MENOPAUSE is marked as one full year after a woman’s last period and is a natural life stage that all women will encounter. Physical changes begin years before the final menstrual period as well as the decline in estrogen and progesterone. This transition phase is called Perimenopause and it is when your body starts transitioning to menopause and can last between 4-8 years. The average age for menopause is 51 yo. Each woman’s experience of menopause is different. Many women report no physical changes during perimenopause except irregular menstrual periods that stop when menopause is reached. Other women experience symptoms of hot flashes, night sweats, mood changes, sleep disturbances, thinning and drying of vaginal tissue that can make sex painful, and weight gain. How severe these body changes are varies from woman to woman.

MY JOURNEY

To be honest, I am not sure I know exactly when my menopause journey started. It was definitely not a straight line and included a lot of struggles in there. 

When I entered my forties, I felt fit and healthy.  I was running, doing pilates and lifting weights regularly. I remember going to Australia for my 40th birthday and feeling really good about my body and was very comfortable wearing a bikini. Also, around this time, I started trying to have a baby. Yes, I know, this is late to start trying, but I have always been a late bloomer to everything in my life and this was no different. Up until then, I was busy having fun, living my best life, traveling, and starting and building my own PT practice.

During this “wanting to have a baby” process, I sadly discovered that I could not conceive… but that’s a whole other story for another time. I learned that my FSH levels were too low to get pregnant. This was my first wake up call that I was in perimenopause. But, since I was feeling good in every other way, I didn’t worry about any other symptoms I may have down the line. 

Around the age of 45 yo, I gained about 10 pounds in a short period of time for no apparent reason. When I mentioned this to my doctor, we tested my thyroid and I was quickly diagnosed with hypothyroidism and later Hashimoto’s (an autoimmune thyroid condition).  With medication and lifestyle changes, I felt like I was able to get most of the symptoms associated with that under control.

Several years later, even though my diet and exercise remained consistent, I started gaining weight again for no real reason. But, this time I also started experiencing hot flashes, insomnia, brain fog, memory issues, irritability, bloating/GI issues, and lack of sex drive. Now THIS I knew was menopause symptoms. And, it was awful. Since I am older than a lot of my friends, no one was really talking about menopause at this time, so I felt alone and didn’t know where to turn. 

I started doing my own research and tried lots of different things. Acupuncture worked for me for a couple of years. I took adaptogens and supplements. Different things helped for short periods of time, but overall my symptoms went from bad to horrible. My night sweats and hot flashes were extreme and I was losing sleep which affected my mood, my memory, and even my diet. Sex was painful and my sex drive was low. All of these symptoms severely affected my quality of life. I thought because I was fit and healthy my entire life, that I would be spared, but I have learned that menopause does not discriminate.

When I turned 49 yo, I bought a Peloton and swore to myself that I was going to do everything possible to look good and feel good on my 50th birthday. I don’t know what it is about those milestone birthdays that get to me, but they do. I was the queen of cardio my whole life and was a runner into my mid-40’s until a back issue forced me to stop. So, instead,  I was cycling almost everyday and became a bit more strict with my diet. I thought if I exercised “enough” and avoided certain foods or restricted calories, I would be able to control how my body looked. It worked for the short term, but it wasn’t sustainable. I couldn’t keep up with all the cycling and even with “cleaning up” what I ate even more, I continued to gain weight - especially around my belly. This drove me nuts because I was doing the same things that were successful for me when  I was younger, but nothing was working for me now. 

I thought about trying Hormone Therapy for a couple of years, but kept putting it off because my Mom had breast cancer and I didn’t want to increase my risk. Little did I know at the time, but I was just not up to date on the most current research on hormone therapy. So, I continued to suffer with my menopause symptoms for 2 more years. After doing more extensive research and talking to several doctors, I decided to give hormone therapy a try. For ME, it was life changing and I wish I had started it much sooner. My hot flashes greatly diminished, I was sleeping better and sex was no longer painful. However, I still felt like I didn’t have control over how my body looked. As a health and fitness professional, I felt like a failure because my body wasn’t cooperating with what I expected it to do. I was frustrated and defeated. But, I also wasn’t ready to throw in the towel.  

WEIGHT GAIN & MENOPAUSE

Menopausal weight gain is very common and super frustrating (maybe even depressing) to many women. But, weight gain is so much more than just a cosmetic issue. It not only decreases a woman’s self esteem, it also increases her risk for chronic diseases, including heart disease, Type-2 Diabetes, hypertension, and even cancer. 

