As most of you probably know, menopause marks the end of a woman’s reproductive period and the term is used to describe the changes that happen to a woman’s body around the time when the ovaries stop releasing eggs. While the most dramatic symptoms are usually felt in the last few years before menopause, or when a woman stops having her period, the hormonal changes and the symptoms they bring with them can take place over the course of a decade.
This period leading up to menopause, when these hormonal changes are happening, is actually called perimenopause. During this time, the ovaries stop producing the sex hormones and estrogen and progesterone levels start to decline. In addition to weight gain, or an inability to lose weight, some of the common symptoms include hot flashes, night sweats, irritability, mood swings, declining libido, lack of energy and joint pain. Clients come to us for help with this because it’s frustrating and stressful, especially when you think you’re doing everything right, and when multiple new symptoms are happening at the same time.
The weight gain that some women (and men - did you know there’s actually a male version of menopause called andropause?) experience during these years is very individual, but may be related to hormonal changes as well as ageing and lifestyle changes that happen around this time.
When men and women age they lose muscle mass. This happens as a result of hormonal changes but also because people tend to slow down a bit as they get older. Less muscle mass means you burn fewer calories at rest and when you exercise. A study published in the American Journal of Epidemiology looked at how different factors such as age, menopause, and lifestyle changes account for the weight gain often experienced by midlife women. As part of the study, they looked at the activity levels of over 3000 peri and postmenopausal women across the United States over three years. Interestingly, the researchers found that by remaining active, many women prevented weight gain.
Now, what if you, like many of our clients, are someone who actually eats well and keeps exercising regularly but can’t seem to keep the weight off? This is when we want to take into account good ol’ hormones. The loss of estrogen that accompanies menopause leads to a shift of fat to the midsection. Estrogen and progesterone also affect how your cells respond to insulin, so with declining levels of these hormones you may have more difficulty balancing your blood sugar, which is a factor in weight gain.
Another hormone that can play a major factor around this age is cortisol, a stress hormone produced by your adrenal glands. During menopause, your adrenal glands take over the majority of the production of estrogen and progesterone. If your adrenal glands are overworked, from years of stress, whether that is from anxiety, physical stress or even sitting in front of a computer, then they will have a hard time keeping up with the demands for estrogen and progesterone. Symptoms like weight gain may then come about much more quickly. Chronic stress is also a factor in blood sugar issues and can contribute to other hormonal imbalances, like thyroid conditions, which can have a major impact on weight.
Some other common symptoms that happen during menopause include night sweats and sleep disturbances. There may also be more fatigue than usual. On a hormonal level, loss of sleep raises the hormone ghrelin, which is a hunger hormone that increases appetite. Cortisol levels are also higher after a few hours of lost sleep, which can lead to blood sugar imbalances that contribute to cravings, energy fluctuations and weight gain around the abdomen. Not to mention that sticking to a healthy lifestyle isn’t easy when you are tired and can’t sleep!
If you were able to get away with eating whatever you wanted, enjoying a glass of wine most nights with dinner or a sweet treat every night before bed, it may not work for you anymore. Focusing on real, unprocessed and nutrient dense food is important for weight management but also healthy ageing in general. Increasing your vegetable and fiber intake, eating healthy fats, whole grains and reducing fatty and sugary foods is a great place to start. That doesn’t mean you can’t still enjoy a sweet treat or alcohol on occasion, but the balance should lean towards healthier alternatives. Working with a nutritionist can help you find a way of eating that supports your health needs and works with your lifestyle. We offer standard and custom meal plans that help you get to your healthy weight.
If you already eat a pretty healthy diet but find that something just isn’t working, you may need to focus more on balancing your blood sugar. Incorporating more protein at each main meal and reducing your overall carbohydrate intake may be your best next step. For example, eggs with avocado and spinach or a green smoothie with protein powder (I like Genuine Health Fermented Organic Vegans+ Protein) rather than cereal or toast for breakfast, will do a better job of balancing your blood sugar to reduce cravings and manage weight.
Many women still tend to lean more towards cardio exercises and less towards strength training. While cardio is great, especially for cardiovascular health, strength training increases lean muscle mass to help counteract the loss that often occurs in middle age. More importantly, strength training also helps to increase bone density and strengthens the muscles that support bones and joints, which is needed because with the drop in estrogen levels, women are more at risk of developing osteoporosis after menopause. It’s important to incorporate a variety of exercises
Make sure to consult with a personal trainer or physio if you're going to start a new program.
Perimenopause, if not sooner, is also a great opportunity to assess how active you are on a daily basis. Consider biking to work versus driving, do more activities on the weekend, garden, get outdoors, go for walks, etc. Look for ways that you can incorporate more movement and less sitting into your daily routine to balance your slowing metabolism.
Cortisol is an ‘alpha’ hormone, meaning the stress response will take precedence over other bodily processes. If you are prone to stress or anxiety, it can make all of the other hormonal changes much more dramatic, leading to issues with sleep, energy, weight, and mood. One of the best ways to support healthy cortisol levels is to stick to a sleep routine. Even if you can’t sleep through the night or have a hard time falling asleep, developing a wind down routine (i.e. no blue light, reading a book or having a bath) about 1 hour before you’d like to fall asleep, can help to prepare your body and mind for a restful sleep. This is also key because melatonin levels also decline around menopause, and blue light at night suppresses melatonin production, which we need to fall asleep and to get into REM sleep.
It can be really helpful to do a full hormone panel for your sex hormones, stress hormones and thyroid to know where your hormones are now. This is something we can order for our clients. By having the full picture, we can get a better idea of the root causes of your hormone imbalances, so we can balance your different hormones to minimize symptoms and help you feel like you again.
One of our one-on-one clients, Jennifer, came to us because she was frustrated with the last few pounds she could not seem to lose as well as classic menopause symptoms like night sweats and disrupted sleep. By testing her hormones we were able to see that not only were her sex hormones low, but she also had elevated stress hormones and low thyroid. By addressing her digestion, stress and her low thyroid, which can lower sex hormone production, we were able to help her lose those last few pounds, improve her sleep and stop the night sweats.
In Jennifer’s own words...
"... By following [your] advice about food choices and supplements, I was able to reach my goal weight. I may never have washboard abs, by my pooch is smaller, clothes fit better and I feel great about myself.” - Jennifer Wacasey
As I mentioned earlier, there is no “one size fits all” solution. But the good news is that by taking a personalized approach and focusing on your root causes, you can often address your symptoms and bring all areas of health into balance at once.
Written by: Natalia Bragagnolo, RHN