Hot Flashes, Night Sweats & More

Transcript:

MELANIE: Welcome to our weekly Dishing Up Nutrition podcast. As nutritionists and dietitians, we've shared life changing nutrition information on Dishing Up Nutrition for the past 20 years. Many of you have listened weekly and we want to thank each and every one of you for listening and supporting us.

Additionally, many of you have taken one or more of our classes such as Nutrition for Weight Loss or a Menopause Solutions class, or even our new class series, How to Break up with Sugar in 28 days. Or maybe you've met individually with one of our dietitians or nutritionists.

We are of the belief that the more you know, the better you'll do. Today to expand your knowledge even more, we want to share signs and symptoms of perimenopause and menopause. I'm Melanie Beasley. I'm a Registered and Licensed Dietitian and I help many women deal with menopause symptoms. I understand how they feel both clinically and also personally because I've been through it. When a client talks about having a hot flash in a work setting, I understand how that feels.

Joining me today as our cohost is Britni Vincent, who's also a Registered and Licensed Dietitian and works with many women who have hormonal concerns.

What is menopause?

BRITNI: You know, first I just want to define what menopause actually is because a lot of people don't know.

MELANIE: Yeah, good.

BRITNI: So menopause is when you haven't menstruated for 12 months. That is technically what menopause is. And the time before that is, is perimenopause, which can go on for several years.

MELANIE: Yes. Yes. I have so many women that are so excited they're at the 11 month mark and they've got their fingers crossed. It's great.

BRITNI: Yep. Yep. And I want to share some interesting numbers about women and menopause. A recent report found that over 1 billion women will be in menopause by 2025. So next year, 1 billion women will be in menopause. That's a lot, a lot of women. And it's interesting to know that almost all women will experience menopause in their lifetime. But generally, a lot of women don't want to talk about menopause. They don't want to share their unpleasant symptoms of hot flashes, sleep problems, thinning hair, vaginal dryness, anxiety, or let alone the loss of their sex drive.

MELANIE: I think women think they have to power through and be tough and talking about it. It means that they feel weak about it.

Menopause doesn’t have to mean suffering

BRITNI: Yeah. I think so. And, I do believe the lack of discussion around menopause, it leads a lot of women to believe that this is just how it is that menopause is suffering through it, and it doesn't have to be that.

MELANIE: It's a good point.

BRITNI: A menopause study was conducted called the State of Menopause Study, and that study found that one third of women never sought out information about menopause before they experienced it themselves. So they went into menopause really not knowing what to expect, and nearly half of the women of women surveyed didn't know the difference between perimenopause and actual menopause.

The study also found that three quarters of women were not thinking of their menopause symptoms as a health concern. Again, I think because they believe it's all menopause. It's all normal. And, and those symptoms are how it has to be.

But our goal today is to start the menopause conversation. We would like to help you realize that the menopause period of life is a very complex time. And during this time of life, many women are caregivers for their parents and are also actively parenting their own children. If they have a teenager that comes with a lot of busyness, plus, you know, many women are working on top of all of that. So there's just not much time left for self care.

MELANIE: You're reminding me of a time I was going through menopause sitting at a concert in a wool sweater with my winter coat tucked behind me and you're wedged in between other parents. And I had a hot flash and you can't take off your clothes in a concert. I just, at that time in my life, I thought never again will I wear something I can unzip and get out of. quickly.

BRITNI: Layers.

MELANIE: Layers. Hot. Oh, it's the hottest I've ever been. So when the body and the brain become overstressed and deficient in nutrients, menopause symptoms often become more intense and lasts longer; not what we want. So good nutrition, adequate sleep, and a supportive community of friends is really very important. So let me encourage you to sign up for our six part class session called Menopause Solutions.

