Mood swings and surgical menopause go hand in hand. However, there is a lot that can be done to manage and help mood swings by maintaining good blood sugar levels and avoiding spikes. What are your tips for managing this?

Food is really important here and ensuring you are getting a constant stream of good blood sugar balancing foods into your diet. Often many women skip breakfast for example and really it is the best way to start your day. It sets up your body for the day ahead and provides it with good energy providing foods to keep it going. This is key when it comes to keeping moods balanced.

Also ensuring you keep yourself hydrated is very important. Drink plenty of water throughout the day. Water is an essential nutrient needed in the body daily for normal function. It’s also absolutely essential for efficient digestion and the processing of food. Mild dehydration can lead to loss of concentration and memory issues.

Here are some great snack ideas:
Dates and almond butter: Take the nut out of the date, scoop in a teaspoon of almond butter and leave in the fridge for a couple of hours, trust me this is divine. It melts in your mouth, I generally prepare about 6-8 at a go and then leave them in a sealed container at the back of the fridge. I use medjool dates.
Rye cracker with almond butter or any nut butter you like, you can add sliced or mashed banana too.
Sliced apple dipped into almond butter, very easy to carry around and really good for you.
Pecans toasted in maple syrup are another divine snack, incorporate nuts and seeds whenever you can.
Humus with celery stick.
Nuts and seeds: to snack on - make sure they are unsalted.
Brazil nuts: Selenium (excellent for anyone with thyroid issues) Vitamin E and Thiamine (a B complex) helps metabolism, brain and memory.
Chia seeds: Protein and fibre. Manganese, iron, selenium, magnesium, calcium, phosphorous.
Almonds: Good fats, heart healthy, slow release of energy. High in protein and Vitamin E.
Minerals: Magnesium, calcium and copper.

Are there any foods which you would recommend steering clear of in surgical menopause and why?

I always refer to these as the ‘nutrient robbers’ and there are a few culprits here! This is my list:
Caffeine: Everything in moderation, we know excess caffeine is no friend of menopause.
Processed food: The odd take home meal is fine but not on a regular basis. The additives/preservatives are not nutrients for your body and will put an extra toll on your body’s reserves of energy.
Alcohol: Not a food but I see so many women where excess alcohol really impacts them especially in relation to moods and hot flushes. Alcohol is a trigger for the vast majority of menopausal symptoms.
Sugar: I could write a book on this one! Sugar is inflammatory and as we get older we need to reduce inflammation throughout our body so reducing/eliminating sugar is key.

It is very important to look after your bone health, even more so in surgical menopause. Eating a diet rich in calcium and vitamin D is recommended, but which foods are particularly beneficial for this? And are there things to avoid which can interfere with calcium absorption?

In relation to bone health the key ingredients are Calcium, Protein, Magnesium, Vitamin D and Vitamin K. These all work in synergy with each other aiding and enhancing absorption of calcium into the bones. Vitamin D is also very important for our immune system, it’s the one vitamin I believe we should all supplement because even eating the foods with Vitamin D it will be hard to get the daily intake we need especially in winter.

Top Foods to eat:
Calcium: Milk, Yoghurt, Cheese, Meat, Fish, Eggs, Beans, Lentils, Fruits ( Oranges & figs especially), Vegetables (go for the greens) , Nuts & Seeds.
Protein: Lean red meat, poultry and fish, eggs are excellent sources of animal protein. Vegetable sources of protein include legumes (e.g. lentils, kidney beans), soya products (e.g. tofu), grains, nuts and seeds.
Vitamin D: Oily fish (salmon, sardines and mackerel), eggs, mushrooms and liver.
Vitamin K: Another key nutrient for bone health. Vitamin K foods: leafy green vegetables such as lettuce, spinach, cabbage, prunes, liver and soya bean products.

Food to avoid:
In addition to the foods mentioned above it is important to monitor your salt intake. Salt can increase calcium loss from your body and should not be taken in excessive amounts. Fizzy drinks are best avoided too

Hormone fluctuations can often trigger IBS symptoms and we know that avoiding those foods and drinks that may trigger your symptoms such as caffeine, alcohol and processed foods can be beneficial. But how important is it to slowly introduce healthy foods into your diet if you have been suffering with digestive issues and how beneficial is good gut health to how well you feel in general?

Drip feed new foods into your body. You need to see how it reacts to changes in diet. Some foods your body will need time to adjust too and may cause bloating so you need to watch and see how you react. I would recommend keeping a food diary while you do this, it is easy to forget what foods will trigger a reaction.

Bowel health is crucial in menopause, it is important to have regular movements with no straining. Regular movements ensures you are eliminating toxins and unwanted waste from your body, this is good for your energy. It will keep your body moving as it should.
Constipation creates a backlog and stop the energy moving, it is not your friend in menopause creating blockages and making you feel sluggish. This is why fibre is imperative in your diet.

The gut is the cornerstone of your body’s health and working with your liver will ensure your body is working at it’s optimum. These two essential organs work side by side - your gut absorbs all those essential nutrients and vitamins from your food and your liver get rids of unwanted toxins from your body, like a filter system - it flushes out what is no longer needed. Both of these organs need special care in menopause. That means reducing the nutrient robbers and increasing the good foods.
This is where prebiotics and probiotics come into play - these essential food sources provide your gut with good bacteria that enhances your gut health. Prebiotics are like the fertilisers to enhance the growth of probiotics and as we know much research has been done to outline the connection between the gut and your brain health.

We often hear that women in menopause become intolerant to alcohol, do you know why that is?

