That’s the conclusion of the first UK study to look at the relationships of diet to menopausal age in the UK, published online in the Journal of Epidemiology & Community Health.

Several genetic, behavioural, and environmental factors are thought to be involved in the timing of the menopause, and some studies have implicated diet.

To explore this further, the researchers drew on participants from the UK Women’s Cohort Study, involving women between the ages of 35 and 69 from England, Scotland, and Wales.

The women provided information on potentially influential factors such as weight history, physical activity levels, reproductive history, and use of hormone replacement therapy (HRT).

Diet under scrutiny

They also estimated the quantities of 217 foodstuffs they ate every day by completing a food frequency questionnaire. The food items were collated into groups according to their culinary uses.

Further information on when the women had gone through the menopause naturally was gathered 4 years later.

In all, the study included the 914 women who had gone through the menopause naturally after the age of 40 and before the age of 65.

The average age at menopause was 51, and certain foods seemed to be associated with its timing.

Health protein good, carbs & snacks not so much

Each additional daily portion of refined carbs – specifically pasta and rice – was associated with reaching the menopause 1.5 years earlier, after taking account of potentially influential factors.

But each additional portion of oily fish and fresh legumes (e.g. peas, beans) was associated with a delay of more than 3 years. Higher intakes of vitamin B6 and zinc (per mg/day) were also associated with later menopause.

Similar results emerged when the analysis looked at particular groups. For example, eating meat was associated with menopause arriving almost a year later than a vegetarian diet.

Among those who weren’t vegetarian, upping daily portions of savoury snacks was associated with the arrival of the menopause almost 2 years earlier, while higher intake of oily fish and fresh legumes was linked to later menopause of more than 3 and nearly 1.5 years, respectively.

Similarly, among mothers, higher intake of oily fish and fresh legumes was associated with later menopause, while additional daily portions of pasta, rice, and savoury snacks were associated with earlier menopause.

Among childless women, eating more grapes and poultry was significantly associated with later menopause.

Do antioxidants offer an explanation?

Egg maturation and release are adversely affected by reactive oxygen species, so a high intake of legumes, which contain antioxidants, may counter this, preserving menstruation for longer, suggest the researchers. Likewise, omega 3 fatty acids, which are abundant in oily fish, stimulate antioxidant capacity in the body.

On the other hand, refined carbs boost the risk of insulin resistance, which can interfere with sex hormone activity and boost oestrogen levels, both of which might increase the number of menstrual cycles and deplete egg supply faster, they say.

Vegetarians consume a lot of antioxidants too, but they are also likely to eat a lot more fibre and less animal fat than carnivores, both of which are associated with low oestrogen levels, which may also alter the timing of the menopause, suggest the researchers.

This is an observational study, and as such, can’t be used to prove a definite link between diet and age of menopause.

But it points research in a new and useful direction since women who go through the menopause early are at increased risk of osteoporosis and heart disease, while those who go through it late are at increased risk of breast, womb, and ovarian cancers, so timing matters, say the researchers.

The scientists conclude: “Our findings confirm that diet may be associated with the age at natural menopause. This may be relevant at a public health level since age at natural menopause may have implications on future health outcomes.”

Now researchers from Charité – Universitätsmedizin Berlin, have found that an app which provides visual guidance on effective acupuncture points could help ease the pain and give women a sense of control.

Period pains primarily manifest as lower abdominal cramping, other symptoms include headache, backache, nausea and diarrhoea.

Acupressure is a technique derived from traditional Chinese medicine (TCM). In contrast to acupuncture, this technique can be used as a form of self-care and is suitable for use at home. Rather than using needles, this technique involves massage or pressure being applied to specific points on the body.

Is there an app for that?

The researchers wanted to evaluate whether self-acupressure would be more effective at achieving a sustained reduction in menstrual pain than usual care alone (e.g. pain medication and hormonal contraceptives).

A total of 221 women (aged 18-34) suffering from severe menstrual pain were randomly assigned to one of two treatment groups, both of which received a study app, called AKUD (or Luna, in English),  which included visualisation of the menstrual cycle, questionnaires, and diaries for both groups as well as a short introduction.

