Unexplained weight gain? Ugh. Here are nutrition choices to help with menopausal menaces

Menopause comes on so gradually that we almost don't know it's happening until our body weight shifts and nothing we've done to control our weight works anymore.

The Type A personalities in us can't understand why eating the exact same things and exercising the exact same way are not yielding the results they used to. Other menopausal menaces begin to emerge - hot flashes, sweating, body aches, sleeplessness - that open a rabbit hole of helplessness and frustration.

Dr. Susan Oakley, a urogynecologist from St. Elizabeth who specializes in pelvic reconstructive surgery, addresses these concerns and others in her podcast, The Lady Bod. With her input and other resources, The Enquirer would like to help women navigate menopause as it relates to food and fitness. (Middle-aged men can also use these food tips)

What are some surprising symptoms of menopause?

Menopause occurs 12 months after your last menstrual cycle. Perimenopause - the period before menopause when the ovaries gradually stop working - starts between ages 40 and 44 but can happen as early as the 30s. Night sweats, belly fat, hot flashes, vaginal dryness, mood changes, changes in body fat distribution, sleep changes and weight gain are the best-known symptoms of that stage in life.

Some, however, you don't necessarily see coming: Joint pain. Food intolerances. Hair growth and hair loss in unwanted places. Brain fog. Pelvic muscle spasms (vaginismus). Gum disease. Body odor. Tingling in your extremities. Heart palpitations.

It's important for your sanity to remember weight fluctuations around menopause have more to do with hormones like insulin, cortisol and leptin than willpower, though regulating those hormones can often be done through nutrition and proper exercise.

What is leptin and how does it affect menopause?

A lesser-known hormone that goes a bit wonky around menopause is leptin, which wanes right along with estrogen. Leptin, in short, is your body's stop sign that tells you when you've had enough to eat. Binge eating and restrictive diets could be causes for your leptin levels to be unbalanced.

You may be eating healthy foods but not paying attention to how much of it you're eating because, well, you don't feel full. Eat plenty of high-quality proteins - poultry, red meat, eggs, Greek yogurt - and try using smaller plates or bowls when determining portions.

What can you do to help with insulin resistance?

What supplements or increased use in food can mitigate menopausal symptoms?

Sometimes, it's just not possible for menopausal women to get all the nutrients they need through food, so supplementation is vital. Vitamins and supplements are considered medication when filling out doctor or hospital paperwork, so be sure to check with your primary care physician to see if any of these suggested nutrients, in food or supplement form, are right for you. Here is a sampling of supplements that could help before and after menopause.

• Magnesium - Besides helping keep bones strong to stave off osteoporosis, magnesium helps with menopausal symptoms like sleep difficulty and depression. This heart-healthy nutrient can be found in dark chocolate, leafy greens, seeds and whole grains.

• Vitamin D - While Vitamin D can best be found through exposure to sunlight, the vitamin can help menopausal women with inflammation, hot flashes, keeping the brain focused, depression, bone health, high blood pressure and heart disease. Many foods are fortified with Vitamin D, like milk, cereal and orange juice, but it can also be found in fatty fish like salmon.

• Omega 3 - Women suffering from joint pain, hot flashes, depression, vaginal dryness and osteoporosis may find relief by consuming Omega-3 fatty acids. It also helps lower triglycerides, which is heart-healthy. Foods rich in Omega-3 include chia seeds, flax seeds, oily fish like tuna or sardines, walnuts, spinach, eggs and soybeans.

• Calcium - Another important reason to take Vitamin D is to help absorb calcium, which is vital to maintain bone mass and prevent osteoporosis. Sources of calcium include dairy products, beans, nuts, dark leafy greens and fortified orange juice.

• Vitamin C - Most commonly known to boost immunity, Vitamin C is important for collagen production in the body as well, a must-have for skin vitality. The antioxidant nutrient is another way to help with hot flashes.

• Biotin -

• Vitamin B 6 or 12

• Turmeric -

• Prenatal vitamin - Dr. Oakley said you can get most, if not all, of these supplements by simply taking a prenatal vitamin, which doesn't have to be used only for expectant mothers.

• Estroven - She also suggested using Estroven, a plant-based supplement that helps relieve common symptoms. Depending on the version bought, the product can target specific symptoms or provide all-inclusive help. She said some oncologists may not recommend this to cancer patients, so it's best to check with a doctor before trying this over-the-counter supplement.

What can I do right now?

• Drink water: "Dilution will always be the solution to pollution," Dr. Oakley said. She said menopausal women really need to be drinking 64 ounces of water a day for good gut and bladder health. Avoid coffee, tea and soda, she said.

• Keep an eye on inflammation: Estrogen is a natural anti-inflammatory. When estrogen begins to wane in a body, joints and other body parts start to ache. Check out anti-inflammatory diets - like the Mediterranean diet - or become aware of which foods reduce inflammation such as tomatoes, dark chocolate (not a typo), berries and fatty fish (salmon, tuna).

• Figure out your new food intolerances: OB-GYNs may recommend a FODMAP elimination diet to help with this task, bloating or other gut health issues. Simply put, you stick to a certain list of foods for a few weeks and then re-introduce restricted foods into your diet to see what causes issues. You might be surprised to learn what foods you once tolerated without issue that now cause you problems. Gluten, enriched flour, dairy and refined sugar are a few examples. Once removed from your diet, you'll be shocked to find your body isn't as inflamed and your joints don't ache as they did.

• Phytoestrogen foods: Dr. Oakley recommends incorporating plant-based estrogens into your diet like leafy greens, garlic and soy.

• Eat clean: Avoid processed foods, fried foods and products with preservatives. Focus on fresh meats, fruits, vegetables and whole grains. Read labels to see what ingredients are in foods. Replace unhealthy ingredients with healthier versions, such as extra virgin olive oil for vegetable oil, oats or almond/nut flour instead of enriched flour or Greek yogurt for sour cream.

• Protein: Be intentional about having good protein in every meal. Slight changes in macronutrients (proteins, fats and carbohydrates) can go a long way in controlling weight gain in mid-life.

• Added sugar, added pounds: Those who follow Dr. Mary Claire Haver, a board-certified OBGYN certified in culinary medicine, on her various social media platforms have heard her discuss tracking fiber, Omega 3, magnesium and Vitamin D intake. She also advises consuming less than 25 grams of added sugar a day. Again, you might be surprised how much additional sugar is in some "healthy" foods like yogurt. Those added sugars could help create insulin resistance, a big roadblock to weight maintenance.

What's next?

Another installment in June will address fitness, mental health, exercise and cortisol.

Melanie Laughman is a 31-year veteran journalist for the Cincinnati Enquirer and a dance fitness instructor. Have any questions you'd like answered? Email her at mlaughman@enquirer.com.

This article originally appeared on Cincinnati Enquirer: How to navigate menopause frustration through nutrition choices