Addressing women’s health risks
WOMEN FACE SEVERAL UNIQUE HEALTH CHALLENGES throughout life. From reproductive health to bone health, it is important to understand their specific needs and the best strategies to support them.
Reproductive health is critical to overall well-being in women throughout their lifespan.
Around the early teenage years, reproductive health includes supporting the menstrual cycle and managing symptoms of premenstrual syndrome (PMS). The exact cause of PMS is not known, but changes in hormones and neurotransmitters likely contribute. Symptoms associated with PMS may be physical, psychological or behavioral changes such as weight gain, headaches, irritability and confusion.1 Disruption in normal blood glucose metabolism and nutrient deficiencies have been implicated in PMS; correcting any imbalance or deficiency may have a profound impact.1
Herbs may also help alleviate PMS symptoms:1,2
Fertility is an aspect of reproductive health that is particularly relevant to women who are looking to conceive. Because it takes several weeks to be able to detect a pregnancy, it is important to consume nutrients a developing baby will need even before pregnancy status can be determined.
Fertility is influenced by many factors:3
- Hormonal balance
- Environmental factors
- Nutritional status
The main source of female infertility is polycystic ovarian syndrome (PCOS), an endocrine disorder characterized by irregular periods, excess androgen and enlarged ovaries with cysts.4 Diet and lifestyle factors can have a profound impact on PCOS and fertility.5 These include consuming a healthy, well-balanced diet full of whole and minimally processed foods, engaging in regular exercise, and possibly weight reduction to reach a healthy weight.4,6
After becoming pregnant, women need to pay special attention to their diet as they have increased requirements for many nutrients during pregnancy and lactation. One vitally important nutrient is folate, or vitamin B9. Folate is critical to women of childbearing age because of its role in epigenetics and neural tube development.7 Folate is required by dividing cells as a component of DNA; without sufficient folate cells cannot properly divide. A developing embryo is constantly growing new cells and as such, ample folate is absolutely necessary. Folate is also involved in epigenetic modifications as the primary methyl donor in the body.7
Methylation plays a role in fetal development during pregnancy as well as throughout life to control genetic expression of key genes involved in phospholipid synthesis, neurotransmitter biosynthesis, metabolism and even disease risk.8 Other important nutrients involved in methylation and embryonic development include choline, vitamin B6 and vitamin B12, omega-3 fatty acids, iron, calcium, vitamin D, zinc and vitamin A.9
As women exit their childbearing years, perimenopause and menopause occur with significant changes to the body and mind. Perimenopause is a gradual process that occurs as the ovaries begin to decrease estrogen production, although levels can fluctuate during this transition period.10 Perimenopause lasts until the ovaries stop releasing eggs, menstruation stops and menopause begins.10
Menopause is a natural biological process that marks the end of menstrual cycles. Symptoms to look for include irregular periods, mood swings, trouble sleeping, fatigue, weight gain, breast tenderness, vaginal dryness and low libido, possibly due to a concomitant decline in testosterone alongside decreased estrogen.10
While menopause is unavoidable, lifestyle factors may help ease the symptoms. Achieving and maintaining a healthy weight can help reduce inflammation which may benefit overall health and reproductive health.11 Exercising can help maintain healthy body weight and lean muscle mass as well as support healthy hormone levels.12
Herbs and foods may also help alleviate menopause symptoms. Cruciferous vegetables and green tea can help reduce inflammatory estrogen metabolites and zinc-containing foods can help support healthy testosterone levels.13 Additionally, soy and soy isoflavones may reduce the intensity and frequency of hot flashes.14 Tribulus and maca can support a healthy libido, while black cohosh and chaste tree have been used to ease symptoms associated with perimenopause and menopause.14,15
Supporting healthy bone formation should begin early in life, as peak bone mass is achieved between 25-30 years of age.
As women age, the gradual loss of estrogen can significantly impact bone health as estrogen is considered a bone protector.16 Consuming adequate dietary calcium, vitamin D, vitamin K, phosphorus and protein can help with bone mass accretion and maintenance of bone health throughout adulthood.17 Engaging in resistance training can also significantly increase bone health.18 Avoiding tobacco use and excessive alcohol can also help support bone mass.
Heart disease is a leading cause of death among both men and women, and many risk factors for cardiovascular disease that affect women may be unknown to most.19 Additionally, women have smaller arteries than men, which may uniquely impact their risk.20
Several risk factors for cardiovascular disease are common to both men and women:
- high blood pressure;
- dysregulated blood sugar;
- high triglycerides;
- sedentary lifestyle;
- chronic inflammation;
- and stress.21
However, some risk factors are more specific to women, including estrogen and reproductive considerations. A systematic review found that cardiovascular risk was significantly higher in women who had preeclampsia, a history of preterm birth, history of stillbirth, gestational diabetes, early menarche, PCOS, premature ovarian insufficiency and early menopause.
Nutrition and lifestyle factors can help manage underlying factors that contribute to poor cardiovascular health, including inflammation.21 Women should consider adopting a dietary pattern that emphasizes whole foods including fruits, vegetables, nuts, seeds, legumes, herbs and spices.21 Foods rich in vitamin C and flavonoids can support healthy blood vessel function while foods high in potassium support healthy blood pressure.21
Engaging in regulate aerobic weight training, adopting healthy sleep hygiene habits and practicing stress management techniques can also contribute to increased heart health. Herbal remedies including hawthorn, gotu kola and garlic may also be helpful.22,23
Mental health can become an issue for women at a very young age, an issue that can continue throughout adulthood. One of the biggest mental health issues facing women is stress.
