How Menopause Might Look Different for Vegans and Vegetarians

As more people embrace plant-based living, questions are emerging about how vegan and vegetarian diets might shape the menopausal experience. Can nutrition choices, like a vegan diet, impact menopausal symptoms or timing? And when it comes to treatment, are hormone replacement therapy (HRT) options compatible with vegan values?

Although menopause is a universal life transition, its effects vary widely among individuals. Given the role diet can play in shaping symptoms and long-term health outcomes, it’s important to understand how plant-based eating patterns can interact with the menopausal transition and shape treatment options.

This article explores whether menopause affects vegans and vegetarians differently, how plant-based diets influence symptom management and long-term health, and key considerations when evaluating HRT options.

The Role of Diet in Menopause

Menopause is a natural phase of life characterized by hormonal fluctuations that can impact overall health. Studies have shown that this transitional phase may increase the risk of weight gain, metabolic disorders, heart disease, and osteoporosis.⁽¹⁾

A key factor behind these menopausal changes is the decline in estrogen, a hormone that helps regulate appetite, metabolism, and basal energy expenditure. As estrogen levels fluctuate during menopause, metabolism slows, and appetite control weakens. This often results in greater fat accumulation, especially in the abdominal area, which may contribute to inflammation and increased cardiometabolic risk. Many individuals also experience symptoms such as hot flashes, joint pain, sleep disturbances, and mood fluctuations during the menopausal transition.⁽¹⁾ 

Although these effects are common, nutritional habits can influence metabolic outcomes, ease the intensity of symptoms, and support overall well-being in the years following menopause. For instance, increasing dietary intake of omega-3 fatty acids — found in vegetable oils, seeds, nuts, and certain legumes — may support cardiovascular health and help manage inflammation.⁽²⁾

The Basics of Vegan and Vegetarian Diets

Vegan and vegetarian diets focus on plant-based foods but differ in their exclusion of animal products. Vegetarians avoid meat, poultry, and fish, though some may include dairy or eggs, depending on the variation. Vegans exclude all animal-derived products, including dairy, eggs, and honey. For many, veganism also extends to lifestyle choices, such as avoiding animal-based materials and products tested on animals.⁽³⁾

People adopt plant-based diets for different reasons. Ethical vegans oppose the use of animals for food, clothing, or other purposes. Environmental concerns also influence the shift to plant-based eating, which typically has a lower environmental impact. Health is another key motivator, with research suggesting that well-planned vegan and vegetarian diets can support heart health, lower the risk of obesity, and reduce the incidence of certain chronic diseases.⁽³⁾

Can menopause affect vegans and vegetarians differently?

Diet can influence various aspects of menopause, including symptom intensity, timing, and nutritional demands. These are some of the most commonly studied areas where dietary patterns may have an impact.

Symptom Experience

Research suggests that vegans and vegetarians may experience fewer vasomotor symptoms, like hot flashes, during the menopausal transition compared to those following a meat-based diet.⁽⁴⁾ According to a 2021 study, combining a low-fat, plant-based diet with soybeans was associated with fewer and less severe hot flashes, as well as an improved quality of life.⁽⁵⁾

These findings suggest that a well-balanced plant-based diet may help manage menopausal symptoms, though more research is needed to confirm its long-term benefits.

Timing of Menopause

The age at natural menopause (ANM) can influence long-term health outcomes. Early menopause, defined as menopause before age 45, affects approximately 5% to 10% of women in Western countries and is associated with increased risks of osteoporosis, type 2 diabetes, cardiovascular diseases, and cognitive decline.⁽⁶⁾

While genetics play a role in determining ANM, diet is also being explored as a contributing factor. Current evidence suggests that adherence to a general plant-based dietary index (PDI) is not associated with an increased risk of early menopause. However, higher adherence to an unhealthy plant-based dietary index (uPDI), which includes refined grains and sugary foods, may increase the risk of early menopause.⁽⁶⁾

Nutrient Demands

As estrogen declines during menopause, nutritional needs shift. Vegan and vegetarian diets, while potentially protective in some respects, may increase the risk of nutritional deficiencies, including calcium, vitamin D, vitamin B12, iron, and zinc.⁽⁷⁾ 

Without adequate dietary sources or supplementation, individuals following plant-based diets may be more vulnerable to nutrient gaps during this stage of life. Monitoring intake and working with a healthcare professional or dietitian can help ensure nutritional adequacy and reduce the risk of long-term complications.

How Vegan Values Can Influence HRT Choices

For individuals following a vegan lifestyle, healthcare decisions — including whether and how to use HRT — may involve additional considerations. While HRT is an effective treatment option for managing menopausal symptoms, the ingredients and testing processes involved may conflict with personal beliefs. As a result, many seek clarity around the sources of HRT products and whether plant-based alternatives align more closely with their values.

Is HRT vegan-friendly?

Whether HRT is considered vegan-friendly depends on how individuals define and practice their vegan lifestyle. Many HRT products are derived from plant sources, such as soy or yam. These plant-based or bioidentical hormones are chemically similar to those naturally produced by the body and are not sourced directly from animals.

However, no medicine can be classified as entirely vegan-friendly. All approved medications are tested on animals at some stage during development, and many contain excipients that may be animal-derived. These include ingredients that bind or stabilize the product, such as gelatin, lactose, lanolin, and magnesium stearate.

Some delivery methods may be more acceptable to those seeking to minimize animal-derived ingredients. For instance, many plant-based HRT patches don’t contain animal-derived excipients and may be preferred by vegans. While effective, HRT tablets often contain lactose and can be considered vegetarian-friendly, though not strictly vegan-friendly.

The decision to use HRT is personal. For many, taking care of their health is a priority, and that includes managing menopausal symptoms safely and effectively. The Vegan Society emphasizes lifestyle choices that are “practicable and possible.” For some, this may mean choosing the most ethically aligned HRT option available, even if it’s not entirely vegan-friendly.

Open communication with a healthcare provider is essential. Discussing personal values, exploring available formulations, and reviewing ingredients together can help ensure that treatment supports both health and ethical commitments. No one should feel they have to choose between their well-being and their beliefs, and with the right guidance, it’s often possible to honor both.

Aligning Nutrition with Menopausal Care

For individuals following a vegan or vegetarian lifestyle, menopause may present unique considerations related to nutrition and treatment options. While plant-based diets can offer certain health benefits during this stage, they must be carefully planned to meet evolving nutrient needs. Similarly, decisions regarding HRT may be influenced by ethical values, particularly when animal-derived ingredients or testing are involved.

There is no single, ideal approach to managing menopausal symptoms. The most effective strategy supports long-term health while allowing for sustainable lifestyle changes. This includes forming habits that are both nutritionally sound and personally meaningful.

It’s essential to consult a qualified healthcare professional before making any changes to diet or medication. Open discussions about values and preferences can help identify options that align with both health goals and ethical considerations. While entirely vegan-friendly medical treatments may not always be available, making informed choices can allow individuals to care for their health without compromising their beliefs.