Managing Menopause Part 2: Estrogen & Your Health

How to Manage The Effects Lower Estrogen Levels Have on your Body

Written by Teagan Evans, University of Alberta Student in the Nutrition and Food Sciences program and reviewed by our Health Stand Nutrition Dietitian Team

Welcome back to Managing Menopause!

In Part 1, we discussed the hormonal changes occurring during menopause and briefly mentioned some associated long-term health effects. Women going through menopause have decreased levels of the female sex hormone, estrogen. Estrogen has been shown to have some protective effects against certain health conditions such as cardiovascular disease, osteoporosis, diabetes, and obesity.

As women age and estrogen levels drop, the risks associated with developing these health conditions increases. These conditions can be worrying, but lifestyle and dietary changes can help you reduce your risk and live a healthy life!

Cardiovascular Disease

Cardiovascular disease (CVD) is an umbrella term for medical conditions affecting the heart and arteries, such as heart attacks and coronary artery disease. Risk for CVD increases when a woman goes through menopause because the protective effects of estrogen decrease as hormone levels drop.

Typically, men are considered more susceptible to cardiovascular disease because of unique biological and lifestyle factors. However, cardiovascular disease is now the second leading cause of death in women ages 45-65 in Canada and the United States.

Your diet, or making dietary changes, can have a significant impact on your cardiovascular health. See our previous articles on the topic:

• Nutrition to protect against heart disease
• High cholesterol diet support: foods for a healthy heart

Type II Diabetes

Diabetes is a condition where the body’s use of insulin is impaired and leads to high blood glucose levels. There are two types of diabetes – Type I and Type II. While there are many factors that increase the risk of Type II diabetes that are beyond your control (such as family history, ethnicity and age), the risk of developing type II diabetes rises if you are carrying excess weight especially in your midsection. Other factors that increase the risk of diabetes is a diet high in ultra-processed food and low physical activity levels. Type II diabetes is a result of your body becoming unresponsive to insulin and is typically diagnosed during adulthood. Diabetes also increases your risk of other metabolic conditions, such as cardiovascular disease, obesity, and kidney disease.

Researchers are looking into the protective effects of estrogen against developing diabetes and there is evidence suggesting decreased estrogen levels during menopause can increase the risk of developing diabetes.

We have written extensively about diabetes and diet on our blog, and recommend these articles for further reading:

• Food and diabetes management
• Diabetes tips: what causes high blood sugars other than food

Obesity

Obesity is a rising health concern within our population and is considered a risk factor for many other metabolic conditions. As women go through menopause, their body composition changes and weight gain often occurs, especially in the abdominal area. This occurs because of the drops in female sex hormones in combination with other lifestyle changes that are occurring in this very busy time of life when family and career demands are high. Excessive weight gain can lead to obesity and increase your risk of developing other chronic diseases such as those mentioned ablove.

You might find these previous obesity articles helpful:

• New obesity guidelines go beyond diet and exercise
• Dietitian answers to your top weight loss questions

What can you do about decreasing estrogen levels during menopause?

We have some good news! It is never too late to make positive changes for your health. The risk of developing these conditions can be reduced through simple lifestyle and dietary changes. Here are some simple changes you can make to reduce your risk of developing cardiovascular disease, diabetes, and obesity:

• Eat a balanced diet of whole foods rich in whole grains, legumes, fruits, vegetables, and lean protein sources
• Engage in regular exercise such as 30-60 minutes of moderate to vigorous activity most days of the week
• Minimize ultra-processed and fast-foods high in calories, sugar and sodium
• Limit alcohol intake
• Get enough sleep and seek support from your doctor if you think you might have sleep apnea
• Manage stress as best you can and work with a Registered Dietitian and therapist for help with emotional eating struggles
• Seek support for help with developing a healthy lifestyle

There is one more significant health impact of reduced estrogen in menopause we’d like to cover and that is:

Osteoporosis

As we age, our bone density decreases and causes our bones to become weaker and more prone to fractures. This condition is known as osteoporosis. Research has found estrogen levelsinfluences women’s bone health and helps to maintain bone structure and density. As estrogen decreases throughout menopause, this protective effect is reduced, and women have increased risk of developing osteoporosis. Fortunately, there are some simple steps you can take to keep your bones strong.

What can you do about it?

Vitamin D

Vitamin D helps keep our bones healthy and strong by influencing calcium and phosphorus levels needed to form and maintain bone structures.

Vitamin D is known as the sunshine vitamin. When sunlight strikes the skin, it can trigger the creation of vitamin D. However, this is not a very reliable way to ensure we get enough of this essential vitamin. Variations in sun exposure, skin pigmentation, and use of sunscreen all affect the production of vitamin D.

Health Canada recommends that all adults up to age 70 get 600 IU of vitamin D per day from food and supplements.

Vitamin D food sources include:

• Fortified beverages (cow’s milk, soymilk, goat’s milk, some orange juices)
• Fatty fish (halibut, salmon, sardines, trout)
• Egg yolks
• Fortified margarine

As with sun exposure, it is difficult to get enough vitamin D from food alone. Health Canada recommends that in addition to following a healthy balanced diet, all adults over age 50 should take a daily vitamin D supplement.

For those over age 70, 800 IU per day is recommended. Some experts suggest that even higher levels of vitamin D supplements may help those who have osteoporosis or are at risk. Speak with your dietitian and doctor about what is best for you.

Calcium

Calcium is a mineral that is involved in the creation of new bone and helps to maintain your current bone density. It is very important to consume enough calcium every day. Dietitians of Canada recommends that women over the age of 50 years consume 1200 mg of calcium every day.

Calcium food sources include:

• Milk and dairy products
• Dark leafy greens
• Fortified beverages (soymilk, orange juice)
• Fish and seafood (with small bones)

For additional reading about calcium supplements, we recommend these blog posts:
Boost your bone strength
How to choose a calcium supplement

Exercise

Exercise is highly beneficial for maintaining bone strength and can reduce your risk of osteoporosis. Alberta Health Services recommends engaging in four main types of exercise: balance, posture, strength, and aerobic as they all aid in maintaining healthy bones.

Some examples include:

• Balance: yoga and Pilates
• Aerobic: running, biking, walking, and swimming
• Strength: resistance exercises using body weight, hand weights, and resistance bands
• Posture: yoga and maintaining good posture while sitting

All of these metabolic changes during menopause can seem overwhelming, but with the right lifestyle choices you can reduce your risk of developing long term health issues. Overall, eating a well-balanced diet and maintaining a healthy weight through diet and regular exercise will help reduce your risk of all these conditions.

You may also want to check out this previous blog post:

• Nutrition for women after 40: healthy eating for perimenopause and menopause
• Managing Penopause Part 1: Recognizing the Signs

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