Additional acupressure-based features – with instructions on how to administer self-acupressure shortly before and during menstruation – were only made available to the intervention group. One advantage of an app, the researchers found, was its ability to provide visual descriptions of the pressure points users need to target in order to achieve the desired effect. It can also send regular reminders. Additionally, the app was used to collect all study-related data.

“Initially, we simply wanted to conduct a study on the use of self-care techniques for menstrual pain. However, the women who were involved during the planning stages, all of whom were affected by menstrual pain, wanted an app,” reports the study’s principal investigator, Professor Dr Claudia Witt of the Institute of Social Medicine, Epidemiology and Health Economics. The app helped participants to apply simple self-acupressure techniques to three different acupressure points.

Significant reductions in pain

Writing in the American Journal of Obstetrics and Gynecology, the researchers report that after three months, 37% of participants in the acupressure group reported a 50% reduction in pain intensity.

After six months, this proportion had increased to more than half of the women in this group (58%). Only 25% of women in the control group reported a similar reduction in pain intensity at both the 3-month and 6-month marks. Women in the acupressure group also used less pain medication than women in the control group and reported lower levels of pain overall.

“We were surprised to see that, after six months, two thirds of participants continued to use self-acupressure. So far, research into the clinical effectiveness of apps has been limited, and only a few have been tested using randomised controlled trials,” says co-author Dr Daniel Pach of the Institute of Social Medicine, Epidemiology and Health Economics. He adds: “We were able to show that apps can be evaluated in a clinical trial setting. However, despite our experience with conventional clinical trials, there was a lot for us to learn – something we found both exciting and eye-opening.”

The Institute for Complementary and Integrative Medicine, University Zurich which developed the app used in the study is now working on an English language version that will work for both android and IOS.

• See related articles, left, for more information on  relieving period pains.

PCOS is a common hormone condition that contributes to infertility and metabolic problems, such as diabetes and heart disease.

It affects an estimated 7-10% of women of childbearing age, and women are diagnosed with PCOS when they have at least two of the three key features of the condition:

• Increased numbers of cysts in the ovaries (called polycystic ovaries) detected by ultrasound
• Slightly higher levels of testosterone or clinical symptoms, such as excess body hair
• Irregular or no menstrual periods

The collaboration between researchers at University of California San Diego School of Medicine, in collaboration with colleagues at Poznan University of Medical Sciences in Poland and San Diego State University was published online in the Journal of Clinical Endocrinology & Metabolism.

Hormonal link to gut flora

The researchers examined faecal swabs from 73 women diagnosed with PCOS. Their samples were compared to swabs from 48 women who did not have PCOS and 42 women who had polycystic ovaries but did not have the other features of PCOS.

The study found the women who had PCOS had the least diverse gut bacteria, women who did not have the condition had the most diverse gut bacteria and women who had polycystic ovaries tended to have more diverse gut bacteria than women with PCOS, but less diversity than women without the condition.

“The findings indicate women with PCOS tend to have less diverse populations of gut bacteria, a trend which appears to be linked to elevated testosterone levels,” said Varykina Thackray, PhD, senior author of the study and associate professor in the Department of Reproductive Medicine at UC San Diego School of Medicine.

The diverse bacteria in the gastrointestinal tract play an important role in human health. Recent research suggests that gut bacteria differ in individuals with metabolic conditions, such as obesity, compared to individuals who do not have those conditions.

“Our study suggests testosterone and other androgen hormones may help shape the gut microbiome, and these changes may influence the development of PCOS and the impact it has on a women’s quality of life,” adds Thackray.

Thackray says additional research is needed to determine whether specific gut bacterial species contribute to the development of PCOS and whether the microbiome offers potential pathways for treating the condition.

Natural Health News — As the rate of caesarean operations increases, so does the risk of urinary tract infections after birth. But a natural remedy, derived from rosehips could help keep infection in check.

Caesareans raise the risk of urinary tract infections because they require the mother to be catheterised post-surgery. As bacteria become more resistant to treatment with conventional medications a urinary tract infection can be hard to treat.

