Perimenopause can start in your early forties and lasts anywhere from 41 to 55, until menopause; when you haven’t had a period for a full year. The drop in estrogen levels can pose issues for many women in the area of weight loss where strategies that used to work in your twenties and thirties are no longer effective. I’m talking about exercising more, longer and harder while eating less. It certainly sounds logical, right? Except when you take into consideration the changing landscape of your hormones that occurs between perimenopause to menopause.
Extreme exercise and undereating puts major stress on the body and is a recipe for disaster that causes the potential for chronic injuries, higher cortisol levels and endocrine disruption. If you have a weight loss goal let me tell you right now, this is going to backfire.
The answer to maintaining optimal levels of physical conditioning, a healthy muscle to fat ratio and hormones during the transition from perimenopause to menopause and beyond is to have a sensible approach to diet,exercise and how we manage stress. This all sounds reasonable on paper, but implementing requires your understanding, planning and preparation. Let’s dive into some of the physiological changes to help you make sense of what’s going on in your body. I compare perimenopause and menopause to a second adolescence, except with less acne.
Body Composition Changes
Muscle to Fat Ratio
One hallmark of perimenopause and menopause is the alteration in body composition. Women often notice a shift in fat distribution, with a tendency for fat to accumulate around the abdomen. This redistribution is influenced by hormonal fluctuations, particularly the decrease in estrogen levels. Additionally, metabolism tends to slow down, making weight management more challenging. However, that can easily be addressed with lifestyle changes like adapting a low carb diet and strength training. This moves the dial in a favorable direction of being insulin sensitive compared to being insulin resistant. When you are insulin sensitive, you have optimal blood sugar levels which keeps insulin levels in check.
Insulin is an energy-storage hormone. After a meal, it helps the cells use carbs, fats, and protein as needed, and store what’s left (mainly as fat) for the future. Problems with weight loss occur when women have chronically elevated levels of glucose in their bloodstream and the pancreas is unable to secrete enough insulin to shuttle it into the cells to be used for energy.
In the case of excess glucose floating around in the bloodstream from a diet too high in carbohydrates, the receptor cells for insulin (Insulin receptors exist on almost all tissues in the body, including muscle cells and fat cells) are like a hotel manager that controls the number of guests. The hotel manager, (a.k.a insulin receptor cells) tells glucose, “Sorry, go find another hotel to stay at. We’re fully booked.” The extra glucose finds another hotel with lots of vacancies called your fat cells, who could use the business and says, “Sure, we have plenty of room. Come on in and make yourself at home!” This is how weight gain can happen during menopause, or as some like to call it, “Meno Belly.” Menopause belly.
I’m a firm believer in helping others understand the mechanisms behind a problem. It’s not enough to tell someone, “Well, that’s how it is. When you get to a certain age, weight loss is harder and the tendency to gain weight is greater.” True as that is, there are solutions and you’re not stuck. Women want answers and a road map to fix the problem of stubborn weight loss and it is available. Your job is to be proactive and commit to a few lifestyle changes.
The Role of Hormones in Weight Management
Estrogen and Progesterone
Estrogen and progesterone play pivotal roles in regulating a woman’s metabolism. As these hormone levels decline during perimenopause and menopause, the body’s ability to efficiently burn calories may decrease. Estrogen, in particular, has a close relationship with adipose tissue, influencing fat storage and distribution. Going back to the previous section about the hormone insulin, it’s basically the same solution. By adjusting your diet (eating low carb and more healthy fats), and exercising with the proper intensity that does not cause chronic levels of high cortisol (another reason the body will store fat) you can successfully lose weight. Fat gives you a feeling of satiation and in general it takes about 30 days to be more fat adapted. Humans are metabolically flexible and can use either glycogen or fat for fuel, however, the use of fat for energy is longer lasting. Plus, more good news, you will no longer have blood sugar crashes at 4PM because low carb eating stabilizes blood sugar. Blood sugar crashes are when many people grab a candy bar, a bagel or some other sugary snack that will only provide temporary relief. Your body is crying out for real food that’s nutrient dense. Not a quick fix that leaves you wanting for more. That’s why most people don’t just eat one cookie. They eat the box.
Thyroid Hormones
Thyroid hormones, responsible for regulating the body’s metabolism, can be affected during perimenopause and menopause. Changes in estrogen levels may impact the thyroid’s function, potentially leading to weight gain. Monitoring thyroid health becomes crucial for women navigating this life stage.
In another blog post I wrote about how the standard thyroid test that your doctor provides doesn’t offer enough information about the health of this important endocrine gland. When it comes to the standard of care blood work you get from most general practitioners, T4 is what’s measured to check thyroid function. That does not tell you if T4 is converting into the active form of thyroxine which is T3 or getting into all the other tissues of your body that make you feel good. The T4 test only tells you how much is in the brain. You need it in all the other tissues of the body, so a full thyroid panel or hormone panel will provide much more adequate information. Check out the complete DUTCH hormone panel.
Chronic stress leads to high levels of the hormone, cortisol, and that has a negative impact on thyroid function. Every cell in the body has receptors for both thyroid and cortisol. Too much cortisol can create a problem of thyroid resistance where the tissues fail to respond to the hormone. This resistance occurs with other hormones like insulin, progesterone, estrogen, testosterone and cortisol itself. Resistance means the body must work harder to make more of the other hormones when cortisol is high. You feel like crap because all the other hormones are unable to operate as they should. That’s why a full panel hormone test can be very valuable.
