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Tackling Menopausal Weight Gain

If you’re a middle-aged woman, you might see your waist expanding for seemingly no reason. This unfortunate physiological change happens to virtually all women as we age. And it’s not something you did or an indication that you have “let yourself go.”

Rather, this weight gain, especially around the midsection, is a natural result of hormonal changes that occur during and around menopause. In this blog, we’ll detail why women tend to gain weight in their midsection during menopause, the role estrogen plays, and what you can do to stop it.

But first, what is menopause?

Menopause marks the end of menstrual cycles. The average age for a woman to undergo menopause is 51, but it can happen throughout your 40s and 50s.

Menopause occurs over three different stages:

  • Perimenopause: In the first stage of menopause, most women experience irregular period cycles. Some women might also experience some symptoms like hot flashes and chills. This typically happens around age 47.

  • Menopause: Menopause marks the day you have your last menstrual period. But you will not be sure it has happened until 1 year has passed without a period.

  • Postmenopause: The final stage occurs when you hit the year mark without a single period. This stage actually lasts the rest of a woman’s life.

Menopause can be spurred by several different circumstances:

  • The natural decline of reproductive hormones: Your ovaries start producing less estrogen and progesterone when you enter your late 30s. While Estrogen and progesterone are known as the hormones that regulate menstruation and fertility their influence affects many physiological process in the brain and throughout the body. The levels of these hormones will continue to decrease until the ovaries stop releasing eggs altogether around age 50.

  • The surgical removal of the ovaries: The hormones that regulate the menstrual cycle, estrogen, and progesterone, are produced in the ovaries. When they are removed, menopause immediately occurs. Hot flashes and other symptoms of menopause occur and your period will stop. This abrupt loss of your sex hormones can wreak havoc on your body and likely cause severe menopausal symptoms. Surgery to remove the uterus doesn’t immediately cause menopause. While periods will cease, hormones will still be produced.

  • Primary ovarian insufficiency: Premature menopause, menopause before the age of 40, occurs in about 1% of women due to primary ovarian insufficiency. Primary ovarian insufficiency occurs when the ovaries fail to produce normal levels of reproductive hormones. This can stem from genetic factors or an autoimmune disease.

The most well-known symptoms of menopause include hot flashes and chills, which are thought to arrive right before menopause. But symptoms of menopause can actually last through the months or years leading up to menopause. Some other symptoms of menopause include:

  • Vaginal dryness

  • Irregular periods

  • Hot flashes and or night sweats

  • Anxiety/Depression

  • Moodiness and irritability

  • Forgetfulness

  • Fatigue

  • Decreased sex drive

  • Sleep problems

  • Weight gain and slowed metabolism

  • Thinning hair

  • Dry skin

  • Loss of breast fullness

Menopausal weight gain and the role of estrogen:

Throughout a woman’s life, fat deposition will change as hormone levels fluctuate. Specifically, the sex hormone estrogen plays a large role in how fat is distributed throughout the body. Throughout puberty, as estrogen levels rise in girls, fat is distributed throughout the buttocks, breasts, and thighs. Then, during the reproductive years, fat in a woman’s body is deposited in the thighs, buttocks, breasts, and pelvis to provide an additional energy source for eventual lactation and pregnancy.

However, when women begin to transition into menopause, estrogen levels drop and weight distribution changes. As estrogen levels decrease, there is a decrease in lean body mass and fat begins to allocate around the belly. This midsection fat is also known as visceral fat, which we will discuss further late in the article. One study found that visceral fat depots may increase to 20% of total body fat during menopause, compared to only 5-8% in the premenopausal state. This increase in midsection fat tends to lead to a more apple-shaped body.

More on visceral fat:

As mentioned above, visceral fat is fat stored in the midsection. This type of fat sits deep inside the abdomen and surrounds the organs. Visceral fat has been linked to a number of health risks, such as:

  • Heart disease

  • Type 2 diabetes

  • High cholesterol

  • Breast and uterine cancers

  • Strokes

Visceral fat is dangerous because it impacts the release of hormones and proteins that lead to inflammation. This inflammation can cause damage to your arteries and enter the liver and negatively impact how your body breaks down fat and sugar.

Moreover, obese post-menopausal women have an overall higher risk of mortality, with as much as a 4-fold increase in cardiovascular death. Further, the risk of death from all cancers was 62% higher in obese women in comparison to women with a normal weight. Overweight or obese women also tend to have worsened symptoms of menopause like hot flashes.

