Perimenopause, Midlife and Body Changes – Butterfly Effect?!

Weight gain is a symptom of perimenopause and menopause experienced by 60% to 70% of women in midlife. On average, women between the ages of 50 to 60, gain 1.5 pounds (0.86 kilogram) per year during their midlife period though this can vary from person to person.

The Midlife Shift: How Your Body Changes During Perimenopause and Menopause

Midlife is a period of big changes for women, especially as they approach perimenopause and menopause. These changes, caused by shifting hormones and the natural aging process, have a major impact on body weight, shape, and nutritional needs. Understanding what’s happening in your body during this time can help you manage health risks and stay well.
Body weight changes happen, but we can stay healthy and accept our new butterfly form! (Grammatikopoulou et al., 2022)

What causes midlife weight gain?

Women in midlife gain weight more easily because of a mix of aging, changes in hormones, and lifestyle factors. As we age, women tend to store more body fat than men. Hormonal changes during perimenopause contribute to weight gain (Kim et al., 2022).

What hormonal changes are we talking about?

Drops in:

• Estrogen 
• Progesterone

 Changes in:

• Insulin – blood sugar regulator 
• Cortisol – stress hormone
• Leptin – appetite control
• Ghrelin – hunger hormone 
• Melatonin – sleep hormone

These hormones affect fat distribution, appetite, metabolism, sleep and stress levels, all of these play a role in how weight is gained and where it is stored. These changes in hormones, leads to more fat around the belly and less muscle, your body uses energy more slowly and that makes it easier to gain weight (Ray et al., 2023).

How can perimenopause change your body shape?

As estrogen levels drop during menopause, women often see an increase in belly fat and a decrease in muscle mass. This not only changes how we look but also raises the risk of serious health problems like heart disease, insulin resistance, and metabolic syndrome. Energy use or metabolism slows down during menopause, which can lead to more fat, especially around the abdomen.

Different racial and ethnic groups may experience these changes in different ways. Some research suggests that African American and Hispanic women might see more changes in fat distribution compared to Caucasian women.

Intermittent Fasting: Is It Right for Perimenopausal Women?

Intermittent fasting has become a buzz trend recently – with some interesting research showing its impact on weight gain and our immune systems. But, is this recommended for women in the perimenopausal transition?

Intermittent fasting (IF) can increase glucose tolerance, lower blood cholesterol, and lower fasted insulin levels. Research has shown that women over the age of 60 lost 2 kilograms of an average body fat after following six weeks of daily 16/8 daily intermittent fasting plan (Domaszewski et al., 2020).

But there are a number of things to consider for women in perimenopause – we’ve summarised these below:

Evidence for Intermittent Fasting (IF) for Perimenopausal Women:

1. Weight Management: Multiple studies show that intermittent fasting (IF) can help with weight loss and reduce waist circumference, which can be particularly beneficial for women during perimenopause. One meta-analysis of 43 randomized controlled trials (RCTs) found that IF was effective in reducing body fat and waist size compared to non-intervention diets. It also improved insulin resistance and blood lipid levels, which are common concerns during perimenopause​ (NEJM)​(Frontiers).
2. Hormonal Balance: IF may influence hormone levels, especially insulin and cortisol. Improved insulin sensitivity from fasting helps manage blood sugar, which is crucial during perimenopause when insulin resistance can increase. Time-restricted eating (TRE) has been shown to regulate sex hormones, although results in this area are still emerging​ (ScienceDaily)
3. Inflammation and Metabolic Health: IF can reduce markers of inflammation, which is particularly useful for women at increased risk of chronic conditions like cardiovascular disease during perimenopause ​(NEJM).

Drawbacks of Intermittent Fasting for Perimenopausal Women:

1. Hormonal Disruptions: While IF can improve some aspects of metabolic health, it may also exacerbate hormonal imbalances. Extended fasting can elevate cortisol, the body’s primary stress hormone, which could worsen symptoms like fatigue, sleep disturbances, or mood swings​ (NEJM).
2. Risk of Nutrient Deficiency: IF, especially when combined with calorie restriction, may lead to nutrient deficiencies, which is concerning for bone health during perimenopause. Lower estrogen levels already increase the risk of osteoporosis, and nutrient deficits could aggravate this ​(Frontiers)
3. Muscle Loss: There is also concern that IF may lead to muscle loss if not combined with adequate protein intake or resistance training, which is crucial during perimenopause when muscle mass naturally declines ​(Frontiers, ScienceDaily)

In conclusion, IF can offer some metabolic and weight management benefits during perimenopause but also carries risks related to hormone balance and nutrient sufficiency. It’s essential to consult with a healthcare provider to tailor the fasting approach to individual needs and ensure it is sustainable.

