Menopause and Bone Health

Menopause represents a major transition period in the lives of most women. That is why it is called the “change of life.” Women experience a decreased production of sex hormones by the ovaries, and many times there are symptoms representative of estrogen deficiency and withdrawal. Men may also experience some “change of life,” but usually this is fairly mild compared to what women experience.

Most women enter menopause between the ages of 45 and 50, but it may occur anywhere between 40 and 55. Those whose ovaries are surgically removed before they have entered menopause will almost immediately experience menopausal symptoms and often are placed on estrogen alone or hormone replacement therapy (HRT), using estrogen and progesterone to simulate their natural cycle. While estrogen therapy or HRT
is helpful to most women, there are potential risks and side effects, so many women eventually want to shift to a more natural program and go off synthetic hormones. The discussion here is therefore oriented toward a natural program of diet, nutritional supplements and herbs to minimize menopausal symptoms and enhance vitality.

The symptoms of menopause include a change in the frequency or volume of blood flow of the periods (or actual cessation of menstrual periods), irritability, hot flashes and night sweats, emotional swings, headaches, depression, insomnia, loss of sex drive, and weight changes. More internal metabolic shifts, such as the bone loss of calcium, may also occur.

There are many factors that influence the intensity of symptoms and probably even the time they appear. A poor diet, emotional stress, and lack of exercise may lead to an increase in symptoms, particularly when these lifestyle habits have been going on for years. Women who become aware of these relationships prior to menopause and change their habits to help build themselves up with diet and supplements, and deal with their stressful issues will most assuredly have an easier time. Not all women have a difficult menopause; some may not even experience symptoms at all.

A good diet along with supportive nutritional supplements and stress management may help to delay the onset of menopause and reduce symptoms when it does occur. Of other positive lifestyle habits, regular exercise is the most important. It strengthens the bones and improves calcium metabolism. It may also help mobilize some stored estrogen from the fatty tissues, which may make for an easier transition. Outdoor exercise, such as walking, bicycling, swimming, golf, or tennis, will add sunlight and thus aid the body’s vitamin D production, and so improve calcium utilization.

During menopause, it is wise for women to get adequate sleep and even take naps
if they feel tired. Menopause can often be a time of lowered energy. Stress reduction
and dealing with the concerns and worries about aging are important. Embracing maturity and wisdom adds a positive attitude and supports this process. Drinking plenty of water helps keep the body vital and young, with the internal processes functioning best.

A diet that contains vital and wholesome foods will support a stronger life force and the ability to better handle changes. As I have emphasized throughout this book, a vital diet is one that includes fresh fruits and vegetables, whole grains, nuts, seeds, and legumes; with fish, poultry, eggs, milk products, and cold-pressed oils used in moderation; and sugar, refined flour products, other refined processed foods, cured meats, fried foods, and chemicals avoided.

A diet with good quantity and quality of protein and one high in B complex foods may help delay the onset of menopause by supporting the pituitary gland, which regulates the ovaries and the female cycle. (It appears that strict vegetarian women and those with low cholesterol levels have an earlier menopause than more omnivorous women; further research in this area may help us to understand more about diet, cholesterol, and menopause.) Some of the protein foods suggested are fish, milk products such as yogurt and cottage cheese, eggs, whole grains and legumes, nuts, and seeds; foods high in B vitamins are green vegetables, whole grains, wheat germ, and yeast. Good levels of pantothenic acid, choline, and inositol also aid the adrenal and pituitary functions. Special foods that offer high amounts of vitamins, minerals, and energy include brewer’s yeast, molasses, lecithin, and kelp (or other seaweeds). These can be used with milk or juice to make a high-nutrient drink.

Osteoporosis is a loss of bone minerals, density, and bone strength, particularly of the spine and long bones of the arms and legs; it is a common problem of menopausal women. Osteoporosis is a difficult problem to diagnose. Regular x-rays are not that sensitive, and they reveal bone loss only after it is fairly significant. The new technique available to measure bone density, photon absorbtiometry, is more sensitive at assessing early osteoporosis. Generally, though, women should be aware of early warning signs, such as periodontal disease, changes in the curvature of the spinal column, such as
a “dowager’s hump,” or pain in the middle or lower back. The most important factor is preventing the loss of bone calcium; this is much easier than correcting bone loss
after it occurs.

To prevent osteoporosis, it is wise to eat a good diet and maintain an adequate calcium intake through foods and supplements in the years before menopause. Many people eat a diet that is much higher in phosphorus than in calcium. This can lead to improper bone metabolism and loss of bone calcium. Meats, nuts, seeds, poultry, boneless seafood, and even whole grains have a much higher phosphorus than calcium content. Soda pops have added phosphates, increasing their phosphorus level. One advantage of using milk products is that they have a very good calcium-to-phosphorus ratio, with actually slightly more calcium. Eggs and many vegetables, especially the green leafy veggies, also have lower phosphorus content.

