🧠Hormonal changes in menopause - why nutrition matters

Menopause is defined by a decline in estrogen (particularly estradiol) and other sex steroids, which affects metabolism, body composition, cardiovascular health, bone density, and many systems throughout the body.

Lower estrogen is linked with:

• Increased visceral fat and reduced muscle mass (changing metabolic rate).

• Higher risk of bone loss, osteoporosis, and cardiovascular disease.

• Changes in lipid metabolism and inflammatory profiles.

Because hormones influence many pathways, nutrition and certain nutrients may affect symptom severity and some physiological outcomes during and after menopause.

💊 Specific Nutrients and Supplementation

While supplements are often heavily marketed to menopausal women, adequate diet matters far more than additional dosing of vitamins creating levels that are greater than normally present in the body. However, the following may be beneficial to supplement from a good quality wholefood source as levels are shown to be low in the UK due to low sunlight levels and soil quality.

Vitamin E

• May improve hot flashes and vaginal changes.

Vitamin D3 (supplementation) combined with Vitamin K2

• Vitamin D3 helps your body absorb calcium from food to support bone mineralisation and improve muscle function.

• Vitamin D3 does not control where that calcium goes.

• Vitamin K2 acts as a traffic controller for calcium by binding the calcium into bones and teeth.

• Vitamin K2 activates proteins that keep calcium out of soft tissues, such as the brain, arteries, and kidneys (reducing the risk of vascular calcification).

Magnesium

• Reduced anxiety.

• Better sleep quality.

• Relaxes muscles and reduces cramping.

• Assists with Vitamin D3 activation.

• Regulates nervous system and maintains normal heart rhythm.

Creatine: Underused but Powerful

Creatine is known for its role in strength and power, but it's particularly beneficial for women, both during and after menopause. Just 5 grams (1 teaspoon) per day has these benefits:

• Preserves muscle, reducing the risk of sarcopenia and osteopenia.

• Improved cognitive function.

  • Short-term memory and function.

  • Reduction in age-related decline.

  • Increased attention time, focus, and processing speed.

⚠️Cautions about Soy

Soy contains natural plant chemicals called phytoestrogens. The main ones are isoflavones. They are called phytoestrogens because they act a bit like oestrogen in the body, but they are much weaker than human oestrogen.

Even though they are weaker, they can still affect the body—especially during menopause, when natural oestrogen levels are already low.

Below are the main reasons scientists and clinicians urge caution, especially with soy supplements.

• In some tissues, activating oestrogen receptors can encourage cell growth, including cancer cells. In others, it can block stronger oestrogen.

• Breast and uterine health concerns - although Asian women eat small amounts of whole soy foods and have lower breast cancer rates, this is not the same as starting soy supplements during menopause. Pills and powders have much higher and more concentrated doses.

There is a major difference between:

• Eating soy foods, and

• Taking soy extracts or supplements

Typical soy foods:

• Provide modest amounts of phytoestrogens

• Are eaten with fibre, protein, and other nutrients

Soy supplements:

• Can deliver very high doses

• Skip the natural food balance

• Have been linked in some studies to:

  • Thickening of the uterine lining

  • Hormonal changes

  • Thyroid interference in some women

In short: more is not better.

Fermented or whole soy foods such as tofu, tempeh, miso are a safer way of introducing isoflavones in to the diet.

FLax

• 1-2 tablespoons of ground flaxseed daily is considered the safest phytoestrogen source.

• Converted by gut bacteria in to very mild oestrogen-like compounds and blocks oestrogen from binding.

• Helps with constipation and blood sugar control.

• Tends to balance oestrogen activity rather than stimulate it.

  
  

🥗 Dietary Patterns and Symptom Relief

Nutrition plays a supportive role in menopause. Balanced diets rich in nutrient-dense foods are consistently associated with better health outcomes during menopause and beyond. The strongest dietary strategies for menopausal health are:

• Adequate protein (included at every meal).

• 1 - 2 tablespoons of ground flaxseed.

• Plenty of non-starchy vegetables (particularly leafy greens).

• Healthy fats (omega 3s found in oily fish/fish oils, olive oil, nuts, seeds, butter, coconut oil) - NOT seeds oils, trans fats

• Calcium-rich foods (cheese, yoghurt, leafy greens, sardines, salmon, almonds, sesame seeds, figs).

• Keep sugar, alcohol, and refined carbohydrates to a minimum.