And this is a video presentation that Kara Carper and I taught together. We had a lot of fun doing it. We covered all phases of menopause from perimenopause to menopause. We shared information about symptoms and more importantly, solutions. You can take these classes at your own pace. Some women form a small group and watch the class presentation together and discuss the issues that they're having and some solutions that have worked for them. You can red more about this class series on our website, weightandwellness.com

Sign Up for Menopause Solutions - Online

BRITNI: You know, you mentioned perimenopause. In reality, many women today start perimenopause in their late thirties and most women go into menopause in their fifties, but there can be a lot of variability at what age that you do go into perimenopause or menopause.

And when I work with women in menopause, I find that some of them have very few symptoms; doesn't really change their life much while other women have all the symptoms and it drastically reduces their quality of life.

MELANIE: Those are the women we talk to.

Common symptoms women can experience during perimenopause or menopause

BRITNI: Yep. More commonly. Yes. And I think two very common symptoms are hot flashes and night sweats. And both the hot flashes and night sweats are vasomotor symptoms. And each woman experiences different symptoms and the intensity or the degree that they experience these symptoms can vary hugely.

MELANIE: Like anything, we're all individuals and we vary differently. So as you're listening to this podcast, ask yourself, what type of symptom do I have and how often do I have them and how intense are they? Let's start with hot flashes. I have a client I worked with a few years ago who came to me having 20 hot flashes a day. The hot flashes were intense and interfering with her work and her life, her sleep, and one or two hot flashes a day is more the norm.

And as a dietitian, I thought to myself, okay, I've been there. How do I help this poor woman eliminate most of these hot flashes so that she can go on with her life and continue with work without being miserable? Well, you might guess as a dietitian, I started with food first. Rather than a muffin and a mocha for breakfast, I had her eat eggs and vegetable scramble and we eliminated the high carb muffin, the hot sweet drink, which was affecting that vasomotor response causing the hot flash.

Vasomotor symptoms include hot flashes and flushes. Women describe these flushes as a sudden wave like sensation of intense heat. It starts internally and it works its way up the neck. It spreads over the body. It's one of the main reasons women seek medical help for symptom management and it's certainly been found to reduce productivity in work.

Sugar, processed carbohydrates, & caffeine can increase menopausal symptoms

BRITNI: Yeah. I can imagine it is a huge deal. And I want to describe, you mentioned the mocha and the muffin, both high sugar, high carbohydrate.

MELANIE: And caffeine.

BRITNI: And then the caffeine. So the reason that this increases hot flashes for many women is it increases your blood sugar. And generally when you get a big blood sugar spike, that's going to also trigger a hot flash. So a simple takeaway is that eating sugar and processed carbohydrates full of flour and sugar can very easily lead to hot flashes.

So let's take that eating example to a time later in the day. I think oftentimes people gravitate towards something sweet and maybe a little caffeine boost in the afternoon, like a coffee and a chocolate chip cookie, but that hot coffee drink will often cause a hot flash and that sugar and flour in the chocolate chip cookie will also create that hot flash, making that could be a recipe for a pretty intense hot flash.

MELANIE: Yeah.

BRITNI: And you mentioned caffeine earlier. So the coffee, it's kind of a double whammy. For some women, any hot beverage can be a trigger. And then for some women, caffeine can also be a big trigger. So what could be a better snack? Maybe an iced decaf coffee with real cream or an iced tea, no sugar, no sweetener. Maybe three quarters of a cup of blueberries with Greek yogurt or cottage cheese if you tolerate that; some nuts on top of that. That would be a really satisfying snack that's not going to trigger a hot flash.

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MELANIE: And switching over to that iced herbal tea is a great, a great way to feel like you're getting, you have that routine in the morning, but it's not going to make you miserable.

BRITNI: Yep.

MELANIE: I wish I knew what I knew back in the day because I would make a cup of coffee every morning and I would, I knew enough not to put sugar in it, but I would go upstairs with an ice pack in my robe pocket because it would trigger a hot flash every time and I would slap that on my neck and push the dogs in the blanket off my lap and every morning. So, yeah, it's miserable.

