Are you a candidate for HRT? Menopause is having a moment in the media these days. Thank goodness the silence is finally breaking on this very normal season of life for anyone born with ovaries. Our grandmothers and moms weren’t as lucky – stuck in cultural narratives centered on jokes, shame, and “just deal with it, you’re being too sensitive.” But what’s missing from the conversation is how to deal with menopause symptoms without HRT, relying on phytoestrogen-rich foods instead.
While many of us experience common symptoms of the menopause transition, we don’t all have to use the same tools to get through those symptoms. Your individual experience matters. You are the expert of your body!
BTS. I have a lot of breast cancer in my immediate family. My calculated risk of getting breast cancer before I’m geriatric is about 30%. Even though I lead a fairly healthy lifestyle (Not perfect. Yes, I still eat cookies and chocolate daily), the genetic cards I’ve been dealt are what they are. Will I take HRT to manage my increasing list of perimenopause symptoms?
I’m considering my life choices, as my friend Mary would say. I’m talking with my care team about my options, and I’m getting regular mammograms. Honestly, at the moment, HRT isn’t for me. Here’s why.
For the past 2 years, I’ve supported women going through the menopause transition as a part of the dietitian team working for Gennev. I’ve witnessed the vast array of experiences with HRT – the good (better sleep, less meno-rage, more energy), bad (irregular bleeding, breast tenderness), and the ugly (rapid weight gain). Ugly is the word the women use, not mine. I’ve also soaked up as many evidence-based recommendations regarding HRT from the OB-GYN team. Including the updated science on the risks of developing breast cancer with HRT. And I’m still not convinced it’s the option for me.
HRT is NOT the only way to survive menopause
What options are available to manage menopause symptoms if you can’t or don’t want to take HRT?
For me, I’ll stick with the food-first approach we nutrition counselors and dietitians are so good at. That means I’ve been steadily incorporating more phytoestrogen-rich foods into my daily eating routine.
What are phytoestrogens?
Phytoestrogens are plant-based estrogen-like compounds called isoflavones that are found in beans, lentils, soy, flax, and herbs like red clover. They can help reduce estrogen fluctuations during perimenopause and reduce symptoms like hot flashes, night sweats, vaginal dryness, and irregular moods. How is this different from HRT?
There are 2 types of estrogen receptors in our bodies. Estrogen receptor (ER) alpha is associated with cellular growth, including cancer cell growth, like breast cancer. Estrogen receptor (ER) beta acts like a counterbalance to ER alpha.
While isoflavones look similar to estrogen in their chemical structure, they preferentially bind to the ER beta receptor and only weakly bind to the ER alpha receptor. Depending on how much estrogen you have floating around in your body, isoflavones will either increase or decrease estrogen binding to the alpha receptor. In this way, isoflavones are considered “selective estrogen receptor modulators.” Which is a good thing – especially if you’re concerned about breast cancer!
It’s also a good thing, because as your estrogen levels become more erratic during perimenopause and decline in menopause, isoflavones are likely to bind to the estrogen receptors to offer relief from symptoms such as hot flashes, night sweats, irregular moods, and vaginal dryness.
How can you add more phytoestrogens to your diet?
Research studies suggest using 50-100 mg daily, typically only achieved through supplementation. However, 25-50 mg/d is more realistic for everyday eating.
This looks like:
- 1 cup of soymilk (preferably unsweetened)
- ½ cup of edamame
- 2-3 Tablespoons of miso paste
- 3-5 oz of Tofu or tempeh
- 1 Tablespoon of ground flax seeds
- ½ -1 cup of beans or lentils (start low, add gradually)
Here’s a sample phytoestrogen-rich menu:
- Breakfast: overnight oats made with ½ cup of oats, 1 cup of soy milk, ½ tsp of cinnamon, ¼ cup dried cranberries, 2 TBSP hemp seeds, 1 TBSP ground flax seeds
- Lunch: brown rice Savor Bowl with roasted root vegetables, sauteed dark leafy greens or spinach, ½ cup edamame, ¼ cup toasted sesame seeds, and miso sesame dressing (1 Tbsp light miso + 1 TBSP toasted sesame oil + 1 TBSP olive oil + 1 TBSP rice vinegar + ½ tsp ground ginger)
- Dinner: Tempeh fajitas with sauteed bell peppers, onions, zucchini, and black beans wrapped in 2 whole-grain corn tortillas
Remember to use the add-in approach to incorporate more phytoestrogen-rich foods in your diet. Think of it as adding more variety to your meals – a key component of the gentle nutrition framework. When you use the add-in approach, you won’t feel deprived by eliminating other foods, and you won’t feel obligated that you “have to eat” phytoestrogens to be healthy in this season of life.
Learn how to use gentle nutrition to get through menopause! Enroll in my 4-week online course.
