Hormonal Changes Affect Your Weight During Perimenopause and Menopause
Hormonal Changes Affect Your Weight During Perimenopause and Menopause
At some point during your menopausal journey, you are bound to experience the side effects of shifting hormonal levels. I reached out to Dr. Apovian who is the Director of the Nutrition and Weight Management Center at Boston Medical Center, a Professor of Medicine at Boston University School of Medicine, and Vice President of The Obesity Society to help us understand why hormonal changes affect our weight.
She explained that the ovaries begin to produce less estrogen around age 30 for most women, marking the start of perimenopause. Around the same time, our natural levels of melatonin drop, in turn impacting our hunger and stress hormones. All of these hormones play important roles in the metabolism and maintaining a healthy weight.
It seems that estrogen, melatonin, cortisol, ghrelin and leptin are some of the main culprits! Dr. Apovain’s breaks it all down for us in a very “layperson friendly” manner and then discusses ways to reverse that weight gain that usually accompanies middle age:
Estrogen
Your ovaries begin to produce estrogen during puberty. Many women are not aware that fat cells also produce estrogen. During menopause, the amount of this important hormone produced by your ovaries decreases. Your fat cells try to compensate for the hormonal imbalance by swelling and becoming larger. These fat cells typically congregate around your waist, as the fat cells in your abdomen are capable of producing more estrogen than fat cells on either the thighs or hips.
Aside from an unpleasant shift in your body shape, extra visceral fat, particularly stored in the belly, raises risks for type 2 diabetes, metabolic syndrome, and cardiovascular disease.
Dr. Apovian’s Recommendations:
Adjust your diet to reduce or eliminate the foods that exacerbate hormonal imbalance, such as added sugars, processed foods, caffeine in excess, alcohol, and foods high in saturated fat, such as fried foods and full-fat dairy items. Eat a diet rich in lean protein sources, which both help you to maintain lean tissue and lose weight in mid-life. Add some foods that imitate estrogen in the body, such as soy proteins and flaxseed meal to help alleviate the side effects of your shifting hormonal levels. And of course, more physical activity is always beneficial for managing your weight and alleviating the side effects of menopause.
Melatonin
Did you know that your melatonin levels begin to decrease around age 30? If you ever wondered why you were able to sleep so soundly and deeply as a young adult, yet struggle to do so now, blame your lowered levels of melatonin. For women, increased incidence of hot flashes, restless leg syndrome, sleep apnea, and a more frequent urge to urinate during the night makes getting enough sleep even more challenging.
How does this relate to weight? Our muscles, the primary drivers of our metabolism, are repaired while we sleep. Getting less than 7-9 hours per night consistently slows the metabolism, in addition to ramping up hunger and stress hormones the following day.
Dr. Apovian’s Recommendations:
Many of us balancing the demands of work and family life consider sleep a luxury. This mindset needs to change! Make it a priority to guard your health, your longevity, and your ability to be a support to your family and your office by consistently aiming for 7-9 hours of sleep per night. Go to bed and rise at the same time every day, power down devices a couple of hours before bed, stop drinking caffeine at noon, and add physical activity into your daily routine to help your body to prepare for sleep. If you continue to have trouble, try adding some tart cherry juice concentrate into your diet, which is one of the richest natural sources of melatonin available. Enjoy a couple of tablespoons in a smoothie or diluted in water a few hours before bedtime.
Cortisol
Stress signals our bodies to prepare for fight or flight by releasing the hormone cortisol. When our bodies experience chronic stress, they believe that energy has been expended in fighting off the stressor, whether we actually engaged in physical exertion or not. As a result, cortisol causes an increase in appetite, particularly cravings for sugar. In turn, high sugar and insulin levels signal the body to store fat, especially around our midsections. Heightened levels of cortisol also interfere with our ability to sleep soundly. Sleep deprivation is a stressor in and of itself, in addition to a strong factor in weight gain and metabolic aging, triggering a cycle of stress, weight gain, and more trouble sleeping.
While heightened cortisol levels are not unique to mid-life, the pressures many of us balance, in addition to adapting to our changing bodies during menopause, can be challenging, to say the least.
Dr. Apovian’s Recommendations:
If you have chronic stressors in your life (and who doesn’t?), prioritize consistent, sufficient sleep and find alternative ways to relieve stress, apart from eating. Regular exercise is a wonderful way to improve mood and lower cortisol levels, and seeking out social support is another healthy way to manage stress and stick to your goals. I find that jotting down my stressors before going to bed helps me to process them and fall asleep faster. Consulting a professional, such as a cognitive-behavioral specialist, has also proved particularly effective for people to lose weight, manage stress, and sleep more soundly.
