Coffee consumption and health effects have been a popular area of research since the year 2000. However, most of these studies lack gender and age specificity, so there is still much remain unknown when it comes to health effects on menopausal women.

Currently, studies have demonstrated that:

Pro 1. Coffee drinking is associated with a lower risk of depression among women, as well a lower risk of stroke (2011 study). 2. In women, moderate consumption has been linked to a small decrease in risk of heart attack.

Con 3. Coffee consumption doesn’t seem to reduce risk of Parkinson’s disease for women as much as it is for men.

Studies like these provide answer to long-term outcomes, but they don’t quite address the day-to-day health concerns such as sleep, fatigue, hotflashes, nightsweats, anxiety, weight gain, just to name a few. These concerns, seemingly minor compared to life-threatening illnesses, actually are determinants of our quality of life. If you’re a daily coffee drinker and are experiencing fatigue in menopause, I would advise you to take a break from drinking coffee. I know for some of you this may sound far from your norm and maybe the idea of quitting coffee is unfathomable, but knowing the science behind it may be helpful for you to try quitting.

 

Let’s take fatigue for example. Menopause women often experience fatigue in spite of 8-9 hours of sleep. The reason behind it is that cortisol output increases with age, and for whatever reason, the body deactivates that cortisol into cortisone. Since cortisol is required for metabolic function, the deactivation of cortisol would make an individual feel tired. This concept is very similar to insulin resistance as in the case of type 2 diabetes – the body becomes desensitized to insulin and not making use of it even though more than sufficient amount is produced.

 

The cortisol response in a patient experiencing fatigue is this: the greater the fatigue, the more cortisol is made by the adrenal glands. However, as a protective and compensatory mechanism, the body converts that cortisol into cortisone, making the metabolic hormone unavailable to cells. Below is the lab’s depiction of a 40 year old woman who’s has high cortisol production but also high cortisol inactivation at the same time. At the time of testing, she had been waking up at 4am every night, and noticed adiposity developing in the mid-section in spite to no change to her weight.

 

Cortisol Pattern

Cortisone Metabolites

How does this relate to coffee consumption?

Coffee consumption pushes the adrenals to keep on making more cortisol and in the same time, it also pushes the body to convert the newly made cortisol into inactive form, cortisone. In the end, while you might get a surge of energy immediately after drinking coffee (which for most fatigued people it’s not that effective and that energy is short-lived anyway), you are also exhausting your adrenal glands faster.

The ultimately consequence of this is that the adrenals are exhausted and the damage is either irreversible or slightly recoverable at best. Patients do suffer from pervasive fatigue and increased risk of high blood pressure, high blood sugar (type 2 diabetes), and poor immune response, because cortisol is the hormone keeping these bodily functions in check. Example below is cortisol pattern of a 55yo women who’s been drinking 4 cups of coffee a day. Notice that the red line reflecting the patient’s value is borderline low most of the time and even below the normal range at B (2 hours after waking).

 

Daily Free Cortisol Pattern

 

This particular patient slept well but just seemed to never have enough. Before she came to see me she was on the treadmill every morning trying to get more energy. Little did she know, she was doing more harm engaging in high intensity exercises. Instead, she should engage in less intensive exercises like yoga, meditation, creative writing, etc. Given this imbalance in cortisol reflecting a suboptimal state of the adrenals, if she kept drinking coffee everyday, she can expect to still experience hotflashes and nightsweats well into her 60s.

In sum, coffee is not your friend when cortisol is high or low, and it’s even worse in menopause because cortisol naturally goes up with age. By cutting out coffee in your regular routine – though it’ll be hard at first I’m not going to lie – you will start to see your energy come back. Not only that, when your adrenals have a chance to recover, you’ll have way less vasomotor symptoms like hotflashes and nightsweats. Just to name a few positive things that you can expect from putting a pause on coffee.

 

Coffee withdrawal

For the first 2-3 weeks, expect to feel tired, brain-fog, inability to focus, mild headache, and even irritability. You can certainly replace coffee with green tea, which has less caffeine but at least the withdrawal won’t be so pervasive. Plenty of rehydration and patience is key.

 

Is there ever a good time to go back on coffee?

In menopause and onward, occasional cup of coffee is ok, and always couple with some snack or a meal. If you’ve cut out coffee for some time and only have it on occasions, you’ll appreciate the stimulating effect of coffee even more. Treat coffee like ice cream – have some on occasion, but not everyday.

A word on cortisol test I find that when it comes to hormones, urine tests are better depictions compared to salivary and blood samples. The examples I have given here are based on Dried Urine Test Comprehensive Hormones (DUTCH). I offer this test in my practice and you can book an appointment to discuss about this test, or you can also purchase the test from the US-Based lab https://dutchtest.com/shop/. For more information about menopause treatment in Calgary you can talk to Dr. Kait now.

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