barnard et al., 2021). Similar findings have already been reported in a survey of 125 peri- and postmenopausal vegans, who had fewer vasomotor and physical symptoms compared to omnivores (Beezhold et al., 2018).
As you have learned, the risk of cardiovascular disease may be increased after menopause. This is reflected in blood lipid levels. In several observational studies, vegans and vegetarians had lower triglyceride levels after menopause, which is associated with reduced risk. Studies that looked specifically at blood levels in vegans often showed lower HDL levels, which are associated with higher risk (Huang et al., 2014).
Have you heard different opinions and been confused about soy products during menopause? The most controversial factor is the phytoestrogen content. These are phytochemicals, such as lignans and isoflavones. They are found not only in soybeans, but also in flaxseed and to a lesser extent in sunflower and pumpkin seeds. Classic fermentation processes, as used in Asian cuisine, increase the concentration and bioavailability of phytoestrogens. These substances are structurally and functionally similar to the female sex hormone 17-ß-estradiol; they can both activate and deactivate the estrogen receptor. However, the intensity of their effect is 100 to 10,000 times lower than that of natural estrogen; in addition, they have antioxidant and antiproliferative effects, i.e., they inhibit cell growth (Danz, 2015).
Postmenopausal symptoms are more frequent, intense, and prolonged in Western societies than in Asian populations. This phenomenon is attributed to differences in the consumption of foods containing phytoestrogens, especially soy (products). There is also a lower susceptibility and incidence of lifestyle diseases such as cancer and cardiovascular disease. Studies with soy products and isoflavone supplements suggest a reduction of hot flushes in postmenopausal women (Küpper, 2007; Barnard et al., 2021), but this effect is not always confirmed. The high consumption of isoflavone-containing foods would be one factor, but the overall situation of diet and lifestyle in Asia compared to Europe has to be considered (Danz, 2015).
For phytoestrogens as isolated nutrient preparations, for example in the form of dietary supplements, no general recommendation can be made for menopausal symptoms. According to the German Federal Institute for Risk Assessment (BfR), long-term use of these preparations may not be completely risk-free. In its 2007 risk assessment, the BfR concluded that isoflavone-containing dietary supplements may alter breast and uterine tissue and negatively affect thyroid function (BfR, 2007).
In a more recent opinion issued by the European Food Safety Authority (EFSA) in 2015, EFSA concluded that no adverse effects in postmenopausal women could be demonstrated with the supplements, doses, and durations of use used in the studies. However, due to the different effects on different tissues, the different dosages and study designs, and the resulting non-comparable study results, it is not possible to derive precise recommendations on dosage and duration of intake (EFSA, 2015).
A doctor will make the diagnosis by asking about changes in the menstrual cycle and the symptoms listed above. Blood hormone levels can also indicate the onset of menopause, which can be particularly helpful for women who have had their uterus removed.
It is always a good idea to see a doctor if you are experiencing severe, prolonged symptoms. In some cases, doctors from different specialties may need to be consulted or work together, since sleep disorders and depressive symptoms may have different causes. In addition, other metabolic disorders, such as those of the thyroid or pancreas, should be ruled out (Müller-Oerlinghausen, 2005).
Summary: Vegan Diet during Menopause
The climacteric, colloquially known as the menopause, is a period in the life of women from the mid to late forties when female hormone production begins to decline. It is characterized by the appearance of certain symptoms, such as hot flushes or sleep disturbances. At the same time, the lack of estrogen protection can increase the risk of cardiovascular disease and osteoporosis.
A whole-food, plant-based diet and a lifestyle that includes regular exercise, resistance training, and adequate rest and relaxation can help. If tolerated, the regular consumption of soy products as isoflavone-containing foods can be used in a supportive manner. Isolated phytoestrogen preparations are generally not recommended, especially for women with a history of estrogen-dependent tumors.