Women tend to react differently to stress and experience more stress and anxiety than men.19,24,25 Stress may arise from career challenges, fertility and postpartum depression, as well as juggling the responsibilities, unpaid labor, emotional labor and caretaking duties that often fall to women.26 Chronic stress can have a profound impact on women’s bodies, negatively affecting cardiovascular health, immune status, fertility and hormone levels.25
Supporting mental health in women should also include ways to enhance cognitive health. Intellectual enrichment activities can help increase neuroplasticity, brain health and mental health.27
Nutrients and herbs can support mental health and cognitive function:28-31
- Fatty fish as a rich source of omega-3 fatty acids
- Ashwagandha for neuroprotective effects
- Gingko biloba and gotu kola to support healthy cerebral blood flow
Adrenal adaptogens are herbs that help the body respond to stress and can help the body build resilience to stress and navigate life’s bumpy transitions and stressors. Examples of adrenal adaptogens include ashwagandha, rhodiola, lemon balm and ginseng. Getting adequate sleep protects the brain, and stress management techniques including deep breathing exercises, yoga, meditation and acupuncture can also help with maintaining a healthy mental state.32
Urinary tract health
Urinary tract health is another important area of health for women. A urinary tract infection (UTI) is one of the most common infections among women, and women are much more prone to UTIs than men due to their lower urinary tract anatomy and its proximity to reproductive organs.33
Many events in a woman’s life can increase her risk, including pregnancy, caesarean sections and catheterizations.33 Additionally, during the postmenopausal period, decreasing estrogen levels can alter the vaginal microbiome, which allows bacteria to spread and infect the urinary tract.33
KERI BARRON, PHD, is the scientific nutrition writer for Standard Process Inc., located at the Nutrition Innovation Center in Kannapolis, N.C. Her work involves creating educational materials and translating scientific articles for audiences to support health and wellness. She is a member of the American Society for Nutrition and can be reached at firstname.lastname@example.org or 262-495-6365.
- Siminiuc, R., Turcanu, D. (2023). Front Nutr, 10:1079417.
- Jang, S.H., Kim, D.I., Choi, M.-S. (2014). BMC Complement Altern Med, 14:11.
- Sharma, R., et al. (2013). Reprod Biol Endocrinol, 11:66.
- Joham, A.E., et al. (2022). Lancet Diabetes Endocrinol, 10(9):668.
- Stephenson, J., et al. (2018). Lancet, 391:1830.
- Lakoma, K., Kukharuk, O., Sliz, D. (2023). Nutrients, 15(5):1180.
- Virdi, S., Jadavji, N.M. (2022). Metabolites, 12(9):876.
- Dhar, G.A., et al. (2021). Nucleus, 64(3):259.
- Jouanne, M., et al. (2021). Nutrients, 13(2):692.
- Santoro, N. (2016). J Womens Health, 25(4):332.
- Daziroglu, M.E.C., Tek, N.A. (2023). Curr Nutr Rep, 12(1):191.
- Ennour-Idrissi, K., Maunsell, E., Diorio, C. (2015). Breast Cancer Res, 17:139.
- Comhaire, F.H., Depypere, H.T. (2015). Climacteric, 18(3):364.
- Yelland, S., et al. (2023). Nutr Bull, 48(1):43.
- Srivatsav, A., et al. (2020). Sex Med Rev, 8(3):431.
- Pellegrino, A., Tiidus, P.M., Vandenboom, R. (2022). Sports Med, 52(12):2853.
- Price, C.T., Langford, J.R., Liporace, F.A. (2012). Open Orthop J, 6:143.
- Hoke, M., et al. (2020). J Clin Neurosci, 76:261.
- Mauvais-Jarvis, F., et al. (2020). Lancet, 396:565.
- Bellasi, A., et al. (2007). Cleve Clin J Med, 74(8):585.
- Casas, R., et al. (2018). Int J Mol Sci, 19(12):3988.
- Ray, S., Saini, M.K. (2021). Clin Phytoscience, 7:64.
- Shaito, A., et al. (2020). Front Pharmacol, 11:422.
- Remes, O., et al. (2016). Brain Behav, 6(7):e00497.
- Verma, R., Balhara, Y.P.S., Gupta, C.S. (2011). Ind Psychiatry J, 20(1):4.
- Swathi, V., Reddy, M.S. (2016). Int J Comput Eng, 19(4):6.
- Vemuri, P., et al. (2014). JAMA Neurol, 71(8):1017.
- Marti Del Moral, A., Fortique, F. (2019). Nutr Hosp, 36(4):939.
- Wongtrakul, J., et al. (2021). Heliyon, 7(10):e08172.
- Singh, S.K., et al. (2019). Neurotherapeutics, 16(3):666.
- Farhana, K.M., et al. (2016). Evid Based Complement Alternat Med, 2016:2795915.
- Scullin, M.K., Bliwise, D.L. (2015). Perspect Psychol Sci, 10(1):97.
- Czajkowski, K., Bros-Konopielko, M., Teliga-Czajkowska, J. (2021). Prz Menopauzalny, 20(1):40.