Menopause & Perimenopause

Anti-inflammatory diet (reduce symptoms, protect heart/bones): Mediterranean or low-carb (both beneficial—Mediterranean proven for heart health, low-carb improves insulin resistance/metabolic syndrome), Phytoestrogen foods (weak plant estrogens—helpful for mild symptoms): Flaxseeds 2 Tbsp ground daily (lignans—phytoestrogenic, also fiber, omega-3), Soy (organic, fermented best—tempeh, miso, natto; avoid processed soy, GMO; controversial—beneficial for menopause but some avoid due to thyroid concerns), Legumes (lentils, chickpeas), Whole grains (if tolerated), Cruciferous vegetables (broccoli, cauliflower, cabbage—support estrogen metabolism, detoxification), Calcium-rich foods (1200mg/day): Dairy (if tolerated—yogurt, kefir, cheese), Sardines with bones, Collard greens, Kale, Bok choy, Almonds, Sesame seeds, Bone health foods: Vitamin D foods (fatty fish, egg yolks, mushrooms—but supplementation needed for therapeutic levels), Vitamin K2 foods (natto, grass-fed dairy, egg yolks, fermented vegetables), Magnesium foods (leafy greens, nuts, seeds, avocado, dark chocolate), Adequate protein (0.8-1g/kg body weight—preserve muscle, bone—sarcopenia risk increases after menopause), Omega-3 foods (wild fish 3x/week—heart, brain, mood, reduces hot flashes, anti-inflammatory), Colorful vegetables (antioxidants—protect heart, brain, reduce inflammation), Berries (polyphenols—cardiovascular, cognitive health), Healthy fats (olive oil, avocado, nuts, seeds—heart health, hormone production), Avoid: Sugar and refined carbs (worsen insulin resistance, weight gain, hot flashes), Trans fats (cardiovascular risk), Seed oils (inflammatory), Excess alcohol (worsens hot flashes, sleep, increases breast cancer risk, bone loss—limit to 1 drink/day or eliminate), Limit caffeine (worsens hot flashes, insomnia in some—<200mg/day), Spicy foods (trigger hot flashes in some—individual), Adequate hydration (8-10 glasses water/day), Intermittent fasting (improves insulin sensitivity, weight management—16:8 or 18:6), Organic (reduce pesticide/hormone disruptor exposure)

Weight-bearing exercise (CRITICAL—bone density, muscle mass, metabolism, mood, sleep): Resistance training 2-3x/week minimum (weights, resistance bands, body weight—builds bone, preserves muscle, improves metabolism, insulin sensitivity), High-impact activities if appropriate (jumping, jogging, tennis—builds bone, but only if no osteoporosis/fracture risk), Walking, hiking (weight-bearing—better than swimming/cycling for bones), Yoga (flexibility, balance, stress reduction—fall prevention), Balance exercises (Tai Chi—fall prevention critical as bone density declines), Aerobic exercise 150 min/week (heart health, weight management, mood, sleep), Consistency key (bones adapt to regular stress—sporadic exercise less effective), Stress management (stress worsens symptoms—cortisol affects hormones): Meditation, yoga, breathwork, therapy, massage, time in nature, hobbies, social connection (loneliness affects health—maintain relationships), Address life stressors (menopause often coincides with empty nest, aging parents, career stress), Prioritize sleep (7-9 hours—insomnia common in menopause): Cool bedroom (hot flashes worse at night—AC, fan, cooling mattress pad, moisture-wicking sheets), Consistent schedule (same bedtime/wake time), No screens 1-2 hours before bed, Magnesium, melatonin, sleep support herbs (see supplements), Layered bedding (easy to remove if hot flash), Progesterone cream (improves sleep), Treat night sweats (keep water nearby, extra PJs/sheets, moisture-wicking sleepwear), Quit smoking (accelerates menopause, worsens symptoms, increases osteoporosis, heart disease, cancer risk—non-negotiable), Limit alcohol (worsens hot flashes, sleep, bone loss, increases breast cancer risk), Maintain healthy weight (obesity worsens insulin resistance, increases estrogen (fat produces estrogen—increases breast cancer risk), but too thin increases osteoporosis risk—healthy BMI 20-25), Cognitive activities (brain health—reading, puzzles, learning new skills, social engagement—"use it or lose it"), Sexual activity (regular activity maintains vaginal health, blood flow—"use it or lose it," lubricants if dryness, consider local estrogen), Supportive partner (communicate symptoms, needs—menopause affects relationships), Cardiovascular health (heart disease risk increases after menopause—control BP, lipids, blood sugar, exercise, diet, don't smoke), Bone density monitoring (DEXA scans—baseline at menopause, repeat to track, guide treatment), Skin care (estrogen loss affects skin—collagen declines, dryness, wrinkles: moisturize, sunscreen, retinoids, collagen supplementation, hydration), Hair health (thinning common—biotin, collagen, scalp care, address thyroid/iron if deficient), Support groups (menopause community—share experiences, reduce isolation, normalize symptoms)