What's the vaginal microbiome?
Why you need to look after your vaginal microbiome in perimenopause, tips for managing food cravings, plus Easy Savoury Granola.
A year ago I started writing Midlife Bites with the aim of sharing my knowledge, along with simple, achievable tips and delicious recipes, to inform, inspire and nourish you. My mission was (and continues to be) to help you feel completely prepared on your journey through perimenopause. I feel passionately that a smooth transition needs a holistic approach that considers everything from what we eat and how we move, to how we manage stress, sleep and our self-talk. When it comes to nutrition, social media can make everything seem a lot more complicated and confusing than it needs to be — healthy eating should be simple, not an anxiety-inducing list of rules and restrictions. Food has the power to improve our wellbeing, particularly during perimenopause, but it’s also much more than just fuel and nutrients, it’s there to be enjoyed!
I hope you’ve liked reading Midlife Bites, and that you’ve been able to incorporate some of the tips, healthy habits and recipes into your routines. I’d love to keep creating useful content for you that helps you experience a smoother perimenopause, so I’d appreciate your feedback. Let me know what you’d like to read in the future issues of Midlife Bites by completing this short survey — PLUS if you’ve subscribed and include your email address in your survey response, you’ll be entered into a draw to win a free 90-minute Nutrition Reset 1-to-1 consultation with me (worth £300)*.
In this month’s edition of Midlife Bites, I share why it’s not just our gut microbiome that we should be looking after — did you know that you have a vaginal microbiome too? Protected by an abundance of beneficial bacteria, this distinct ecosystem changes over time, particularly during perimenopause and beyond. Find out the reasons why, along with the symptoms to look out for and what you can do to support your vaginal microbiome during this life stage.
We’ve all been there, 3pm hits and you can’t think of anything else except cracking into some chocolate; or you’ve had a tough day and all you fancy is a glass of wine. But what if there were some simple ways to curb those cravings without feeling as though you were depriving yourself, so that you could stick to your healthy eating habits long-term? I share three tips to manage your food cravings without giving up the things you love.
Who said granola had to be sweet? This month’s recipe is for Easy Savoury Granola. Sprinkle it on anything from soup, or salads, to scrambled eggs or pasta dishes — it’s a great way to add fibre, healthy fats and plant protein to your meals.
For paid subscribers this month, there’s been a lot of discussion recently about the use of testosterone for some women experiencing symptoms in perimenopause, so I look at the ways you can support your testosterone levels naturally through food and lifestyle. Adding electrolytes into your daily routine has also become a hot topic recently, so I share why they may be useful, plus my top picks.
As always, I’d love to hear from you if you’re interested in working together, or if you have any questions or comments — either hit reply or book a free 1-to-1 chat.
*Entries can be submitted until 30 November 2024; winner will be notified by email after this date. Free 90-minute Nutrition Reset consultation to be booked within 3 months of notification.
Yes, your vaginal microbiome is a big deal
The gut microbiome has become a hot topic over the last few years, but did you know that it’s not your only microbiome? There are several distinct microbiomes, or ecosystems of microorganisms, that exist on or in the human body and all perform vital functions for our health — they include the nasal, oral, lung, skin, urinary, gut and vaginal microbiomes. The less-known relative of the ever-popular gut microbiome, the vaginal microbiome varies substantially through a woman’s lifetime.
A healthy mucosal lining in the vagina produces glycogen, a substance that feeds the bacteria Lactobacillus, making it dominate the microbiome. Unlike the gut, where diversity is a marker of a healthy microbiome, the ideal environment in the vagina is one that lacks diversity, so this abundance of Lactobacillus actually helps to create a protective environment. The Lactobacillus ferments the glycogen to produce lactic acid which reduces vaginal pH to 3.5–4.5 — the ideal acidic environment to inhibit the growth of harmful bacteria and yeast, protecting against bacterial vaginosis (BV) and yeast infections.
In pre-menopausal women, around 70% of the bacteria in the vagina is Lactobacillus; anything less than this may lead to an increased risk of inflammation, infections, UTIs or urinary tract symptoms. Some research has found that in post-menopausal women, the proportion of Lactobacillus in the vaginal microbiota is significantly lower at around 45%.
But what causes the vaginal microbiome to change over time? Day-to-day, factors such as hormonal birth control, smoking, diet, stress, exercise, antibiotics, sexual activity, menstruation and personal hygiene practices may throw your vaginal microbiome off balance. In perimenopause, fluctuating (and ultimately decreasing) oestrogen levels may lead to a thinning of the vaginal mucosal lining (vaginal atrophy), although research is still developing. This means less lubrication, less food (glycogen) for the Lactobacillus and a subsequent increase in the vaginal pH — potentially leading to the proliferation of harmful microorganisms and increasing the risk of infections and inflammation. Vaginal atrophy and dryness are common symptoms during the menopause transition, where around 50% of postmenopausal women are affected by genitourinary symptoms of menopause (GSM). This often leads to discomfort during intercourse and an increased risk of abrasions, which may further increase the risk of infection.
So what can you do about it?
