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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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June 13 2019

Does Diet Influence Menopause Timing?

By Mark Sisson
18 Comments

Last week, I linked to a story about a popular vegan blogger, author, and influencer who found herself going into menopause at the age of 37 despite doing “everything right.” She exercised, she ate raw, she avoided gluten and refined sugar, and, most importantly, she avoided all animal products. Now, this wasn’t a randomized controlled trial. This wasn’t even a case study. But it was a powerful anecdote from someone whose livelihood depended on her remaining a raw vegan. It wasn’t in her interest to make it up.

So, it got me wondering: How do diet and lifestyle influence the timing of menopause?

Now, before I begin, let’s just state the obvious: Menopause isn’t a problem to be avoided. It’s not something to be feared or maligned. It’s not “the end.” I wrote an entire series on menopause last year, and there will always be more to come on the subject because it’s an important time of life with its own questions and possibilities. While it’s a natural, evolutionarily-preserved part of being a woman, it also follows a natural cadence. Menopause at the right time in accordance with your genetics is normal, expected, and healthy. Menopause that occurs earlier than your genetics would direct suggests something is amiss. Sure enough, early or premature menopause—defined in most places as menopause before the age of 40—has a number of troubling links to poor health outcomes.

Early menopause is linked to:

Not to mention that all the other things normally associated with menopause, like osteoporosis and changes in mood, also have the potential to occur, only earlier.

Okay, so early menopause can have some health consequences. Is veganism actually linked?

What Research Says About Diet and Menopause Timing

There was one study that found people who’d never been a vegetarian developed menopause at a later age, which is a roundabout way of saying that vegetarianism may increase the risk of early menopause.

Other lifestyle factors linked to later menopause included regular strenuous exercise, never smoking, midlife weight gain, and drinking alcohol. Strange mix of behaviors, both classically healthy and unhealthy.

But then another study in Han Chinese women found the opposite—that vegetarianism was associated with a lower risk of premature menopause.

Those are the only direct (if you can call it that) lines of evidence, and they conflict. No solid answers there. That said, there’s more indirect stuff pointing toward a link between exclusion of animal foods and earlier menopause:

  • A high intake of vitamin D and calcium from dietary sources has been linked to a lower risk of premature menopause. Oddly enough, supplemental vitamin D and calcium were not linked to lower risks, suggesting that it’s the food—dairy primarily, but also bone-in small fatty fish like sardines—and not the nutrients alone. So a vegan might not be in the clear simply by supplementing with D and calcium.
  • The amount of protein and carbs a woman eats throughout her life seems to predict the age at which menopause occurs. More protein, later menopause. More carbs, earlier menopause. Protein is harder and carbs are easier to come by on a plant-based diet—that’s for sure.
  • Another fairly consistent finding is that polyunsaturated fat intake “accelerates” menopause. Women who eat the most PUFA tend to have menopause earlier. High PUFA intakes are pretty unavoidable when your diet is awash in seeds, nuts, and other plant-based fat sources.

Then there was a different connection in another study.

The Nurses Health Study found that women who ate the most plant protein were more likely to avoid premature menopause; animal protein intake had no effect. They even found beneficial links between specific foods and protection against early menopause, including dark bread, cold cereal, and pasta. Those are about as unPrimal as you can get.

How Can We Make Sense of Conflicting Research?

In addition to smoking (which we all know is trouble for almost all markers of health), one thing that keeps appearing in all these observational studies—and they’re all observational studies, unable to prove causation—is that underweight BMIs predict early menopause. In the Nurses Health Study, for example, BMIs under 18.5 were linked to a 30% greater risk of early menopause and BMIs between 25 and 29 were linked to a 30% lower risk. If that’s true, and if that’s actually a causal factor, then the most important thing a woman who wants to avoid early menopause can do is avoid being underweight. In that case, filling up on foods known to cause weight gain in susceptible people like bread, pasta, and cereal would be protective (at least for early menopause).

And that could really explain why the vegan blogger developed premature menopause. In her own words, she “had run out of fuel.”

