This post was written by Abigail Masters, NP, PPG – Family Medicine.
As women age, their hormones and bodies change. In this post, we’ll discuss perimenopause and menopause, and how it can lead to unwanted pounds.
Perimenopause
Perimenopause is the time leading up to menopause. Your body is basically trying to stop periods at some times and trying to keep them going other times. A woman can go months without a period and then suddenly start having them again with varying degrees of severity.
Menopause
Menopause is when a woman’s ovaries stop producing estrogen and she becomes unable to become pregnant. The typical age for menopause is around 52 years old. A woman is in menopause when she has not had a period for a full year.
Menopause symptoms
The menopause experience exists on a continuum of very mild annoyances to symptoms that affect everyday life. The symptoms are caused by the drastic changes in hormone levels that cascade and affect other areas.
Symptoms can include:
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Irregular periods. Some women have light periods, while others have heavy bleeding. Your menstrual cycle may be longer or shorter, or you may skip periods.
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Hot flashes
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Trouble sleeping (insomnia)
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Mood swings or feeling grouchy, depressed or worried
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Headaches
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Feeling that your heart is beating too fast or unevenly (palpitations)
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Trouble remembering or thinking clearly
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Vaginal dryness
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A change in sexual interest or response
Weight gain and menopause
In midlife, from ages 45-75, women gain more fat mass around their waist and lose muscle mass (AOM, 2024). This redistribution of fat or adipose tissue around the waist has implications of increasing risk of cardiac disease, metabolic disease/diabetes and arthritis.
Weight gain is a common side effect of menopause. It’s difficult to know whether menopause causes this, or the symptoms associated with menopause are the culprit. For instance, if a woman has hot flashes all night, she will be exhausted the next day. Due to being exhausted she is more stressed, less cognizant of her food choices (or does not eat at all), and not as active due to the fatigue. In this example, the behaviors that lead to weight gain started with the hot flashes.
This becomes further complicated because several months or years of this strain and lifestyle behavior can result in significant weight gain. Adipose tissue/fat tissue will then produce its own hormones that perpetuate the vicious cycle.
Preventing weight gain during menopause
Unfortunately, symptoms of perimenopause and menopause can last years. The encouraging part is that there are measures to help.
The first is be prepared. All women know we will be going through this life transition at some point. Making sure that we are starting good habits is a great initial step.
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Get an exercise routine in place, incorporating weight lifting/weight bearing activity 2-3x/week of moderate intensity to keep the muscle mass. Muscle also burns more calories at rest than other tissues.
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Adopt healthy eating habits, including at least 3 cups of varied vegetables a day, several servings of whole fruit a day, a diet low in processed foods and drinks (including diet soda).
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Prioritize your mental health. Take time to relax and connect with your family, friends and hobbies. If you find that work is your life, you probably need to make some changes and create space for more cup-filling practices.
Second, speak with your primary care provider. Your doctor can help determine if your hormone levels need checked or symptoms align with a hormone imbalance. There are medications, such as hormone-replacement therapy, that can help manage your symptoms. Your provider can help you evaluate the right treatment plan based on factors such as family history, existing diagnoses and your health history. There is also medications and accountability that can help with weight loss during this transition.
Midlife can be a challenging time for women and the people who love them. Setting yourself up for success with healthy lifestyle habits can help. Don’t hesitate to lean on your primary care provider if you have concerns or want help navigating this chapter.
