Women’s bodies face a variety of changes throughout the lifecycle. Through puberty, childbearing years, perimenopause, menopause, and beyond, women’s bodies require an approach to wellness that evolves along with them.
Women in their 20s and 30s are considered “of childbearing age,” and much attention surrounds preparing women for healthy pregnancies. But women are more than just the health of their reproductive organs. While fertility certainly gets the spotlight, in reality, optimizing nutrition and overall health also provides a solid foundation and healthy terrain for whole body health in addition to supporting fertility.
Methylation is extremely important to women’s health throughout the lifecycle – for example, by supporting fetal development during pregnancy. It is the process by which epigenetics regulate genetic expression and the healthy replication of DNA. Methylation, or the transfer of one carbon methyl group from one molecule to another, is greatly dependent on the presence of certain nutrients that act as co-factors to keep the process moving smoothly. These methylation nutrients include choline, betaine, methionine, folate, vitamins B12 and B6, as well as certain minerals like magnesium, zinc, and sulfur.
Methylation is critical to a multitude of metabolic processes including:
- Cell division, DNA and RNA synthesis
- Detoxification and hormone biotransformation
- Neurotransmitter biosynthesis
- CNS development and neural tube formation
- Histamine clearance
- Phospholipid synthesis
- Myelination of peripheral nerves
Reproductive health and fertility support
Female reproductive health and fertility are influenced by many factors, including nutritional status, genetics and epigenetics, hormonal balance, diet, stress management, lifestyle, and other environmental factors.
Lifestyle modifications to improve fertility include:
- Eating a healthy and well-balanced diet emphasizing whole and minimally processed foods, emphasizing key nutrients for fertility, such as:
- Folate (Dark leafy green, cruciferous vegetables, turnip greens, beef liver)
- Choline (Eggs, cruciferous vegetables, sunflower seeds)
- Selenium (Brazil nuts)
- Iron (Red meat, beans, lentils, spinach)
- Omega-3s: (Fatty fish, walnuts, flaxseed, chia seeds)
- Maintaining an active lifestyle, including regular exercise
- Minimizing and managing stress
- Limiting alcohol consumption
- Maintaining a healthy weight and lean muscle mass
Hormonal Health and Detoxification Support
Environmental toxins pose a unique risk to hormonal and reproductive health. Persistent organic pollutants (POPs) and other pesticides, heavy metals, parabens, phthalates, dioxin, polychlorinated biphenyls (PCBs), bisphenol A (BPA), and other plasticizers have all been found to disrupt the endocrine system in several ways, including mimicking estrogen and disrupting insulin sensitivity.1 Increased exposure and bioaccumulation of environmental toxins and pesticides are associated with:
- Decreased fertility, increased risk for miscarriage and reduced fetal viability2
- Early menarche2
- Increased risk for polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids and breast cancer4
Minimizing contact with environmental toxins is an important strategy in protecting the endocrine system and optimizing hormonal balance. In addition, establishing daily habits that support detoxification may also be helpful in more efficiently eliminating environmental toxins and reducing overall toxic body burden, along with periodic metabolic detoxification protocols to better address stored toxins.
Because environmental toxins may be passed to the fetus via umbilical cord and placenta and to newborns via breast milk, detoxification protocols are not advised during pregnancy and breast feeding. Rather, incorporating metabolic detoxification protocols prior to conception may help to reduce overall toxic burden and support healthy fertility, conception, and pregnancy.
Hormonal Balance and Premenstrual Syndrome Support
Many women struggle with symptoms of premenstrual syndrome (PMS). There are several types of PMS, each signaling their own specific imbalance. Fortunately, each type may be relieved or improved with specific nutritional and herbal support. In many cases, blood glucose dysregulation and nutrient insufficiencies may play a big role, as well as increased histamine levels. Herbs like gymnema, rosemary, , rhodiola, chaste tree and peony may be helpful.
Stress management and sleep hygiene
Stress management and sleep hygiene are incredibly important to health at every age. Younger women in their 20s and 30s may be finishing university and higher education degrees, entering the work force and building careers, getting married, and starting families. These important life events may all be reasons to celebrate but may also be accompanied by periods of stress. Chronic stress may negatively impact fertility among other markers of health, with stress being described by many health providers as being a major contributing factor to infertility and hormonal imbalances. Stress management techniques such as deep breathing exercises, yoga, meditation, and acupuncture along with adrenal adaptogens like ashwagandha, rhodiola, lemon balm, and ginseng may help smooth life’s bumpier transitions, building resilience to stress, and maintaining good health, as can and other stress management techniques.
