A Natural Approach to Menopause
There are dietary steps and other lifestyle changes that can make menopause much more manageable.
Natural Changes
At around age 50, the ovaries stop producing estrogens. The adrenal glands (small organs on top of each kidney) continue to make estrogens, as does fat tissue. But the ovaries have produced the greatest share of the body’s estrogens for decades, and when they quit, the blood levels of estrogens drop dramatically.
Women typically spend a few years in perimenopause (the years preceding menopause), during which time they can experience symptoms such as hot flashes, mood changes, anxiety, irregular or heavy menstruation, and weight gain. Women may also experience negative metabolic changes, less favorable fat distribution, worsening bone health, and worsening brain function.1-4
Hot Flashes
Hot flashes are one of the most bothersome perimenopausal symptoms for women. The Physicians Committee conducted a clinical trial called the WAVS trial (the Women’s study for the Alleviation of Vasomotor Symptoms) in 2020.5 The trial included postmenopausal women reporting two or more hot flashes per day. They were randomly assigned either to eat a low-fat, vegan diet with half a cup of cooked soybeans daily or to make no changes to their diet for 12 weeks.
In the intervention group, total hot flashes decreased by 79% and moderate-to-severe hot flashes decreased by 84%. At the study’s conclusion, 59% of intervention-group participants reported becoming free of moderate and severe hot flashes.
Soybeans and other soy products (such as tofu and soy milk) contain plant-based estrogens, called phytoestrogens. This type of estrogen is somewhat different from human estrogen and appears to have favorable effects in the human body.
Weight Gain
Perimenopausal weight gain affects many women. A plant-based diet has proved to be very effective at maintaining a healthy body weight and helping with weight loss. Plants are naturally lower in calories than animal-based foods. Plants also contain fiber, which can trap calories in the gut and promote a healthy weight.
The Physicians Committee tested the effects of a low-fat vegan diet compared with the National Cholesterol Education Program guidelines in 64 overweight, postmenopausal women.6 After 14 weeks, the women who were following the low-fat plant-based diet lost more than 12 pounds on average, which was more than the comparison group.
Find out more about how plant-based diets can aid weight loss at our Weight Loss page.
Depression Symptoms
A study called the Study of Women’s Health Across the Nation (SWAN) found that when women were perimenopausal or early menopausal, they were two to four times more likely to experience a major depression episode.7 Diet quality can affect depressive symptoms and mood. After accounting for body mass index, physical activity, and other variables, the Nurses’ Health Study II which included over 30,000 women, found that women who ate the most ultra-processed foods had a 49% higher risk of depression.8 On the other hand, fruit and vegetables have been associated with a lower risk of depression. A meta-analysis published in the British Journal of Nutrition found that every 100 grams (3.5 ounces) of either fruit or vegetables was associated with a 3% lower risk of depression.9 This is the equivalent of only around one half to one cup of fruits or vegetables.
Insulin Resistance
Insulin resistance is when cells no longer respond well to insulin, resulting in rising blood sugars and potentially type 2 diabetes. The study the Physicians Committee did with postmenopausal women, mentioned above, also investigated the effects of a low-fat vegan diet on insulin resistance. When women ate the vegan diet, they were able to improve their sensitivity to insulin (thereby reducing their insulin resistance), despite increasing the amount of carbohydrates they were eating. A plant-based diet can reduce the risk of type 2 diabetes and help to manage blood sugars when there is established type 2 diabetes, because it is high in fiber and low in fat. To learn more, visit our Diabetes page.
Cholesterol
Declining estrogen levels during menopause has been found to negatively affect cholesterol levels, with total and LDL cholesterol levels often rising during menopause.10 Weight gain during menopause has also been implicated in these cholesterol changes. To learn seven dietary tips for optimizing your cholesterol levels, visit our Cholesterol page.
Heart Health
During menopause, along with the decline in estrogen levels, several metabolic changes including weight gain, increased total and LDL cholesterol levels, and insulin resistance all increase the risk of heart disease, which is the leading cause of death in women in the Unites States.11 A plant-based diet is not only able to address these underlying risk factors for heart disease, but it has also been shown to reverse the plaque buildup in arteries around the heart seen in heart disease.12,13 To learn more about a heart-healthy diet, visit our Heart Disease page.
