Menopause Journal: The Menopausal Menu

It's official. I'm in menopause. I've blamed my warmth on weather, but today it's cool and I'm hot! My doctor did a Follicle Stimulating Hormone test, measuring hormones produced by the pituitary gland that tell the ovaries to make estrogen. High numbers of hormones indicate menopause. In other words, pituitary calls to ovaries, "Make estrogen." Mine is screaming.

We discussed my breast man's concerns, my breast cancer risk. To determine my risk of osteoporosis, I had a bone density test. I have "107 percent of average age-related BMD," the normal range. According to "Susan Love's Hormone Book," it's the rate at which one loses bone, rather than how much one has. Still, better to have bone than not.

My blood pressure's good, my cholesterol's not. My doctor agreed that the research doesn't show whether hormones have a positive or negative affect on the risk of cardiovascular disease. He pointed out my weight gain, a known contributor to heart disease.

Even Tom Brokow is reporting on the difficulty of the "older woman's decision." Experts he interviewed concurred that they don't know what's best for the menopausal woman, there are "no right answers." It's kind of discouraging.

When I asked to hear from women who'd never taken hormones, only a few emailed me at Discovery. Maybe the rest didn't survive or maybe they're not reading or writing about menopause. Others tried alternatives to HRT. One wrote, "Two treatments from my acupuncturist eliminated my hot flashes." Another tried black cohosh. My mother says it sounds like hogwash. I mentioned these to my doctor, but he asked about diet.

My diet is high in coffee with cream, chocolate in almost any form, brie, fresh mozzarella with tomatoes and basil, milk, ice cream, salmon, lobster and blueberries in season, salad, broccoli and nuts. And popovers or blueberry pancakes with pure maple syrup, cake, pie, cookies, and the brick-oven-baked bread from Pain de Famille.

He concluded that my dairy propensity was good for my bones, but bad for my weight. He agreed with my breast man—skip the hormones. But he suggested that I watch my diet, particularly carbohydrates.

The Huge Topic of Diet: Which diet? There are low-carbohydrate, high-fat diets that concentrate on high protein and almost no carbohydrates. That might be good, but one study showed that a low-fat, high-carbohydrate diet reduces dense breast tissue (a risk factor for breast cancer) in menopause. There's the Dietary Approaches to Stop Hypertension diet, which emphasizes chicken and fish , fruits, vegetables and whole grains. That means more fiber, which irritates my Crohn's disease.

Menopause-friendly Diet

Crohn's doesn't help any diet. Often I'm nauseous in the morning, unable to eat, and starving later on. When Crohn's is active, I can't eat for days. My metabolism becomes confused, and when I feel better, I fill up on comfort foods to compensate for the deprivation. Can a menopausal diet help?

The essentials for the menopausal menu are calcium, phytoestrogens and antioxidants. Calcium is important for the menopausal woman, who needs at least 1,000 milligrams per day, plus vitamin D, to prevent bone loss.

Soybeans and soy products are recommended by nutritionists and traditional, as well as homeopathic, doctors because of the high content of phytoestrogens, natural plant estrogens that studies indicate have beneficial effects. A diet rich in soy isoflavones claims to decrease hot flashes, depression, moodiness and sleeplessness, as well as restore vaginal moisture. Studies at Bowman Gray Medical School indicated that the consumption of 30 to 40 grams of soy per day lowered blood pressure and cholesterol. Studies at the University of Illinois showed increased bone density. Soy is recommended for breast cancer prevention.

Some people probably like a good helping of soybeans twice a day, but the only soy "products" (is a food product a food?) I like are soy sauce and the deep-fried tofu in masaman curry at the local Thai restaurant. I've ordered a free sample of soy "milk."

Coffee depletes calcium, but green tea has antioxidants, the compounds that prevent oxidation, a process thought to lead to clogged arteries. Antioxidants are recommended to prevent cardiovascular disease. Vitamins E, A and C are high in antioxidants and are good for the prevention of bone loss.

Blueberries are high in antioxidants, and I've been happy to eat a bowl of fresh ones every day for a few weeks, but the season is over and I'm faced with giving up coffee for tea, cutting back on carbohydrates and dairy products, and choking down vitamins with soy milk. It's no wonder women go into depression in menopause. Studies of chocolate show that its chemicals have an effect on the neurotransmitters in the brain, giving a sense of well-being, a "lift," a "good feeling." I'd better have a piece of emergency chocolate now!

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