Perimenopause is a natural phase in a woman's life that typically begins in her 40s. This period is marked by hormonal fluctuations that bring about various changes in the body, including weight gain. Understanding the connection between perimenopause and weight gain is crucial for women going through this transformative stage, because it can be frustrating when you haven't changed your diet or exercise routine, but the extra pounds still find a way to creep in anyway. It’s been estimated that the average weight increase experienced during perimenopause and menopause is around two to five pounds. So why does this happen and what can you do about it?
Perimenopause is a natural process caused when the ovaries gradually stop working. This period is marked by hormonal fluctuations and can bring about various changes in the body. When perimenopause begins, progesterone levels go down and estrogen levels start to fluctuate every day. This happens because parts of the brain – the hypothalamus and the pituitary gland – are telling your ovaries to produce more estrogen. When estrogen is higher, you have symptoms like you might have with PMS, such as moods swings, bloating, and breast tenderness. When estrogen is low, you may have hot flashes or night sweats.
Metabolic changes occur as estrogen levels decline. Women may experience a decrease in basal metabolic rate (BMR), which is the number of calories the body needs at rest, making it more challenging to maintain or lose weight. This is also affected by the age-related loss of muscle mass which can be attributed to simultaneous declines in testosterone levels and more sedentary behaviors. Moreover, changes in insulin sensitivity may occur leading to fat storage.
But it’s not just the additional weight that’s problematic; another issue is the way fat is distributed and stored during perimenopause. When we begin puberty—and throughout much of our lives—excess fat is stored in our hips and thighs. During menopause, however, fat deposits shift to the abdomen, causing our bodies to seemingly change shape. This redistribution can make it look as if you’ve gained extra weight, even if you haven’t. This shift is associated with an increased risk of cardiovascular disease and other health issues.
A number of other factors may influence weight gain during perimenopause. Some issues occur independently, while others work together to contribute to additional weight gain, such as:
Increased Appetite
A hormone called ghrelin is found in higher quantities in perimenopausal women. Ghrelin tells your brain that you are hungry, and if you eat more in response to this cue, your calorie intake will obviously increase.
Additionally, estrogen levels, which tend to drop in later stages of perimenopause, may affect the way leptin and neuropeptide Y work together in the body – leptin is a hormone that helps the body maintain consistent weight, while neuropeptide Y is a chain of amino acids that controls appetite and feelings of fullness. Women in this later stage of perimenopause may consume more calories because of the prevalence of these specific hormones.
Loss of Muscle Mass
As we age, muscle mass naturally decreases and the rate at which our bodies burn calories slows. These factors, plus additional calorie consumption, may result in weight gain during perimenopause. As we age, the average adult also tends to have lower levels of activity that can also lead to decreases in muscle mass. Poor dietary intake of protein can also contribute to these losses.
Lack of Sleep
About half of all women in menopause are affected by sleep disturbances, like difficulty falling asleep, staying asleep, or tossing and turning throughout the night because of night sweats. Poor quality sleep can be a key factor for weight gain. Sleep disturbances decrease fat utilization and may increase the likelihood of fat storage and subsequent weight gain during menopause.
Underactive Thyroid
The thyroid is a gland that helps regulate our metabolism, or the rate at which our bodies burn calories. Women with an underactive thyroid may experience a slower metabolism, meaning the calories they consume are stored in the body instead of converted into usable energy. This condition, called hypothyroidism, may lead to excess weight gain.
Other Factors
Genetics, medications whose side effects include weight gain, and high stress levels that increase the release of the hormone, cortisol, may all also cause sudden weight increases in perimenopause.
It may seem like the effects of perimenopause are out of our control, so what can be done?
Be mindful of your dietary choices
Increases in appetite should be met with nutrient-dense foods and watching your caloric intake. You will need about 200 fewer calories each day as you enter your 50s. A sedentary woman should consume about 1,600 calories a day, while an active woman may need around 1,800. Protein-rich diets can help preserve losses of muscle mass and help you maintain active metabolism while at rest.
Engage in regular exercise
Incorporating a mix of cardiovascular exercise, strength training, and flexibility exercises can help maintain muscle mass, boost metabolism, and manage weight. The American Heart Association recommends 150 minutes of moderate exercise or 75 minutes of vigorous aerobic activity per week. Strength training exercises should also be incorporated to help build bone and muscle strength as well as to help support your metabolism.
Make healthy lifestyle choices
Stress can increase levels of cortisol in your body and increased levels of cortisol can contribute to weight gain. Prioritizing sleep, managing stress, and adopting healthy lifestyle habits can positively impact weight management during perimenopause. Stress management techniques such as meditation, yoga, or deep breathing exercises can be particularly beneficial.
Get your hormones checked by a healthcare provider
The use of bioidentical hormone replacement therapy (BHRT) can alleviate the symptoms of perimenopause, help you manage your weight, and improve your quality of life. You can schedule a one-on-one consultation with a BHRT-certified Trio Provider, who will let you know if BHRT is right for you.
Navigating perimenopause and weight gain involves understanding the complex interplay between hormonal changes, metabolism, and lifestyle factors. By adopting a holistic approach that includes a balanced diet, regular exercise, and healthy lifestyle choices, women can empower themselves to manage weight effectively during this transformative stage of life. Seeking guidance from qualified healthcare professionals, with specialized training in hormone replacement, can provide personalized strategies to address individual needs and concerns.
References:
American Heart Association. (2023, October 24). Recommendations for Physical Activity in Adults and Kids. Retrieved January 10, 2024, from https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults.
Healthline. (2020, April 3). Why Some Women Gain Weight Around Menopause. https://www.healthline.com/nutrition/menopause-weight-gain
Johns Hopkins Medicine. (n.d). Perimenopause. Retrieved January, 10, 2024, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/perimenopause
Mayo Clinic. (2023, July 8). The reality of menopause weight gain. Retrieved January 10, 2024, from https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menopause-weight-gain/art-20046058#:~:text=To%20keep%20your%20current%20weight,you're%20eating%20and%20drinking.