BRITNI: Yeah, it sounds like it. And you know, it is rare for women to experience 20 hot flashes a day, but two or even eight, that's not uncommon. And frequent hot flashes, you know, from seeing this in my clients, they are certainly stressful for people and eliminating the sugar and the processed carbs, I think is really the first step and often the only step needed to eliminate hot flashes. I have had so many women over the years, we just focus on balancing blood sugar, reducing sugar and carbohydrates, and their hot flashes dramatically improve.

MELANIE: Yes. And I want to say that the wine is a form of sugar and it's a big trigger for women for night sweats and hot flashes. So your diet is the key factor in controlling those hot flashes. And that may be a new thought for a lot of women, but diet is considered key in hot flash control. And if you drink alcohol and are struggling with hot flashes and night sweats, it may be time to quit the wine or quit the alcohol and just realize it's, it's going to have an impact if you're really desperate, giving up those hot flashes. Drinking any type of hot drink or even eating the hot spicy food, it can set off a hot flash. Again, your diet is the key factor in controlling hot flashes.

BRITNI: Yeah. I can't count how many times I've had a client tell me, “When I drink a glass of wine, I get hot flashes or I'm more likely to have night sweats.” There is definitely a direct correlation. And, you know, I think when we're working with clients, we really like to set up an eating plan that provides the most nutrient for that person's health condition.

Supplement support that can help with menopausal symptoms

And sometimes we recommend additional supplements if nutrition alone doesn't reduce these hot flashes or other menopausal symptoms. I like to suggest taking vitamin E and I usually start a client on 400 IU’s daily, and then if that isn't enough, I suggest increasing to 800 IU’s a vitamin E daily. And research that was conducted over 60 years ago found that vitamin E helps to control hot flashes.

And there's been, you know, more recent research that has stated that as well. Vitamin E has been found to help regulate body temperature. So it works to reduce that vasomotor response.

MELANIE: So I'd like to suggest the use of the essential fatty acid called GLA, gamma linoleic acid. I often suggest using four to six GLA softgels daily. That GLA not only helps with hot flashes and night sweats, but it also helps to keep the vaginal tissue hydrated, really any skin on the body hydrated. And GLA also supports healthy hair, skin, and nails.

Remember, GLA is an essential fatty acid that our body cannot make and we need to get it from food or a supplement. Women are often deficient in essential fatty acids due to low fat eating for 30 years, but incorporating nuts and seeds, borage oil or evening primrose oil are all good sources of GLA.

You're listening to Dishing Up Nutrition. Earlier, we mentioned our Menopause Solutions class. This is a six hour online course that covers that covers everything you need to know to get you through the space of life with some ease. Yes, you do not have to suffer through menopause.

Let me read you a review from a class participant. “The presentation of this class was done well. It was easy to follow and very clearly understood by the presenters. They did an excellent job helping me to understand what I need to do to feel better and be healthy in my senior years.”

Don't spend another day suffering. Let us help you. To learn more, visit our website at weightandwellness.com, and click on the nutrition classes tab to find this class.

Sign Up for Menopause Solutions - Online

BRITNI: Welcome back to Dishing Up Nutrition. Today we are discussing nutritional solutions for hot flashes and night sweats. And before the break we were discussing the benefits of GLA supplementation and it can help to reduce hot flashes, vaginal dryness. A lot of times women in menopause also have some incontinence. So I did want to mention that GLA can help with that as well.

Sleep deprivation and what to do about it

And earlier in the podcast, we mentioned that women are often parent caregivers, also have teenage children, plus working. And these women are often considered the most sleep deprived people with all of that going on in life coupled with, you know, night sweats or other sleep disturbances. So I think it's, it's safe to say women and menopause are stressed.

MELANIE: Yes, they're stressed and they're sleep deprived, which leads to more stress.

BRITNI: Yeah. It's a vicious cycle. Commonly, they have anxiety and their body is experiencing fatigue and sometimes pain could go along with that. And oftentimes, women in menopause are experiencing these hormonal changes, which can cause these sleep issues.