Consider supplementing with probiotics formulated with lactobacillus strains specific to the vagina. Although research is still emerging, supplementation has resulted in an increase in Lactobacilli abundance after 28 days.
Look to your diet and lifestyle. Aim to eat a balanced diet rich in fibre and pre-and pro-biotic foods; and stay hydrated. Increased intake of folate, vitamin A, and calcium have been found to reduce the risk of bacterial vaginosis, so including plenty of green leafy vegetables in your diet is a must. Try to also avoid vaginal douches, heavily fragranced soaps, detergents, body washes, wipes, or bath bombs.
Speak to your GP or healthcare provider. If you have GSM and it’s affecting your quality of life, make sure to discuss it with your doctor. Some research has shown that vaginal pH and Lactobacilli levels were restored to premenopausal levels in women who underwent hormone therapy after 16 weeks.
If you’d like to learn more about your vaginal microbiome, or if you’ve been experiencing symptoms such as recurrent UTIs or vaginal dryness, please do get in touch, I’d love to chat!
To curb cravings
Managing food cravings during perimenopause can be challenging, as hormonal fluctuations — particularly in oestrogen and progesterone — can impact our hunger cues and cravings. Oestrogen is known to suppress appetite, so as levels decline, the ability to regulate hunger and satiety signals may become impaired. The hormones ghrelin (which communicates hunger) and leptin (which tells us we’re full) are impacted — research has found that for some women during menopause, ghrelin increased while leptin decreased — meaning that you may end up overeating or snacking when you’re not actually hungry. While we shouldn’t be too hard on ourselves for feeling this way, there are habits we can adopt to better manage and reduce the impact of the cravings we have. Here are three tips to manage your food cravings without giving up the things you love:
Get enough sleep. Sleep disturbances and increased stress during perimenopause can lead to cravings, especially for sugary or high-carb foods. Prioritise sleep hygiene (eg have regular sleep schedule and limit screens before bed) and manage stress through mindfulness practices like yoga, meditation, or deep breathing exercises.
Include protein and fibre with every meal. Blood sugar fluctuations can trigger cravings, especially for carbs and sweets. Include high-protein foods (like lean meat, eggs, Greek yoghurt or legumes) and fibre-rich options (such as vegetables, wholegrains, and nuts) with each meal. Protein and fibre help stabilise blood sugar, keep you full longer and reduce the intensity of cravings.
Enjoy the food you crave in moderation. When we restrict ourselves too harshly, we often end up feeling deprived, which can make cravings even stronger. Have you ever tried to stop eating something and then found that you want it even more? Allowing yourself to enjoy small portions of the foods you love helps satisfy the craving and makes it easier to stick to healthy eating habits long-term.
If you’re interested in working with me on a 1-to-1 basis, why not book a complimentary chat to find out more about how I can support you through perimenopause. And if you’re on Instagram, come and say hi.
Easy Savoury Granola
Serves: 8 to 10 | Time: 30 minutes
This savoury granola is a delicious twist on the classic sweet variety and is loaded with wholesome ingredients, including nuts, seeds and oats. Lower in sugar than its sweeter sibling, this savoury version is full of fibre, healthy fats, and protein to support hormones, digestion, energy and to keep you feeling satisfied.
Diversity is key when it comes to looking after your gut (which is an essential part of a healthy perimenopause), so adding some of this granola to your meals will help rack up those plant points. Pumpkin seeds are great to incorporate into your diet during perimenopause — they’re a good source of zinc and magnesium, which are important for skin health, strong bones, immunity, mood and sleep; chia seeds also add extra fibre and anti-inflammatory omega-3 fatty acids; and fennel seeds are great for supporting digestion. Try sprinkling this granola over salads, soups, or just enjoying by the handful.
INGREDIENTS
100g jumbo oats
40g pumpkin seeds
20g chia seeds
20g sunflower seeds
120g mixed nuts, roughly chopped
1 tablespoon fennel seeds
2 tablespoons nutritional yeast
½ teaspoon garlic powder
1 tablespoon soy sauce
1 tablespoon maple syrup
1 tablespoon olive oil
1 egg white
large pinch of sea salt
METHOD
Preheat the oven to 160C (fan). Line a shallow baking tray with baking parchment.
In a large bowl, mix together all of the dry ingredients, including a pinch of salt.
In a small bowl, mix together the soy sauce, maple syrup and olive oil. Stir through the dry ingredients, making sure everything is well combined.
In another small bowl, beat the egg white until frothy. Stir through the granola.
Pour the granola onto the lined baking tray and spread out evenly. Place in the oven for 20 minutes, stirring occasionally, until golden.
Remove from the oven and leave to cool on the baking tray before decanting into an airtight jar.
How to support testosterone naturally
It’s easy to simply focus on oestrogen and progesterone when we think about perimenopause, but testosterone also has a powerful effect in women. Produced by the ovaries and adrenal glands, it can have an impact on mood, energy, cognition, muscle strength and libido. Testosterone levels decline by around 50% over a woman’s 30s and 40s, so it’s no surprise that some of the first symptoms of perimenopause (feeling tired, poor sleep and reduced libido) are linked to declining testosterone levels. But what are the strategies that we can adopt to support our testosterone through perimenopause?
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