The holy month of Ramadan is almost upon us for 2024, expecting to begin on Monday 11th March 2024, and end on Tuesday 9th April 2024, depending on the sighting of the moon. This is spiritual time of year for all Muslims that involves fasting during the hours of daylight. However, for women going through the perimenopause and menopause, and the common side effects associated with these times of hormonal upheaval, fasting for four weeks can raise some potential challenges which might impact on the Ramadan celebrations.
Here GP Dr Hannah Allen and Nutritionist Helen Roach give their tips on how to navigate your way through the month so that you can fully enjoy it.
Making adjustments
Not eating any food or drinking any liquid in daylight hours as you observe Ramadan is a tradition that is there to celebrate patience and self-control. This can be a challenge for everyone but for women going the perimenopause or menopause who may be experiencing common signs like night sweats, trouble sleeping, headaches, exhaustion and mood swings it can make it a whole lot harder to feel patient and spiritual. Add to this not eating or drinking during the day and a disruption to your usual sleeping routine and this can make you feel potentially worse, so you need to make sure the foods you do eat are as nutritionally dense as possible. Plus, you need to take good care of yourself to stop you feeling like you are dragging yourself through the celebrations because you are tired and hungry. There are also other practical considerations including, for example, if you have been prescribed HRT when, and if, you should you use it and whether dietary supplements constitute nutrition and therefore would break your fast.
Common FAQs around Ramadan and Menopause
We’ve compiled a list of the common FAQs women may have when undertaking Ramadan during perimenopause or menopause:
Q. Will taking HRT break my fast?
A. If your hormone levels are being topped up using HRT skin patches, gels, the Mirena coil or a vaginal pessary or creams they will not break your fast, they are considered to be ingested through the skin so you don’t need to make any changes to your routine. However, if you take oral HRT you’ll need to take it before, or after, daylight hours. So, if you normally take it in the morning, move it back earlier to Suhur. If you usually take it in the evening wait until after sundown and Iftar.
Q. Can I take dietary supplements during Ramadan?
A. Whilst the best source of vitamins and minerals is from food, given that your diet is restricted during the holy month dietary supplements can be a helpful addition to ensure you are getting the nutrients you need. As supplements are ingested via the mouth, during Ramadan, you’ll need to take them before Suhur in the morning and after Iftar at night. Choosing a multi-vitamin and mineral supplement or one that is specially formulated with nutrients to support perimenopause and menopause symptoms can be especially useful at this time
Q. What are the best foods to eat at Suhur and Iftar?
A. When you have been without food for some time it can be tempting to grab the first tasty looking thing in your field of vision at Iftar - but try to avoid fried, processed, ultra-sugary and/or salty and starchy foods which can make managing your blood sugar levels harder and may also affect your weight. Instead include plenty of lean protein like fish, meat or pulses with a range of vegetables and fruits (including dried ones like apricots and dates). Try grilled meat or fish with a chickpea salad - loading at least half of your plate with vegetables or salad. You can also find more diet and recipes to help balance hormones in menopause here. And be mindful of how spicy foods can affect you as these are known to trigger perimenopause and menopause symptoms in some women. For Suhur, eggs are a good choice but if you can’t face much at that time of the morning whizz up a smoothie with Greek yogurt, banana, berries and phytoestrogen flax seeds or chia seeds. You can also make this the night before and put it in the fridge so it’s all ready for you at dawn.
Q. How can I stop myself feeling so tired?
A. It might seem counterintuitive to have to get up to eat when you are tired but try to avoid sleeping through Suhur and prepare yourself a protein-rich, vitamin and mineral packed meal (see above) to provide you with the energy you need for the day. And keep yourself well-hydrated. Have water handy everywhere during the evening hours of Ramadan and sip it throughout the allotted time. Also try herbal teas like sage (linked to a reduction in hot flushes and night sweats), digestive-soothing peppermint and/or relaxing camomile. Plus eating water-rich foods such as tomatoes, celery, cucumber, melon and/or unsweetened natural yogurt can all contribute to your hydration levels. If you are completely wiped out take a short nap if you can – but no longer than 30 minutes.
7 simple tips for managing menopause during Ramadan
Develop a Ramadan routine.
It can be helpful to try and eat your meals at around the same time during Ramadan and then, if you are taking HRT or nutritional supplements, this can help act as a handy reminder that you need to take them too. If necessary, use sticky notes to jog your memory or set alerts on your phone to remind you as a change of routine can cause you to forget.
Don’t skip Suhur.
Many women find that their sleep is already disrupted during the menopause, and they are tired due to night sweats and/or anxiety. The temptation during Ramadan can be to stay in bed and miss Suhur before dawn, especially as you might not have much of an appetite at that time. But do try to prepare yourself a healthy meal (see suggestions above). Eating before dawn can also help manage your blood sugar and levels of cortisol (the main stress hormone). The quality of your food is vital during Ramadan and you only have a limited ‘window’ each day in which to eat to eat and drink so try to make it count.
Talk to others.
Being grateful for your community is what Ramadan is about and reaching out and talking to other women going through the menopause (or who have been through it) is a huge source of support and reassurance at any time - but may be of particular benefit if you are struggling during Ramadan.
Be kind to yourself.
If you are really struggling and break your fast don’t beat yourself up and feel you have failed – make it up at another time.
Keep your cool.
To help reduce the likelihood of overheating and triggering a hot flush wear loose clothing in breathable fabrics, especially during prayer time. Some women also recommend you avoid positioning yourself in the middle of the prayer line and join it at the end where you are less likely to become overwhelmed and overheated by people around you. Carrying a portable fan can also help.
Try to stay active.
If you feel tired from fasting it can be hard to motivate yourself to exercise. Whilst nobody is suggesting you do a high intensity work-out, walking before and after Iftar can be a simple way to keep active, reduce stress and help you sleep.
Rest and relax.
Menopause is well-documented for its ability to disrupt your sleep and during Ramadan the lack of food and disruption to your usual sleep and eating habits can make you feel particularly tired and possibly stressed. If you feel you need it, take a short nap during the day but no longer than 30 minutes as much more can leave you feeling drowsy and groggy. There are useful tips here on how to reduce stress and anxiety during menopause and there are more helpful tools and tips on the free Health & Her app.
