There are lifestyle changes you could be making in your 40s to make your menopause a little better. Anna Magee spoke to the experts
1. Eat more oily fish
New research out this week has shown that eating a daily portion of oily fish such as salmon, mackerel and sardines could help delay the menopause by three years. However, a diet rich in pasta could in fact hasten the onset by around 18 months, according to a study by the University of Leeds on more than 14,000 women in the UK. The average age of the menopause was 51.
Nutritional therapist Marta Anhelush isn’t surprised that oily fish showed these benefits. ‘Adding oily fish to a meal helps to slow down the release of glucose into the bloodstream, thanks to its high content of protein and healthy fats, which helps balance our hormones: oestrogen and progesterone’ explains Anhelush.
If you’re feeling tired oily fish – or a supplement – could give that essential energy boost
And since many of us are battling lifestyle factors that destabilise bloodsugar, such as sleep deprivation and stress, omega-3 can help stabalise the typical blood sugar rollercoaster. ‘Omega-3 fatty acids have also been shown to increase insulin sensitivity, which is another way they can help with blood glucose balance and hormones’ explains Anhelush.
And that’s not all. If you’re feeling tired, eating oily fish regularly – or taking a supplement – could give that essential energy boost, since it contains the key fatigue fighting nutrients: selenium, iodine, zinc, vitamin B6 and B12.
And there are other reasons for women in their forties can benefit from eating oily fish. Multiple studies show that fish oil can boost heart health and lower your cholesterol.
But what if you don’t like oily fish or can’t eat it everyday?
‘In that case, I would recommend taking a good quality fish oil supplement on a daily basis’, says Anhelush, ‘it’s difficult to get sufficient amounts of omega-3 fats from other sources’. Look for a supplement sourced from a from a traceable, sustainable source, like BioCare Omega-3 Fish Oil which is sourced from wild anchovies and sardines from the clear Pacific waters.
Vegetarians will need an alternative. Most people know about flax seeds or flax seed oil as a vegan source of omega-3, however the type of omega-3 found in flax seeds – ALA, needs to be converted in the body to EPA and DHA (the fats mainly found in oily fish) – and this process isn’t very efficient so the best way to get them directly is to supplement with an algal omega-3 product, such as Biocare Vegan Omega 3.
2. Eat hormone-loving vegetables
Many plants contain oestrogen-like substances known as phytoestrogens that can help balance your hormones naturally. The best known, isoflavones, are found in soybean products and members of the cabbage and turnip family of vegetables. These include broccoli, Chinese leaves, pak choy, radishes and kohlrabi. Another form, known as lignans are obtained from sweet potato, beansprouts, chickpeas, lentils and seeds – especially flaxseed and pumpkin seeds. Soy milk and soy yoghurts are easy ways to increase your intakes (but get calcium from other sources if you’re not eating much dairy generally). Isoflavone tablets and capsules are available with suggested doses of between 40mg to 100mg isoflavones a day – Try Healthspan Soy Isoflavones 100mg £15.95. If you use soy protein powder for shakes, 60g of soy protein provides 45mg isoflavones. Healthista loves Pulsin Soya Protein Isolate Powder £17.99
3. Eat more fibre
‘Our ability to absorb nutrients depletes with age and this happens most dramatically in the later stages of life,’ says Robert Hobson, nutritionist. ‘Even in your forties, the demand for certain nutrients can often outweigh dietary intake, which can impact on future health. As you age your metabolism slows down and in many cases, cholesterol and blood pressure can rise as you approach the menopause,’ he explains. Top up on high-fibre foods such as wholegrains, pulses and vegetables to help lower cholesterol and manage weight – the average intake of fibre amongst women falls short of the recommendations by a third. ‘Eating plenty of vegetables can help to increase your potassium intake that is required to maintain healthy blood pressure (in fact, 26 per cent of women don’t get enough potassium in their diets and only 28 per cent manage to eat five-a-day). Vitamins and minerals are needed for every metabolic reaction and inadequate intakes can lead to dry skin, brittle nails, hair loss, hormone imbalances, low mood and thinning bones to name just a few’.
