Taking the time to learn about what your body needs at every age can help you live better. Did you know that some women are able to manage symptoms of perimenopause and menopause through dietary changes alone, or in combination with other therapies? If you are seeking relief from symptoms such as hot flashes, low energy, or sleep disturbances, you may want to put some natural remedies to the test before trying medication. If this is you, here are answers to help get you started.

Can you reduce hot flashes and stress and boost energy levels through changes to your diet?
Not all women get hot flashes, but if you do, you know how uncomfortable they can be, especially when they occur at night as night sweats, or in the middle of an important meeting. Many women find relief from hot flashes with black cohash, a natural herb made from plant roots. Others find relief from products derived from rhubarb extract. There are many natural products that claim to help with hot flashes.

Additionally, you should evaluate your intake of some vitamins that can help, including vitamins B6 and B12 that may help reduce hot flashes and can also aid in coping with stress and insomnia. However, as with other vitamins, it is possible to overdo it, so make sure you check the dosage in any supplement If you go that route.

  • Vitamin B6 can keep menopausal depression at bay and boost energy by increasing serotonin. Vitamin B6 can be found in beans, fish, poultry, some vegetables (especially leafy dark greens) and fruits such as bananas, oranges and cantaloupe, and also fortified cereals. Too much vitamin B6 can cause nerve damage.
  • Vitamin B12, which is essential for red blood cell production and the central nervous system. It increases energy, protects the heart and brain, helps the eyes, and supports good gut health. Vitamin B12 is normally found in products such as fish, poultry, eggs, and dairy. Vegetarians and vegans can find it in fortified cereals or enriched non-dairy products such as soy milk. Because older people are more susceptible to vitamin B12 deficiency, some over age 50 may benefit from somewhat higher doses than younger adults.

Are there any nutrients that help with sleep?
Besides hot flashes and weight gain, poor sleep is one of the biggest complaints of women as they enter perimenopause and beyond. Practicing good sleep hygiene involves exercising regularly, cutting down on caffeine and alcohol, keeping your sleep area cool, and putting away electronic devices an hour before bedtime. However, good nutrition can also play an important role in helping get you to sleep and keep you sleeping soundly. Amino acids, enzymes, nutrients, and hormones work together to promote good sleep and regulate the sleep cycle. Other nutritional elements that influence sleep and can be consumed include tryptophan, calcium, potassium, antioxidants, vitamins D and B, and zinc. While these can be found in lots of foods, only some have high enough concentrations to potentially affect a person’s sleep cycle. For example, almonds contain high levels of melatonin and your grandmother’s remedy of warm milk contains a number of these elements. However, because poor sleep is so debilitating, many people turn to supplements, such as melatonin, to help them get to sleep or stay asleep.

Can CBD help with better sleep?
Some people turn to CBD (cannabidiol) to improve their quality of sleep. CBD is derived from the hemp plant, a cousin of the marijuana plant. However, while the marijuana plant contains THC (tetrahydrocannabinol), a psychoactive cannabinoid that causes the sensation of getting “high”, CBD is not psychoactive. Some people use CBD products to help induce a deeper, more continuous sleep. It is legal to sell and buy CDB products in the United States.

What aids with joints and bones?

  • Magnesium glycinate: Magnesium is important for a wide range of bodily functions, from strengthening bones and maintaining joint cartilage, to improving nerve and muscle function, heart health, and regulating blood sugar levels. It can also be helpful in treating menopausal joint pain due to decreased estrogen levels. Some women also see improvements in cold flashes, anxiety, and sleep disturbances with magnesium. It can be found naturally in many foods such as dairy, nuts, seeds, whole grains, leafy green vegetables, and fortified cereals. Both magnesium glycinate and magnesium citrate are good options, but magnesium citrate can produce a gastric effect leading to loose stools (this can be helpful if you have chronic constipation). Women ages 50+ need about 310-320 mg of magnesium daily.
  • Vitamin C is a good source of anti-oxidants and can help with bone density. Many believe it also helps with immunity. It can be found in many fruits and vegetables, including citrus, berries, Brussel sprouts, leafy green vegetables, and tomatoes. The recommended daily dose of vitamin C for adult women is 75 mg; however, too much can cause loose stool.
  • Vitamin K is important for bone density and also helps your blood clot properly. It has been linked to improvements in heavy period bleeding. Main food sources include all the leafy greens and cruciferous vegetables, and berries (blue and black). A good goal for vitamin K is about 90 mcg daily for women ages 50 and up.
  • Calcium is critical to build and maintain bone strength and is best absorbed along with vitamin D. After menopause, women are at greater risk of osteoporosis, a disease that thins and weakens bones and makes them more likely to break. When women enter perimenopause, lower estrogen levels accelerate calcium lossYour heart, muscles, and nerves also need calcium to function properly. Calcium and vitamin D together may have additional benefits, such as protecting against cancer, diabetes, and high blood pressure. The best sources of calcium are dairy products and calcium-fortified beverages such as almond or soy milk. Calcium is also found in dark-green leafy vegetables, dried peas and beans, fish with bones, and calcium-fortified juices and cereals. To ensure good bone health, women over age 50 should make it a priority to have 1,200 mg of calcium daily through diet and supplements (if needed). However, as with many nutrients, more is not necessarily better-- excessive calcium intake can be harmful.
  • Calcium supplements may take several forms, each compound containing varying amounts of the mineral calcium, but the main two are carbonate and citrate. You should be sure to check with your doctor or pharmacist because calcium supplements may interact with medications for blood pressure, thyroid hormones, and antibiotics, to name a few. If you have a choice, calcium carbonate is cheapest and contains the highest percentage of the element calcium, so that is often a good first choice. You should be aware that some calcium supplements are combined with other nutrients, so be sure to read the label carefully to be sure you are not getting too much. Calcium causes few, if any, side effects, but some people may experience gas, constipation, and bloating, so you may need to try a few different types to find the one you like best.
  • Vitamin D: helps your body absorb calcium, the main building block for strong bones. Calcium and vitamin D together are protective against osteoporosis. Your muscles need vitamin D to move, and your nerves need it to carry information between your body and brain. It also helps the immune system fight invading bacteria and viruses. The best source of vitamin D is actually sunlight, but if you’re wearing sunscreen, have darker skin, or live in a climate (or season) where your exposure to unprotected sunlight is limited, you can get vitamin D in fatty fish or fortified foods such as cereal. Despite its importance, more than 40% of people in the United States are vitamin D deficient, and that number almost doubles for women who are Black or Latinx. After age 50, you should try to get at least 25 mcg or as much as 100 mcg daily (1,000 to 4,000 IU) – preferably taken together with calcium. If you’re not getting enough vitamin D, you should take it as a supplement in the form of D3 if possible, which is more than twice as effective at raising vitamin D levels than D2.
  • Turmeric: When people talk about the health benefits of turmeric (a spice, not a vitamin), they are actually referring to curcumin, its active ingredient. Curcumin is a very potent anti-inflammatory that can help with various menopausal issues such as joint pain. Turmeric is anti-inflammatory and anti-arthritic and can help reduce pain and stiffness due to bone disease. It can helps prevent the loss of bone minerals and maintain bone density, reducing the risk of osteoporosis. It can also help in bone healing and help relieve knee pain. As an added benefit, turmeric can also improve cognitive function and heart health, reduce the effects of depression, and help delay the onset of Type-2 diabetes among prediabetic, post-menopausal women. You can get it from foods that contain turmeric, although probably not in the amount that may be beneficial. Women who take blood thinning medications should consult their healthcare provider before adding a turmeric supplement to their diet, as it can act as an anti-coagulant.