Sometimes night sweats, wake them up. You know, I have many times had women come in and tell me that they have to change their pajamas in the middle of the night. It sounds pretty miserable; not comfortable at all. And we know that interrupted sleep slows down metabolism and it triggers more cravings. So if you are sleep deprived, you are more likely to gravitate towards sugar and carbohydrates.

Balanced blood sugar supports better quality sleep

MELANIE: Yeah, that's been proven in research. So to help with sleep, I start with the food. If you're struggling with sleep, I often think blood sugar balance is important and a bedtime snack might be helpful. And that's going to be something that includes a healthy source of fat such as peanut butter or cream cheese or organic cream. You might ask, why is it important to eat a healthy fat at bedtime?

Well, the fat can help your blood sugar stay balanced through the night and fat anchors your blood sugar so it doesn't dip. Because if your sugar goes up and then comes down too low, that's when we get a night sweat. That's when we wake up. So that fat helps anchor that blood sugar and it breaks down slowly so your blood sugar stays in balance.

And a great snack for a good blood sugar balance would be just to spread two tablespoons of peanut butter on a half an apple. Another good snack would be three fourths cup of blueberries with a handful of nuts before bed. People love those blueberries with a couple, two to three tablespoons of organic whipping cream.

BRITNI: Yeah. And if you have frozen berries, the cream kind of freezes a little bit. Some, some people like that cause it's a little bit the texture of ice cream.

MELANIE: Yes. And you can blend it too.

BRITNI: Yeah. Yeah. I think a lot of people don't know that when your blood sugar dips, your body actually makes more cortisol, also known as our stress hormone to increase our blood sugar on its own. So even if you're not eating, which obviously you're not doing while you're sleeping, your blood sugar can still be on that rollercoaster, dipping and, and swinging back up.

MELANIE: Yeah. I know if I, if I am hungry when I go to bed, it's never a good night's sleep.

Mineral imbalances often lead to insomnia

BRITNI: No, never go to bed hungry. That is not good. I think it might surprise some listeners to learn that mineral imbalances often lead to insomnia. You know, I have found that 400 to 600 milligrams of magnesium is usually the sweet spot, and sometimes coupling that with calcium can be the perfect combination for a great deeper sleep. And we have lots of information about magnesium and signs of deficiency.

I know that we did an “Ask a Nutritionist” podcast on that, and we have some articles if you want more information. But we do know that frequently women and I would say everybody is deficient in minerals. Our, the quality of our food is really lacks minerals nowadays. It's just not the same quality as it used to be.

MELANIE: That's one of my favorite classes to teach in Nutrition for Weight Loss is the class on minerals.

BRITNI: Yeah. Yeah. It's a great one.

MELANIE: It’s an eye opener.

BRITNI: It is such an eye opener.

Progesterone: what does it help with?

MELANIE: I also found that many women are deficient in the hormone, progesterone. And as women, we naturally make progesterone when we ovulate. Well during menopause, ovulation ceases, and we stopped making that progesterone and your level can drop low.

Progesterone is a wonderful hormone that helps us relax, helps us be calm. So often I suggest using a progesterone cream at bedtime to help with night sweats and frequent waking. That progesterone is a, it's very calming, like I said, and it can help with anxiety that often occurs through the night when women wake up from anxiety.

BRITNI: Yeah, I think anxiety is a very common symptom through perimenopause and menopause and low progesterone during that time reduces GABA function in the body. And GABA is a very calming, relaxing neurotransmitter. So if we're not getting enough of that in our body, that could create a lot of anxiety and depression.

The importance of individualizing needs

And dietary choices, we know, we see it every day with our clients, can really make a huge impact on anxiety as well. And just realizing that it's not only the food you eat, but what you're eating, when you're eating; all of that can impact anxiety. And I think that's a, that's new information for a lot of people. And helping women manage anxiety during perimenopause and menopause can be complex, complicated, but very doable.