Decreasing menopausal visceral fat:

If you saw an increase in visceral fat during menopause without changing your diet or exercise habits, it’s important to remember that this is a natural bodily process and to not feel defeated. Further, dieting excessively or over-exercising can actually be harmful. Menopause is a stressful period in a woman’s life which increases the secretion of the stress hormone cortisol. This increase in circulating cortisol will further cause fat to redistribute in the midsection. It may feel like fighting an uphill battle when trying to lose weight during menopause. However, there are several things that can be done in an attempt to lose the belly fat:

  • Think about hormone replacement therapy → With the help of your medical provider, hormone replacement therapy (HRT) could be a great way to prevent negative symptoms of menopause. But is is very important that hormones are given in a bioequivalent method by a physician who is specializes in Menopausal Women. Currently, due to the sensationalized findings of the 1993 Women’s Health Initiative study on HRT, many doctors are not prescribing it. To read more about the problems in the Women’s Health Initiative’s study, click here. The true findings of many researchers after the 1993 study prove that HRT has been demonstrated to:

    • Alleviate menopausal symptoms.

    • Lower risk of death by 39% for women who started HRT before menopause.

    • Improve sleep, muscle aches, and pains in menopausal women.

    • Reduce the incidence of coronary heart disease by 50%, if started within 10 years of menopause.

    • Help prevent osteoporosis and associated injuries.

    • Decrease the risk of heart disease.

    • Slow the progression of atherosclerotic plaques, which lead to heart attacks and cardiac death.

    • Improve symptoms related to vaginal atrophy.

    • Help alleviate depressive symptoms.

    • Increase skin collagen content, thickness, elasticity, and hydration.

    • Help reduce belly fat.

  • Get more sleep → Several studies have found that sleep disturbances can contribute to weight gain in midlife women. One study found that women who slept 5 or fewer hours per night gained more weight than women who slept over 7 hours per night. Such sleep disturbances could potentially be caused by night sweats, changes in mood, sleep apnea, and low estrogen. Chronic sleep deprivation leads to daytime fatigue and a decrease in physical activity. If you struggle to sleep through the night, try these tips to increase your sleep hygiene.

  • Move more throughout the day → Aging is associated with a decrease in physical activity. Moving less is associated with a decrease in lean body mass, which is important for postmenopausal women. Luckily, incorporating more movement throughout the day isn’t too hard, try taking your meetings while standing or including walks in your morning routine. If you’re an exercise novice, click here to see your beginner’s guide to working out.

  • Change your dietary habits → On average, you need about 200 fewer calories per day during your 50s than in your 30s and 40s. These 200 calories can easily be taken out by decreasing added sugars in your diet. Added sugars count for 300 calories per day in the average American’s diet. And, over half of these added sugars come from sugar-sweetened beverages like juice, soft drinks, and flavored waters. It’s also important to prioritize eating a nutrigenomic diet, one tailored to your unique genome. Fasting and tackling overeating may also be beneficial.

  • Seek support → Menopause is hard. Your body is rapidly changing and it will likely result in changes in mood. In fact, nearly 25% of perimenopausal and postmenopausal women see an alteration in their mood. This is because menstrual hormones can impact serotonin release. As we know, serotonin is a chemical in the brain that promotes feelings of happiness. And, as estrogen levels drop, serotonin levels are not far behind. For some women, especially those who have suffered from depression in the past, these falling serotonin levels can set off a depressive episode. During this time, it’s incredibly important to utilize the social support in your life, including family and friends. It might also be necessary to look into other forms of social support like therapy or counseling.

The bottom line:

Menopause is a challenging time for many women. Your body will inevitably change in many ways, including the redistribution of fat into the abdominal region. But also, don’t feel defeated! There are ways to tackle this unfortunate effect of menopause.

At the Johnson Center for Health, we specialize in peri-menopause, menopause and post-menopausal women. We work with our patients to develop a personalized weight loss plan using a detailed personal history, bloodwork, microbiome analysis, genetic testing, and hormone testing. We can work together to tackle menopausal weight gain and get you on the path to optimal health.

To learn more about the Johnson's Center's approach to menopause, click here to contact us! If you have any more questions about your path to optimal health, email our office at or call 276-235-3205.

The Johnson Center for Health services patients in-person in our Blacksburg and Virginia Beach / Norfolk locations. We also offer telemedicine for residents of Virginia and North Carolina!

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