Is Keto Good for Menopausal Women?
We all hear about the challenges for menopausal women: hot flashes, insomnia, mood swings, weight gain, night sweats, and more. Menopause is usually portrayed on television and elsewhere as comedic. However, for women going through menopause, it is certainly no laughing matter.
Menopause is the transition women go through from having menstrual periods to no longer having regular periods. The hormonal changes women experience result in many difficult and unwanted symptoms. High insulin levels and blood sugar imbalances are also common in menopause and can play a big role in the problems associated with this time.
Keto for Menopausal Women
Menopausal women are one of the largest groups of individuals seeking alternative and natural therapies to manage their symptoms. Fortunately, implementing a ketogenic diet can be an effective strategy to alleviate many of these symptoms.
A ketogenic diet is a low-carb, high-fat, moderate-protein nutrition and lifestyle plan that transitions your body from chronic sugar burning mode to an efficient fat burner. While in ketosis, the body will use stored fat and dietary fat rather than sugar for fuel. Using fat for energy can benefit a woman going through menopause in many ways.
This article will discuss what happens to a woman’s body as she goes through menopause and problems associated with menopause. I will discuss how the ketogenic diet can help reduce these unwanted and uncomfortable symptoms. I will also address numerous issues that must be considered for menopausal women implementing the ketogenic diet.
What is Menopause?
Menopause is a natural part of every woman’s aging process. There are three stages of menopause: perimenopause, menopause, and post-menopause.
Hormonal changes can begin years before menopause, and this period is known as perimenopause. The average age for the onset of perimenopause is 46, but a woman can start perimenopause anytime between her mid-30s to mid-50s (1). Menopausal women begin to experience irregular menstrual cycles and symptoms commonly associated with menopause such as hot flashes, night sweats, and vaginal dryness. Perimenopause typically lasts about 5 years, but can last from 4-14 years.
The average age for women entering menopause is 51-52 years old. Menopause is technically reached when a woman has gone 12 months without a menstrual period.
Post-menopause starts after a woman has gone through menopause, and women may continue to experience the symptoms that started in peri-menopause. While there are symptoms common to menopausal women, every woman is unique and will experience it differently.
How Menopause Affects Hormones
There are many hormones impacted in menopausal women. Hormones are the messengers in the body that travel through the blood stream to regulate many physical and chemical functions in the body. A woman’s ovaries are the source of estrogen and progesterone, the two key hormones that control her reproductive system. Two other hormones involved are Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH). These hormones regulate estrogen, progesterone and testosterone.
FSH stimulates the production of estrogen and causes the release of eggs from a woman’s ovaries during her reproductive years. A surge in LH causes the ovaries to release an egg during ovulation. Progesterone is produced by the follicles that house the egg. As a woman ages and enters perimenopause, her ovaries contain fewer eggs and produce less estrogen and progesterone and her FSH levels increase. Changes in these hormone levels in turn affect other hormones such as insulin, ghrelin, and leptin.
Lower levels of estrogen promote insulin resistance and higher levels of sugar in the blood (2). Insulin is a hormone produced in the pancreas that regulates the amount of glucose in the blood. It does this by helping to unlock cells so that sugar can be used by the cells for energy.
Insulin resistance is a condition in which the body’s cells become resistant to the effects of insulin. The cells do not become unlocked and do not let enough of the glucose into the cells. This stimulates the release of higher amounts of insulin than are typical for the body. Glucose remains in the blood stream causing high blood sugar levels as well. This promotes weight gain and leads to numerous health problems.
Ghrelin is called the “hunger hormone” because it stimulates appetite, increases food intake, and promotes fat storage. Studies show that levels of ghrelin are increased in menopausal women (3).
Higher levels of ghrelin contribute to the weight gain and increase in abdominal fat that is common for women in menopause. As you can see, menopause has a significant impact on numerous hormones. This can cause many difficult symptoms.
