The Menopause Belly
We are inundated, and have been for as long as anyone’s memory stretches back, with messaging about what an ideal female body should look like. Between diet culture, shifting fashion trends and the crescendo of social media: it’s a mess of messaging, fact, myth and everything inbetween. At Vitality, we believe in core tenets of evidenced-based information and education to help you be your optimal self. We never want to see the return of low rise jeans with thongs peeking out the back, and we never want you lost in a minefield of pseudoscience, unhelpful fad diets, ineffective therapies or harmful supplements.
Today we are starting a deeper dive into how the female body changes during perimenopause and menopause. These changes are real. They are caused by your changing hormones. You are not lazy. You are not unmotivated. Working out harder is not the answer. Eating less calories is not the answer. Let’s take a look at what is going on so you can start to build a toolkit for managing the changes your body is going through and work with your physiology instead of against it.
The Backgroud
Women often have difficult relationships with our bodies. Between the confusing and conflicting messages from well-meaning but misguided family, the entirety of the 1970’s and 1980’s diet culture, and the constant barrage of societal messaging it’s easy to see why. There are as many diet trends out there as uninformed wellness personalities who don’t understand the hormone changes in women’s bodies. They promise menopause relief in 24 hours with a supplement only they sell, or offer one workout move that will change your life. There is no science in these claims, but there is a reason women spend thousands of dollars on them. Women in menopause are desperate. Their bodies and minds feel disconnected from the self they used to know and the changes do not feel welcome. Menopausal women are prime targets for the promise of a quick fix to get the sweats, brain fog, anxiety and weight gain to stop. One reason menopausal women struggle with body composition changes is because they continue the same exercise and nutrition they always have. Unforunately, because of cellular and metabolic changes , that no longer works. Let’s look at what we know actually works.
The Facts
Women’s bodies change with age. Hard stop. As we age, our available hormones (primarily estrogen) change. The new deposit of belly and midsection fat that seems to arise overnight is one of the first symptoms women talk to me about. As one client recently said, “I’ve never had a belly. And this (wildly gesturing to her lower belly) feels like some alien visited me in the night and plopped this thing down and no matter how hard I work out it doesn’t go away and maybe I’m crazy but it seems the harder I work out the worse it gets”. She’s not crazy, and neither are you if this is your experience. What’s happening to your body is driven by changes in your hormone levels which fluctuate in perimenopause and decrease in menopause. This seemingly abrupt change can feel frustrating, confusing and can increase symptoms depression and anxiety. Understating the changes your body is going through and learning how to work with it rather than against it is our goal. I want to acknowlege how hard this change is on your mind and body, while giving you tools to do something about it. The science behind hormone changes is complex and you can look forward to hormone specific blog posts in the near future to help demystify the concepts.
The Science
In medicine, we call fat, adipose tissue, which comes in two varieties: subcutaneous and visceral.
SUBCUTANEOUS: This is the fat you can pinch under your skin and is throughout your body. It’s usually fairly evenly distriuted and can be changed through exercise, weight lifting, nutrition changes etc. As hormones change and withdraw from the system, the way the body processes fats changes, which can lead to extra unwanted fat if our habits don’t change.
VISCERAL: This is the dreaded “menopot”. This fat is internal and surrounds the organs in the abdomen. We need this fat because it supports or organs, but too much of it leads to resistance in insulin and increased inflammation which are risk factors for diabetes, high blood pressure, cardiovascular disease and other metabolic syndromes. As women enter perimenopause and menopause, this is the fat we want to prevent and/or lose to reduce disease risk. You cannot diet your way out of this kind of fat. It takes specific exercise training regimens and nutrition changes to manage, but it is possible, even if you are postmenopausal.
The Answers
SCIENCE : DEXA scan is the gold standard to measure fat, muscle, and bone density. It provides an android/gynoid ratio, which tells you about the risk of heart and metabolic diseases based on belly fat. It also gives you details about your body composition. By comparing scans over time, you can see how your body has changed. Vitality has the only publically available DEXA outside Seattle. Schedule your DEXA to have a starting point and ongoing data to track your changes.
EXERCISE: The best way to support lean muscle during hormonal changes is lifting heavy weights. Your body needs a mix of high intensity interval training (HIIT) and heavy weight training. The days of spending an hour on the treadmill walking or zoned out on the eliptical are gone and will only make the fat deposition worse.
NUTRITION: To key to nutrition in hormone change is balancing carbohydrates, fats, and proteins without using ultraprocessed foods, added sugars, or excessive alcohol. This combination can reduce inflammation and support hormone function in your body. If you have a sweet tooth, lean in close. Consuming more than 25g of added sugar daily can harm your body's functions and hormones and promote more belly fat deposition. Aim to consume at least 20g of fiber and around 120g of protein each day. It may seem like a lot, but there's scientific evidence to support the need for increased protein in women experiencing perimenopause and menopause. We will delve deeper into this topic in a future nutrition post.
STRESS: You don't have to check the boxes of the social media guru, meditating for an hour, doing yoga twice a day, going on long walks in nature, and only listening to classical music during your cold plunge, because that's not realistic. But you can to find ways to reduce stress in your every day routine. Can you relax your shoulders? Can you take 5 deep belly breaths while waiting in the carpool line? Can you use a 5-minute meditation app during a break at work?
SLEEP: Getting enough sleep is vital for healing, hormone regulation and your mental health. To improve your sleep, try keeping your room cool, keeping your phone away from your bed, and establishing good sleep routines. Additionally, there are hormonal and medical treatments available to help women with sleep during this transitional phase. If you have concerns about sleep apnea please bring this up at your consultation so we can address it.
SUPPLEMENTS & MHT (HRT): There are both non-hormone and hormone treatments available to support menopause changes. Omega-3 and fiber are beneficial for reducing visceral fat. Ashwaganda and reishi can help with energy and sleep. Eating fermented foods helps maintain a healthy gut bacteria balance, especially as estrogen levels decrease. Hormone therapy is not suitable for everyone, but we can talk about it and see if it's right for you.
Perimenopause and menopause are real. We cannot stop the rapidly fluctuating hormones of perimenopause nor the withdrawal of estrogen in menopause. We can, however, develop an evidence-based toolkit to help you manage the symptoms, prevent bone loss and extra fat deposition, build muscle, maintain your mental and emotional health, maintain your sex drive and build community through education. Schedule your consultation with us today and let’s work together navigate the new you.