March is Women’s History Month. We would like to take this opportunity to talk a little bit about women’s health. While we believe in equality and gender equity, we also know there are differences between female and male biologies that make our nutritional and wellness needs slightly different.

In this article, we will be delving into the unique nutritional needs of female bodies through their many changes from pre-adolescence to post-menopause. We have some suggestions for nutrients that may be especially helpful to supplement during each of these phases.

Adolescence and a Strong Foundation

Throughout childhood, the general nutritional requirements are similar between sexes. Puberty is the time when nutritional needs begin to diverge as hormones and average body frame sizes diverge. 

Female teens also grow during adolescent years, but typically the changes are more gradual and require less energy or caloric input in comparison to males.  

Supplement Suggestions

Adolescents of all genders need adequate calcium and vitamin D for optimal bone development. Calcium and vitamin D supplements may be beneficial for those with inadequate dietary intake or limited sun exposure. Long hours indoors for school (or sleep) and healthy use of sunscreen all threaten teen vitamin D levels.

When females begin to menstruate, heavy bleeding can put a strain on iron levels. Talk to your doctor and consider adding an iron supplement, or a daily multivitamin that contains iron, upon menarche.

Through the Reproductive Years

We often call the period of time between puberty and menopause “the child-bearing years” for females. Whether or not biological motherhood is the path chosen, these are the years when, typically, women are menstruating monthly, are reproductively mature, and capable of bearing a child. Because of this, there are some serious nutritional needs to consider. 

Supplement Suggestions

Calcium and folate, specifically, are essential to early development of a fetus. If a mother’s calcium levels are too low, calcium will be pulled from her bones to maximize her baby’s growth. If a mother’s folate levels are too low, it can lead to neural tube defects and other challenges in a growing fetus. With more than half of all pregnancies occurring unexpectedly, it is important that all sexually-active, fertile female bodies consider their calcium and folate levels, even when having a baby is not top-of-mind.

Even when not pregnant, the fertile years have other challenges that can be answered nutritionally. Calcium and vitamin D, together, have been suggested to have an impact on hormones in a way that supports a better mood and more energy during the premenstrual period [1].

Omega-3 fatty acids have also been shown to lessen the severity of mood shifts and other uncomfortable symptoms associated with the premenstrual period [2]. The effects seen in omega-3 studies are typically more pronounced with the length of treatment period. This suggests making omega-3s part of a daily supplement regimen all month long is likely more effective than just taking them before your period. Omega-3’s are also excellent for supporting your heart, your metabolic health, and maintaining a healthy weight [3].  

Pregnancy: Nutrition for Two

Should a person decide to become pregnant, again, their nutritional requirements change a bit. The old saying “eating for two” does not mean you must eat double, however. Your caloric requirements don’t change much for a growing fetus (about 300 extra calories per day), but the specific nutritional building blocks your body needs to grow a brand new human are critically important. It may be better to think of “eating twice as healthy”.

Supplement Suggestions

During pregnancy, your nutritional priorities should be folate, iron, calcium, vitamin D, choline, omega-3 fatty acids, B vitamins, and vitamin C. 

Folate (vitamin B9) is critical to the development of your baby’s neural tube, which becomes the spine and brain [4]. It also contributes significantly to other processes related to fetal growth and placental health. As mentioned earlier, folate levels must be adequate before conception, and through the first trimester, at least, to mitigate risks to development [4]. As half the population cannot process folic acid efficiently, look for a supplement with l-methylfolate, the activated form of this vitamin. Methylfolate is more effective than folic acid for raising circulating folate levels.

Choline and iodine are also important nutrients for fetal brain and spinal cord development [4]. While many of us get plenty of iodine from iodized salt in the diet, choline can be harder to come by, making it an excellent choice of supplement during pregnancy.

Iron is always important for the prevention of anemia. However, it becomes extra important during pregnancy, as it assists red blood cells in bringing oxygen to the growing fetus [4]. Vitamin B6 and B12 are crucial for production of healthy red blood cells [4]. All cells use oxygen to make ATP energy efficiently, and ATP is required for growth. If you are eating a lot of red meat and dark leafy greens, you are less likely to suffer iron or B vitamin insufficiency. 