Symptoms of Menopause
Symptoms associated with menopause can occur during and after the menopause transition. The natural decline of estrogen during menopause can bring on a combination of hormonal and biochemical fluctuations. These fluctuations can lead to changes in a woman’s brain and nervous system such as mood swings, memory loss, fatigue, hot flashes, night sweats, and insomnia.
Other common symptoms for menopausal women are low libido, weight gain, and vaginal dryness. Bone loss is also common in menopausal women.
Most menopausal women turn to natural therapies to address these health issues. In fact, eighty percent (80%) of women aged 45-60 use nonprescription, alternative therapies to manage their symptoms (4). An effective strategy to help manage the symptoms and health problems associated with menopause is the ketogenic diet and lifestyle.
Basics of the Ketogenic Diet and Lifestyle
A ketogenic diet and lifestyle can have a dramatic effect on menopausal symptoms. The ketogenic diet is a high fat, low carbohydrate, moderate protein nutrition plan. The macronutrient breakdown for the ketogenic diet is 60-80% of calories from healthy fats, 20-30% from protein, and 5-10% from net carbs (total carbs minus fiber). This nutrition and lifestyle plan helps your body use fat (stored fat and dietary fat) rather than sugar for fuel.
Unfortunately, many women in menopause have relied upon a high-carbohydrate, low-fat diet for decades. This way of eating causes a myriad of health problems. Foods made with refined sugars and carbohydrates spike insulin levels, lead to the storage of fat, increase inflammation, and cause hormonal imbalances.
To the contrary, the ketogenic diet and lifestyle helps reduce inflammation, lower insulin levels, balance blood sugar, and decrease weight gain and stored fat. This style of eating encourages healthy metabolism and enables your body to function at a more efficient level.
Ways the Ketogenic Diet Can Help During Menopause
There are many health benefits associated with a low-carb, high-fat ketogenic diet that will have particular benefit for women in menopause. The ketogenic diet lowers inflammation, increases energy, reduces risk of cognitive decline, balances blood sugar levels and your mood, and helps control weight gain.
Lowers Inflammation and Increases Energy
Chronic inflammation is the cause of most, if not all, chronic disease. Chronic inflammation can increase during menopause so it is critical to take steps to reduce inflammation. One of the most amazing benefits of the ketogenic diet is its ability to drastically lower inflammation.
The ketogenic diet lowers inflammation by reducing the amount of free radical production, stabilizing blood sugar levels, and reducing insulin levels. With lower levels of inflammation and stabilized blood sugar levels, more of the energy carrying molecule Adenosine Triphosphate (ATP) is produced in the mitochondria. Mitochondria are the energy powerhouses of your cells, and the ketogenic diet stimulates the growth of new and stronger mitochondria.
By reducing inflammation and improving mitochondrial function, the ketogenic diet allows the body to heal and mitigate disease processes more effectively. This improves your risk factors for metabolic and other chronic diseases, gives optimal energy production, and creates an efficiently functioning body.
Reduces Risk of Cognitive Decline
Women have estrogen receptors all throughout their body, including in their brains. Reduced signaling through these estrogen receptors due to low estrogen levels in menopause can leave brain cells more vulnerable to disease and dysfunction.
Studies show that women who go through menopause or are in perimenopause have significantly lower levels of glucose metabolism in several key brain regions than those who were pre-menopausal (5). Estrogen loss means the loss of a key neuroprotective element in the female brain and higher vulnerability to brain aging and Alzheimer’s disease.
One of the functions of estrogen is to get glucose into your brain for fuel. During menopause, estrogen levels drop. Without estrogen, the ability of glucose to fuel the brain is diminished. Utilizing ketones rather than glucose for fuel provides steady, clean energy to brain cells. This can reduce menopausal symptoms like brain fog and hot flashes.
Ketones can also reduce neurological inflammation by shutting down neuro-inflammatory pathways and stimulating BDNF (brain derived neurotrophic growth factor). Reducing neurological inflammation is critical because it is linked with depression, anxiety and poor cognitive function (6).
