Modern middle-age women are in the primes of their lives, focusing on health and fitness and their ability to use their wisdom from experience and self-clarification to fulfill all goals and dreams.
Menopausal symptoms, however, often throws roadblocks in their path, making fulfillment of goals a bit challenging. In some women who are reasonably healthy, symptoms can be so intense that quality of life is significantly impaired.
But the key concern women have about menopause remains bone health, preventing their bones from losing strength and mass to become porous.
What is Menopause?
Menopause is when the female body no longer can produce a pregnancy, and it is hallmarked by the ending of the menstrual cycle. Typically in middle age, the number of ovarian follicles decline, and there is also a reduction in ovarian cells that manufacture estradiol and inhibin, which increases other hormones (luteinizing hormone or LH and follicle-stimulating hormone or FSH). Estrogen also diminishes. As these hormones are fluctuating, menstruation becomes irregular, leading to complete cessation.
Diminished estrogen during and after menopause impacts organs that are sensitive to estrogen – these organs include the brain, bones, urogenital tract, skin and cardiovascular system. In the US, approximately 1.3 million women enter menopause each year, usually around 51 or 52.
There is some confusion, as you may hear about “peri-menopause.” This refers to the stage leading to menopause, which is when menstruation stops completely. Peri-menopause is the transitional time when symptoms begin to appear. This phase lasts anywhere between two and eight years before the final menstruation. Menopause is considered to occur when a woman goes one full year from the date of her last period.
Symptoms vary, affecting every woman differently. Symptoms include hot flashes, sleep disturbances/insomnia, memory problems/problems focusing, mood fluctuations, anxiety, depression, and thinning of vaginal walls/dryness (painful intercourse). These symptoms can also last for years following the last period when the woman is considered post-menopausal.
Authors of a review about post-menopausal syndrome write, “Principal health concerns of menopausal women include vasomotor symptoms, urogenital atrophy, osteoporosis, cardiovascular disease, cancer, psychiatric symptoms, cognitive decline, and sexual problems. Many symptoms are found related to postmenopausal syndrome: Hot flushes, irritability, mood swings, insomnia, dry vagina, difficulty concentrating, mental confusion, stress incontinence, urge incontinence, osteoporotic symptoms, depression, headache, vasomotor symptoms, insomnia etc.”
In post-menopausal years, women become more at risk for developing osteoporosis (and heart disease). Osteoporosis literally translates to “porous bones,” and is characterized by loss of bone density, which eventually creates holes in bone and a brittle bone consistency.
Natural Support for Menopause Symptoms
If you are peri-menopausal or post-menopausal there are foods and supplements you can take to help sustain health, wellness and improve quality of life.
Besides providing high levels of numerous vitamins, minerals, fiber and antioxidant, plant foods may help ease some discomforting symptoms. Fruits, vegetables nuts, whole grains and seeds can provide some phytoestrogens, which help restore the body’s sense that it still has estrogen. Studies abound showing that phytoestrogens, such as those in flaxseeds can reduce hot flashes.
According to one online health resource, a study of women who were having hot flashes reported relief when they took 40 grams of ground flaxseeds daily.
Soyfoods such as tofu and tempeh, as well as soymilk, are high in phytoestrogens and have been reported to be viable in lessening frequency and severity of hot flashes, among other menopausal symptoms. Yet other studies have not shown these effects. This could be due to the extreme variance between women and subjective reporting of hot flashes and mood swings. One review study concluded that soy supplements created a significant decrease in a marker of bone resorption, showing bone protective benefit. Soyfoods, such as tofu, do offer a favorable protein amount, as soybeans contain all eight essential amino acids.
There are several herbal supplements that may help provide relief of particularly annoying menopausal symptoms such as hot flashes and mood swings.
Red clover: One meta-analysis of red clover and menopause reviewed 11 randomized controlled trials and found that overall, red clover had a positive impact on lessening hot flashes in menopausal women. The researchers observed that there were changes in hormone levels (LH, FSH, testosterone and sex hormone binding globulin), as well as estrogen. A more recent meta-analysis looked at another post-menopausal factor – blood fats/cholesterol – and red clover. This found that taking red clover may have a beneficial effect on lipid profiles in peri-menopausal and post-menopausal women.
