Perimenopause And Weight Gain

Introduction

Perimenopause is a natural process during which the body starts to transform itself to menopause. During this transformation, the female reproductive organ lowers the level of hormones produced, which leads to irregular menstrual cycles.¹

Understanding perimenopause

Perimenopause starts about 8 to 10 years (usually at the age of mid-40s or earlier) before menopause. The duration of perimenopause varies from female to female, but the average duration is about 4 years. When you haven’t experienced periods for more than 12 months, this indicates that you have entered menopause.¹

Throughout perimenopause, hormonal levels fluctuate, resembling a roller coaster ride. This fluctuation is caused by decreased levels of oestrogen. Oestrogen is produced by the ovaries and is essential for the function of the reproductive system. When oestrogen levels gradually decline, the levels of progesterone and testosterone produced by the ovaries are disturbed.¹

Symptoms of perimenopause

Since adolescence, your body has been generating oestrogen. When your oestrogen levels start to drop, your body has to adapt to the new hormonal balance.

Although the symptoms differ, most persons have at least one of the following:

1. Irregular or absent intervals of time
2. Heavier or lighter-than-normal periods
3. Hot flashes or an intense, transient sensation of warmth all over your body
4. Uncomfortable and dry vagina during sexual activity
5. Urinary urgency: the need to go to the bathroom more often
6. Issues with sleep (insomnia)
7. Alterations in mood, such as depression, impatience, or mood swings
8. Weight gain⁶

Causes of weight gain during perimenopause

Weight gain during the perimenopause is substantially impacted by hormonal changes. There are several reasons for this:

• Metabolism slows down - Hormonal changes may cause a slowdown in metabolism, which makes weight gain easier
• Enhanced Appetite: Hormonal fluctuations may intensify appetite, which may result in overindulging
• Fat Redistribution: Belly fat, or the accumulation of fat around the abdomen, is a common result of lower oestrogen levels

Further research has found that there are various changes in women's body composition. This entails an increase in waist circumference, a decrease in muscle mass, and an accumulation of fat around the belly. A poor diet, inactivity, and insufficient sleep are examples of lifestyle variables that might exacerbate weight growth.³

Health risks associated with weight gain

Carrying extra fat leads to serious health consequences such as heart disease, type 2 diabetes, musculoskeletal disorders like osteoarthritis and specific cancers like endometrial, breast and colon. These conditions can lead to substantial disability and death. 

Body size has a biological link with a higher risk of having mental health disorders, including anxiety, depression, bipolar disorder and eating disorders.³ 

Managing weight gain during perimenopause

Reducing the likelihood of weight gain can be achieved by :

1. Eating Habits
   • Emphasise a diet that is well-balanced and abundant in fruits, vegetables, whole grains and lean proteins
   • Limit your intake of high-fat, sugary, and processed foods
   • Take note of portion proportions to prevent overindulging
2. Frequent Exercise
   • Combine strength training with cardio exercise ( such as swimming, jogging, and walking)
   • Try to get in at least 150 minutes a week of moderate-to-intense activity
3. Stress Reduction
   • Use calming methods like mindfulness, meditation, or deep breathing
   • Take part in enjoyable and relaxing hobbies or pastimes
   • Consult your family, friends, or support networks for assistance
4. Adequate Sleep
   • To enhance the quality of your sleep, create a consistent sleep schedule 
   •  Reduce the amount of time you spend on screens and coffee before bed to create a peaceful sleeping environment
5. Observation and Expert Advice
   • Maintain a record of your weight, food, and exercise to see trends and make changes
   • For individualised guidance, speak with physicians, dietitians, or fitness experts²

Medical and alternative treatments

Menopause symptoms are treated with hormone replacement therapy (HRT). Hormone replacement therapy (HRT) replenishes the depleted hormones in your body, particularly in those in their 30s and early 40s. Most patients find that their symptoms go away after their hormone levels rise. In addition, HRT can aid in the treatment of osteoporosis and osteopenia, which are prevalent conditions among individuals classified as female at birth (AFAB) due to insufficient oestrogen.⁴

Other treatments could relieve your symptoms if hormone replacement therapy (HRT) doesn't work for you. You can inquire with your physician if any of these would be effective:

1. Over-the-counter (OTC) lubricants for vagina
2. Antidepressants for hot flushes
3. Selective oestrogen receptor modulators (SERMs) for sex pain and hot flashes
4. Hot flashes and sleeplessness can be treated with clonidine, gabapentin, or oxybutynin
5. The FDA has approved both fezolinetant and paroxetine as a treatment for hot flashes
6. Alternative therapies (acupuncture, herbal remedies)⁴

Practical tips for coping

In terms of taking care of yourself during this period, make the following changes to your health:

1. Changing to a healthier diet
2. Boost your quality of sleep
3. Exercise to help with stress management and ageing well
4. Handle stress by engaging in constructive self-talk, self-compassion exercises, talking through feelings, mindfulness, meditation, and social support
5. Consult a psychologist to comprehend the shifts, manage to balance many responsibilities, and deal with loss of identity and sadness⁵

Conclusion

Getting through the perimenopause doesn't have to be stressful. You may improve your health and well-being by putting useful methods into practice and having a thorough awareness of the variables that contribute to weight gain. To take charge of this significant time in your life, adopt a healthy lifestyle that includes regular exercise, investigating treatment choices such as hormone replacement therapy, and adopting a nutritious diet.

It all comes down to empowerment, self-care, and education. Choosing better foods, exercising, or seeking advice from experts are all steps that take you closer to a more satisfying perimenopausal experience. Never forget that you are not travelling alone. You may effectively control perimenopausal weight gain and confidently enter this new chapter of life with the correct assistance and perseverance.