The sensitivity to alcohol comes more with age I think, so both men and women become more sensitive to the ill effects of excess alcohol consumption. As we get older our body will hold less water and the less water in our bodies the harder it is for your body to dilute the alcohol consumed.
Women are more impacted by this due to the fact we are generally smaller than men, which means our bodies absorb alcohol faster. There is ample research to show how excess alcohol consumption can increase a women’s risk of cancer, liver, heart disease and osteoporosis

Are there certain foods that can help our bodies to retain oestrogen?

There are phytoestrogen foods which mimic the action of oestrogen in the body - they will never be as strong as HRT but it still provides small amounts of this essential hormone. Phytoestrogens are plant sources of estrogen, they are compounds that are naturally found in plants and plant foods.
The richest food sources of isoflavones are soya products, flaxseed, lentils, chickpeas, mung beans, sunflower, pumpkin and sesame seeds, other beans, green and yellow vegetables (to some extent) and red clover.
Edamame beans are an excellent source and can be found in the freezer section of most supermarkets.
Other foods that contain some phytoestrogens include whole-wheat breads and pastas, olives and olive oil, apples, pomegranates, cherries, carrots, eggplant, potatoes and alfalfa.

It’s often said that women gain weight in menopause. Is there any truth in this?

Unfortunately yes. Oestrogen helps our body metabolise food and the decline in this hormone will impact weight gain. Most women will find it around the middle and more often than not it will take more work than before to lose that weight.

The reduced oestrogen can also cause our energy to work less efficiently so our metabolic rate is not quite as good as it used to be - we aren't turning around the food as quick as we used too, in essence it's on a slow burner.
That lean body mass of your 20's and 30's decreases as we age (men too), this is because of hormone changes and also lifestyle changes, sitting more, commuting further, less movement daily etc. Losing this muscle mass causing us to burn fewer calories when we are sitting and also when we are moving. Add this to all the other factors and the result is weight gain. Many women I talk to can't understand why they are heavier when they are doing the same exercise and same diet as always - but what worked in the past won't work when you hit your 40's. You need to tweak your habits and your approach.

The good news is you can lose it, it just means tweaking your approach and add in foods that will encourage metabolism. Starting your morning with sliced lemon, fresh ginger in warm water is a great way to get those digestive juices flowing first thing in the morning.

We have found our hair and skin have dried out in menopause. Are there any supplements or foods you’d recommend to help?

B Vitamins are excellent for hair and skin health, in particular Riboflavin (Vitamin B2) helps keep skin, nails, and hair healthy. Good sources of B2 are milk and eggs.
Biotin (Vitamin B7) helps the body convert food into energy, it boosts the health of the hair and nails, supports a healthy pregnancy, and helps manage blood sugar levels, among other benefits.
Food sources with all the B’s are a great add or else a good B complex like Terranova B Complex or Cleanmarine Menomin.

Low energy can be a real issue in surgical menopause. What food/supplements would you recommend to help with energy levels?

I would start with your liver health and make sure you are looking after it, once your liver and gut are functioning optimally then you can work on releasing more energy by the many good foods already mentioned and reducing the not so good ones. Drinking water is very important here too.
I always like to look at food first before using a supplement but if you need more on top then a good supplement for energy would be Sara’s Choice Camu Camu. The B Vitamins also are a key ingredient for good energy.

We’ve read that it’s important for women in menopause to eat ‘healthy fats.’ What foods contain healthy fats?

Foods that are termed high fat are actually super healthy, we now know that fat including saturated fat is not the evil it was portrayed to be. The top foods for good fats to include in your diet are: avocados, cheese, dark chocolate, eggs, fish, nuts, chia seeds, extra virgin olive oil and full fat yogurt.

Sleep disturbances are really common in surgical menopause. Can you recommend anything to help with this?

Magnesium is great to help with sleep, it’s very important to get the right form so make sure you read the label. Good sleep hygiene is the place to start too and remember no phone by the bed!
Often women underestimate the stresses of the day and they often fall into the night and result in an elevated cortisol level. Ensuring you have relaxation during your day and take time to manage your stress is important too.

Top Magnesium food sources:
Pumpkin Seeds - the heavy hitters, a 1/4 cup gives a whopping 317mg of magnesium.
Flaxseeds
Brazil nuts
Sunflower seeds and/or butter
Fermented soy
Almonds
Cashews
Soybeans
Dark green leafy vegetables Avocado
Raw Cacao

Are there any other supplements you’d recommend for women in surgical menopause?

My top ones are as follows:
Omega 3 - for brain health
Vitamin D - as above it’s essential! My preference is for an oral spray
B vitamins - are key and many women struggle to get enough in their diet so they may need to supplement
Magnesium - my preference is Mag365 as it is absorbed brilliantly by the body.

If a woman in surgical menopause wants to lose weight how would you recommend that she go about this?

Start the day with fresh lemon and ginger to get your digestion moving, have a good healthy breakfast, ensure you are incorporating healthy snacks throughout the day. Drink fresh ginger during the day, again to keep your digestion flowing.

A key part is looking after your gut and liver health as above as this will ensure your body’s energy is working nicely.
Sleep and exercise are integral too. Remember we lose weight when we sleep well as our bodies are churning away energy and working away while we sleep. Where possible avoid snacking late in the evening as the longer your body can go without food in the evening the better - it allows your body more time to work away on the energy providers/food it has consumed during the day. If you can get a minimum of 12 hours from last eating to your breakfast the next day that will be a great start.

And remember there are always a few what not to do's:
Don't depress yourself by trying fad diets. It's my personal opinion but I just think they put more pressure on you and bottom line eating well and exercising are the key habits to encourage. You want long term sustainable change not a quick fix that will rebound in another few months. Also most fad diets wreak havoc on your blood sugar levels which is a recipe for disaster in menopause!
Cut out sugar where you can - your liver hates sugar and so does your immune system
Look at your meat consumption and try add more vegetables where you can.