Hormonal changes that occur during the lead up to menopause can persist for a number of years, and can result in hot flushes, irregular periods, mood and cognition disturbances, insomnia and lowered libido. The reduction of oestrogen can also increase the risk of heart disease and osteoporosis over the longer term. However lifestyle behaviours, exercise routine, food choices, stress management strategies and psycho-social support networks can help ease the impact menopause has on the body and mind. For example, we know regular moderate intensity exercise improves sleep quality, controls weight gain and supports bone density. Reducing or avoiding caffeine and alcohol can also reduce hot flushes.As a naturopath, I recommend using food as medicine as a part of an overall treatment plan to manage this transition in a woman’s life. Hormone fluctuations“Phyto-oestrogens” refer to a group of plant-derived compounds that activate the oestrogen receptors and are known to influence the menstrual cycle, reduce the risk of oestrogen-responsive cancers, and decrease the frequency and severity of menopause symptoms. Consumption of the following phyto-oestrogen rich foods is associated with a reduction in hot flushes during menopause, and has an oestrogen-modulating effect in the body: Heart healthDeclining oestrogen levels are associated with an increased risk of cardiovascular disease. The Mediterranean diet consisting of fish, monounsaturated fats from olive oil, fruits, vegetables, whole grains, legumes and nuts has shown to improve cardiovascular parameters, including blood pressure, cholesterol markers and body weight. Try the following suggestions: Bone healthAs women go through the menopause transition, bone loss is accelerated due to declining oestrogen levels, therefore a combination of physical activity, particularly weight bearing exercise, and adequate nutrition is important.Increasing calcium intake may help support bone density. This essential mineral can be found in milk, yoghurt, cheese, sardines or small fish with bones, vegetables such as broccoli, kale, bok choy, spinach, celery, brussels sprouts, onion, avocado as well as nuts and seeds. To ensure the calcium is fully absorbed and deposited in the bones, it should be combined with foods rich in phosphorus such as meat, cheese, onions, garlic, and combined with vitamin D in oily fish, lentils, eggs and brown rice. Safe sun exposure to ensure adequate vitamin D levels for calcium absorption is important. Aim for 15 to 20 minutes of sun exposure per day, whilst staying sun aware. Do not use sunscreen or shower straight away, to allow for vitamin D skin conversion. Also eliminate smoking, caffeine and reduce soft drinks, as these will leach calcium from the body. Magnesium is also an important mineral to include in the diet, which facilitates calcium absorption and is involved in over 300 different biochemical reactions in the body. Chronic magnesium deficiency is also associated with the development of arthritis. Magnesium is found in nuts, legumes, whole grains, seeds, bananas and vegetables (especially green leafy ones).Choosing good food and a balanced lifestyle including exercise, stress reduction and social support networks can help the transition through menopause be an exciting time to focus on the next phase of life. Your naturopath can help with additional support through herbal medicine, nutritional supplements and flower essence therapy to manage symptoms and provide guidance.