Black Cohosh and Evening Primrose Oil: One study compared the two botanicals in how they support hot flash frequency and duration in 80 post-menopausal women experiencing hot flashes. The team found that while both were effective in reducing intensity of hot flashes, black cohosh seemed to do a better job than evening primrose oil as it also seemed to reduce the number of hot flashes.
How Do Probiotics Help Menopause?
One of the more distressing physiological outcomes of menopause is vaginal dryness and thinning of the vaginal walls, both combining to make intercourse uncomfortable. A newer moniker – genitourinary syndrome of menopause (GSM) describes a cluster of symptoms – dryness, burning, irritation, lack of sufficient lubrication for intercourse, pain, urinary urgency
A randomized clinical trial on 60 post-menopausal women who had symptoms of menopausal genitourinary syndrome compared hormone therapy with and without probiotics. They took isoflavones plus a probiotic blend (Lactobacillus acidophilus, Lactobacillus casei, Lactococcus lactis, Bifidobacterium bifidum, and Bifidobacterium lactis) or allopathic hormone therapy for 16 weeks. The results showed that the probiotics improved isoflavone metabolism.
The vagina has its own microbiota, separate and discrete from the gut microbiota and the skin microbiota. And in peri- and post-menopause, it too is somewhat impacted by the hormonal cascade of this life phase.
One review of studies concluded that there is merit of Lactobacillus species in maintaining vaginal homeostasis and the vaginal microbiome structure in postmenopausal women. The authors write, “Oral and vaginal probiotics hold great promise and initial studies complement the findings of previous research efforts concerning menopause and the vaginal microbiome.”
Sufficient estrogen (prior to peri-menopause) help maintain diversity of gut microbiota, supporting an effective immune response and overall homeostasis. Deficiency of estrogen can destroy microbial diversity, thereby disrupting the gut immunity.
Heart health becomes a significant concern for post-menopausal women, especially in those who are overweight or obese. One placebo-controlled 12-week study investigated two different doses of a probiotic blend on 81 obese post-menopausal women with endothelial dysfunction. The results, according to the authors, was that the higher dose of probiotics “favorably modifies both functional and biochemical markers of vascular dysfunction in obese postmenopausal women.” The probiotic blend decreased systolic blood pressure and other parameters, contributing to support of cardiovascular health.
Probiotics and Bone Health
Probiotics have also been shown to be quite useful for maintaining bone health as women age. Postmenopausal bone loss is caused by plummeting levels of estrogen, which leads to accelerated bone breakdown. The microbiota has been shown to influence production of hormones necessary for maintaining bone health. The authors of this study assert that “it has become clear that the intestinal microbiota is relevant for bone health…advances in other areas suggest that manipulations of the microbiota may be used in the future to treat common skeletal disease.” They even suggest that eating a low-glycemic diet may help promote a sturdier microbiota that in turn helps slow progression of bone loss.
One review of studies linking post-menopausal osteoporosis to status of the microbiota concludes that probiotics positively influenced metabolic bone diseases, and that “the effects of the intestinal microbiota on bone metabolism suggest a promising target for post-menopausal osteoporosis management.”
Indeed, say authors of another study of 76 healthy post-menopausal women, there is correlation between gut microbiota and post-menopausal bone loss. This study suggests that those women consuming Bacillus subtilis C-3102 daily for 24 weeks had significantly increased total hip bone mineral density (BMD) compared to placebo. The authors suggested that in healthy post-menopausal women, C-3102 improves BMD by inhibiting bone breakdown and modulating gut microbiota.
A newer study of 90 women in their mid-70s (on average) took either Lactobacillus reuteri 6475 or placebo for one year, and had bone measurements prior to and after 12 months. The women who consumed the probiotic had half the bone loss than women in the placebo group. This is the first time that researchers have shown that it is possible to cut age-related bone loss in elderly women in half if they take probiotics, according to researchers.
Menopause is not a disease – it is merely a transition that can, in some women, cause discomfort and a sense of physiological imbalance. Although with higher age comes many risks for age-related complications, bone loss does seem to occur more among women than men. Probiotics can be tool to provide a feeling of balance by lessening menopausal symptoms as well as be a part of a bone preservation regimen.