Rhian Stephenson is a registered nutritional therapist and naturopath. She has also spent the last seven years at the forefront of the fitness industry. She led London fitness studio Psycle London as CEO when it launched in 2014. After leaving Psycle at the end of last year, Rhian returned to the world of nutrition.
These days, Rhian dedicates herself to helping people tackle the root causes of their health issues. She works to help clients take control through preventative medicine and positive lifestyle choices. Her aim, she says, is to empower individuals to reach new levels of physical and emotional health.
Informed by her experience in fitness and functional medicine, in 2019 Rhian founded Artah Retreats. Set in the foothills of the Spanish Pyrenees, her retreats integrate naturopathic principles, functional fitness and therapeutic nutrition. The programmes are created for people looking to transform the state of their health.
Here, Rhian explains the changes your body goes through during the menopause and shares her recommendations on diet and lifestyle choices to keep you healthy and feeling good.
What are the hormonal changes affecting metabolism and digestion in the perimenopause and menopause years?
As women progress through perimenopause, their hormones can become more erratic before they reach a steady state after menopause. In early menopause, progesterone is the hormone that usually declines first, resulting in a relative oestrogen dominance. In this phase women can experience shorter and heavier cycles, more period pain, bloating, headaches, anxiety, irritability, and depression. Oestrogen eventually declines, and this is what causes symptoms like longer periods, hot flushes, night sweat and vaginal dryness.
READ MORE: What are the 34 symptoms of menopause?
In terms of metabolism, as our oestrogen declines we become more insulin resistant, so it’s important to be more mindful of nutrition habits.
Another hormone that is often overlooked for women is testosterone. Testosterone naturally declines as we age, but it also declines as adrenal and ovarian functions change through perimenopause and menopause. This can affect mood, energy, weight, libido, muscle tone and vaginal atrophy, which is why weight training is so important for women throughout their menopausal years as it will help boost testosterone and help with insulin balance in the process.
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What causes the bloating and weight gain that can occur during the menopause?
Fluctuating hormones and changes to the gut microbiome can contribute to these symptoms, but it’s important to realise that bloating and weight gain aren’t a given. Women are more prone to these symptoms as hormones fluctuate, but there are things they can do to optimise their experience of menopause. Changes to nutrition and the right types of exercise can go a long way to alleviate the severity of your symptoms.
What are the key foods to manage these symptoms and which foods are best to avoid?
As we become more insulin resistant, modifying the amount of sugar, starch and refined carbohydrates is a must. Not only will this improve fluctuations in mood and energy, but it will help stave off weight gain. Increasing lean protein, vegetables, fibre, and good quality fat will help keep blood sugar balanced. Ultra-processed foods need to go – these will be bad for insulin, weight management, your gut, your mood, you name it.
If hot flashes are an issue for you, it’s often a good idea to limit spicy foods, caffeine and alcohol and any food that you know you’re intolerant or sensitive to.
How does alcohol affect menopausal women?
Women can often become more sensitive to alcohol during these years. The fluctuations in hormones can already cause insomnia, mood swings, anxiety, depression, and hot flashes. Alcohol will exacerbate all of these symptoms. It also has a detrimental effect on blood sugar, insulin balance, and can increase visceral fat storage (the bad kind), which makes us more susceptible to chronic disease.
Once women have experienced menopause, their risk for certain diseases changes. This is because of the decline in oestrogen – menopausal women have an increased risk of cardiovascular disease, diabetes, and osteoporosis, all of which are also affected by alcohol. Oestrogen detoxification also affects the liver and gut, both of which are stressed when alcohol is consumed, and when this is disrupted, oestrogens can be reabsorbed rather than eliminated.
READ MORE: Why menopause and alcohol don’t mix.
With all of this being said, it doesn’t mean menopausal women can’t enjoy a drink every now and then, but for comfort and long-term health’s sake, alcohol is definitely something that should be moderated during this phase of life. If you’re suffering and have terrible symptoms, cut out alcohol all together until you feel more balanced and healthy. If your symptoms aren’t bothering you, then a low to moderate amount of alcohol is probably fine.
Are there any supplements that can help with menopause symptoms?
There are a lot of supplements that can be used to support women throughout menopause. For example, Vitamin E has been shown to decrease hot flashes, as has black cohosh and sage; GLA from Borage or Evening Primrose oil can help hot flashes and mood swings.
Other helpful supplements include blood sugar support and supplements to help with anxiety, mood and energy. I recommend working with a practitioner to get the right balance.
READ MORE: 10 of the best menopause supplements.
How important is gut health during midlife? Do hormonal changes affect gut health?
Gut health is important throughout every stage of life, but it’s especially important for women during midlife. An imbalance of gut bacteria contributes to inflammation, weight gain, anxiety and even depression – all of which we become more vulnerable to during perimenopause and menopause.
The health of the microbiome affects our oestrogen levels – but this is a two way street. Our oestrogen levels can also affect our microbiome. The estrobolome is the gut’s oestrogen specific bacterial network, and declining levels of oestrogen during menopause can affect the oestrogen-dependent processes and pathways of this part of the gut.
In addition to the symptoms mentioned previously, this can result in an onset or worsening of IBS symptoms. This is another reason why women should be mindful of processed foods, alcohol and other gut disrupting foods in this phase.
Got a perimenopause or menopause question?
How should you change your diet in the perimenopausal years?
First and foremost, eating in a way that promotes healthy blood sugar and insulin regulation is going to be key. Getting rid of excess sugar and ultra-processed foods (which aren’t good in any stage of life!) will help with insulin, hormone balance, mood, gut health – pretty much anything. Instead, rely on a whole foods, natural diet as much as possible.
Increasing the amount of phytoestrogens and isoflavones in the diet may help with some of the symptoms of low oestrogen – so this is where organic soy is going to be your best source. Other isoflavone rich foods include legumes, flax, cruciferous vegetables, sesame seeds and dried fruits (prunes, dates, and apricots). Fruit and vegetables are also a good source.
If hot flashes are an issue for you, it’s often a good idea to limit spicy foods, caffeine and alcohol and any food that you know you’re intolerant or sensitive to. These can increase inflammation and exacerbate gut issues, which will fuel your symptoms.
Reading about all of the potential symptoms and side effects of menopause can feel overwhelming, so taking a proactive approach can help you feel more in control. Whole, nutritious foods, regular exercise that includes strength training, and having a form of social or emotional support will go a long way.
As told to Alex Peters.