“I would rather suffer with coffee than be senseless.” ~Napoleon Bonaparte
I call coffee the “elixir of life” since it reverses the zombiedom of my mornings. I love its taste, smell, and energy I receive. Yet for myself and many women, caffeine sensitivity can gradually develop over time with lesser amounts needed to energize us and make us jittery or anxious. Furthermore, as estrogen levels decline in perimenopause, caffeine can attack full throttle, precipitating hot flashes. These effects are due to a decreased ability to metabolize caffeine as we age and a heightened sensitivity to coffee’s effects due to diminishing estrogen.
There are several ways that coffee can wreak havoc during the menopause transition. First off, coffee itself has a very “warm” thermal property according to Traditional Chinese Medicine (TCM) and as such, is a food that can ignite hot flashes. Darker roasting of coffee only enhances this thermal quality. Secondly, caffeine in high enough doses can be like a shot of adrenaline, inciting hot flashes as well as other perimenopausal symptoms such as palpitations, anxiety, and insomnia. Coffee also stimulates acid production in the stomach which predisposes to reflux.[1] A known diuretic, coffee triggers the bladder into feeling the need to void with lesser volumes of urine, thus promoting overactive bladder symptoms.[2] These bladder issues may be complicated by artificial sweeteners such as aspartame, acesulfame, and saccharin which are bladder irritants in their own rights.[3]Subscribed
So how much caffeine is in coffee? A regular cup of coffee may contain anywhere from 12 to 25 mg of caffeine per ounce (about 96 to 200mg/8 oz.) while espresso contains 50 to 75 mg of caffeine per 1 ounce serving. Variations in concentration depend on the selected coffee, amount used, and the method of brewing. Arabica beans (more commonly sold) have approximately half the caffeine of Robusta beans. Darker roasts of coffee taste stronger but contain slightly lesser amounts of caffeine than a lighter, more complexly flavored roast. Cold brewed coffee contains more caffeine per cup than drip brewed. Even “decaf” coffee is not devoid of caffeine, with approximately 1 to 4 mg/caffeine per ounce (8 to 32 mg/8 oz.).
Coffee is not the only beverage containing caffeine. Black tea contains about 40 to 80 mg/8 oz. and green tea has 20 to 40mg/8 oz. Decaffeinated tea has minimal caffeine and herbal teas generally have none unless they are blended with black or green tea. While hot chocolate may only contain from 10 to 25 mg. caffeine per 8 oz. serving, solid dark chocolate itself contains quite a bit depending on the percentage of cacao. Colas, other caffeine-containing sodas, and energy drinks all have varying caffeine levels and energy drinks may contain other stimulating compounds.
If caffeine is added to a product, the label should show it as an ingredient although listing the actual amount is not required. Mountain Dew is known for its caffeine content, but did you know some root beers are also supplemented?
For those of us who love coffee, we have to make a decision—uncomfortable symptoms vs. inattentiveness and fatigue. So, what can one do to tame hot flashes, palpitations, and other symptoms mentioned above? Here are some suggestions:
1) Cut back on the total amount of coffee consumed as well as avoid or cut back on colas, other suspect sodas, and energy drinks.
2) Cut back on sugar since that also precipitates hot flashes in some women.
3) If you brew your own, you can try mixing ½ caffeinated to ½ decaffeinated coffee. While this dials back the stimulant effect of caffeine, the “warm” quality of both roasted coffees may still elicit hot flashes.
4) Since ingesting a hot beverage might precipitate a hot flash, drink your coffee at a cooler temperature instead of piping hot. While TCM does not recommend icy drinks, popping a few ice cubes into the cup until they melt could help.
5) Pour half a cup of coffee and add milk to fill the mug. It neutralizes the acidity and adds calcium too. Since cow’s milk has a “neutral” thermal property, it would tone down the “warm” thermal property of the coffee.
6) Stagger your cups of coffee, alternating with tea or water.
7) Start out with coffee and switch to tea later on.
8) Try switching to tea entirely since black tea is “neutral” and green tea is “cool,” the latter being more of a hot flash suppressant. Adding lemon juice is more “cooling.”
9) If insomnia is an issue, stop drinking caffeinated beverages after a determined cutoff time. (For me that is 12 noon for a regular cup of coffee and 3 p.m. for decaf.)
10) Careful with chai drinks since they contain black tea with a mix of spices, most of which have “warm” thermal properties and may fuel hot flashes too.
[1] P. J. Boekema et al., “Coffee and Gastrointestinal Function: Facts and Fiction. A Review,” Scandinavian Journal of Gastroenterology. Supplement 230 (1999): 35–39, https://doi.org/10.1080/003655299750025525.
[2] Supatra Lohsiriwat, Muthita Hirunsai, and Bansithi Chaiyaprasithi, “Effect of Caffeine on Bladder Function in Patients with Overactive Bladder Symptoms,” Urology Annals 3, no. 1 (2011): 14–18, https://doi.org/10.4103/0974-7796.75862.
[3] “Bladder Issues? Consider Your Diet.,” Brigham Health Hub (blog), June 5, 2020, https://brighamhealthhub.org/bladder-issues-consider-your-diet/.
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