I mean, everybody is different. So, we really individualize everything with our clients. And I had a client a few months ago that I saw, and she came in and she explained her mood swings, anxiety, she's in newly in menopause and she said, “I just don't feel like myself”. And what we did is we improved blood sugar balance throughout the day, making food modifications, individualized her, her supplements.

And then I talked to her a month later and she was already feeling so much better mentally. She wasn't having those huge mood swings. She was feeling more like herself. I hear that a lot in menopause. “I just don't feel like myself.”

MELANIE: I hear that too. “I just want to get me back”.

Eat sufficient protein & balance blood sugar to manage symptoms

BRITNI: Yeah. Yeah. And you can do that. It's entirely possible. And without individualizing it, I do think that big picture for most individuals to manage anxiety, you need to eat four, sometimes five times a day and include enough protein. That protein is so important. I would say four, you know, some people need five ounces of protein at each meal. And eliminate or significantly reduce those processed carbohydrates.

MELANIE: Such, such key right there is being protein forward and eating real food is so key in balancing your blood sugar, which in turn stops the hot flashes, helps us produce, I mean, our, the protein is where we're getting those minerals; a lot of those minerals, zinc and magnesium.

And so being more protein forward in your thinking as you're eating, instead of just grabbing an apple and peanut butter, really key to make sure, hey, maybe I do a couple hard boiled eggs here and, and not lean so hard into other foods; get that in first. And you're going to be getting a big source of your minerals.

BRITNI: And when you're eating that much protein, it, it really does curb your appetite; significantly reduces or just completely eliminate your cravings, which is great. And it's important when you're getting rid of those processed carbs, replace them with lots of vegetables, some fruits to get more fiber, the nutrients, vitamins, minerals, all the good stuff that we find in fruits and vegetables.

And then that serving a fat every time you eat is really important as well. As you talked about Melanie, that fat anchors your blood sugar. And during a counseling session, what we do is we address all of your personal menopause symptoms and your health history. And we develop a plan based on that. So it might look different from, from person to person, just depending on what their needs are. And the eating is number one. And then we may recommend some supplements as well to help with symptom management.

Schedule Nutrition Counseling

MELANIE: Yeah. If you're living in that menopause space and you're feeling like you're kind of miserable, just know there's help, that this is not what you have to do for the next year and a half, two years, three years. There are some people that have been in menopause for three or four years and 10 years and they're still hot flashing. So if you're in that menopause space of misery, there's help.

BRITNI: Yeah. We can help you. And, and it's really creating a plan of self care. It's prioritizing yourself, which I know is, can be very difficult, but it is so important.

Recap

So to recap today, you know we talked about menopausal symptoms, a lot about hot flashes, night sweats, and anxiety. And first things first is keeping that blood sugar balanced is really important.

MELANIE: Which is very hard to do if you're eating processed foods.

BRITNI: Yes. So focusing on real food, getting that protein, the veggies, the healthy fat, and then your blood sugar is going to feel more stable throughout the day. That alone can significantly reduce anxiety, sometimes completely eliminate hot flashes.

MELANIE: And if you start with that food first concept. I like to see how is your body going to respond when we just get your blood sugar balanced and you're eating foods that nourish and see how that works with your hormones. Then you can add some key supplements if we're still on the struggle bus.

BRITNI: Yep. It's a great approach and often I take that approach too. And for many women, just that blood sugar alone really eliminates things.

MELANIE: And when you get a mile high above it and you think about it, it's, it's not just about hormone balance. It's about longevity. It's about preventing osteoporosis. It's about keeping your hormones in a good place. So you're not at risk for hormonal issues and it's going to help your overall health so you can live long, strong.

BRITNI: Yeah; creating that self care plan.

MELANIE: Yep. Well, our goal at Nutritional Weight and Wellness is to help each and every person experience better health through eating real food. It's a simple yet powerful message. Eating real food is life changing. Thank you for joining us today.