Don’t worry, there are other solutions!

Absolutely, you can face severe symptoms during your perimenopause and menopause. But, there are always solutions. Why don’t your lifestyle, eating diet and personalized care pass over all of this. Start changing your fats to your passion!!!

• Eating Right for Midlife Health
  • Protein and balance: As your body changes during midlife, your diet needs to change too. Eating a balanced diet is essential for managing your weight. Experts recommend focusing on a diet rich in protein to help maintain muscle and cutting down on refined carbs and unhealthy fats to manage weight and reduce belly fat. Never forget you are not the same as before. So, natural food like fruits and vegetables must be top of mind also and even with meat, it must not be preserved. 
  • Don’t Forget about Fiber: Fiber-rich foods are also a key to improve insulin sensitivity and supporting a healthy weight. Supporting digestion, maintaining weight, controlling sugar in blood and preventing depression.

• The Power of a Healthy Lifestyle

Eating well is an important factor, combining it with regular physical activity is even better. Regular physical activities are keeping muscle mass, losing fat, and improving heart health. Staying active helps counter the slowdown in metabolism that comes with aging (Juppi et al., 2022).

• How about the condition that can need MHT?

Perimenopausal women who are overweight are more likely to need menopause hormone therapy (MHT) due to their symptoms. But, MHT can increase the risk of blood clots, heart problems, breast cancers and endometrial cancers. That’s why, it’s important to consider carefully whether MHT is the right choice or not. If MHT is still needed, it’s best to use the lowest possible dose of estrogen and should be used only for a short time (Opoku et al., 2023).

I was promised HRT would help with weight loss, but my belly is still doing its own thing. HW, USA

• Personalized Care might be more accessible soon…

With Artificial Intelligence (AI) rapidly developing, it might soon become much easier to get  personalized care according to your specific needs (Garg et al., 2024).
Watch this space – we aim to bring you news of all the latest AI and femtech tools that might help people navigate major hormonal transitions in life.

Conflicting Advice: Navigating Midlife Nutrition and Health Tips

As women approach midlife, we will encounter a flood of sometimes contradictory advice on how to maintain our health. For example, one common piece of advice is to eat more protein to preserve muscle mass as metabolism slows down. But at the same time, women are also told to cut calories to prevent weight gain. Balancing these recommendations can be confusing and frustrating. What we must do is listen to our bodies, and determine what might be right for each of our individual needs.

In Conclusion

Midlife and menopause are important times for a woman’s health, bringing significant changes in body shape and weight that can have lasting effects. Considering that women may spend 30-40% of their lives after menopause, it’s really important to keep a healthy body weight and composition for reducing the risk of chronic diseases like heart disease, type 2 diabetes, and certain cancers.

We can make changes now, no matter what stage of our lifetime reproductive cycle we are in. A healthy lifestyle like eating a balanced diet and staying active, is a key for managing these midlife changes and improving your health. By understanding what drives weight gain during midlife and adjusting nutrition and lifestyle strategies, women can better navigate this transition and maintain their health and well-being into later life.

References

1. Grammatikopoulou, M. G., Nigdelis, M. P., & Goulis, D. G. (2022). Weight gain in midlife women: understanding drivers and underlying mechanisms. Current Opinion in Endocrine and Metabolic Research, 27, 100406.
2. Opoku, A. A., Abushama, M., & Konje, J. C. (2023). Obesity and menopause. Best Practice & Research Clinical Obstetrics & Gynaecology, 88, 102348.
3. Domaszewski, P., Konieczny, M., Pakosz, P., Bączkowicz, D., & Sadowska-Krępa, E. (2020). Effect of a six-week intermittent fasting intervention program on the composition of the human body in women over 60 years of age. International journal of environmental research and public health, 17(11), 4138.
4. Juppi, H. K., Sipilä, S., Fachada, V., Hyvärinen, M., Cronin, N., Aukee, P., … & Laakkonen, E. K. (2022). Total and regional body adiposity increases during menopause—evidence from a follow‐up study. Aging Cell, 21(6), e13621.
5. Kim, S., & Won, C. W. (2022). Sex-different changes of body composition in aging: a systemic review. Archives of gerontology and geriatrics, 102, 104711.
6. Ray, E., Maybin, J. A., & Harper, J. C. (2023). Perimenopausal women’s voices: How does their period at the end of reproductive life affect wellbeing?. Post reproductive health, 29(4), 201-221.
7. Garg, R., & Munshi, A. (2024). Revolutionizing Menopause Management: Harnessing the Potential of Artificial Intelligence. Journal of Mid-life Health, 15(2), 53-54.
8. https://www.youtube.com/watch?v=jO361hKsgUI | Weight Changes during the Perimenopause and Menopause