Hot flashes, irritability, sleep disturbance, weight gain, mood swings, loss of libido, joint and muscle pain… the menopause is very hard for many women. While some sail on, about one in four have severe symptoms that can last for years.
My wife, Clare, who is 59, said one of the worst things was the unpredictable hot flashes.
At night, she could never decide whether to put the duvet on or off, and the resulting insomnia added to brain fog and fatigue, which affects many women going through the Change.
I once heard a woman say, “I’m getting so forgetful that I could throw myself a surprise party.”
Clare, who has been a GP for over 30 years, is a fan of hormone replacement therapy (HRT) – in the right patients – and currently uses a cream-based version. Despite all the terrifying stories, she thinks that for many women, the benefits of taking it clearly outweigh the risks.
But there are plenty of women who can’t or would rather not take HRT, so what are the alternatives?
Researchers from the University of Barcelona in Spain enrolled 37 postmenopausal women in a study in which – after testing and completing a menopause-related symptom questionnaire – they were randomly assigned to drink half a pint of beer or a pint of non-alcoholic beer per day.
One of the more surprising suggestions, supported by a clinical trial, is that women struggling with menopause should consider drinking beer.
The idea is that beer is a good source of isoxanthohumol, a chemical produced by hops that has anti-inflammatory properties.
This is converted by the microbes in your gut into a very potent phytoestrogen, a plant-based version of the female hormone estrogen.
Since a drop in estrogen is the cause of many menopausal symptoms, in theory supplementing your phytoestrogens should be a good way to reduce them.
To test this, researchers from the University of Barcelona in Spain enrolled 37 postmenopausal women in a study in which – after testing and completing a menopause-related symptom questionnaire – they were randomly assigned to drink half a pint of beer or a pint. non-alcoholic beer per day, or to continue as before.
As the researchers reported in the journal Nutrients, those who drank beer — both alcoholic and non-alcoholic — experienced significant improvements in their menopause-related symptoms at the end of six months.
The most common symptom, joint and muscle discomfort, improved significantly (70 percent of beer drinkers reported this), as did their physical and mental exhaustion (70 percent) and difficulty sleeping (65 percent).
Surprisingly, the beer drinkers did not gain weight, while those who drank the non-alcoholic beer also experienced a significant reduction in blood pressure and cholesterol levels.
There are many drawbacks to alcohol, so I wouldn’t recommend sitting back beers based on this one little study.
Hot flashes, irritability, sleep disturbance, weight gain, mood swings, loss of libido, joint and muscle pain… the menopause is very hard for many women
But what it does point out are some of the potential benefits of eating foods rich in phytoestrogens. Think of legumes (such as beans, peas, lentils) and fermented soy products: tofu, tempeh or miso.
There were concerns that some of these foods, particularly soy, would increase the risk of breast cancer.
But a review of studies, published in November 2020, concluded that eating phytoestrogen-rich foods can actually protect against breast, endometrial or colorectal cancers, plus improve bone density (a problem for many postmenopausal women).
Other ways to improve symptoms include exercise, eating more fatty fish, and losing excess weight.
PS: CAN BEER HELP ‘MENOPAUSAL’ MEN?
The short answer is no – even if you accept that there is such a thing as male menopause, adding plant estrogen to your diet is unlikely to help.
But what about this question of the existence of a “male” menopause?
What we do know is that when men reach middle age, many experience symptoms similar to women’s menopause — that is, loss of sex drive, low mood, trouble sleeping and poor concentration.
Some of these symptoms are related to a large drop in testosterone levels, which usually occurs between the ages of 30 and 50.
This, in turn, has led some to argue that men have their own form of menopause (or “penopause,” as it’s more cynically described).
As the Barcelona researchers reported, those who drank beer experienced significant improvements in their menopause-related symptoms at the end of six months.
It is certainly true, as I told my son Jack, who has just turned 29, that after age 30, muscle mass and testosterone levels drop by an average of about 1 percent per year.
But the good news, as I also quickly noted before he got too depressed, is that unlike menopause, such major falls are not inevitable.
This was made clear in a 2013 study by researchers in Australia. They tested the testosterone levels of nearly 1,400 men over a five-year period and found that while the average levels fell by 1 percent per year, there were huge variations.
The biggest falls were in men who gained much weight and remained single.
One reason weight gain lowers testosterone is because fat cells contain high amounts of the enzyme aromatase, which converts testosterone into estrogen.
So gaining weight means less testosterone, which in turn means a lower sex drive and less muscle.
On why being single can affect testosterone, said Dr. Gary Wittert, a professor of medicine at the University of Adelaide who led the study, said this is likely because married men are healthier and happier.
Married men also enjoy regular sex more than single men and this is a surefire way to boost testosterone levels.
Other less fun ways to keep your testosterone levels up include strength training and adequate sleep.
I only have to look at a cookie to maintain my weight while my wife stays effortlessly slim.
Is it because I have a weaker will – or is it because of subtle differences in our genes that drive hunger and food preferences?
I think it has more to do with the genes — and Giles Yeo, a professor of genetics at the University of Cambridge, and the author of a fascinating new book, Why Calories Don’t Count, confirms that up to 70 percent of the differences in weight between people can be explained by genes.
A mutation in the KSR2 gene leads to persistent hunger pangs, while a mutation in the GPR75 gene appears to protect against weight gain — a recent study of about 645,000 people found those with this mutation were 54 percent less likely to become obese.
Unfortunately, most of us aren’t blessed with lean genes, so we have to work a little harder to maintain a healthy weight.