Menopause means different things for different women. Some are thankful to be done with the reproductive stage of their lives, while others think the onset of menopause is the beginning of the end. The end of what, though? Menopause is a time of significant physical, emotional, and psychological change, and it’s important to understand what’s going on inside the female body during this phase of life. What really counts is not that menopause happens—it's inevitable—but how one responds to the changes menopause brings.
Strictly speaking, menopause describes the time in a woman’s life when twelve consecutive months pass without a menstrual cycle. Menopause is divided into three stages: before the change a woman is considered pre-menopausal, around the time of the change a woman is considered peri-menopausal, and after the change a woman is considered post-menopausal. In the U.S. women generally experience the first changes at around age 51.
Every woman’s journey through menopause is unique, but most experience some combination of hot flashes, mood swings, anxiety, loss of libido, weight gain, and depression. For the purposes of this article, we’ll focus on why women tend to gain or hold onto excess weight after menopause, and why it’s hard to keep it off once it’s there.
The primary cause of symptoms associated with menopause is decreased hormone production. The post-menopausal period is characterized by changes in the following:
- Progesterone: Post-menopausal women show a whopping 75% reduction in circulating progesterone levels. This explains the cessation of menstruation, since the main functions of progesterone are thickening the uterine lining to prepare for a fertilized egg and maintaining uterine health during early pregnancy.
- Testosterone: Yes, it’s widely known as the male hormone, but women produce testosterone, too. When production decreases, it affects both muscle mass and muscle repair.
- Estrogens: There are three types of estrogen—estrone, estriol, and estradiol. Of these, the most potent and active form is estradiol. Estradiol production drops about 35% in post-menopausal women.
Changes in progesterone and testosterone contribute to post-menopausal weight gain, but it’s the estrogen family that’s the real difference-maker. Though the overall decrease in estrogen is less than half the decrease seen in progesterone, the consequences are asymmetrical due to the key role estrogen plays in female physiology. The estrogens act on hundreds of different types of tissue: they affect reproductive processes, fat production/storage, muscle mass, muscle repair, stress response, insulin processing, bone health, nerve cells, and the function of primary organs like the liver, kidneys, and digestive system.
Estrogen, Weight Gain, and Metabolism
When estrogen levels go down, two things happen:
- Metabolism slows down.
- Muscle production and repair slows down.
Granted, distilling a discussion of hormones and menopause down to two simple points is a gross oversimplification. Medical scientists and doctors spend almost a decade in school studying women’s health and endocrinology, then practice for decades and still admit there’s more they don’t know than they do know. Stress, sleep problems, and the role of cortisol are relevant areas to address as well—but for the sake of brevity and focus, we’ll leave those for a different article. And for all of us without PhD’s in biochemistry, we’ll stick to metabolism and muscle production/repair because of how they intersect with our subject—weight loss—and address the points one at a time.
Metabolism is a general term to describe the chemical processes that occur inside our cells to maintain life. In this context, metabolism refers to how fast we process energy, i.e. food. The general effect of menopause on metabolism is that the body doesn’t process food as quickly as it used to. This means that if you maintain the same activity level and eat the same amount of food that kept you healthy and thriving before menopause, you’re likely to gain weight after menopause as a result of the hormonally-induced metabolic changes. The decrease in estrogen also makes you more sensitive to carbohydrates, and increases the likelihood that excess carbs will be stored as fat instead of burned right away as energy.
Muscle Production and Repair
This is a one-two punch: a jab, then a stiff cross. Muscle mass naturally declines for both men and women as they age, but when women lose their primary muscle-builder, estrogen, the decline is more pronounced. That’s the jab. Here’s the cross: muscle burns more energy than fat, so when the ratio of lean muscle mass to fat decreases due to reduced estrogen levels, it feeds back—in a negative way—to the menopause-related decrease in metabolic rate. The net effect: weight gain around the midsection. Also, since muscle repair slows down, recovery from injury or exercise induced muscular stress is compromised, which also lead to weight gain.
It would appear the deck is stacked against post-menopausal women who want to either avoid gaining weight or lose weight once it’s there. But appearances can be deceiving. There are tried and true ways to manage weight gain after menopause, and there are strategies you can use to lose unwanted fat, no matter what age you are.
Not to mention the fact you have the collective wisdom of generations of women to draw from. You don’t have to reinvent the wheel. Women have walked this path before, and they know how to help. What you have to do—according to the experts—is take three simple steps:
- Eat sensibly. This is your grandmother’s wisdom combined with modern science. Prioritize high quality food sources rather than just focusing on smaller portions; incorporate moderate amounts of anti-inflammatory fats into a typical day including salmon, extra virgin olive oil, avocado, and coconut oil to name a few. The main component of every meal should include a heavy hand of non-starchy vegetables – no one ever binged off of broccoli, it typically can’t happen given all the fiber and roughage. Finally, honor your hunger and avoid the “I need to lose weight so just cut back on portions and avoid food like the plague” mindset. It is vital to make sure women are listening to and respecting the signals sent from their bodies.
- Stay moving. Moderate aerobic exercise—not intense cardio workouts—improves everything from brain health to metabolism to emotional well-being. Go for walks, spend time gardening, paddle a kayak, or go for a light jog. Elevate your heart rate for a few minutes every day and you’ll quickly notice the benefits. Consistent movement is what matters the most.
- Strength training. We previously covered Three Ways Strength Training Speeds Weight Loss, and in that article, we discussed reasons strength training is a crucial component of any weight loss program. The three reasons cited in that article apply directly to post-menopausal women. Strength and resistance training:
- Increases lean muscle mass while decreasing fat, which maximizes body composition.
- Triggers EPOC, a.k.a "excess post-exercise oxygen consumption.” The EPOC effect keeps the body burning calories for up to 38 hours after a workout.
- Optimizes hormone levels related to hunger, metabolism, and stress, which ultimately lead to positive weight-loss outcomes.
Weight Loss at Skyterra
In yet another recent Skyterra article, How to Find the Right Weight Loss Retreat for You, we discuss pinpointing the right weight loss retreat to help you become the happiest, healthiest version of yourself. At Skyterra in particular, we specialize in creating custom weight-loss programs tailored to meet the specific needs of each individual. When you come for a visit, we’ll assess every aspect of your life, from your age to your goals to your medical history to your lifestyle, then together come up with a plan that works for you. We’ll make sure you can apply the plan when you get back home. Come to us with your goals, and we’ll work with you to create a health and wellness plan that’s practical and leads you to the life you want to live. And if that means losing weight after menopause, then come see us here in the beautiful Blue Ridge mountains of Western North Carolina.
We can’t wait to meet you.