WHY DO WE GAIN WEIGHT DURING MENOPAUSE?

Hormonal changes, lifestyle factors, aging, and genetic factors can all contribute to women gaining weight in menopause. Estrogen is one of the main sex hormones in women. During perimenopause, estrogen (and progesterone)  levels begin to decrease. As estrogen levels decrease, the accumulation and distribution of fat changes which causes our body composition to change. Our muscle mass decreases, while the rate at which we gain fat increases. Where we store fat also changes. After menopause, more fat will get stored around our mid-sections and our internal organs. This kind of fat is called visceral fat or “internal fat”. This visceral fat is to blame for the increased risk of heart disease, insulin resistance and other health issues.

To make matters worse, we start to lose muscle mass as part of the aging process. The less muscle mass we have, the slower your metabolism becomes and the less efficient we are at burning calories. As we lose muscle, we also have more hormonal challenges because muscle acts like a blood sugar sponge and when we have less muscle, blood sugar is not removed as easily from the blood stream so the extra blood sugar gets stored as fat. This combination of estrogen decreasing and losing muscle mass, means that most women will gain some weight during menopause even without eating more. 

BRIEF HORMONE OVERVIEW:

Hormones are chemical messengers that send signals to your body (via the bloodstream and tissues) so your body knows what to do. Several glands, organs and tissues make and release hormones. For most hormones, having too much or too little of them causes symptoms and issues with your health. Below is a list of some of the hormones that play a role in our health and menopause symptoms. 

1. Estrogen - Sex Hormone

2. Progesterone - Sex hormone

3. Testosterone- Sex hormone 

4. Thyroid - Controls the speed of your metabolism

5. Cortisol - Stress hormone

6. Insulin - Regulates blood sugar and fat storage

7. Melatonin- Instrumental in your sleep/wake cycles and your internal body clock

Although we tend to blame our hormones on everything, I want to remind you that it is not the only factor involved. Even if we can’t control all of our hormones, we have the most control over cortisol and insulin and we can take control of our bodies by focusing on healthy habits in order to see better results. Exercise, nutrition, stress reduction, and recovery all play a role in making this period of life not more manageable and more enjoyable. 

WHAT I HAVE LEARNED: 

There are lots of things that we can do during menopause to look and feel our best. I know that menopause is very individual and that there isn’t a one size fits all approach to this experience, but there are ways to feel better, stronger, empowered, and to be happier.  I think that instead of just focusing on weight loss during this time, the key is to focus on the daily healthy habits that will make you feel better overall and then weight loss can be an outcome of your wellness program. 

5 HEALTHY HABITS TO FOCUS ON DURING MENOPAUSE:

1. Strength Training

   • Strength training is the game changer in mid-life. It will help maintain muscle mass which naturally declines as we age, and it also helps with increasing bone density. The strength training program should focus on building lean body mass. As we age, muscle mass decreases. Age related muscle loss is called sarcopenia. It begins as early as age 40 and can get increasingly worse without intervention. This decline becomes even more drastic after the age of 60. Decrease in muscle mass slows down our metabolism which makes it harder to lose weight. Strength training also helps maintain bone density, decreases risk of depression and anxiety, and helps balance blood sugar. 

     Recommendation: Strength train 2-3 times a week. Lift heavy weights! - which means lift weights that are heavy enough to create muscle fatigue. Perform 2-3 sets. 

2. Eat more protein

   • Adding and maintaining muscle mass also requires adequate nutrients, especially protein as it is the main constituent of healthy muscle tissue. Most of us are not getting enough protein in general, including me. I really have to plan ahead and focus on making sure I am eating protein with every meal and snack.  Protein helps regulate blood sugar, curbs cravings, and recover from work-outs. From a weight loss perspective, protein helps regulate blood sugar and helps us feel satiated (fuller) for longer. It is also a thermogenic (heat generating) which increases metabolism. 

   • And, yes, we also need to eat plenty of plants, healthy fats and complex carbohydrates. Try to limit processed foods and added sugars which are not good for us and will just make us feel bad. 

   • Recommendation: Generally, I recommend aiming for at least 30 g of protein at each meal for a total of >100 g throughout the day. To calculate your specific protein goals, multiply your ideal body weight in pounds by (x)  .7-1.0. Try to get in the habit of front loading your protein and continue to eat it throughout the day in order to feel more energetic and calm. For breakfast I usually eat a protein packed smoothie, greek yogurt and/or eggs. 