Getting adequate and restorative sleep is also important to maintaining good health. Sleep is important throughout the lifecycle but may be neglected in younger women, especially mothers of young children. Sleep is necessary to maintain memory, immune function, oxidative stress reduction, and hormone regulation. Inadequate sleep is associated with a number of chronic illnesses including obesity, hypertension, type two diabetes, and certain cancers.5 Certain nutrients and herbs can support and enhance healthy sleep patterns, including:
- B vitamins
- Passion flower
Bone and muscle health
Musculoskeletal health is a common concern for women in their 40s and beyond. However, bone health later in life is dependent on the peak bone mass achieved in the late 20s. It is important for women in their 20s and 30s to consume adequate dietary calcium and protein and establish other bone-healthy habits such as regular exercise and avoid unhealthy habits such as tobacco use and excessive alcohol. While calcium gets most of the attention when it comes to bone health, other key minerals are just as important, including phosphorus, magnesium, manganese, boron, selenium, silicon, and vitamins C, D and K. Herbs such as black cohosh, red clover and kudzu may also support bone health.6
Foods that support healthy bones include:
- Calcium (Dairy, sesame seeds, and green leafy vegetables)
- Magnesium (Green leafy vegetables, legumes, nuts, seeds, and whole grains)
- Manganese (Nuts, pineapple, beans, shellfish, chocolate, cinnamon, and tea)
- Boron (Prunes, raisins, dried apricots, and avocados)
- Selenium (Wheat, red meat, and seafood)
- Silicon (Cereals, carrots, and green beans
While many of the above strategies recommended to younger women still stand as they approach their 40s and 50s, women eventually find themselves shifting their focus to longevity, hormonal health, stamina, and cardiovascular health.
Heart disease remains the leading cause of death among women; however, lifestyle can make a tremendous impact in reducing risk. Because women have smaller arteries than men, coronary artery disease tends to affect smaller arteries and may occur more diffusely as compared to men.7 Women may also be at greater risk because cardiovascular disease (CVD) has been considered a disease that mostly affects men; women may be less likely to do routine monitoring for cardiovascular health as compared to gynecological and breast health screenings. Monitoring additional biomarkers of inflammation and cardiac function may even be more important than monitoring total cholesterol alone. These markers may include homocysteine, high sensitivity c-reactive protein, fibrinogen, hemoglobin A1c, omega fatty acid levels, calcium score, and fractionated cholesterol panels.
Many of the factors for CVD are well known, such as high blood pressure, uncontrolled blood glucose, high triglycerides, smoking, sedentary lifestyle, chronic inflammation, and stress. However, some women-specific factors include decreases in estrogen, which is considered an important risk factor for CVD. Researchers are exploring other risk factors specific to women related to reproductive factors earlier in life. According to a systematic review, significant increases in cardiovascular risk were found among women who had preeclampsia, preterm birth, stillbirth, gestational diabetes, and hypertension, premature ovarian insufficiency, early menarche, PCOS, and early menopause. Conversely, breastfeeding was associated with a reduced risk. Similar associations were found for ischemic heart disease and stroke, with a greater risk found among women who experienced preeclampsia and gestational diabetes, PCOS, recurrent miscarriage, early menopause, and among women who used oral contraception.8 More research is needed to better understand these associations and whether they may be causal.
Stress management is especially important for women’s cardiovascular health. Women under the age of 60 have a two-fold increased risk of developing mental stress induced myocardial infarctions, possibly related to microcirculation issues.9
Fortunately, nutrition and lifestyle strategies may help balance inflammation, support healthy circulation, and reduce the risk for cardiovascular disease and cardiac events. Key interventions to reduce the risk for CVD among women include:
- Whole foods-focused diets high in vegetables, fruit, nuts, seeds, legumes, herbs, and spices are rich with vitamins, minerals, and phytonutrients that help the body balance inflammation
- Reducing added sugar and highly processed carbohydrates can help improve blood glucose balance, which supports healthy triglyceride levels
- Foods high in vitamin C and flavonoids can help support healthy blood vessel function
- Eating potassium-rich fruits and vegetables supports healthy blood pressure
- Regular aerobic and weight training exercise supports heart health and mitochondrial function
- Adequate, restorative sleep has been shown to reduce cardiovascular risk factors and protects against age-related cognitive decline10,11
- Stress management techniques such as deep breathing exercises, yoga, meditation, and acupuncture
- Personalized herbal remedies to support heart health may include hawthorn, gotu kola, and garlic may be helpful, in addition to methylation-supportive nutrients
Perimenopause, menopause and hormonal health
One of the most significant changes in a woman’s body is the hormonal shift of perimenopause and menopause. Perimenopause is a gradual process that occurs as the ovaries begin to make less and less estrogen and can occur anywhere between two and ten years prior to menopause. It typically begins in the 40s but can also start in a woman’s late 30s as well. Perimenopause lasts until the ovaries stop releasing eggs, menstruation stops, and menopause begins. Typical symptoms include irregular periods, mood swings, trouble sleeping, fatigue, weight gain, breast tenderness, PMS, vaginal dryness, and reduced sex drive – especially when a decline in estrogen is accompanied by a decline in testosterone. Luckily, there are ways to smooth the transition.