Premenopausal women should regularly consume 1,000-1,200 mg. of calcium per day. Supplementing some calcium without phosphorus will usually balance out these nutrients. Adding about 500-1,000 IUs of extra vitamin D and 500-800 mg. of magnesium per day will help the calcium be best utilized and protect against osteoporosis. Adequate boron, a trace mineral, in the diet and supplements to include 2-3 mg. is
also shown to aid calcium utilization. A diet containing good amounts of fish, leafy greens, whole grains, and dairy foods will support healthy bones. Phosphorus, zinc, copper, and manganese are also important to building strong bones. If osteoporosis is present, research suggests that estrogen therapy may help slow its progress and even improve the bone health, though it also poses risks. Fluoride, 2-4 mg. per day in foods or even taken as a supplement, has been shown to strengthen bones, but it, likewise, may have other concerns.

When estrogen is used during or after menopause, it is wise to follow a program similar to that suggested for users of birth control pills (if the woman still has a uterus, a progestin agent should also be used to simulate the natural cycle and to protect the uterus from cancer development). Extra vitamins C, E, and B6, extra zinc, and minimum copper intake are the main suggestions. It is clear that estrogen or hormone replacement therapy does prevent osteoporosis, possibly better than any other program, especially with a good diet, adequate calcium intake, and plenty of exercise. Regular exercise has clearly been shown to minimize bone loss, especially postmenopausally. Weight-bearing exercises, such as walking, tennis, or golf, help to strengthen the bones, probably more than swimming. When taking estrogen, usually less calcium is needed than when no hormones are used. Still, a natural program such as the one described here will help prevent osteoporosis and ease the symptoms and transition of menopause. (For more on osteoporosis, see the Calcium discussion in Chapter 6.)

Younger women also can develop osteoporosis, usually due to a poor diet, low calcium intake, and excessive vigorous exercise. Dancers, gymnasts, and long-distance runners have this problem most commonly, and it is exaggerated with anorexia and weight loss. These young women often have associated low body fat, low estrogen levels, and irregular or nonexistent menstrual periods. A more nourishing diet, reduced activity, and calcium-vitamin-mineral supplements can help to correct this problem
and prevent future ones.

For menopausal hot flashes, irritability, and/or night sweats, supplemental calcium and vitamins D and E will often help. Dong quai herb has also benefited many women with those symptoms. Two capsules taken two or three times daily is the standard usage in this regard. Ginseng has also been helpful, especially when there is associated fatigue. Other herbs that work are some of the female tonics, such as the cohosh herbs, unicorn root, and licorice root. The FE-G and female formulas described in the section on Premenstrual Syndrome in Chapter 17 may also be helpful in menopause, as they seem to support estrogen production by stimulating the female organs. Sarsaparilla root has been used as a female herb, and valerian root can be used for insomnia and irritability. Calcium-magnesium is helpful for muscle and back pains or cramps. Kelp tablets have been used to support thyroid function, which helps women through the changes of menopause. Iron is still needed in premenopausal amounts until there is no more bleeding; then the iron requirements decrease from 18-10 mg. per day.

The nutrient program presented here includes dietary plus supplemental needs. Nutrients such as chloride, phosphorus, fluoride, sodium, and potassium are usually not supplemented, but obtained from diet. The ranges allow for individual comfort in using the higher amounts, which may be best for this program. (See the following program for the Elderly for further information. The programs on Anti-Aging and Anti-Stress in Chapter 16 may also provide assistance to the menopausal woman.)


Vitamin A
5,000-10,000 IUs
1-2 mg.
15,000-20,000 IUs
2-4 mg.
Vitamin D
400-1,000 IUs
150-300 mcg.
Vitamin E
800-1,000 IUs
10-18 mg.
Vitamin K*
150-400 mcg.
Thiamine (B1)
50-100 mg.
2.5-15 mg.
Riboflavin (B2)
25-50 mg.
150-500 mcg.
Niacinamide (B3)
50-100 mg.Phosphorus*
800-1,000 mg.
Pantothenic acid (B5)250 mg.
Pyridoxine (B6)10-25 mg.Optimal:
Cobalamin (B12)50-100 mcg.L-amino acids500-1,000mg.
Folic acid400-800 mcg.L-cysteine250-500mg.
Biotin200 mcg.DL-methionine250-500mg.
Vitamin C1-4 g.L-glycine250-500mg.
Bioflavonoids250-500 mg.Psyllium seed4-8g.
Flaxseed oil1-2 teaspoons
Olive oil3-6 teaspoons
Calcium600-850 mg.Liquid chlorophyll2-4 teaspoons
Chromium200 mcg.Apple cider vinegar1-2 Tablespoons
Copper2 mg.Acidophilus culture1-2 billion organisms
Iodine150 mcg.Detox formula herbs: echinacea, yellow dock, goldenseal, garlic, parsley, licorice, cayenne pepper 4-6 capsules

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Written by Elson M. Haas MD

Explore Wellness in 2021