Over-Exercising and Hormonal Imbalance
Cortisol Overload
While exercise is essential for overall health, excessive workouts can contribute to elevated cortisol levels. Secreted by the adrenal glands that sit on top of your kidneys, cortisol, often dubbed the stress hormone, can lead to weight retention, especially when consistently elevated. Balancing exercise intensity and duration is key to preventing cortisol overload. It’s not only during stressful situations, but cortisol can be elevated from exercise too. Elevated cortisol consistently produces too much glucose, increasing blood sugar levels that lead to insulin resistance.
Low or High Estrogen Levels
Over-exercising with little to no recovery (downtime) in perimenopausal, menopausal and postmenopausal women can lead to bone loss, and weight gain. You need estrogen for weight loss. It helps regulate fat metabolism. When you’ve got adequate estrogen in your cells, there’s less chance for fat to move in. The 3 types of estrogen to be familiar with are:
- Estradiol – Most common in non-pregnant women
- Estrone – Post Menopause (made by the adrenal glands and in fat tissue)
- Estriol – Major role in pregnancy
You can be either low in estrogen or high. In perimenopause and postmenopause the thinking is that you would naturally be low since estrogen levels typically decrease at this time of life. This is not necessarily true and the only way to really know is by having blood labs done. If you are low in estrogen, and over exercise, then you will need to decrease the volume and intensity of your workouts to help increase your estrogen levels. Type A personalities who try to do it all are generally the over-exercisers and burn the candle at both ends. More is not always better. If this sounds like you, try the opposite for 30 days. Instead of taking 90 minute Soul Cycle classes 5x/week, cut it back to 2x/week and do one pilates or yoga class and a 30 minute walk with a friend. You may be surprised how weight loss becomes easier along with eating correctly.
Let’s look at the opposite scenario. If you are estrogen dominant, then higher intensity workouts will bring estrogen down more. For instance, short higher intensity workouts like twenty minutes of HIIT on the bike, short weight training workouts with enough weight that gets you to fatigue, keep the emphasis on strength over too much cardio, and walks in nature. Whether you are estrogen dominant or low estrogen, always include recovery time to help reset cortisol levels and activate rest and digest (parasympathetic nervous system).
This is the main reason why the best way to exercise during perimenopause and menopause really depends upon what’s happening to each individual woman hormonally.
Estrogen and its partner hormone, progesterone, need to be in balance with each other and if they are not, it’s due to higher cortisol levels which block progesterone. You can have a sense of higher cortisol levels when you are chronically stressed, have more anxiety and mood swings. Another sign is more belly fat (due to low estrogen and higher cortisol). Again, lab testing will give you the best information. Knowledge is power, as I said earlier, when you know the mechanism behind the symptoms it’s easier to know what steps to take for optimum health.
The Importance of Rest
Amidst the pursuit of fitness goals, the significance of rest is often underestimated. Rest days are essential for hormone recovery, allowing the body to repair and balance hormonal levels. Incorporating rest into a workout routine can prevent burnout and support overall well-being. If you’re constantly on the go and pushing yourself, you’re most likely raising your cortisol levels. When you stop and really think about it, the average person doesn’t say to themselves, “Gee, I should really stop and do some deep breathing for 5 minutes and give myself some Zen time.” We need to be intentional about setting aside 3-5 minutes at minimum every day, to practice any restorative activity (i.e. stretching or meditation). In addition to giving yourself a mental detox, you’re allowing the body much needed recovery time and that helps with a weight loss goal.
Nutrition Strategies For Hormonal Balance
Balanced Diet for Hormone Support and Health
Nutrition plays a crucial role in supporting hormonal balance and overall health. A balanced diet rich in whole foods, lean proteins, and healthy fats provides essential nutrients for hormone production and regulation. Certain foods, such as those rich in omega-3 fatty acids and antioxidants, can be particularly beneficial during perimenopause and menopause. Many women find eating low carb and high fat helps with weight loss and nourishes their hormones. Even with all the research out there that proves eating healthy fats that come from sources like beef tallow, grass fed butter, whole eggs and grass fed beef are beneficial, there are many women who still fear it will cause weight gain.
It’s best to look at nutrition on a continuum rather than an all or nothing approach. That may work for a small percentage of people in the world but the majority benefit from a slower pace when it comes to a change in diet. The ultimate goal, in the case of a perimenopausal or menopausal woman, is a diet that supports hormonal health where you make better choices every day and over time.
As a health coach, I realize each woman is unique and so are her circumstances and life experiences. Any changes need to fit with her lifestyle and who she is. Meal plans and measuring and weighing food often fail because they are not realistic for the majority of women with busy lives that include a family and a career. It’s one of the reasons I recommend using the hand technique. See the image below to see how it works.
Stress Management for Weight Loss
Mind-Body Connection
The mind-body connection is a powerful influencer of hormonal balance. Chronic stress can disrupt hormone production and regulation, contributing to weight gain. Mindfulness practices, such as meditation and deep breathing, can help manage stress levels and support overall well-being. When we’re stressed, the hormone cortisol is secreted and cortisol sends the message to store more fat.
Holistic Approaches to Stress Reduction
Holistic approaches, including yoga and tai chi, offer not only physical benefits but also contribute to stress reduction. If those options are not practical, then consider anything that helps you slow down and feel a sense of calm. It could be taking a walk, drawing, or journaling. These practices combine movement, breath awareness, and mindfulness, creating a holistic approach to stress management during perimenopause to menopause.
Whether it’s midlife or a little later, weight loss is definitely doable. Depending upon what your hormone levels are, it may mean doing less for some or a little more for others.
May you always look, feel and be kuhle!