Coffee and Menopause: Comfort Brew or Hormone Hijack?

Why Do Americans Love Coffee?

For millions of Americans, coffee is something to look forward to in the mornings. That promising moment of warmth and flavor is a pleasant way to start the day. Americans drink more than 400 million cups of coffee every day. According to the National Coffee Association, 7 out of 10 Americans drink coffee weekly, and the average American coffee drinker enjoys just over three cups per day.

Coffee gained popularity in the U.S. after the Boston Tea Party, in part because of its energizing effects and ability to promote wakefulness throughout the day.

Where Is Our 1980’s Cup of Joe?

After the Boston Tea Party, there was a patriotic shift from tea to coffee. By the late 1800s, coffee had become a worldwide commodity, and entrepreneurs began looking for innovative ways to profit from the beverage.

Are you old enough to remember the Folger’s commercials? Instant coffee was the most common form of coffee in the 1950s and 60s, but during the 1970s, people started shifting toward brewing coffee from beans. In that same decade, an interest in specialty coffee began to grow, leading to the opening of the first Starbucks in Seattle, WA in 1971.

Specialty coffee culture has surged in the last 20 years. In 1992, Starbucks had 140 stores, and a cup of coffee cost $1.65. Today, in 2025, Starbucks has more than 80,000 stores, and drinks can cost up to $6.00.

Coffee today often goes far beyond a plain cup — many people opt for milkshake-like drinks filled with syrups, sweeteners, and creamers. For those who don’t enjoy the taste of coffee, these additives make it more palatable but also add sugar and calories.

How Does Caffeine Affect Our Body?

Coffee contains caffeine along with nearly 1,000 bioactive compounds, many of which have potential antioxidant, anti-inflammatory, antifibrotic, and anticancer effects.

Caffeine acts as an adenosine receptor antagonist in the nervous system, producing a psychoactive effect. It stimulates cognitive performance, alertness, reaction time, and decision-making. Caffeine has also been studied for its effects on physical performance, muscle strength, endurance, and exercise outcomes.

Adenosine naturally builds up in the body throughout the day, promoting sleep onset. Caffeine disrupts this process, and its impact varies depending on how quickly an individual metabolizes it. Sleep expert Matthew Walker recommends avoiding caffeine after noon for optimal sleep quality.

While caffeine offers many benefits, overconsumption is associated with insomnia, anxiety, jitteriness, panic, and increased sympathetic nervous system activity.

Caffeine Impacts People Differently

Bioindividuality — the idea that each person is genetically and biologically unique — plays a significant role in caffeine response.

The liver enzyme CYP1A2 metabolizes about 95% of the caffeine you consume.

• Fast metabolizers have an upregulated enzyme, breaking down caffeine quickly.

• Slow metabolizers have a downregulated enzyme, processing caffeine more slowly and feeling stronger effects from smaller amounts.

Coffee and Menopause: What You Need to Know

Many women wonder whether they should continue drinking coffee during menopause. Coffee contains caffeine and other compounds that can affect your hormones and sleep.  During menopause, your body is going through hormonal changes, and caffeine may impact symptoms such as hot flashes, and sleep disturbances.  But coffee also contains antioxidants and beneficial compounds.

A meta-analysis by Poole et al. (2018) compared high coffee consumption with low or no coffee consumption. Findings included:

• High coffee consumption was associated with a 10% reduction in all-cause mortality.

• Once smoking was accounted for, higher coffee intake was linked to lower risk of all cancers.

• Higher consumption was also associated with reduced risk of Type 2 diabetes and cardiovascular disease.

Coffee acts as a bitter that activates the vagal nerve, stimulating motility and secretions in the gut to support digestion. However, for those with reflux, coffee can relax the lower esophageal sphincter and worsen symptoms.

Caffeine and Sleep During Menopause

Menopause can already make sleep more difficult due to night sweats, hormonal changes, and mood fluctuations. Caffeine, especially later in the day, can make it even harder to fall asleep and stay asleep.

Sleep disturbances are linked to higher stress, poorer mood, and increased appetite — all of which can make menopause symptoms worse. If you enjoy coffee, try limiting it to the morning hours to protect your sleep quality.

