Menopause is not just a hormonal change it is a METABOLIC change. There is a LOT we can do to avoid weight gain, brain fog, hot flushes and many of the other unwanted symptoms that can accompany menopause if we understand what is going on inside our body.
Oestrogen has many roles in the body and its important to understand these so that we can learn how to modulate the impact of it’s initial wildly fluctuating levels (peri-menopause) and then adaptation to lower levels (menopause). Some of the roles oestrogen are:
- Sensitises cells to insulin (our hormone that gets sugar out of the blood into the cells) and thus has a huge role in carbohydrate metabolism.
- Oestrogen is an appetite suppressant.
- Oestrogen plays an important role in lipid regulation – one of the reasons one can see cholesterol markers rise as approaching menopause and pressure to go on statins.
- Muscle growth stimulus – loss of oestrogen makes a woman more at risk of sarcopenia. This is more than just loss of muscle tone. Muscle is one of biggest metabolic organs. More muscle loss has been shown to independently contribute to insulin resistance (pre-cursor to diabetes). Lost muscle is then replaced by fat – you could consider this as osteopenia of the muscles.
We do still produce oestrogen in menopause but not from the ovaries – two main sources in our body where we can produce it ourselves – our adrenal glands and from fat tissue. When you understand this it becomes easier to see why managing stress (demand on adrenal glands for cortisol and adrenaline) is such a big driver of worsening menopause symptoms.
In simple terms, if the adrenal glands are working at max capacity to produce your stress hormones (cortisol and adrenaline) as fight or flight hormones, the production of these will take precedence over the production of oestrogen. THEN – the body will look elsewhere – and it will look to hold onto fat tissue. Thus LINK weight gain, stubborn fat gain around the middle.
Another factor that may be contributing to stubborn weight gain is training in a fasted state. I see this frequently with clients who come and train fasted in an attempt to lose weight. However, this frequently results in the opposite as it is creating a large stress response: cortisol has to be produced to produce glucose so an additional adrenal demand (most of us have too much of this in day to day life without asking our body for more!), this is placing your body in a catabolic state (one of tissue breakdown and remember its vital to PRESERVE MUSCLE MASS), increasing inflammation and resulting in the body holding onto fat.
An added demon can be is that our blood sugar may then crash later on, we think it’s ok as we’ve not eaten and reach for a carby sugary meal or snack to give us a pick up, leading to a roller coaster blood sugar rise and potentially contributing to insulin resistance if this is a pattern we repeat day in day out.
SO what do we need to do?
- Start early!! The earlier you address weight gain and other unwanted symptoms the easier it is to reverse it. Learn to understand your own body’s unique responses to food – this is powerful information.
- Ensure a robust nervous system – so that your body can provide a healthy response to stress and the adrenal glands have healty reserves as oestrogen from the ovaries declines. With my clients I use FIRSTBEAT to monitor this and as a coaching device.
- Learn how to time your carbohydrates – be careful with intermittent fasting – this can be useful in terms of eating in a certain time window but as mentioned, be careful of fasted training and typically I find 12-14 hours is long enough for women.
- Protein – 25-30g of protein with each meal as a minimum, protein should be added to most snacks too, especially after training. Before can be useful too in some circumstances.
- Look at your thyroid – check it is working well – no autoimmunity that is not being managed or sub-clinical hypothyroidism (common in busy athletes).
- Take care with xenostrogens – these are synthetic oestrogens found in the environment, commonly in hormones in some animals products, plastics and make-up. They can block oestrogen receptors and cause disruption to our hormone system. Assess your lifestyle and where exposure may be coming from.
- Do include natural phytooestrogens such as fermented soy (not processed soy) and ground flax, lignins, that have been shown to safely modulate the action of oestrogen.
- Combine the above with Mediterranean principles – exactly how you do this will depend on body type and your current metabolism (need to test) but the key principles are plenty of healthy fats, good quality protein and plenty of vegetables and fibre – look for lots of colour on your plate and diversity.
- Testing to consider – fasting insulin, HBA1c, thyroid function (including T3), homocysteine, a comprehensive lipid panel, immune function, RBC magnesium (more to follow on why serum magnesium is not sufficient), a full iron panel and vitamin D are good starters.
- Discuss HRT with your Doctor. As a nutritional therapist I cannot advise on HRT but I do recommend testing what is happening to any exogenous hormones you are taking and how you are breaking them down. You cannot tell this in blood – a test known as a DUTCH test using urine is needed. This test uses dried urine at 4 or 5 different points in the day to look at the metabolites of oestrogen some have a greater cancer risk factors than others so you want to know which pathways are being favoured). Contact Katherine if you want to know more on how to arrange this.
You can read more about the various packages Katherine offers including 6week and 3month Executive Packages for time-pressed professionals here and if you’d like to find out more how you can work with Katherine, please do get in touch directly at info@kchnutrition.co.uk