Osteoporosis
Estrogen promotes bone formation and prevents the breakdown of bone. When estrogen levels plummet during menopause, bone gets broken down at a faster rate than it is being formed, which leads to weaker bones and a higher risk of fractures.12 During menopause, it is important to get sufficient calcium and vitamin D to support bone healthy. Vitamin D is made by the body when it is exposed to the sun and calcium can be found in a variety of plant-based foods including leafy greens and beans. To learn about other nutrients that can support bone health, visit our Healthy Bones page.
Plant-Powered Prescription
- Eat 1/2 a cup of soybeans, 1 cup of soy milk, or half a block of tofu daily to reduce hot flashes.
- Aim for at least 40 grams of fiber each day to optimize weight and cholesterol.
- To boost your mood, limit ultra-processed foods and fast food and eat at least five servings of fruit and vegetables.
A plant-based diet including soy is a game changer for women aged 45 and over, most of whom we now know can get prompt relief from the most severe and troubling menopause symptoms without drugs.
Neal Barnard, MD, FACC, President, Physicians Committee
These 3 Things Are Proven To Help Menopause
References
- Inaraja V, Thuissard I, Andreu-Vazquez C, Jodar E. Lipid profile changes during the menopausal transition. Menopause. 2020;27(7):780-787. doi:10.1097/GME.0000000000001532
- Kodoth V, Scaccia S, Aggarwal B. Adverse changes in body composition during the menopausal transition and relation to cardiovascular risk: a contemporary review. Womens Health Rep (New Rochelle). 2022;3(1):573-581. doi:10.1089/whr.2021.011
- Metcalf CA, Duffy KA, Page CE, Novick AM. Cognitive problems in perimenopause: a review of recent evidence. Curr Psychiatry Rep. 2023;25(10):501-511. doi:10.1007/s11920-023-01447-3
- Charde SH, Joshi A, Raut J. A comprehensive review on postmenopausal osteoporosis in women. Cureus. 2023;15(11):e48582. doi:10.7759/cureus.48582
- Barnard ND, Kahleova H, Holtz DN, et al. A dietary intervention for vasomotor symptoms of menopause: a randomized, controlled trial. Menopause. 2023;30(1):80-87. doi:10.1097/GME.0000000000002080
- Barnard ND, Scialli AR, Turner-McGrievy G, Lanou AJ, Glass J. The effects of a low-fat, plant-based dietary intervention on body weight, metabolism, and insulin sensitivity. Am J Med. 2005;118(9):991-997. doi:10.1016/j.amjmed.2005.03.039
- Bromberger JT, Kravitz HM, Chang YF, Cyranowski JM, Brown C, Matthews KA. Major depression during and after the menopausal transition: Study of Women's Health Across the Nation (SWAN). Psychol Med. 2011;41(9):1879-1888. doi:10.1017/S003329171100016X
- Samuthpongtorn C, Nguyen LH, Okereke OI, et al. Consumption of ultraprocessed food and risk of depression. JAMA Netw Open. 2023;6(9):e2334770. doi:10.1001/jamanetworkopen.2023.34770
- Saghafian F, Malmir H, Saneei P, Milajerdi A, Larijani B, Esmaillzadeh A. Fruit and vegetable consumption and risk of depression: accumulative evidence from an updated systematic review and meta-analysis of epidemiological studies. Br J Nutr. 2018;119(10):1087-1101. doi:10.1017/S0007114518000697
- Ko S-H, Kim H-S. Menopause-associated lipid metabolic disorders and foods beneficial for postmenopausal women. Nutrients. 2020; 12(1):202. doi:10.3390/nu12010202
- Ahmad FB, Cisewski JA, Anderson RN. Leading causes of death in the US, 2019-2023. JAMA. 2024;332(12):957–958. doi:10.1001/jama.2024.15563
- Esselstyn CB Jr, Gendy G, Doyle J, Golubic M, Roizen MF. A way to reverse CAD? J Fam Pract. 2014;63(7):356-364b.
- Ornish D, Scherwitz LW, Billings JH, et al. Intensive lifestyle changes for reversal of coronary heart disease [published correction appears in JAMA 1999;281(15):1380]. JAMA. 1998;280(23):2001-2007. doi:10.1001/jama.280.23.2001
- Yong EL, Logan S. Menopausal osteoporosis: screening, prevention and treatment. Singapore Med J. 2021;62(4):159-166. doi:10.11622/smedj.2021036