Caffeine and Heart Health in Midlife Women

Heart disease risk increases after menopause due to the loss of estrogen’s protective effects. Research on caffeine’s effect on heart health is positive. In moderate amounts, coffee appears beneficial for most people, possibly due to its antioxidants and anti-inflammatory compounds. However, in sensitive individuals, high caffeine intake can raise blood pressure or cause heart palpitations.  If you have heart rhythm issues, or feel jittery after caffeine, monitor your intake and see if reducing it improves your symptoms.

Coffee and Breast Cancer

The impact of coffee on breast cancer risk may depend on caffeine metabolism speed. Coffee intake is associated with higher urinary metabolites of 16OH estradiol, which is linked to breast cancer risk.

A 2021 meta-analysis found:

• Inverse correlation between coffee consumption and breast cancer risk in postmenopausal women and women with a BRCA1 mutation

• Association between coffee intake and reduced recurrence risk after diagnosis, surgery, and aromatase inhibitor treatment

• Less clear association in premenopausal women, BRCA2 mutation carriers, and triple-negative breast cancer cases (Nehlig et al, 2021).

Caffeine and Hot Flashes

A 2015 cross-sectional survey of 2,507 postmenopausal women found caffeine use associated with higher vasomotor symptom scores (2.3 vs. 2.15, p = 0.011), even after adjusting for smoking. Drinking hot beverages can trigger hot flashes, and caffeinated soda was also linked to increased symptoms  (Faubion, et al, 2015). .

However, a study of Libyan women found that higher coffee and tea intake correlated with fewer menopausal symptoms (Taher et al., 2013). In contrast, a Korean study (Park et al., 2003) linked caffeine intake to more frequent hot flashes in postmenopausal women.

Why does this happen? Caffeine is a stimulant that can temporarily raise your heart rate, increase body temperature, and affect blood vessel dilation — all of which may trigger hot flashes.  If you notice your hot flashes are worse on days you drink more coffee or other caffeinated beverages, consider cutting back or switching to decaf.

Coffee and Bone Health

Bone density naturally declines with age, and menopause accelerates this process due to lower estrogen levels. Some research suggests that high caffeine intake may slightly decrease calcium absorption and increase calcium loss in urine. Over time, this could contribute to lower bone mineral density, especially if your dietary calcium is low.

However, research is mixed. Some studies suggest a connection between coffee and reduced bone density, while others find no association. Poole’s 2018 metaanalysis showed a slight association with increased fracture risk in older women.  Another 2023 meta-analysis concluded there was no increased risk of bone mineral density loss or osteoporosis from coffee consumption (Chen, et al, 2023).

Coffee and Alzheimer’s

Evidence suggests coffee may have neuroprotective effects, reducing the risk of cognitive decline and neurodegenerative diseases. Moderate intake (200–400 mg/day, about two to four cups) appears to offer the greatest benefit in preventing dementia and Alzheimer’s disease (Xu et al, 2015, Wasim et al, 2020).

Healthiest Ways to Consume Coffee

Coffee becomes less healthy when loaded with sugars, artificial sweeteners, and highly processed creamers.

Nutritional value of some popular drinks:

• Starbucks Iced Hazelnut Oat Milk Shaken Espresso (Large): 220 calories, 23g sugar

• Starbucks Vanilla Sweet Cream Cold Brew (Large): 200 calories, 23g sugar

• Dunkin’ Caramel Macchiato (Large): 120 calories, 35g sugar

• Dunkin’ Pecan Swirl Iced Coffee (Large): 170 calories, 36g sugar

Tips for a healthier cup:

• Brew at home with minimal, natural sweeteners (monk fruit, stevia, honey, maple syrup)

• Use unsweetened creamers or milk

• Avoid coffee after 12-3 p.m. to protect sleep

• Choose organic brands to reduce pesticide exposure

• Add cinnamon or cardamom for flavor and blood sugar support

Coffee Substitutes

• Green Tea: Contains less caffeine, is lower in acidity, and is rich in antioxidants with cancer-preventive properties.

• Fig Coffee: Made from roasted figs, caffeine-free, alkaline, and supportive of healthy digestion.

• Dandy Blend: Caffeine-free herbal coffee alternative made from roasted barley, rye, dandelion root, and chicory (certified gluten-free).

• Reishi Roast: Adaptogenic herbal blend (reishi, chicory, dandelion, milk thistle, milky oats) that supports stress resilience and liver health.

• Four Sigmatic: Coffee blends with medicinal mushrooms like chaga and lion’s mane, offering lower caffeine content.

