In addition to a wholesome, nutritious diet, there may be some foods that can help ease some of the vasomotor symptoms that accompany menopause. Two classic examples include soy and flax. There are also some foods that can act as “triggers” for hot flashes including caffeine, alcohol, spicy foods and hot (temperature) drinks or foods. Explore Soy and Flax below.

Total Isoflavone, Daidzein and Genisteing Aglycone Content in Selected Foods


Another significant dietary source of phytoestrogens is flaxseed (Linum usitatissimum). Flaxseed contains lignans, which are absorbed in the circulation and have both estrogenic and antiestrogenic activity. Flax is a rich source of plant omega-3 fatty acids and is a healthy addition to the diet.


There is little controversy that calcium intake is positively correlated with bone mass at all ages. Evidence supports use of 1200 mg calcium for women aged 50 years or older.

Vitamin D

Vitamin D3 (cholecalciferol) is made in skin by the action of UVB light on 7-dehydrocholesterol and is considered to be more efficacious than Vitamin D2 (ergocalciferol). The dietary reference intake for vitamin D for ages 50-70 is 600 IU/d and 800 IU/d for those over 70.

Substances that may harm bone

Sodium ~ average American diets exceed sodium intake guidelines and high salt diets are known to increase urinary calcium excretion (Harrington, 2003). Limit sodium intake < 2,400 mg/day.

Caffeine ~ The data for caffeine and osteoporosis has been inconsistent. Excessive caffeine intake (> 300 mg/d) was associated with a modest increase in the risk of osteoporotic fracture in one study (Hallström, 2006). Another showed decrease in BMD, but no increased fracture risk (Hallström, 2013)

Vitamin A ~ pre-formed vitamin A (retinol) intakes of 5000 mg/day or higher were thought to be associated with a significantly increased risk of hip fracture (Feskanich, 2002) but more recent data has failed to confirm this effect. An intervention study found no increase in fracture risk among 2,322 adults who took a controlled, high-dose retinol supplement (25,000 IU retinyl palmitate/day) for as long as 16 years (Ambrosini, 2013).

Smoking ~ cigarette smoking increases the risk of fracture (Kanis, 2005). This, in addition to the lengthy list of other health issues, is one more reason to help patients quit.


Exercise training programs have been shown to consistently prevent or reverse bone loss in both the lumbar spine and the femoral neck (Kelley, 2012). In a 2011 Cochrane review, progressive resistance strength training and combination exercise programs were both found beneficial (Howe, 2011).

Women should aim for 30 to 45 minutes of exercise, 5 or more times per week. It is wise to dissuade women with osteoporosis to avoid exercise in which their fall risk is high.

Adapted from Arizona Center for Integrative Medicine – IMR – Family Medicine 2018