THEWeight gain is one of the most common fears women have when they think about menopause. But talking about “hormones’ fault” is an understatement. More than the weight itself, the body composition certainly changes and many interconnections of hormonal, metabolic and psychological origin change with sometimes a boomerang effect on each other, like an orchestra that becomes out of tune.
What promotes the increase in adipose tissue
We know well that one of the most striking symptoms of perimenopausal women are hot flashes, but we don’t think about how those frequent nocturnal awakenings related to them are a harbinger of a loss of circadianity in the production of cortisol, which upsets its rhythms by increasing the production of glycogen, favoring resistance to insulin and the consequent increase in its production, which in turn promotes lipogenesis (increase in adipose tissue).
The estrogenic decline favors the redistribution of fat towards the visceral abdomen (rather than on the breasts and hips) according to a metabolically more active android model associated with greater cardiometabolic risk. In parallel muscle mass is reduced, resulting in a drop in basal metabolism.
The body consumes less energy
This means that, even with the same diet, the body consumes less energy. Observational studies published in internal medicine journals show that lThe average weight gain during menopause is modest, while the change in the fat/lean mass ratio is more marked.
They have a decisive impact also non-hormonal factors: sedentary lifestyle related to asthenia which often arises from unrestful nights with fragmented sleep, which in turn generate chronic stress, inability to sustain the same professional rhythms as before with the same energy with which one was able to face the long days of modern women who are increasingly performing and multitasking. All this creates enormous discomfort and stress that we vent with craving (compulsive attitudes towards food that becomes comfort food).
How important is lifestyle
According to the North American Menopause Societylifestyle weighs more than the endocrine transition on final weight gain, but I must say that sedentary lifestyle often arises precisely from the inability to continue to find the same energy for daily management: and this is sometimes a source of depression.
It is therefore clear that menopause truly represents a chain of events that intertwine, giving rise to one another. And we find ourselves like Patients often tell me: “in a body I no longer recognize.”
Myths to dispel
A myth to dispel concerns hormone replacement therapy: it does not cause significant weight gain. On the contrary, it can contribute to rediscovering that lost harmony primarily with a rediscovered quality of life, sleep of circadian rhythms, with a less visceral fat distribution and better preservation of muscle mass, as also reported by European Menopause and Andropause Society.
What should be done then?
However, truly effective strategies always include physical activity which must and can never be missing: strength training, adequate protein intake, quality of sleep and stress management. In other words, the Menopause requires a “metabolic reset”, not resignation.
The central point is not just how much you weigh, but how the body changes and how to keep it metabolically healthy in the long term we have ahead of us possibly of healthy longevity.
Doctor Cinzia Polo
Doctor Cinzia Polo.
Specialist in Gynecology and Obstetrics, Menopausologist, la Doctor Cinzia Polo for years it has been carrying out dissemination and training work on the physical and psychological transformations that accompany menopause, with the aim of giving women a freer, more informed and positive approach.
Co-founder and vice-president of the Association Menopauseboost, Dr. Polo is also part of the parliamentary commission established for women’s rights which brought the revision of the leaflets to the attention of both the Chamber of Deputies and Montecitorio.
In this column, the expert answers the most current and useful questions to help women better experience the delicate period of menopause through the sharing of scientific information.
