Q: Is there a specific diet for menopause that can help reduce my hot flashes?
Hot flashes, the hallmark symptom of the menopausal transition, are estimated to affect 80 per cent of women. While some hot flashes are mild and tolerable, others can be intense to the point of disrupting daily life.
There’s no single “menopause diet,” but certain dietary modifications may help ease hot flashes.
Menopause is about more than hot flashes and its other symptoms, though. It’s a stage of life when women need to be pro-active about adopting, or reinforcing, a healthy diet and lifestyle.
The following dietary advice for hot flashes can also help protect your health in the years after menopause.
What is menopause?
The transition to menopause, called perimenopause, typically occurs between the ages of 45 to 55, when circulating levels of the hormone estrogen are fluctuating. Perimenopause can bring on physical symptoms such as hot flashes, sleep disturbances, mood changes, irregular periods and an increase in abdominal fat.
Menopause is defined as the point in time 12 months after a woman’s final menstrual period when estrogen levels become very low. In North America, the average age of menopause is 51.
Some women experience early menopause because of to genetics, autoimmune conditions, surgery to remove the ovaries, chemotherapy and radiation.
Postmenopause is the time after menopause has occurred. Hot flashes can get milder and disappear, but, for some women, they can continue for up to a decade. The risk of osteoporosis, heart disease and breast cancer are increased after menopause.
Anatomy of a hot flash
Hot flashes are thought to occur when declining estrogen levels cause changes to the hypothalamus, the region of the brain that regulates body temperature. When this “thermostat” senses you’re too warm, it attempts to cool you down, resulting in a hot flash.
A hot flash causes a feeling of warmth in your chest, neck and face. Other symptoms include flushing, sweating, rapid heartbeat, anxiety and, as the flash subsides, chills. Night sweats are hot flashes that occur during sleep.
Foods and dietary patterns to ease hot flashes
Avoid foods and beverages that can trigger or worsen hot flashes such as caffeinated drinks, alcohol and spicy foods. (Other triggers include hot weather, feeling stressed, cigarette smoking and tight clothing.)
Adopting a Mediterranean diet, rich in vegetables, fruits and whole grains, may also help reduce hot flashes. A 2013 study of 6,040 menopausal women found that those whose diets closely matched Mediterranean-style were significantly less likely to report hot flashes and night sweats compared with women who didn’t follow the eating pattern.
On the other hand, women who ate a diet high in fat and added sugars were more likely to experience hot flashes and night sweats. A Mediterranean diet that’s low in unhealthy fats and high in fibre is associated with lower and more stable estrogen levels.
Studies suggest including soy in your diet is also helpful for hot flashes. The most recent trial (2021), published in the journal Menopause, showed that postmenopausal women who ate a low-fat plant-based diet that included one half-cup of soybeans each day experienced 80 per cent fewer hot flashes after 12 weeks.
During the study, nearly two-thirds of women in the plant-based diet group became free of moderate-to-severe hot flashes. While this study was small, it adds to previous evidence that soy may reduce hot flashes.
Soybeans contain isoflavones, phytochemicals thought to help reduce hot flashes by weakly binding to estrogen receptors in the body. Edamame, soybeans, tofu, tempeh, soy nuts and unsweetened soy milk are good choices.
Do herbal supplements work?
The most studied herbal remedy for hot flashes is black cohosh. While there’s been consistent evidence for one specific commercial extract (Remifemin), the findings for others have been mixed. A 2016 review of four trials concluded that black cohosh did not lead to a reduction in daily hot flashes.
Flower pollen extract (brand names Relizen, Femal) has been shown to improve hot flashes in one small three-month clinical trial. Not much to go on.
Evening primrose oil, dong quai, ginseng, chasteberry and red clover are not effective for hot flashes.
Tell your doctor about any herbal therapies you are considering or already taking. While many are generally safe, others have side effects. Do not take black cohosh if you have liver problems.
Leslie Beck, a Toronto-based private practice dietitian, is director of food and nutrition at Medcan. Follow her on Twitter @LeslieBeckRD
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