Stabilizes Blood Sugar Levels and Improves Mood
Many menopausal women experience mood swings, anxiety and depression. This is due to a decline in estrogen levels. There are abundant estrogen receptors in the region of the brain called the medial amygdala (MeA)(7). The MeA regulates mood, endocrine, and metabolic stress responses. When estrogen levels decline in menopause, this can affect your mood and lead to emotional distress and depression.
Consuming a high-carbohydrate, high-sugar diet will cause massive fluctuations in blood sugar levels. This can lead to rapid changes in your mood and behavior. The high-fat, low-carb ketogenic diet decreases and stabilizes blood sugar and insulin levels. This will have a positive impact on mood by providing your brain with a stable source of energy.
Helps Control Weight Gain
Increased body fat (particularly abdominal fat) and weight gain are common in menopausal women. As discussed above, the medial amygdala (MeA) contains an abundance of estrogen receptors. This region of the brain helps regulate body weight. With lower amounts of estrogen (characteristic of menopause), your metabolism slows and fat storage shifts to the abdomen. Excess abdominal fat is linked to insulin resistance, heart disease, toxin accumulation and hormonal imbalances.
The ketogenic diet helps reduce weight and body fat through a number of mechanisms. When in ketosis, you are burning both dietary fat and stored body fat for energy. You are also less hungry and feel satiated quicker and longer on a ketogenic diet. This is due to the healthy fats, protein, antioxidants and fiber in the diet.
In a study of the long-term effects of the ketogenic diet, weight and body mass index of the patients significantly decreased, HDL (good) cholesterol levels significantly increased while LDL (bad) cholesterol levels and levels of triglycerides significantly decreased (8). More studies have shown that a high-fat, low carb diet is superior to a low-fat, high-carb diet for improving weight loss (9). Implementing the ketogenic diet can be an effective fat and weight loss strategy for menopausal women.
Issues to Address in Menopause
Women in menopause often have low stomach acid, a sluggish gallbladder, and a low functioning thyroid. These issues must be addressed in relation to the ketogenic diet or the full range of benefits may not be experienced.
Low Stomach Acid
Adequate stomach acid is important for optimal protein digestion in the body and for disinfecting and killing bad microbes. As we age, our production of stomach acid slows down so many women in menopause do not have adequate stomach acid levels.
There are several strategies you can take to improve stomach acid. Using liquid nutrition during the day with at least half of your meals in an easily digestible form (such as a protein shake) can be very beneficial. Squeezing fresh lemon juice or apple cider vinegar on your meat and vegetables to help pre-metabolize the food can help with digestion. Consuming ginger, fermented foods (such as kimchi and sauerkraut) and fermented drinks (such as coconut kefir) can also improve digestive juices.
Super hydrating outside of mealtimes and drinking very little with or after a meal can help. Drinking water during the meal can dilute your digestive juices. Timing is also important when eating protein. Protein should be eaten at the beginning of the meal. You should also eat your largest meal when you are most relaxed. These strategies are key to improving stomach acid production.
Another important method of optimizing stomach acid is to supplement. A supplement with Betaine HCl such as Acid Prozyme or Super Digest HCL can be taken half-way through your meal for stomach acid support.
The Super Digest HCL is a powerful blend of betaine HCL, bile and digestive enzymes to support the digestion of fats, proteins, carbohydrates and fiber. For optimal digestion and absorption of nutrients, it is important to ensure you have adequate stomach acid support during menopause.
The gallbladder is a reservoir for the bile that is produced by the liver. Bile is a digestive fluid that emulsifies fats and creates fatty acids that can be absorbed and used by the body. Bile also has antimicrobial effects that help to kill off unwanted pathogens.
Metabolic dysfunction can lead to poor bile production and sluggish bile flow causing serious health problems. There are numerous strategies you can use to strengthen liver function and bile flow formation, along with improving gallbladder health and bile duct motility.
An anti-inflammatory diet high in healthy fats is critical for cholesterol production, bile production, and secretion. Super hydration, intermittent fasting, stomach acid support, and eating small meals can support the gallbladder. Foods rich in chlorophyll and high in fiber, as well as fermented foods, bitter herbs, broccoli and kale sprouts, can improve gallbladder health.