A big downfall of many plant-based diets is that they starve you. They starve you of vital micronutrients you can really only get in animal foods, like B12, zinc, creatine, cholesterol, and others. They starve you of vital macronutrients, like protein and animal fat. And they starve you of calories. It’s hard to maintain your weight and physical robustness eating a diet of leaves, twigs, and seeds (unless you’re a gorilla). Oddly enough, I think vegans who eat grains and vegan “junk food” like fake burgers and weird nut cheeses are probably better off than the gluten-free ones who live off salads, simply because they’re getting more calories. It’s true that there are many ways to eat vegetarian and even vegan—and some are healthier than others (I’ve written about Primal recommendations for vegetarians and vegans in the past), but the more restrictive a person is with animal products, the trickier it will be to stay well-nourished.

If I had to make a bet, it’d be that any diet that provides sufficient nourishment in the form of micronutrients, macronutrients, and total calories will help stave off early menopause.

What about you? What’s your take on this? Has anyone out there experienced premature/early menopause that didn’t follow natural, familial patterns? What can you recall about the diet and lifestyle leading up to it?

References:

Wang H, Chen H, Qin Y, et al. Risks associated with premature ovarian failure in Han Chinese women. Reprod Biomed Online. 2015;30(4):401-7.

Velez MP, Alvarado BE, Rosendaal N, et al. Age at natural menopause and physical functioning in postmenopausal women: the Canadian Longitudinal Study on Aging. Menopause. 2019;

Sujarwoto S, Tampubolon G. Premature natural menopause and cognitive function among older women in Indonesia. J Women Aging. 2019;:1-15.

Løkkegaard E, Jovanovic Z, Heitmann BL, Keiding N, Ottesen B, Pedersen AT. The association between early menopause and risk of ischaemic heart disease: influence of Hormone Therapy. Maturitas. 2006;53(2):226-33.

Purdue-smithe AC, Whitcomb BW, Szegda KL, et al. Vitamin D and calcium intake and risk of early menopause. Am J Clin Nutr. 2017;105(6):1493-1501.

Sapre S, Thakur R. Lifestyle and dietary factors determine age at natural menopause. J Midlife Health. 2014;5(1):3-5.

Boutot ME, Purdue-smithe A, Whitcomb BW, et al. Dietary Protein Intake and Early Menopause in the Nurses’ Health Study II. Am J Epidemiol. 2018;187(2):270-277.

Szegda KL, Whitcomb BW, Purdue-smithe AC, et al. Adult adiposity and risk of early menopause. Hum Reprod. 2017;32(12):2522-2531.

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18 thoughts on “Does Diet Influence Menopause Timing?”

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  1. Well, I started the journey at 37 and was “done” by about 40. My maternal grandma went through it about 37/38, my mom was about 38/39. So it was kind of “normal” for me to go about then. However, all my sisters went though later, maybe it was because I was always slim, my mom was slim until menopause, and my grandma was slim (and a smoker/drinker). All my sisters were over 50 pounds overweight so that may mean they had more estrogen in their fat stores that held it at bay a few more years? Who knows, it’s interesting to think about though. I always wondered if it was the extra fat stored that made them pass through later.

  2. 2Rae I bet it WAS the extra fat they carried. Similar observation in my family. The chubbiest one of 3 sisters (all non-smokers) was the only one to go through later menopause and she also happens to be the one with the least health problems at this point. Probably because, as you said, more estrogen in the fat stores, I’m guessing.

  3. I’m at the other end, have always eaten plenty of meat eggs and dairy, I’m overweight, tall 6′, started my period at 14. I started having 100 day gaps in my cycle at 52 & 53, a “last period” at 54 10 months, 16 months no periods, then another one this year. I have started counting my year again, I will be 57 when I am finally through menopause – I hope!!

    1. Good news for you Joss…… You will have fewer wrinkles than me. Those are always a shock. I know at 65 they come on, but still…… I look fine in candle light tho.

    2. Mine sounds like it may be a similar story, I didn’t start until I was 15 and right now I am at 15 weeks with no period at age 56. I had made it to 13 weeks once before but then had two in a row. My sister is 60 later this year and is still not finished. She is very overweight on a SAD diet, I am normal weight and primal for six years.

  4. Interesting. I was done at age 38. Periods started at 11. My Mom was malnourished and thin for years and was done at 42. I was very active in my early 30’s, 6 days a week, split routines 5 days a week with weights and was on a low fat, high carb diet(the 80’s). I had underwater fat % of 18.9. I was at my lowest weight, thought I was healthy! BUT, menopause at that age was not good, I am 69 now, but have always wondered why it occurred so young, no one had answers.