Ghrelin and Leptin
These are the hormones that signal hunger and satiety, or fullness. When they are working together in a healthy balance, ghrelin notifies our brains when we need to eat, and leptin signals that we have had enough for our energy needs. Insufficient sleep, caused by lowered levels of melatonin and estrogen, chronic stress, and added sugars in the diet all cause these hormones to become unbalanced. A chronic lack of sleep increases ghrelin and suppresses leptin, which explains why we feel ravenous after a sleepless night, no matter what we eat. Insufficient sleep also ramps up our cortisol levels, leading to feelings of anxiety and a tendency to overeat. A diet high in added sugars triggers our bodies to develop a resistance to leptin, interfering with our ability to feel full and satisfied.
In addition, our bodies require fewer calories as we approach middle age. However, since many of our eating patterns are dictated by habit, most of us continue eating the same amount in our 40s as we did in our 20s. Regularly overeating contributes to heightened ghrelin levels.
Dr. Apovian’s Recommendations:
Consistently getting enough sleep and managing your stressors will go a long way in balancing out these important hormones. In addition, eat a diet rich in lean protein sources. Protein is the most satiating of the macronutrients and keeps you feeling full and satisfied longer between meals, for fewer calories. Try my high protein smoothies, specifically designed to battle the weight gain that accompanies middle age.
Armed with the correct information and guidance, we can combat that menopausal weight gain. Now, I am off to have a serious talk with my fat cells!
My Motto: Suffering in silence is OUT! Reaching out is IN!
For more great tips on how to deal with menopause download my free ebook: MENOPAUSE MONDAYS the Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.
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These are excellent and easy to understand points! Thank-you Ellen. Sleep is so important. I was surprised to read the changes start as early as 30!
So many things begin changing early. I wished I had understood all of this early in my life!
I am curious about the statement “our bodies require fewer calories as we approach middle age”. Is this a biological truth? Or is it a bi-product of the fact that most people lose muscle mass as they age? If it’s the former, eating less makes sense. If it’s the latter, eating less while trying to build metabolically active muscles might actually be more harmful. Just curious.
Good question, Tamara. I have emailed Dr. Apovian for her response. Stay tuned!
Thanks! :-)
Here is Dr. Apovian’s answer:
“That is a great question. The answer is, that it is a combination of factors that causes the metabolism to slow down in middle age. One of the primary ones is muscle degeneration, but that is not the only. Factors like hormonal fluctuation and changes in the gut microflora cause the metabolism to slow down as well. In addition, people tend to be less active in middle age. The most effective way to lose weight past middle age to combat all of these factors is to both eat fewer calories while increasing protein intake. So, it’s a combination of eating more protein and eliminating nutritionally empty calories.”
Thank you so much for this. It’s reassuring to know that there are things one can do to keep the metabolism revved up. The gut microflora explanation is new to me.
That metabolism is key…………many say that increasing our weight- bearing exercising is a big help as well. What works for you?
I’m a big proponent of strength training. I train 3-5 days per week. Big lifts, whole-body and lots of variety. For me, HIIT-style cardio is much more beneficial than the traditional long, slow distance approach. It keeps stress hormones at bay.
Thanks for sharing your routine with us!
What a great, informative post (yet again!). I knew a lot of this information in a general sense, but not the explanations behind it. Thank you for sharing Dr. Apovian’s expertise!
Glad you found the information helpful. Like you, I kinda knew some of this, but it did help to get a more medically driving perspective.
Hi Ellen, the link to the Dr. Apovian’s smoothie is broken. I was curious as to the ingredients.
Jennifer, thanks for letting me know. LMK if you have any more questions……….I can reach back and ask her.
All this is true. I’m fascinated by how much there is to learn about women’s health and this time of our lives.
So true. And………….the information is always changing as new science is uncovered.
Hi Ellen:) wow this post really hits home! Never will I forget not recognizing myself in the mirror. It’s a terrible feeling. Once my menapause specialist helped get all in balance and I started on an everyday exercise routine that is comfortable for this particular time in my life…. I call it, don’t stress just move. I started to see the weight come off! The protein in snacks and meals is so important, plus I learned that I am gluten and dairy intolerant. Exercise and removing foods that know longer helped me was key!
Thanks for sharing your story with us! I am so happy that you got your menopause dance down!