Bile Flow Support is a specialized liver support formula that provides nutrients involved in bile flow and fat metabolism. Bile Flow Support targets lipid metabolism and supports healthy liver function. This supplement can be helpful for a sluggish gallbladder. In addition, adding stomach acid support and some additional ox bile and pancreatic enzymes can be extremely helpful here. I use the Super Digest HCL for this with my clients.
Low Thyroid Function
Many women in menopause struggle with low thyroid function (or hypothyroidism). They will experience low energy, weight gain, mood instability, brain fog, and lower vitality. The ketogenic diet can be a helpful tool to improve thyroid function.
The ketogenic diet creates metabolic flexibility, stabilizes blood sugar levels, and burns excess stored fat. Fluctuating blood sugar contributes to inflammatory proteins called advanced glycolic enzymes (AGEs). This enables the body to function at a more efficient level and helps to balance the production of thyroid hormones.
Another way the ketogenic diet can improve thyroid function is by reducing inflammation in the body. Low thyroid function is often associated with chronic inflammation. Inflammation damages the mitochondria which can affect energy levels and how well your body is able to function.
Chronic inflammation also affects the immune system which can contribute to autoimmunity. Autoimmunity is one of the leading causes of hypothyroidism (10). Lowering inflammation through the ketogenic diet can improve the conversion of the thyroid hormone T4 to the active form T3 and reduce autoimmune activity.
For anyone on a ketogenic diet, and particularly those with hypothyroidism, it is critical to ensure you are consuming adequate calories. Not consuming enough calories causes the body to shift to a state of conservation and is often associated with lower T3 levels. This can lead to many hypothyroid symptoms that are erroneously attributed to the ketogenic diet.
In some cases, an individual may need thyroid hormone support from a medication, bio-identical form or glandular supplement. I see this commonly and have used our thyroid strong supplement successfully with hundreds of cases to give the extra thyroid hormone support the body may need. In the image below, I go over some additional strategies that you can read about in this article to support the thyroid on a ketogenic diet and lifestyle.
Carb Cycling During Menopause
While eating low-carb, your body produces glucagon to help you burn fat, is more sensitive to insulin, and is more metabolically efficient. For some individuals, eating a low-carbohydrate diet for too long can lead to problems. Over long periods, your thyroid hormones may drop, you may become less sensitive to insulin, and you may gain weight. Carb cycling will optimize your body’s metabolic needs and is a great strategy for women in menopause.
As I discuss carb cycling, I want to make sure you understand that if you are feeling great in ketosis than you do not have to carb cycle. However, if you begin to experience persistent fatigue, hair loss, dry skin, weight gain, etc. while in ketosis and following a ketogenic lifestyle than you may want to consider carb cycling.
Carb cycling is alternating periods of lower and higher carbohydrate content in your diet. I recommend 6 days of very low-carb meals and 1 day of slightly higher-carb meals each week. If your body is signaling that it needs more carbohydrates, you can do a higher carb day every fourth day. For example, low-carb for 3 days, higher-carb for 1 day, low-carb for 3 days, etc. Other individuals may cycle in and out of ketosis once a month or once every other week. It takes time and experimentation to find the right carb cycling rhythm for your body.
On the higher carbohydrate days, you should consume foods with a low glycemic index and high nutritive value such as sweet potatoes, organic berries, carrots, beets and sprouted quinoa. You may also enjoy other high quality fruits and sweeteners such as honey during the carb phase if you wish but it is always best to stick with real foods and not processed man-made foods that are full of toxins.
On the lower carbohydrate days, you would consume 20-50 or fewer grams of net carbohydrates. You are looking for the range that allows you to get into nutritional ketosis with blood ketones over 1.0 mmol. For some, this will be 20 net carbs or less…while others can handle a higher amount of net carbs and still be in ketosis. Of course, be sure to consume a diet high in healthy fats and moderate in protein.