Some natural remedies like cranberries have produced good results in human tests. But while laboratory ​studies demonstrate that rose hips -or fruits of the Rosa canina ​plant -prevent the growth of UTI-causing bacteria Escherichia coli​, the researchers said that no clinical trials have been done yet looking specifically at the plant’s role in reducing post-partum UTIs, especially among women who have undergone caesareans.

A human trial

The triple-blind study, published in the journal Phytotherapy Research, involved 400 women recruited from two hospitals in Tabriz, in Iran who underwent a caesarean between August 2016 and March 2017. The women were divided into two groups of 200 women each taking either a rose hip supplement or placebo.

To be included, the women had to have had a caesarean in the 48 hours before they begin the intervention period, and to only have had a maximum of three doses of antibiotics post operation.

The doctors were looking for the incidence of any type of UTI during the 20-day follow-up.

Rich in vitamin C, flavonoids​

The capsules were made out of Rosa canina ​fruits procured from an herbalist in Tabriz and milled into a powder. For the placebo, starch powder was used.

A separate analysis of the capsules revealed that each contained 880 mg/100 mL of vitamin C, as well as flavonoids such as quercetin, which has been studied for its antibacterial effect.

The women took the rosehip or placebo capsules twice daily half an hour after meals with a glass of water. This period lasted from 48 hours after the caesarean and continued for 18 more days. The women were followed up with telephone calls to ascertain compliance with the regimen.

Significantly fewer UTIs​

After all women from both groups completed their intervention period, the researchers found that the total risk of UTI on the 7th​ to 10th​ days of the trial was significantly lower in the rose hip group compared to the placebo group.

For instance, only 4 women from the rose hip group had positive asymptomatic urine cultures, which means asymptomatic UTI, compared to 13 in the placebo group. After the 20^th ​day, just 3 women from the rose hip group had a UTI compared to 19 in the placebo group.

The results led the researchers to conclude that rose hip “can be used in post caesarean post-partum as an inexpensive and cost-effective substance for promoting maternal health.”​

It is also likely to be effective for the general treatment of UTIs as an alternative to conventional medications and as a natural therapy to stand alongside cranberries.

The positive effect of the herbal remedy, say the researchers from the University of Medical Sciences in Tabriz, could be due to the high vitamin C levels which can help prevent UTI through its antioxidant properties.

Previous studies have examined the link between gut microbiota and the development of breast cancer. These have suggested that the microbes in the gut may regulate estrogen levels, leading to estrogen-receptor positive breast cancer.

But less attention has been paid to the microbiome residing in the breast tissue, which the researchers suggest is unique and somehow becomes altered in women who have breast cancer.

Researchers have long suspected that a “microbiome” exists within breast tissue and plays a role in breast cancer but it has not yet been characterised. The research team has taken the first step toward understanding the composition of the bacteria in breast cancer by uncovering distinct microbial differences in healthy and cancerous breast tissue.

Published online in the journal Oncotarget the study examined the breast tissue of 78 women – 57 of whom had undergone a mastectomy because they had invasive breast cancer, and 21 of whom were healthy and had undergone cosmetic breast surgery.

More harmful bacteria in breast cancer patients

In addition to the breast tissue microbiome, the scientists examined the urinary and oral bacteria of these women. Not only did they find that women with breast cancer had considerably lower levels of a bacterial genus called Methylobacterium, they also discovered that these women also had higher levels of so-called gram-positive bacteria in urine, including Staphylococcus, Corynebacterium, Propionibacteriaceae, and Actinomyces.

Probiotics as form of prevention?

“To my knowledge, this is the first study to examine both breast tissue and distant sites of the body for bacterial differences in breast cancer,” said co-senior author Charis Eng, M.D., Ph.D., chair of Cleveland Clinic’s Genomic Medicine Institute and director of the Center for Personalized Genetic Healthcare.

“Our hope is to find a biomarker that would help us diagnose breast cancer quickly and easily. In our wildest dreams, we hope we can use microbiomics right before breast cancer forms and then prevent cancer with probiotics or antibiotics.”

Breast cancer is the second most common cancer in women (after skin cancer). In the UK and US 1 in 8 women will develop the disease in their lifetimes.

