Managing menopause and post-reproductive health with nutrition and lifestyle

Background: There has been increasing interest in nonhormonal- and nonmedication-based approaches to managing menopausal symptoms and optimising post-reproductive health.

Aim: To examine the recent evidence for dietary and lifestyle management of post-reproductive health in women, specifically examining interventions for menopausal vasomotor symptoms, cardiovascular disease, osteoporosis, and dementia and cognitive decline.

Methods: Published systematic reviews and clinical trials were drawn upon and narratively synthesised.

Results: Physical activity of any kind and a plant-based dietary pattern rich in extra virgin olive oil and fish, such as the Mediterranean diet, were found to improve menopausal vasomotor symptoms, cardiovascular disease and osteoporosis risk, and cognitive function. Vitamin D and calcium supplementation may improve osteoporosis risk only if the nutrients cannot be met by diet alone. Omega-3 polyunsaturated fatty acids and resveratrol supplementation may have beneficial effects on cognitive function. There is no evidence avoiding “triggers” improves menopausal vasomotor symptoms, and nutraceuticals such as black cohosh may cause serious adverse events. Dietary restriction for weight loss may worsen osteoporosis risk.

Conclusion: Promoting a healthy plant-based dietary pattern, whilst preventing both obesity and protein-energy malnutrition needs, to be combined with physical activity. All interventions must be cost effective, culturally acceptable and enjoyable.