Menopause is the time of life when we naturally stop having menstrual periods. It marks the end of our reproductive years. Because our periods can fluctuate during perimenopause (the phase when the ovaries start to produce less estrogen), you know you’ve truly hit menopause after you go 12 months without a period.
The average menopausal age is 51 in the United States, with perimenopause (the onset of hormonal fluctuation and a period of transition toward menopause) beginning from five or even 15 years before then. Sometimes, perimenopause can start as young as when we are in our 30s. You change a lot during these years. And, as you may remember from puberty, transitions can be awkward when your body and your mood frequently betray you.
For some women, menopause is not a life-shattering event. For others, it can be truly agonizing. In a survey by the American Association of Retired Persons, 84 percent of participating women said that menopausal symptoms interfered with their lives. My own symptoms were those that many of you have experienced: weight gain, brain fog, sleepless nights, hair loss, irritability and more. I truly believed that if I just hung in there long enough, the symptoms would disappear
Unfortunately, that was not the case. They just seemed to go on forever.
Aside from the misery some of us have felt, we are not getting the help we should from our physicians. A 2013 Johns Hopkins University survey found that only one in five American obstetrics and gynecology residents had received formal training in menopause medicine. That’s only 20 percent of gynecologists!
If they do pay attention to us, they give advice something like this: “Just ignore it; it’s going to get better.” Or, “You can take an antidepressant, which will help your hot flashes—but it’s going to lower your sex drive and you might gain weight.” Or, “Here, try this prescription for standard hormone replacement therapy, but it may increase your chances of getting blood clots, heart attacks, strokes or breast cancer.”
Whoa. Your body is already changing like crazy, and you surely don’t want to burden it with more, and especially with pharmaceuticals that could potentially harm your well-being at the same time. (Full disclosure: Yes, I do believe in hormone replacement, as long as the hormones are bioidentical.)
Obviously, the options are not too fabulous. So, I’m not surprised that many women are casting about for more natural, safer approaches than pharmaceuticals—and nutrition is at the top of the list.
It works magic to fix our hormones, as I wrote in The Hormone Fix. Nutrition and lifestyle rather than drugs are intimately involved in healing and regulating our master hormones: insulin, cortisol, and the most powerful of the three—the love, joy, and bonding hormone—oxytocin. When those three are working at peak function, our reproductive hormones, estrogen, progesterone, testosterone and DHEA are balanced throughout the menopausal
Menopause Around the World: Asia
Japan gives us a beautiful example of a different attitude toward menopause—and a different experience of it, too. Japanese women tend to view menopause as their “second spring,” a time of renewal. They worry even less about hot flashes and night sweats because they get them less frequently. There’s a very good reason for that: their diet.
Many experts have suggested that menopause is much easier for Asian women than for Westerners because Asian women follow traditional, mostly plant-based diets. It is well documented that Western women eat much more meat, and about four times as much saturated fat, as women on traditional Asian plant-based diets, and only one-fourth to one-half the fiber that Asian women eat.
Plus, Japanese women do not consider menopause to be a sign of middle age; rather, they see it as a natural process. Their word for menopause is translated loosely as “renewal and regeneration.” I believe that when you develop a positive mindset, with a perspective like this, it changes your physiology to greater physical well-being and good health. Until recently, there was no word for “hot flash” in Japanese, and only about 25 percent of Japanese women even experience hot flashes! Here is one of my Asian-inspired recipes on the following page to keep you feeling good.
Miso-Ginger Zoodle Ramen
Makes 2 servings
This dish begins with a super-savory combination of onion, garlic, ginger, carrot and miso (which is essential for the salty flavor that ramen is known for). Then, I add the spiralized zucchini (zoodles), which are the perfect low-carb swap for the traditional ramen noodles. Other veggies, like mushrooms and mustard greens, add additional healing power. Of course, to make this you will need a spiralizer; as an alternative, you can slice the zucchini on a mandoline slicer. The dish can be made on the stovetop or in a slow cooker.
3 tablespoons extra virgin olive oil
(1 tablespoon for slow cooker)
1 medium onion, halved and sliced
4 garlic cloves, chopped
1⁄4 cup shredded carrot
1 tablespoon grated fresh ginger
1 tablespoon white miso paste
1 tablespoon coconut aminos
31⁄2 cups vegetable broth
Sea salt and black pepper
11⁄2 cups chopped shiitake mushrooms
1 large zucchini, spiralized or sliced paper thin
2 cups chopped mustard greens or bok choy or spinach
Toasted sesame oil (optional)
White sesame seeds (optional)
Heat 2 tablespoons of the olive oil in a large pot over medium- high heat. Add the onion, garlic and carrot and cook for 2 to 3 minutes, until the onion softens and becomes translucent. Add the ginger and miso, stir, and cook for another 2 minutes. Add the coconut aminos and broth, then season with salt and pepper. Bring to a boil, then reduce the heat to medium-low and simmer for 20 minutes.
While the miso broth simmers, heat the remaining tablespoon olive oil in a medium skillet over medium-high heat. Add the mushrooms, season with salt and pepper, and sauté for 8 to 10 minutes, until the mushrooms become tender.
Transfer the mushrooms to the miso broth. Add the zucchini and greens, cover the pot, and cook for another 5 to 10 minutes, until the zoodles are tender and the greens are wilted. Serve, if desired, with a small drizzle of the sesame oil and pinch of sesame seeds on top.
Slow Cooker Directions
In a slow cooker, combine the onion, garlic, carrot, ginger, miso, coconut aminos and broth. Stir to combine, season with salt and pepper, cover, and set to cook on high for 2 to 3 hours. Twenty minutes before you plan to serve, heat 1 tablespoon olive oil in a medium skillet over medium-high heat. Add the mushrooms, season with salt and pepper, and sauté for 8 to 10 minutes, until the mushrooms become tender.
Transfer the mushrooms, zucchini and greens to the slow cooker. Cover and cook for another 5 to 10 minutes, until the zoodles are tender and the greens are wilted. Serve, if desired, with a small drizzle of the sesame oil and a pinch of the sesame seeds on top.
Adapted from MenuPause, copyright © 2022 by Dr. Anna Cabeca. Used by permission of Rodale Books, an imprint of Random House, a division of Penguin Random House LLC, New York. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.