Ok, let’s be real. I’m about to turn 51 and most of my pants don’t fit. I am not thrilled with this turn of events. Not because I’m super body conscious per se, but because new wardrobes are expensive! Over the past 5-6 years I’ve noticed a real change in my body, how my weight is distributed, my energy levels and my post-workout recovery time. These are not fun changes. And frankly, I’m a bit pissed off.
As a healthcare professional, you’d think I would have all the answers, but I don’t. And that makes me even more cranky. But rather than just sulking and eating chocolate, I decided to do my research and try to get on top of all of this. So this is my little love letter to all of you ladies who are also going through the joys of perimenopause or menopause. Because dammit, people don’t really talk about this enough.
Weight Gain: Seriously, what the hell?
Changes in hormonal levels cause a bunch of cascading reactions in our bodies starting anywhere around ages 45-50. Plummeting levels of sex hormones (estrogen, progesterone, testosterone) wreak havoc on myriad issues in our body. As hormone levels fall, our body tries to compensate. Did you know that fat cells produce estrogen? Especially abdominal fat cells. Yep, therein lies a big part of our mid-life weight gain. Unfortunately these fat cells are not all that efficient at estrogen production, so fat accumulates in ongoing efforts to compensate.
Metabolism also shifts. As we get older, our metabolism rate slowly starts to wane. Some of this is a result of hormonal shifts (including things like cortisol), but some of it is a natural evolution. Our body muscle mass starts decreasing after age 30 (yes, you read that right!), where we lose anywhere between 3-5% of our total muscle mass each decade. Muscle requires a few more calories than fat to maintain, so as we lose muscle, our body’s calorie burning furnaces also slow down.
It also turns out that in menopause, your body tends to burn less calories and less fat doing the same exercise it used to (truly unfair). Plus, as we age we often lose flexibility and our recovery time following hard workouts is a lot longer. We just don’t physically bounce back the way we once did. This can mean we exercise less or not vigorously enough to keep the metabolism stoked. Pounds can creep on….
Sleep issues that accompany perimenopause and menopause (hello nighttime hot flashes) can also affect nutrition and weight. Hormonal changes that result from lack of sleep (decreased leptin, increased ghrelin) can increase hunger and make it harder to make good food choices. Lack of sleep can also affect cortisol levels (which can have a direct affect on belly fat) and blood sugar regulation. Fluctuations in insulin and blood sugar can also cause stress in the body and increase potential for fat storage, and increase the risk for metabolic issues such as type 2 diabetes.
So it’s not your imagination. Your body is changing. That in itself isn’t any cause for alarm (nor is it a sign you need to go on a diet!), but it’s important to remember that some of these issues can lead to chronic health concerns over time (increased risk for heart disease or metabolic syndrome), so we want to stay on top of them and be aware of what’s happening within.
How to Cope With Menopausal Changes in Your Body
Besides just feeling cranky, there are a few things you can do (and that I’m definitely working on) to help maintain overall health as you grapple with some of these changes.
See your doctor for a complete physical. Check your cholesterol, blood sugar, blood pressure and hormone levels. Also check things like thyroid, iron and B12 levels, as these are also energy regulators in your body. Make sure there isn’t something that’s off and causing your body to struggle with energy regulation.
Eat regular meals versus snacking and grazing. Every time you eat something your body goes through a cycle of producing insulin to help manage your blood sugar. As we get older, sometimes the pancreas struggles to properly match insulin release with incoming glucose from meals, leading to overproduction of insulin (and possibly, insulin resistance) and/or challenges with low blood sugar. Low blood sugar can then lead to increased hunger and cravings for sweet or high carb/high fat foods. Eating 3 squares per day can help keep this cycle from getting further out of whack.
Consider a lower carb diet. No, this doesn’t mean you need to cut out all carbs (especially NOT fruits and veggies and whole grains!) or go keto, but there is some scientific evidence that a lower carb diet can help with blood sugar and hormonal regulation that may get a bit out of whack with the arrival of menopause. Aiming for 30g of carbs per meal and 15g per snack (if you snack) is a good rule of thumb.
Make sleep a priority. Practice good sleep hygiene by keeping a cool bedroom at night, going to bed at the same time every night, keeping screens and smart phones out of the bedroom (or at the very least, off for an hour or more before bedtime), limiting alcohol intake and avoiding caffeinated beverages past noon. If you struggle with things like reflux/GERD, also make sure to eat your last meal no later than 3 hours before bedtime. Nighttime heartburn isn’t the key to good sleep.
Exercise regularly. 150 minutes per week is the minimum recommendation for good health, and more can be helpful for weight control. Aim for a variety of activity that includes cardiovascular exercise, strength or resistance training and flexibility training. I find I don’t recover well anymore after hard CrossFit or HIIT workouts, so I aim for 3 days per week of that, plus 2 days of yoga and 1-2 days of walking or running. And if I’m really tired and wrung out, I just walk. Elevated stress from working out too hard can lead to a high cortisol response and a trend toward fat accumulation. If you’re not already doing strength training, now is a good time to start to help ward off aging-related loss of muscle mass.
Eat lots of fruits and veggies! Rather than focusing on a fad diet or a list of foods you need to cut out, I recommend (and do it myself) tracking your daily fruit and vegetable intake. I find that by getting at least 6-7 servings of fruit and veg daily, plus my daily bowl of morning oats, I get my fiber intake in, which keeps me full, keeps my gut happy, and ensures I don’t have a lot of room for snacks and other not-so-healthy foods. Now don’t get me wrong, I still eat chocolate. Daily. But by aiming for high fiber intake, along with moderate fat and protein intake, I don’t have as many sweets cravings as I used to during times of low sleep or hormonal fluctuations.
Find simple and easy ways to reduce calorie intake just slightly. 200 calories per day should be enough to halt the weight gain train, and a tiny bit more will help you slowly back it off. Some things in my bag of tricks:
bigger bowl of salad, one less slice of pizza.
stick to one glass of wine when i go out for dinner
have dessert 1-2x per week rather than daily.
fill half my plate with veggies before i add (or eat) anything else.
drink water often, along with unsweetened tea, and limit my cappuccino habit to several times per week rather than daily.
Focus on TOTAL health. Weight is really just one piece of the puzzle. Dial in your exercise, sleep, nutrition, and stress management, get regular medical checks, supplement vitamins or minerals as appropriate, and live a full and happy life. While there can be health risks associated with too much weight gain during menopause, we also can’t set the clock backwards. We’re in the phase of life we’re in. And really, aren’t you glad you’re not 20 anymore? Also, stressing about weight is contrary to health.
Talk with your doctor about hormone replacement therapy. It’s definitely not right for everyone, but it can make a world of difference, even at very low doses, for some individuals in terms of energy, better sleep and weight management.
Before taking any vitamin, mineral or herbal supplements, talk with your doctor. There are a lot of supplements out on the market that claim to help “balance hormones”, relieve hot flashes or increase metabolism, but there is very limited science to support this. The few that have some reasonable evidence include black cohosh, soy isoflavones and red clover extract (and of course, calcium and vitamin D for bone health), but some of these may cause interactions with other medications or medical conditions, so it’s important to chat with your healthcare provider first before taking them.
Enjoy life! This is another new phase of life, and one where there’s not a lot you can do to change how the body naturally functions. Expending too much energy and worry here will only make you less healthy overall, not more. (Don’t worry, this is the one I still need to work on too!).
Yours in good health and stretchy jeans,