The following strategies can support healthy hormone levels:
- Optimize diet by eating more vegetables, fruit, healthy fats, and high-quality protein-dense foods; less sugar and refined carbohydrates
- Cruciferous vegetables, green tea, and brown rice specifically help eliminate inflammatory estrogen metabolites and should be encouraged
- Zinc-containing foods like beef, oysters, and pumpkin seeds support healthy testosterone levels
- Consuming soy and soy isoflavones may reduce intensity and frequency of hot flashes
- Achieve and maintain a healthy weight, as excess adipose tissue can be inflammatory
- Get seven to nine hours of sleep per night; If sleep is a challenge, assess progesterone levels and consider herbs such as chaste tree
- Exercise regularly and include strength training to support healthy hormone levels, maintain lean muscle mass, and support mitochondrial function
- Implement daily stress management techniques, like deep breathing exercises, meditation, and mindful movement
- Consider hormone supportive herbs, such as tribulus and maca to support healthy libido, and black cohosh and chaste tree to ease peri- and menopausal symptoms
In 2021, the United States Preventive Services Task Force revised their previous guidelines by recommending people of average risk begin colorectal cancer screening at age 45.12 While colorectal cancer screenings are important, there are other proactive steps that can be taken to support a healthy gut ecology. Because the digestive tract influences many other body systems, including brain, cardiovascular, and immune health, it is an important area to emphasize for healthy aging. Excess inflammation in the digestive tract can contribute to chronic low-grade inflammation that impacts overall health and disease risk. Optimizing digestion and gut health by including probiotics and probiotic-rich fermented foods, getting adequate dietary fiber from vegetables, whole grains, and pulses, chewing food well, and using digestive support when needed are all important ways to support a healthy gut.
60s and Beyond
In recent years, interest and research in healthy aging has grown substantially, adding evidence to the observation that healthy habits, nutrition, lifestyle, community, and botanicals are all important aspects to healthy aging. While the health areas above are all very relevant to women over 60, these are key areas of interest to this population. It is never too late to positively affect one’s health.
Cancer prevention and inflammatory balance
Cancer risk appears to rise as women get older, with the most common cancers being breast, colorectal, endometrial, lung, cervical, skin, and ovarian cancers. While there are genetic predispositions that influence these risks, diet, lifestyle, and nutrient status are all epigenetic factors that can make a big impact in balancing inflammation, supporting DNA repair, and reducing cancer risk. These healthy habits have been found to reduce cancer risk:
- Optimize the diet by focusing on high phytonutrient, antioxidant-rich minimally processed foods like fruits, vegetables, pulses, green and black tea, whole grains, nuts, seeds, fresh and dried herbs, and healthy fats and oils
- Emphasize methylation-supportive foods like beets, egg yolks, green leafy vegetables, cruciferous vegetables, broccoli sprouts, liver, tea, turmeric, and rosemary
- Choose organic whenever possible; people who reported eating organic food most frequently associated with a lower risk for cancer13
- Limit alcohol, added sugar, and refined carbohydrates
- Avoid tobacco smoke
- Exercise regularly and manage stress
- Take a vitamin D3 supplement, and consider a multivitamin and omega-3 dietary supplement
When it comes to brain health and cognitive function, the old adage “use it or lose it” remains relevant. Research has shown that “intellectual enrichment activities” defined as occupational, advanced educational learning, and leisure learning are all associated with a lower risk for dementia and age-related cognitive decline. These benefits were seen even when older adults began engaging in cognitive activities later in life, thanks to neuroplasticity.14 In addition to cognitive activities throughout life, certain nutrients and botanicals have been shown to support brain health and cognitive function, including:
- Eating fatty fish as part of an anti-inflammatory, Mediterranean style diet and supplementation with omega-3 fatty acids may help prevent cognitive decline in older individuals16,17
- Ashwagandha has been found to have neuroprotective effects and may reduce the risk for neurodegenerative diseases like Parkinson’s and Alzheimer’s diseases. It has also been found to improve performance on cognitive tasks, executive function, attention, and reaction time17
- Ginkgo biloba and gotu kola have been found to support healthy cerebral blood flow18,19
- Adequate sleep has been shown to protect against age-related cognitive decline20
Solid nutrition and a healthy lifestyle are important habits that may provide powerful protection of women’s health throughout the lifecycle, enhancing longevity, vibrancy, and overall health beyond simply avoiding disease.