🍩 SUGAR, REFINED CARBOHYDRATES, and alcohol

During menopause, the body becomes less tolerant of sugar and refined carbohydrates. Note that the body process alcohol in a similar way to sugar. With the declining levels of oestrogen, changes in insulin sensitivity, fat storage, and blood sugar swings are more likely and more disruptive. This means that there becomes a greater tendency to store fat around the abdomen and increases inflammation. These types of food and drinks can:

• Increase hot flashes and night sweats.

• Disrupt sleep quality.

• Worsen fatigue and brain fog.

• Contribute to weight gain.

• Negatively affect bone and cardiovascular health.

• Increase anxiety and irritability.

• Recovery from stress and exercise is impaired.

References

Akenhead, R. and Nassis, G.P., 2016. Training Load and Player Monitoring in High‑Level Football: A Critical Review. Sports Medicine, 46(10), pp.1461–1474.

Antonio, J., et al., 2021. Creatine Supplementation in Women’s Health: A Lifespan Perspective. Journal of Women’s Health, 30(9), pp.1232–1240. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7998865/ 

Barbagallo, M. and Dominguez, L.J., 2020. Magnesium and oxidative stress during menopause stage. Austin Journal of Nutrition and Metabolism, 7(1), pp.1–7. Available at: https://austinpublishinggroup.com/nutrition-metabolism/fulltext/ajnm-v7-id1083.pdf

Booth, S.L., et al., 2024. The importance of vitamin K and the combined action of vitamins D and K for bone health. Nutrients, 16(15), p.2420. Available at: https://www.mdpi.com/2072-6643/16/15/2420 

Dolan, P., et al., 2023. The effects of creatine supplementation on cognitive performance — a randomised controlled study. BMC Medicine, 21, p.440. doi:10.1186/s12916-023-03146-5. Available at: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-03146-5

Gavrilova, N.M. and Sytnik, K.M., 2008. The importance of nutrition in menopause and perimenopause: a clinical review. Climacteric, 11(5), pp.375–383. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10780928/ 

Halson, S.L., 2014. Monitoring training load to understand fatigue in athletes. Sports Medicine, 44(Suppl 2), pp.S139–S147.

Holick, M.F., 2025. Vitamin D and bone health: physiology, metabolism, and clinical implications. Nutrition & Metabolism Insights, 18, pp.25–40. Available at: https://link.springer.com/article/10.1186/s12986-025-01011-1 

Ingram, D., et al., 2002. Effects of dietary phytoestrogens in postmenopausal women. Journal of Clinical Endocrinology & Metabolism, 87(10), pp.4330–4337. doi:10.1210/jcem.87.10.8023. Available at: https://pubmed.ncbi.nlm.nih.gov/11907915/ 

Li, N., 2026. Creatine supplementation and exercise in aging: a narrative review of the muscle–brain axis and its impact on cognitive and physical health. Frontiers in Nutrition, 12, p.1687719. doi:10.3389/fnut.2025.1687719. Available at: https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1687719/full 

Pietinen, P., et al., 2018. Effects of phytoestrogens on bone mineral density during the menopause transition: a systematic review of randomized, controlled trials. Menopause, 25(5), pp.560–567. doi:10.1097/GME.0000000000001067. Available at: https://pubmed.ncbi.nlm.nih.gov/27710141/

Prokopidis, K., Giannos, P., Triantafyllidis, K., Kechagias, K.S., Forbes, S.C. and Candow, D.G., 2023. Effects of creatine supplementation on memory in healthy individuals: a systematic review and meta‑analysis of randomized controlled trials. Nutrition Reviews, 81(4), pp.416–427. doi:10.1093/nutrit/nuac064. Available at: https://pubmed.ncbi.nlm.nih.gov/35984306/ 

Sandkühler, J.F., Kersting, X., Faust, A., Königs, E.K., Altman, G., Ettinger, U., Lux, S., Philipsen, A., Müller, H. and Brauner, J., 2023. The effects of creatine supplementation on cognitive performance — a randomised controlled study. BMC Medicine, 21, p.440. doi:10.1186/s12916-023-03146-5. Available at: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-03146-5 

Theiler, S.E., et al., 2017. The synergistic interplay between vitamins D and K for bone and cardiovascular health. International Journal of Endocrinology, 2017, Article ID 7454376. doi:10.1155/2017/7454376. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC5613455/ 

Volpe, S.L., 2013. Magnesium in disease prevention and overall health. Advances in Nutrition, 4(3), pp.378S–383S. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11557730/ 

Xu, C., Bi, S., Zhang, W. and Luo, L., 2024. The effects of creatine supplementation on cognitive function in adults: a systematic review and meta‑analysis. Frontiers in Nutrition, 11, p.1424972. doi:10.3389/fnut.2024.1424972. Available at: https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2024.1424972/full