What can I eat to keep my immune system strong?
Vitamin A plays an important role in sustaining and protecting the immune system, vision, and communication between cells. It also supports cell growth and differentiation, playing a critical role in the normal formation and maintenance of the heart, lungs, kidneys, and other organs. There are two forms of vitamin A in the human diet: preformed vitamin A and provitamin A carotenoids. The main food sources of preformed vitamin A include dairy products, liver, fish, and fortified cereals, while the top sources of provitamin A include carrots, broccoli, cantaloupe, and squash. The recommended daily dose of vitamin A women over 50 is 700 mcg a day – but not more, so make sure you’re not doubling up on vitamin A in different supplements.

Selenium is an essential trace mineral that plays a role in many bodily functions including immunity and cognitive function. It is essential for healthy thyroid function, and may protect against cancer and cardiovascular disease. It can be found in some fish, brown rice, eggs, and Brazil nuts. The recommended daily selenium allowance for women over 50 is 55 mcg per day.

What can I do to minimize stress and depression?
Vitamin E can help minimize the symptoms of low estrogen that occurs during menopause. It is an antioxidant that helps fight cell-damaging free radicals in the body, and may also help reduce inflammation in the body. Vitamin E helps ease stress and can help reduce the risk of depression. You can get vitamin E in foods such as almonds, sunflower seeds, avocado, broccoli, spinach, and shellfish. You should aim for 15 mg daily, but people with eye damage, kidney, or heart problems, or cognitive decline such as Alzheimer’s should use it with caution.

Can I take anything to improve my cholesterol profile?
Omega-3 fatty acids can help reduce low-density lipoprotein (LDL, often called “bad” cholesterol) in the blood, decreasing plaque buildup and blockages, and lowering the risk of stroke or heart disease (the leading killer of women). It may also help with menopausal symptoms such as hot flashes, night sweats, vaginal dryness, and joint pain. Omega-3 fatty acids are found mainly in oily fish, eggs, beans, tofu, some nuts (such as walnuts) and leafy vegetables (such as spinach). If you’re not getting enough omega-3s, you should consider a supplement unless you’re on blood thinners.

My stomach hasn’t been feeling great, is there something I can do to help my digestion?
Probiotics: Research is increasingly pointing to good gut health as foundational to good health overall. Microorganisms inside our gut are critical for many life functions including digestion. Changes to your gut flora can leave you susceptible to harmful bacteria. Taking antibiotics, for instance, can kill off both helpful and “bad” bacteria, leaving your body with an overgrowth of the “bad stuff” (for instance, a yeast infection). If you suffer from digestive issues including bloating or gas, or have taken antibiotics, consuming probiotics are a good way to re-colonize your gut with the bacteria you need to feel good. Live microbes can be found in some yogurts or probiotic supplements with at least 10 billion colony forming units (CFUs) and at least 5 different bacterial strains (look for the phrase “live active cultures”). You could also consider integrating fermented foods that contain naturally occurring probiotics into your diet. In addition to yogurt, this list includes kefir, sauerkraut, kimchi and pickles (look for words like “raw," “lacto-fermented” or “unpasteurized."

My hair has lost its shine and my nails are always breaking. What can I do?
Biotin! While biotin isn’t going to give you more energy, adding it to your diet when you are in menopause can strengthen your hair and nails (which are all impacted by hormonal changes in menopause) and help you feel more like yourself. For perimenopausal women, you should aim for 30 mcg of biotin daily.