Menopause: How to take charge and keep the weight off

Dr. Elaine Chin gives us her plan of attack for moving through menopause to a healthier, happier you

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Menopause is a phase in every woman’s life. “It’s not a disease,” says Dr. Elaine Chin, the visionary behind Executive Health Centre and a Chatelaine health advisor. It can start as early as the late 30s or as late as the early 50s, when the ovaries’ egg supply starts to decline. This drop triggers hormonal changes, which sets off different reactions throughout the body, including (but not limited to) hot flashes, night sweats, irregular periods, mood swings, depression, changes in libido, severe headaches and weight gain. Left unmanaged, these symptoms can continue for as many as eight years before a woman’s menstrual cycle ends.

Changes in hormones also affect the strength of bones, heart health and blood sugar levels. That makes menopause management two-fold: It’s about addressing changes in quality of life and controlling disease risk. Now is the time to be vigilant for hormone-driven cancers (regular screening is often advised), osteoporosis from declining growth hormone and calcium levels, and cardiovascular- and diabetes-related issue from rising cholesterol and stress hormone levels.

Why weight gain weighs more now
Hormone fluctuations also play games with body weight. In the late 30s, the body may slow down how it metabolizes sugars and carbs. The main culprit? Declining estrogen levels. As the ovaries generate less of this hormone, they put pressure of the rest of the body to produce corresponding hormones to fill in the gap. Cortisol levels are often thrown into whack, and this stress hormone promotes extremely stubborn belly fat. “Most women gain 10 to 15 percent of their body weight as a result of fluctuating estrogen levels,” says Dr. Shelley Burns, ND the director of health services at Executive Health Centre.

Diet and supplements
Portion control and a clean diet high in omega-3 fatty acids and protein from vegetable sources like quinoa can help steady unruly hormones. In a recent study reported in the journal Menopause, researchers found women on low-fat diets were three times more likely to lose weight, in addition to reducing hot flashes and night sweats, compared to women who didn’t modify what they ate in mid-life. Chin and her team often recommend a diet that favours phytoestrogen-rich foods, like soy, lentils, nuts and green and yellow vegetables. The foods to avoid? Caffeine, aspartame (in diet sodas and sugar-free alternatives), refined carbs, red wine and peanuts.

Chin also may recommend natural sleep aids like valerian and melatonin, and advise on upping vitamin E, calcium and magnesium. Burns may suggest complementary herbal supplements like dong quai, red clover, chaste berry, black cohosh and licorice root. “When we talk about natural supplementation, which can be hugely beneficial, we think ‘natural’ always means safe but that’s not necessarily the case,” says Burns. “That’s why it’s so essential to work with doctors to look at blood work and screening, like mammograms and bone density tests, to make sure we’re not causing any aggravation to the body. It’s a case of buyer-beware, and that’s why I always recommend speaking to a healthcare professional before taking supplements.”

Fitness
Staying active helps combat stubborn belly fat. Researchers at Duke Medical Center found moderate activity (walking or jogging 12 miles per week in this case) was one of the best ways to tackle hormone-driven fat. “When you get fit, your body gets going again,” says Roberts. Yoga has also been loosely linked with increases in progesterone levels, which can promote greater feelings of calm.

Hormone therapy
Supplementing low levels of hormones can relieve the worst symptoms of menopause. These might include bio-identical hormones, which are synthetic derivatives that mimic estrogen. They can cause headaches and water retention, as well as increase the risk of breast cancer and blood clots, which is why these options should be carefully considered with your doctor. “When it comes to hormone replacement, or anything like that, every woman needs to make sure every piece of the health puzzle is thoroughly examined. We never start treatment until we have a good full screening,” says Chin. 

Other options
Acupuncture and two-percent natural progesterone cream have been shown to reduce hot flashes and migraine headaches. 

What to look for
There’s a science and an art to menopause management, says Chin, and it centres on how well your doctor can read your numbers from blood and salivary hormone tests.

Here’s a brief breakdown
Blood sugar: Hemoglobin A1C levels should be below six percent. Higher levels may signal increased diabetes risk.

Cholesterol: High levels of LDL (bad cholesterol) indicate increased risk for heart disease.  

Cortisol: Unbalanced levels can cause sleep difficulty and make your body feel under attack so it won’t let go of fat as easily.

Estrogen: Declining levels affects menstruation, bone density, sleep cycle, mood and libido. Low levels can increase bad cholesterol and also warp the area in the brain that regulates temperature, which may contribute to hot flashes and night sweats. Low levels are also linked with increased levels of cortisol.

FSH: Stands for follicle-stimulating hormone. It regulates the production of estrogen. Higher levels contribute to hot flashes, decreased libido and irritability.  

Growth hormones: Low levels increase the risk of osteoporosis and weight gain. That’s because in addition to helping build bone and tissue, growth hormones also work with metabolic hormones to regulate weight.

Inflammation: Certain markers can indicate early organ damage (particularly as it relates to your heart).

Leptin: If levels of the hunger hormone are high, you may overeat unintentionally.

LH: Stands for luteinizing hormone. It works with FSH to stimulate the production of testosterone. Higher levels let your doc know you’re starting menopause.  

Progesterone: Lower levels occur at least a few years before periods become irregular and may be the reason you feel exhausted or anxious.

Testosterone: Low levels have been found to increase depression in menopausal women.

Discover other helpful tips for managing menopause at MenopauseCanada.com.