To menopause and beyond! Bodies, brains (and beetroot hummus)

In the last couple of weeks, our social media feeds – and real-life conversations – have exploded with discussion about the menopause in the wake of Davina McCall’s documentary on Channel 4, Sex, Myths and the Menopause. If you missed it, there’s a link here.

The programme is a brilliantly-made polemic about how healthcare providers, employers and governments have failed those of us who are menopausal. The stats it provides are staggering: 13 million women in the UK are currently living with the menopause, nine out of 10 women say it’s adversely affected their work. The programme has also ignited the conversation about how women can best be supported during this time of change. Do look at @menoscandal and The Menopause Charity for more.

The programme has a heavy emphasis on the benefits of HRT which has caused some controversy since broadcast. Nutritionists and psychologists, among others, have pointed out that lifestyle changes can be very beneficial in dealing with menopause symptoms. The programme does highlight the importance of weight training during menopause and beyond (we’ve written about that here and here). However, menopause isn’t just about a decline in hormones, it’s also a time of profound physical and psychological change, when our bodies and brains go through the biggest shifts they’ve experienced since we left childhood. No wonder menopause can be brutal for so many of us.

Ageing at a cellular level

Menopause affects how we age at a deep cellular level. Research published as a preprint (meaning it’s a preliminary report and has yet to be peer-reviewed) earlier this month by Dr Louise Newson, Tim Spector and others, found that ageing accelerates during perimenopause, so our biological ageing overtakes our chronology. The research looked at tiny sugar molecules, called glycans, which cluster on our immune system antibodies. These clusters change as we age, but during perimenopause, the rate of these changes more than doubles. Some women in the report added up to 20 years to their biological age.

Thankfully, ageing does return to a more normal pace when we’re post-menopausal. But during perimenopause, it seems that falling oestrogen levels cause anti-inflammatory immune system antibodies to become pro-inflammatory. And as we’ve written about here, inflammation is at the root of ageing and linked to many of the chronic conditions of later life, including arthritis, osteoporosis, heart disease and dementia. The good news is that healthy lifestyle factors – not smoking, a good diet, exercise and stress reduction – all help slow the process and keep us young at a cellular level.

Menopause and Alzheimer’s risk

It’s widely known that women are more at risk of Alzheimer’s and other dementias than men. Around two-thirds of dementia sufferers are women, and women are far more likely to experience other issues related to brain health, such as depression, headaches, strokes and MS. Increasingly, this discrepancy is being laid at the feet of the dramatic decline in oestrogen levels we experience in midlife.

As Dr Lisa Mosconi points out in her brilliant book The XX Brain (there’s a really good 13-minute TED Talk summary you can find here) oestrogen is so much more than a reproductive hormone. It regulates energy production in the female brain, as well as encouraging the production of new neurons and shielding existing ones from harm. When oestrogen declines, so do all these benefits. In men, testosterone functions in a similar way, but the difference is that levels of this hormone don’t fall off a cliff in midlife. For women, hormonal change accelerates the brain’s ageing process, as it’s less able to produce energy.

When Mosconi looked at brain scans of perimenopausal and postmenopausal women, she found a 30% reduction in brain energy levels. Our brains are effectively starving. Her advice? Exercise regularly, sleep well, reduce stress and lower the ‘mental load’ (the amount of cognitive gymnastics we do to keep all the balls in the air, all the time). She’s also an advocate of the Mediterranean diet, the plant fibre of which promotes the action of a molecule called SHBG (sex hormone binding globulin), which helps promote the action of oestrogen. We’ve written about the Medi diet – and shared recipes – here and here.

RECIPE – BEETROOT HUMMUS

A beetroot (almost) the size of my head arrived in my organic veg bag this week, so I’ve been looking for creative ways to use it. Beetroot is high in the fibre women need to help regulate SHBG, and therefore oestrogen. It’s also a good source of nitrates, which the body can convert into nitric oxide which helps keeps arteries flexible and in turn reduces blood pressure.  Post-menopause, many women find their blood pressure increases, along with heart disease risk.

• 100g cashews, soaked in warm water for 30 mins
• 150g cooked, peeled beetroot
• 200g white beans, such as cannellini, drained and rinsed
• 2 tbs extra virgin olive oil
• 1 garlic clove finely grated
• Splash chilli sauce
• Juice of half a lime

Drain the soaked cashews and blitz in a food processor with the beetroot. Add the rest of the ingredients and whizz again. Add a little water as necessary to loosen the mix and achieve your desired consistency. Season well with salt and pepper. Scoop it all into a pretty bowl (the colour is amazing) and serve with lots of vegetable crudities for dipping.

Susan