Does Mediterranean diet could have a role on age at menopause and in the management of vasomotor menopausal symptoms? The viewpoint of the endocrinological nutritionist

Menopause marks the end of a woman’s reproductive lifespan and it is represented by the permanent cessation of the spontaneous menstrual cycle. Several environmental factors have been associated to both menopause and vasomotor menopausal symptoms, nevertheless the current evidence of the association between menopause, vasomotor menopausal symptoms with diet has not yet been thoroughly investigated and present evidence of this association are discordant. Mediterranean diet is a healthy dietary pattern characterized by plant-based foods with a high intake of phenolic compounds present in the foods of this dietary pattern, including extra-virgin olive oil, whole-grain cereals, nuts, legumes, vegetables, fish, red wine, and fruits. Dietary factors could influence the sex hormones concentrations and the timing of natural menopause. Therefore, in this narrative review we have evaluated actual evidence on the relationship of Mediterranean diet with menopausal age and the incidence and severity of vasomotor menopausal symptoms, reporting observational studies and providing insights on physiopatological mechanisms.