 There's a great variety of symptoms suffered by women undergoing menopause. They're the so-called vasomotor symptoms like night sweats and hot flashes, difficulty sleeping or full-on insomnia, vaginal dryness and pain during sex, as well as adverse effects on mood, including full-blown depression. Might exercise help? Exercise can certainly help with physical and psychological quality of life in general, but unfortunately there's no evidence for the effects of exercise and menopause-specific symptoms. You know researchers are getting desperate when they try to see if giving people big placenta will help? Spoiler alert, it doesn't. Well, we know oxidative stress, which is a consequence of excessive free oxygen radicals or impaired antioxidant defense, is linked not only to diseases such as diabetes, obesity, and cardiovascular disease, but also menopausal symptoms like hot flashes. Low free oxygen radical defense is associated with more menopausal symptoms, just like having a diet with more antioxidants is associated with fewer menopausal symptoms. In fact, high intake of fruits and vegetables may delay the onset of menopause in the first place, thought to be because the presence of antioxidants in fruits and vegetables may counteract the adverse effects of free radicals on the number of functional eggs you still have in your ovaries, whereas the reason high meat consumption has been related to degenerative diseases may not just be the saturated fat and cholesterol, but the pro-oxidation products generated during their production, storage, digestion, and the metabolism of meat. Similarly, since a pro-inflammatory diet has also been associated with higher menopause-specific somatic symptoms, meaning like hot flashes and sleep issues, that would mean moving towards a more plant-based diet packed with anti-inflammatory components like fiber and away from pro-inflammatory foods containing saturated fat and cholesterol. No wonder whole-plant food's intake has been associated with fewer menopausal symptoms. In terms of specific foods, poultry and skim dairy products may be particularly bad, whereas soy milk seemed to help, so women may derive benefit from lower consumption of poultry and skim dairy and a greater consumption of vegetables and soy milk. You don't really know, though, until you put it to the test, and indeed, women randomized to drink soy milk reduced their menopausal symptoms by 20% within 12 weeks. No wonder that those eating strictly plant-based diets report less bothersome menopausal symptoms. Among women undergoing menopause, vegans reported less bothersome symptoms, and within the diet groups more vegetables and in the meat-eating group less flesh food was associated with less bothersome symptoms as well. So eating a plant-based diet may be helpful for women in their menopausal transition who prefer a natural means to manage their symptoms, consistent with all the other studies demonstrating reduced menopausal symptoms and those consuming greater quantities of plant-based foods and less meat. But again, maybe there are other reasons healthier eaters have fewer symptoms. You can't prove cause and effect until you guessed it, an interventional trial to see if changing your diet actually reduces symptoms. And in this study, where women were encouraged to decrease fat and increase fruit, vegetable, and whole grain intake, they were significantly more likely to eliminate their phase of motor symptoms like hot flashes and night sweats compared to the control group. So it's certainly not all or nothing. And within a plant-based diet, those randomized to a meat-free diet with daily flaxseed oil, walnuts, and almonds did better than those randomized to the same diet but with daily extra virgin olive oil. After 16 weeks, the vegetarian diet that was rich in omega-3s did better reducing vasomotor symptom frequency. In fact, even just two teaspoons worth of ground flaxseeds a day alone can significantly decrease menopausal symptoms to about the same extent as hormone replacement therapy, but without the side effects.