  5. I was ovo-lacto vegetarian most of my life, so still consuming animal protein in the form of dairy and eggs. Was raw vegan for awhile…started out feeling great and went downhill from there. I’ve been Primal since my mid 40s. I’m now 52 and still not in menopause. No studies here…just my own experience. Still don’t know what a hot flash is. Haven’t had my BMi calculated in quite awhile. I am small boned and know it is always pretty low but definitely above the numbers listed in the study.

  6. I am sure that there are multiple variables that affect it. But there is obvious genetic influence in my family – my mother hit menopause at 56, I hit it at 55, my older sister at 52, and my oldest sister at 54. The sister that reached menopause at 52 is the heavy-ish one; my oldest sister and I are pretty slim.
    I am very curious as to menopause in the vegan community, however…

  7. I am 52 and my only just started to recognise menopausal signs. I have largely followed a low carb diet for over 20 years. An endocrinologist recommend the Atkins diet to address health issues I was having and I have never looked back. Interestingly though I have been vegetarian until very recently.

  8. Thank you for this, Mark! I’d be curious to see whether there are connections between the age of menopause and consumption of conventional animal products injected with growth hormones. Also between the age of menopause and endocrine disruption via personal product use.

  9. I have been in perimenopause for a couple of years with rich bleeding, shorter periods etc. In my case I guess there are many reasons for the earlier perimenopause (I am 38 now). I have had hashimotos for 10 years, had a lot of stress in my life (adrenal fatigue), too much cupper in my body which leads to imbalance between estrogen and progesterone. I have been eating keto/Paleo for 8 years but cannot say whether it helped or not, maybe I would have been feeling worse if I did not exclude high carbs etc.. My symptoms have gotten better by adding zinc and eliminating SIBO. Hopefully I can avoid getting early into menopause.

  10. I finished going through menopause at 57 years old. Obviously later. My take is that the healthier a person is, the more chances of them being reproductively capable. Unhealthy diet, unhealthy lifestyle equals probably not so good reproduction. So then wouldn’t it make sense that the healthier you are the more reproductively capable we would be and hence forth a later menopause.? And conversely if we weren’t healthy, we would not be able to sustain a healthy pregnancy. We already know this when someone is very low body fat or does a lot of heavy activity. They go into a “menopausal“ state until their body fat and their lifestyle changes such that they would be able to have a pregnancy and sustain it. Then menses return. Just the 10 cents worth of a menopausal RN crone.

  11. Chemicals which mess with estrogen may contribute to early menopause when combined with low weight or weight loss.

    Three in my family–I’m one–one was working with synthetic fabrics and foams in a furniture factory. I was employed part-time by an inventory firm which had me working in fast-fashion outlets with a second PT job in a fast-food joint with trans fat fumes. A third had early menopause but was employed by a blood bank with no apparent risk factors and a normal American diet, so heredity could also be a factor.

  12. I’m going to be 55 years old in 4 months, and I still get a period every month. My mother didn’t start menopause until she was over 55 years old, but I don’t recall her exact age. I’m glad I still get my period, it keeps me young and regulates the body. I watch my weight, I’m 5’5, about 130 – 135. I excercise regularly, mostly walking. I have coffee every morning & alcohol on some weekends. I’ve never had a hot flash. I believe there’s a genetic component as well, it’s said you follow the mother.

  13. The end of menstruation is not bad for the health in every way, in spite of having some definite drawbacks for heart and bone health. Shorter exposure to estrogen over the years leads to a lesser likelihood of breast, endometrial and ovarian cancer, I was always told. That’s why women who have had children get these less often than women who have not, on average. Have researchers discovered differently in recent years? I am honestly curious, not trolling.

  14. That is funny cos every time I read something it says about early menopause. What about late menopause? I am 55 years old and my periods are still pretty regular. Now, I am a very health conscious person, I try to eat very healthy, lots and lots of vegetables, not so much grains, some animal products now and then like grass fed liver, pasture raised eggs, (not very often). Not too high fat and definitely no vegetable fats. Sometimes some good quality olive oil, sometimes a handful of nuts. A lot of fermented food. My diet leans towards more the plant based lifestyle, and I excercise 5 times a week. Some days I walk also after dinner to bring my blood sugar down. And I do OMAD most days. I am on the underweight side too. And I am asian.