3. Prioritize sleep  

   • Getting enough quality sleep is so important for overall health and wellbeing, but especially as we age. Sleep is when your body has time to heal and recover. There is also a strong connection between getting enough sleep and maintaining a healthy weight. When we don’t get adequate sleep, the body releases cortisol (the stress hormone), which creates a spike in blood sugar. Inadequate sleep can also mess with your levels of ghrelin and leptin, hormones that control how hungry or satiated you feel. 

   • Recommendations: 

     • Turn off electronics at least 1 hour before bed. 

     • Wear blue light blocking glasses: artificial light interferes w/our melatonin production which allows for deep sleep

     • Make the room as dark as possible- helps with the production of melatonin

     • Lower the temperature in your room as we sleep better in cooler temps

     • No caffeine after noon. 

4. Manage Your Blood sugar

   • Blood sugar balance is linked directly to how we function and feel and is essential for optimal health. It impacts our mood, appetite, sleep, and ability to control cravings. Hormonal changes during menopause can throw blood sugar levels out of whack which leads to weight gain. Insulin is an important hormone that helps regulate our blood sugar. When we eat, glucose is released into the bloodstream and then insulin is secreted by the pancreas which directs the muscle and fat cells to take in the glucose so it can be used as fuel. 

   • It is normal for our blood sugars to rise when we eat. However, when we eat more carbs than the body needs and our cells are already at their glucose limit, we will store this extra glucose as fat. Repeated blood sugar spikes increase fat storage and can also lead to insulin resistance which increases our risk of Type II diabetes, high blood pressure, high cholesterol, abdominal fat and metabolic syndrome. 

   • There are ways to lessen the glucose spike when planning your meals. Less glucose spikes means less glucose enters your bloodstream and less fat storage. When you eat a balanced meal that includes protein, healthy fats, and complex carbs (but not too many), less insulin is secreted and therefore less fat storage. You will also have more even energy throughout the day and feel better without the high blood sugar spikes. 

     • FIBER:

       • If we are talking about regulating blood sugar, we must talk about fiber. Many people know that fiber is key for good digestion, but it also plays an important role in weight loss by regulating our blood sugar level and controlling our hunger. Fiber adds bulk to foods, so it helps you stay full for longer which will help control weight gain. Even though fiber is so important for our health and hormonal balance, most of us don't get enough of it. 

       • Recommendations: Eat a diet rich in fiber. Aim for 25-35 g a day. Combine protein, fat, and fiber at every meal to create a balanced plate to prevent blood sugar spikes.  Make sure to choose complex carbs. Avoid eating carbs alone. 

5. MOVE more!

   • Without even noticing, we become less active as we age. Even if you work out regularly, there is a good chance you are also sitting for too many hours a day. It’s important to get up and move your body as often as possible.

   • Have you heard of NEAT? 

     • NEAT stands for Non-Exercise Activity Thermogenesis and is the energy expended for everything we do that does not include sleeping, eating, or exercise. It  helps us burn more calories without having to spend more time in the gym. Increasing your NEAT increases your metabolic rate and energy expenditure as you will burn more calories throughout the day. People with higher NEAT levels are often more successful at achieving and maintaining weight loss. Even light physical activity burns more calories than doing nothing at all. But, the benefits of NEAT go well beyond extra calories expended. More NEAT also means less risk of metabolic syndrome, cardiovascular events, and death from all causes.

     • RECOMMENDATIONS: To increase your NEAT: Take a walk and listen to a podcast or audible, park on the far end of the parking lot, take the stairs, take an active break from sitting at work, walk in place when you wait, walk around when you are on the phone.

     • If you are doing cardio regularly, I still recommend adding walking into your daily routine as it triggers your body to reduce stress (reduces cortisol). If you track steps, you should aim for >7500 k steps a day. Current guidelines suggest that adults should aim for 150 minutes of moderate-intensity exercise, Moderate-intensity exercise, also known as cardio or aerobic exercise, includes anything that gets your heart rate up. This can be walking for 30 minutes, 5 times a week. 

CONCLUSION:

Menopause is a natural life transition and I am really happy that it is finally being talked about and that the culture surrounding menopause is changing for the better. There is no reason to feel like you are going through this phase of life alone, because you are certainly not. Although menopause can be overwhelming and challenging at times and there are no quick fixes, a change is definitely possible. And, remember, it is never too late to start making changes. We all have the power to make sustainable lifestyle changes that can help you feel better, get healthier, and lose some unwanted pounds if they are affecting your self-image and health. We all deserve to feel healthy, strong and empowered at any age.