More research is needed, the authors note, to understand the role of these bacteria in breast cancer. The findings also need “a larger cohort of clinically matched patients” to be validated. However, the research remains “one of the largest studies to examine the microbiome in human breast cancer patients,” write the authors.

Primary dysmenorrhea (period pain) is the most common health complainant in women of childbearing age, with up to four in five women suffering at some stage during their reproductive years.

The small study in the international journal PLOS ONE, involved 74 otherwise healthy women, aged 18-45 years, with suspected or confirmed primary dysmenorrhea.

Women in the trial kept a menstrual diary and were given individualised acupuncture treatments after being randomly assigned to one of four treatment groups: high frequency manual acupuncture, low frequency manual acupuncture, high frequency electro-acupuncture and low frequency electro-acupuncture.

Twelve treatments were performed over three menstrual cycles, either once per week (low frequency groups) or three times in the week prior to their period (high frequency groups). All groups received a treatment in the first 48 hours of their period.

Over half the women receiving traditional manual acupuncture had a least a 50% cent reduction in their severity of period pain over the three months of treatment.

Researchers also found a connection between both the treatment timing and frequency, with those receiving high frequency treatments experiencing greater improvements quality of life, including feelings of vitality and increased participation in sports and social activities

A reduction in pain relief medication when using manual acupuncture compared to electro-acupuncture was also found.

Towards new guidelines

Lead researcher Dr Mike Armour of Western Sydney University and the Department of Obstetrics and Gynaecology, University of Auckland says the results are promising and may lead to the development of evidence-based guidelines for acupuncture in the treatment of period pain and its associated symptoms.

“Pragmatic trials of acupuncture have shown a reduction in pain intensity and an improvement in quality of life in women with period pain, however evidence has been limited for how changing the ‘dosage’ of acupuncture might affect the outcome,” he says.

“Our pilot study found that using manual stimulation of the needles, rather than an electrical pulse, commonly used in many Chinese studies for period pain, resulted in reduced need for pain relieving medication and improvement in secondary symptoms such as headaches and nausea. The latter was unexpected and will be explored further in future, larger trials.”

It’s a remedy rich in a type of plant estrogen known as isoflavones, that has been show to work for many – but not all – women.

Now Danish researchers suggest that the form of red clover can make a big different to how well – and how broadly – it works.  In a new study they found that fermented red clover stopped hot flushes and, in addition, prevented the accelerated menopausal bone loss affecting one in three women over the age of 50. Indeed the results showed the herbal treatment stopped bone loss in the spine completely.

“The challenge with isoflavones is that they can be difficult to digest as they naturally occur in the plant bound to sugar molecules which prevent absorption. Hence, a large proportion of the isoflavones that are consumed (e.g. as a pill or capsule) can pass through the intestine without entering circulation. This problem is bypassed when the red clover extract undergoes a fermentation process… [which] separates the sugar molecules from the isoflavones, thereby increasing bioavailability,” explains study author Max Norman Tandrup Lambert.

Fast results

In this small trial, published in PLOS One, 62 pre-menopausal women aged 40–65, who were experiencing more than 5 hot flushes per day and who had a follicle stimulating hormone (FSH) level of over 35 International Units Per Litre (iu/L, indicating they were at the menopause “stage) were enrolled.

The women received either twice-daily treatment with a liquid fermented red clover extract, providing 34 milligrams per day (mg/d) of isoflavones plus a lactic acid probiotic, or a placebo formulation for 12 weeks.

The probiotic was added, say the researchers because previous work has shown that it can improve bioavailability of red clover extract.

Within 24 hours there was a significant decrease in hot flush frequency and intensity in those women taking the red clover extract.

“After 12 weeks we tested again and were speechless about the data,” said Lambert. “There was a much greater effect than we had hoped for.”

Bioavailability too often ignored

The issue of bioavailability highlighted within this study is one which the research team say has often been ignored.

“Previous studies fail to account for inter-individual differences in GI microbiota of their participants or the molecular form of the isoflavones provided,” they commented.

“This has led to high variability in isoflavone bioavailability, bioactivity and efficacy in other clinical trials.”

These findings are important since to 80% of women may experience symptoms during menopause and it is estimated that in 2030 numbers of pre- and post- menopausal women will reach 1.2 billion globally.