4. Make friends with your pelvic floor
Your pelvic floor muscles naturally thin as oestrogen levels fall in your late forties. These muscles are slung like a hammock at the base of your pelvis, supporting your bladder, womb and lower bowel. Pelvic floor exercises can strengthen these muscles to reduce the chance of stress urinary leakage (for example, when coughing or sneezing) and are credited with improving your sex life, too. If you’re not exactly familiar with your Kegel’s exercises, Healthista loves the Aquaflex £23.50 from Boots, a set of weighted vaginal cones that you pop in and use like a weight training regime for your vagina. Slightly sleeker and more high-tech is the Lelo Luna Smart Bead £95 which senses your muscles’ strength and sets a routine that’s right for you. It’s amazing.
5. Boost your libido
As you get older, lowered oestrogen levels can lead to less lubrication during intercourse. ‘If you are having problems with arousal, L-Arginine may help,’ says Dr Sarah Brewer. ‘This amino acid increases production of a nerve communication factor called nitric oxide (NO) which plays an important role during sexual arousal in both men and women. L-arginine supplements can improve all aspects of female sexuality including interest, arousal and satisfaction. It can take up to six weeks for L-arginine to produce an optimum effect.’ Try Healthspan L-Arginine £15.95 from healthspan.co.uk
6. Fire up your energy
Coenzyme Q10 is vitamin-like substance that is needed to generate energy in cells. The amount you produce naturally, and the amount you absorb from your diet decreases with age and when cells do not receive all the energy they need, they function less efficiently, says Dr Brewer. ‘In the ovaries, low coenzyme q10 levels reduces sex hormone production and, as well as lowering fertility, may make symptoms associated with the ‘change’ of life worse”. Try Healthspan’s Ubiquinol, which is the most absorbable form of co-enzyme Q10, found in all cells of our bodies and in particularly high concentration in the energy intensive cells of our hearts. ‘Ubiquinol is also often referred to as ‘the spark’ and is often recommended if people are looking to support their energy levels and cardiac function and are on statins,’ says Dr Brewer. ‘Research shows that our ability to convert CoQ10 into ubiquinol diminishes at a faster rate over the age of 50 so keep levels up in your forties’.
7. Invest in health screening
Health screening plays a vital role when looking at the wellbeing of women, especially after the age of 40, says Dr Amarjit Raindi, a GP at 25 Harley Street a new integrated health clinic with a specific interest in personalised health and health screening. ‘In the UK, we are behind the curve compared to some countries in Europe and the USA where proactive and preventative medicine is very much part of the health culture.
These are the tests I suggest in your 40s:
A basic full blood count can check for anaemia and look at the immune system. Other important blood tests to consider can evaluate the kidneys, liver, thyroid, cholesterol and check for diabetes.
The cervical smear screening programme has been a phenomenal success in the UK. Having a regular smear test identifies any early warning (pre-cancerous) cell changes on the cervix. If present these can either be closely monitored (as sometimes they do regress) or treated to prevent progression to cervical cancer.
Having a regular mammogram after the age of 40 can help identify breast cancer. The aim is to pick up any potential cancers early enough so that once identified they can be removed and treatment ultimately resulting in a cure. In high risk patients (for example those with an early family history of breast cancer) we would recommend screening after the age of 30 with an annual MRI or ultrasound and mammogram.
Screening for ovarian cancer can also be done by a blood test called CA-125 which measure biomarkers in the blood for ovarian cancer. In addition to this a pelvis ultrasound or MRI scan can further evaluate the ovaries and potentially identify any sinister pathology.
A CT coronary calcium score can indicate if there is any plaque build up in your coronary arteries which could put you at risk of angina and a heart attack.