Calcium and vitamin D seem to be becoming a theme here for women’s health, but you need this vitamin mineral combination to build baby’s bones and teeth [4]. If a mother does not have enough calcium coming from the diet, her body will pull calcium from her own bones to help build baby’s. It’s a process that is inefficient, and the mother’s bone density suffers.

It may be possible to get these nutrients from the diet, but it’s difficult to know how much you have consumed, what you absorbed, and what is circulating and available to your fetus. Especially if you experience morning sickness, a supplement takes all of the pressure off of your appetite to deliver these nutrients, and provides a nutritional safety net, filling any gaps created by the diet.

Lactation: Nourishing the Newborn

While you still don’t need to “eat for two”, lactating mothers should keep up the added 300-400 additional calories per day for milk production energy. Keep in mind that whatever you eat will come through your breast milk to your baby, even flavors and food pigments.

Supplement Suggestions

Omega-3 fatty acids, and especially DHA, may be beneficial for lactating mothers. DHA is necessary for the health of your brain and your nervous system. It contributes to mental health, vision, and a healthy heart [5]. DHA is critical for the growth and development of your baby’s brain and nervous system, especially since your baby’s brain triples in size by their first birthday [5]. It also plays a significant role in the development of a baby’s eyes [5]. The body cannot (ours nor our baby’s) make DHA internally, so we require it from the diet or a supplement, and babies must get it from breastmilk or formula for healthy development.

Again, calcium and vitamin D nourish mother’s bone density and baby’s growth. And, the B-vitamins are critical to healthy red blood cells, cellular division, and growth. A B-complex including methylfolate (not folic acid) is a great choice during lactation, especially for mothers following a plant-based diet.

Post-Menopause: Navigating Changes

With the end of monthly periods and reproductive fertility, nutritional needs change again. Women likely need slightly less iron in the diet without a monthly bleed. Plus, caloric needs are further reduced as our level of physical activity slows down. Unfortunately, this caloric reduction happens simultaneously to a reduction in the nutrition we can absorb from our food. So, not only are we eating less, we are taking fewer vitamins and minerals from what we eat. This is probably the best reason to take a multivitamin supplement in our later years. It’s a great way to get the nutrition we need while maintaining a healthy diet for healthy body weight.

The biggest shift in the body accompanying menopause is that of changing hormone levels. This shift is the one that generally causes the symptoms and discomfort associated with “the change”. A downstream result of reduced estrogen in the body is its effect on calcium and bone health.

Estrogen receptors on bone cells play a major role in the building and recycling of bone mass and density in both males and females [6]. In the years surrounding menopause for females, however, estrogen levels take a steep dive. This drop in estrogen leads to an average 10% decrease in bone mineral density [6]. There is a link between reduction in bone density and an increased risk of bone fractures in post-menopausal women [6].

Suggested Supplements

Some women find that this discomfort can be lessened with a supplementary hormone mimic. We have one such product available as a cream. Progeste Cream contains 2% natural, bio-identical progesterone derived from enzymatic conversion of wild yam extract. The dosage pump consistently delivers 20 mg of progesterone per use. This is a product you definitely want to discuss using with your healthcare provider before using.

Perhaps more universally important is a multivitamin containing B-complex vitamins (and no iron). Our recommendation for this can be found here. You may want to add extra calcium and vitamin D depending on your personal bone density levels and needs.

Omega-3 fatty acids are still an important daily supplement. They support heart health, cognition, and joint comfort in all people. However, they may be especially supportive to the physical comfort and mental health of women during and post menopause [7,8].

Back to Nutrition Alert

References

  1. https://synapse.koreamed.org/articles/1118309
  2. https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/jog.15217
  3. https://link.springer.com/article/10.1007/s13105-013-0265-4
  4. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy
  5. https://www.verywellfamily.com/should-i-take-dha-supplements-when-im-breastfeeding-431987
  6. https://www.erkenmenopoz.com/konu/dosyalar/menopoz_makale_ozetleri/haziran2020_3.pdf
  7. https://synapse.koreamed.org/articles/1147314
  8. https://www.sciencedirect.com/science/article/abs/pii/S1744388120311142