While conventional approaches to menopausal such as hormone therapy may alleviate some symptoms they are also linked to an increase in cancer and cardiovascular risk. This is why, studies show, many women turn to natural remedies.

Fermented isoflavone supplements are beginning to appear on the market meaning more women can soon benefit from them. In the mean time, adding a lactic acid probiotic (eg  Lactobacillus acidophilus) to your supplement regimen may greatly improve the results you get with red clover.

For the study, the researchers carried out a systematic review of the published literature on yoga practice and common menstrual disorders.

Jennifer Oates, PhD, King’s College London, UK, assessed the evidence from 15 published studies on the effects of yoga practice on problems such as amenorrhea, oligomenorrhea, dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder.

The term ‘yoga’, the author notes, describes a variety of practices, which include physical exercises (Asanas), breathing exercises (Pranayama), relaxation techniques, and meditation or concentration practices, including yoga Nidra (a form of guided relaxation practice). There are many different types of yoga, according to different schools or traditions (for example  Krishnamacharya, Iyengar, Ashtanga etc). Yoga practice in the modern context is primarily focused on Asana as a physical exercise regimen, whereas traditionally, and certainly before the mid-20th century, yoga has been more widely associated with spirituality and contemplation.

Physical and emotional wellbeing

In the studies included in this analysis a range of different types of yoga were used as an ‘intervention’ for women suffering menstrual pain, including a combination of Asana, Pranayama, and other yogic relaxation or meditation techniques. They also varied in duration and intensity of the yoga ‘intervention’. And yet all of the studies evaluated reported a beneficial effect and reduced symptoms.

Enhanced mood, reduced pain, increased wellbeing, and a heightened relaxation response were among the improved outcomes reported by women who participated in a yoga intervention, according to the findings published in the Journal of Alternative and Complementary Medicine.

Frustratingly few of the studies offered explanations as to how or why yoga could help with menstrual pain and discomfort. However, increased body awareness, improved physical health and well-being may play a part.

“All included studies reported some change in their outcome measures, suggesting reduced symptoms of menstrual distress following a yoga intervention,” the study concluded.

In a related study people with major depressive disorder were shown to have a significant reduction in depressive symptoms during an integrative health intervention that included Iyengar yoga classes and coherent breathing. Participants who took three yoga classes a week were more likely to be less depressed after just 12 weeks of practice.

The study analysed data from more than 6,500 women aged 65-80 who participated in the Women’s Health Initiative Memory Study, which began in 1996.

The women’s PUFA levels were measured in 1996 and then their health and causes of death, were tracked through August 2014.

Over an average 15-year follow-up period per woman, the researchers found that those aged 65 to 80 with the highest omega-3 blood levels were 20% less likely to die from any cause than those in the lowest levels. This was true even after adjusting for a wide variety of lifestyle and other factors that can hasten death such as smoking, physical activity and history of cardiovascular disease.

Furthermore, women who died during the follow up period were more likely to have lower omega-3 status then those who lived.

“This is the largest – but far from the only – study to confirm that blood levels of EPA and DHA omega-3 fatty acids, in this case the omega-3 index [a measure of EPA and DHA levels in red blood cells], are independent predictors of risk for death,” said Dr. William Harris, lead author of the study. “These findings support the view that higher EPA and DHA omega-3 levels are associated with better overall health.”

Most aren’t getting enough

To put the results of this study in context, recent evidence suggest that around 80% of Americans have less omega-3 in their blood than was found in the healthiest women in this study,

Another 2016 paper confirmed this is not just a US phenomenon. It found that very low omega-3 levels “were observed in North America, Central and South America, Europe, the Middle East, Southeast Asia, and Africa.”

Although this study was observational and did not analyse the effect of a specific intervention, the authors estimated that intakes of approximately 1g of EPA and DHA per day were required to increase omega-3 status from the lowest levels observed in this study to the highest.

This can be done by supplement or in food terms it is equivalent to two and a half to three salmon fillets per week.

The FDA considers dosages of EPA and DHA up to 3g per day Generally Recognized as Safe (GRAS), a higher level than the 1g per day estimated as a requirement to move from the lowest to highest level of omega-3 status in this study.