The Morning Ritual of Coffee

Coffee can be part of a mindful morning routine and an opportunity for habit stacking — pairing a new habit with one you already do daily.

Ideas include:

• Meditation or prayer

• Calling a loved one

• Sitting outside in the sunlight

• Taking a gentle walk in nature with your coffee in a to-go cup

I personally add medicinal mushroom extracts to my coffee. Chaga was even used during WWII in Finland and Holland when coffee was scarce.

My favorites:

• Maitake – Supports immunity, blood sugar balance, metabolism

• Reishi – Helps with stress, cortisol balance, sleep, immune support

• Cordyceps – Boosts energy, lung health, libido, and focus

• Lion’s Mane – Promotes brain health and BDNF production

• Chaga – Extremely high in antioxidants, supports skin health, may help prevent cancer

Quick tip: Add a small pinch of salt to reduce bitterness when blending coffee with mushrooms.

References

Bijelic, R., Milicevic, S., & Balaban, J. (2017). Risk Factors for Osteoporosis in Postmenopausal Women. Medical archives (Sarajevo, Bosnia and Herzegovina), 71(1), 25–28. https://doi.org/10.5455/medarh.2017.71.25-28

Chen CC, Shen YM, Li SB, Huang SW, Kuo YJ, Chen YP. Association of Coffee and Tea Intake with Bone Mineral Density and Hip Fracture: A Meta-Analysis. Medicina (Kaunas). 2023 Jun 20;59(6):1177. doi: 10.3390/medicina59061177. PMID: 37374383; PMCID: PMC10301353.

Faubion, S. S., Sood, R., Thielen, J. M., & Shuster, L. T. (2015). Caffeine and menopausal symptoms: what is the association?. Menopause (New York, N.Y.), 22(2), 155–158. https://doi.org/10.1097/GME.0000000000000301

Mikkelsen, T. F., Graff-Iversen, S., Sundby, J., & Bjertness, E. (2007). Early menopause, association with tobacco smoking, coffee consumption and other lifestyle factors: a cross-sectional study. BMC public health, 7, 149. https://doi.org/10.1186/1471-2458-7-149

Nehlig A, Reix N, Arbogast P, Mathelin C. Coffee consumption and breast cancer risk: a narrative review in the general population and in different subtypes of breast cancer. Eur J Nutr. 2021 Apr;60(3):1197-1235. doi: 10.1007/s00394-020-02465-0. Epub 2021 Jan 13. PMID: 33442757.

Park, Y. J., Paik, H. Y., Kim, Y. J., Hong, S. S., Kim, M. J., Yoon, J. W., & Moon, S. H. (2003). Taehan Kanho Hakhoe chi, 33(3), 386–394. https://doi.org/10.4040/jkan.2003.33.3.386

Poole R, Kennedy OJ, Roderick P, Fallowfield JA, Hayes PC, Parkes J. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ. 2017 Nov 22;359:j5024. doi: 10.1136/bmj.j5024. Erratum in: BMJ. 2018 Jan 12;360:k194. doi: 10.1136/bmj.k194. PMID: 29167102; PMCID: PMC5696634.

Taher, Y. A., Ben Emhemed, H. M., & Tawati, A. M. (2013). Menopausal age, related factors and climacteric symptoms in Libyan women. Climacteric : the journal of the International Menopause Society, 16(1), 179–184. https://doi.org/10.3109/13697137.2012.682107

Taher, Y. A., Ben Emhemed, H. M., & Tawati, A. M. (2013). Menopausal age, related factors and climacteric symptoms in Libyan women. Climacteric : the journal of the International Menopause Society, 16(1), 179–184. https://doi.org/10.3109/13697137.2012.682107

Wasim, S., Kukkar, V., Awad, V. M., Sakhamuru, S., & Malik, B. H. (2020). Neuroprotective and Neurodegenerative Aspects of Coffee and Its Active Ingredients in View of Scientific Literature. Cureus, 12(8), e9578. https://doi.org/10.7759/cureus.9578

Xu, W., Tan, L., Wang, H. F., Jiang, T., Tan, M. S., Tan, L., Zhao, Q. F., Li, J. Q., Wang, J., & Yu, J. T. (2015). Meta-analysis of modifiable risk factors for Alzheimer's disease. Journal of neurology, neurosurgery, and psychiatry, 86(12), 1299–1306. https://doi.org/10.1136/jnnp-2015-310548