Bowel cancer screening tests may also be useful if this runs in your family or if you have symptoms such as ongoing abdominal pain, stool changes or dramatic weight loss. This can include a simple stool test looking for microscopic traces of blood. More detailed and accurate investigations are also available such as a CT colonography or colonoscopy.
Talk to your GP in the first instance as some of these will be available to you on the NHS.
8. Invest in your teeth
The lower third of the face is the most ageing part of the face, which is why teeth are so important in the anti-ageing process,’ says Dr Uchenna Okoye, leading London cosmetic dentist at londonsmiilng.com says. ‘Think of your teeth like scaffolding. They support your cheeks, lips and anything that shifts this architecture affects how youthful you appear. As we age lots of changes take place in our gums due to hormones and approaching menopause and our teeth shift. The expression ‘long in the tooth’ is because our gums shrink,’ she says. Thankfully, there’s plenty that can be done for ageing teeth. ‘Braces, gum contouring and simple techniques like whitening can make a huge difference to our smile. Plus this is a time to make sure we have all the right tools to look after our smile which means power up with an electric brush’. Healthista loves the new Phillips Diamond Clean £299, expensive but it is your teeth.
9. Think in Shades of Grey
Well, not that Shades of Grey…this refers to not seeing everything in black and white, which can sabotage your best health intentions. ‘People struggle with making changes because they can be prone to Zebra Thinking,’ says Dr Meg Mehta, a leading psychologist, author and health researcher. ‘That’s when you think about life in black-and-white terms. It makes change difficult because it can lead to extreme reactions, such as completely abandoning health changes when life throws us a curve ball’. Look out for extreme trigger words in your thoughts such as ‘perfect’, ‘always’, ‘never’, ‘impossible’ or all-or-thing thinking such as ‘I will never eat sweets again’ or ‘I must always follow this health advice’. Write these down when they come to mind to see how common the zebra is rearing its head in your head. ‘People who feel they must do everything perfectly often find it hard to maintain long-term health change as it’s simply unrealistic. By changing your zebra thoughts to shades of grey statements such as ‘I am able to make positive one step health changes but if I do slip-up it’s okay and I can start again – this doesn’t make me a failure,’ you can set yourself free from self-defeat.
10. Get your 10,000 a day
‘If you’re new to exercising, the key to any new regime is to build up gradually,’ says Nicola Addison, London personal trainer who has trained Daisy Lowe, Elle Macpherson and Erin O’Connor. Exercising lighter, but more regularly is always a good starting point for women in their 40s just starting exercise. Start by walking for 10 continuous minutes, three times a day. Aim to build your way up to 30 minutes of consecutive walking every single day with a total daily steps of 10,000,’ she suggests. ‘If your aim is weight loss, try and get to 15,000 steps a day. You will be surprised how you can build up your steps by doing a little extra movement throughout the day.’ Invest in a monitoring device to help motivate you – you’ll get competitive with it and there will be no stopping you. The Moves app can count your steps if your phone is with you. But if you prefer a wearable fitness device and have the budget Nokia Steel £79.99 from Amazon is the best we’ve tried.
‘If you are a regular exerciser it is important to maintain strength throughout your older years if you are to maintain independence and overall health as you age,’ suggests A. As you age, strength naturally declines, muscle mass is lost and (ADLs) Activities of Daily Living (ADLs) become increasingly difficult. Studies have shown that resistance training not only slows, but also reverses the aging process at the gene level.’ Click on this link to watch a series Nicola Addison has made with Healthista to encourage women to get into weightlifting safely and effectively.
‘As you age beyond 40 your body becomes less efficient at producing and releasing key hormones responsible for many important body functions,’ adds Nicola. ‘If strength training is undertaken your body begins to respond by regulating the release of many hormones. Insulin levels become more stable, helping with blood sugar regulation and resulting in a positive chain reaction of physiological responses that slow the effects of aging. Testosterone and other steroid hormones allow for maintenance of muscle mass and the building of more muscle’. So get lifting ladies.
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