On your higher carb days you can bump it up to 80-100 grams of carbohydrates. Unless you are very active, this will bump you out of ketosis for a period of time, but you can get back in as you lower your carbs and increase fats on your ketogenic lifestyle. It is important to remember that every woman is different and will respond to the ketogenic diet in her own unique way. These suggestions are guidelines for determining what may work for you.
Additional Lifestyle Modifications for Menopausal Women
It is critical to stay very hydrated when on a ketogenic diet especially if you are menopausal. Hormonal fluctuations cause osmotic pressure changes in the tissue and organs of women in menopause (11).
Too little water intake can cause sodium retention, increased risk for cardiovascular complications, and faster dehydration. Water is also absorbed slower in the body during menopause due to the natural aging process that slows kidney function. It is important to drink at least half of your body weight in water. Try to super hydrate first thing in the morning.
Menopausal women may have a diminished capacity to fend off the effects of toxins. Toxins are virtually inescapable. They are found in foods, personal care products, conventional cleaning products, and medications. Toxins are even in the air we breathe and the water we drink.
Environmental toxins such as dioxins, polychlorinated biphenyls (PCBs), and phthalates are known as endocrine disrupting compounds (EDCs). EDCs are linked to early menopause. This is important because there is an association between early menopause and greater health problems. Since it is impossible to completely avoid toxins, we must take the steps we can to reduce our exposure.
Be sure to choose organic as much as possible and opt for naturally-derived products for personal care and household cleaning.
Staying physically active is critical during and after menopause. Walking, biking, and swimming are great low-impact ways to exercise. Resistance (strength) training is one of the most beneficial forms of exercise for managing symptoms (12).
Strength training slows the aging process and improves body composition. Incorporating a variety of exercise and activity into your lifestyle is very important during menopause.
Practicing stress reduction techniques can be extremely beneficial. In fact, yoga has been shown to improve quality of life in menopausal women (13). Other stress reduction techniques include deep breathing, practicing gratitude, barefoot walking, Epsom salt baths, and supplementing with magnesium. I am a huge fan of our Brain Calm magnesium supplement for reducing anxiety and perceived stress and improving mental performance, mood and quality of life.
Poor quality sleep (or insomnia) is common for women going through all stages of menopause. In fact, 26% of women approaching or in menopause experience severe sleep difficulties that impact daytime functioning (14). Balancing your blood sugar levels with the ketogenic diet can be helpful for sleep as well.
There are numerous other strategies you can implement to improve the quality of your sleep. Using herbs such as valerian, lavender, lemon balm, chamomile, and passion flower can improve sleep quality. Getting sunlight during waking hours, limiting daily caffeine, blacking out your room, and practicing relaxation techniques.
It is also very important to turn off electronics before bed. Cell phones, TVs, and computers give off blue light that inhibits melatonin production in the brain. It can also increase cortisol levels and body temperature which are contrary to the body’s natural sleep response. Implementing the ketogenic diet, along with these strategies can greatly improve the quality of your sleep during menopause.
Menopause is a natural part of the aging process. Unfortunately, the hormonal changes that accompany menopause can result in various symptoms and health problems. Common symptoms associated with menopause are hot flashes, night sweats, insomnia, weight gain, fatigue, and memory loss. Many menopausal women turn to natural and alternative therapies to alleviate these symptoms.
An effective strategy for managing the symptoms of menopause is the ketogenic diet. The ketogenic diet is a high-fat, low-carb, moderate-protein diet that influences the metabolism to promote fat burning over sugar burning.
Eating this way can lower inflammation, increase energy, balance blood sugar levels, improve mood, reduce risk of cognitive decline, and help control weight gain.
Other issues that are important to address in menopause are low stomach acid, sluggish gallbladder, and low thyroid function. A helpful strategy for implementing the ketogenic diet during menopause is to follow a cyclical ketogenic diet where you increase your carbohydrate intake at specific periods.
In addition to the ketogenic diet, there are several lifestyle modifications that can make the menopause transition easier. Super hydrating, avoiding toxins, physical activity, stress reduction, and improving sleep quality important during menopause.