By The MotherMind Doctor
‘The Change,’ as some people euphemistically call menopause, does actually change lots of things for a woman’s body as well as emotionally.
Hormonal changes include decreasing levels of oestrogen (called oestrodiol) which in turn lead to the body compensating in other ways.
It attempts to produce a type of oestrogen (called oestrone) from fat cells but it is less effective and more inflammatory than oestradiol.
Reduced oestrogen hormone can cause changes in fat distribution or, less affectionately called, middle aged spread. This results from increased fat around your waist rather than hips and thighs (a "spare tyre") which is annoying visible. But it can also increase internal (or visceral) fat associated with higher cardiometabolic (heart health) risk.
1. Lower oestrogen affects metabolism.
It can lead to higher blood sugar (glucose) and insulin levels in general, as well as higher levels of after-meal blood sugar levels (or postprandial glycaemia). Too much of the wrong type of foods can lead to changes in the gut microbiome and further add to the problem.
Other hormones also impact appetite. Increased hunger can result from increased ghrelin ( an appetite stimulant) or leptin resistance (an appetite suppressant).
This all means post-menopausal women tend to weigh more, crave more sugary foods plus have higher blood sugar (glucose) and insulin levels.
The impact of menopause has far reaching effects:
2. Oestrogen also affects the sympathetic nervous system.
Low oestrogen triggers fight/flight/freeze responses leading to a sense of not coping as well as increased stress hormones (adrenaline, cortisol). And cortisol-induced glucose release (from the stress response) can lead to fat storage when not used up (to fight of those perceived life threats).
3. The inflammation that follows a drop in oestrogen can lead to joint pain (and increased risk of osteoarthritis). This in turn means you exercise less if you experience pain which can then contribute to increased weight (from slowed metabolism as well as more time to eat those sugary foods). Let’s not forget the increased risk of osteoporosis which is a more talked about consequence of menopause.
4. Then there is the impact of lower oestrogen on sleep.
Hot flushes and night sweats can wake you during the night. Disrupted melatonin and cortisol levels can impact your sleep pattern. Anxiety and night-time hunger cravings add fuel to the fire.
Menopause also reduces testosterone.
This is the hormone traditionally talked about in men but in fact everyone has some levels of each. When the level drops for women, this reduces muscle mass and lowers energy levels. Plus it contributes to a lower baseline metabolic rate as well as impact on cognition (or brain fog).
Neurotransmitter changes occur in menopause.
Fluctuations in dopamine, oxytocin, and serotonin all impact on mood and reward centres. Many women who had previous mood changes around periods (menses) find this particularly affects them.
Seratonin is related to mood and is produced in the brain and gut. Dopamine can be linked to repeated patterns of behaviour such as comfort eating at the end of of a stressful day and also impact concentration. Sufferers of ADHD like symptoms can intensify around this time.
Post menopausal women can also suffer from poor sleep, joint pain, increased stress, low or irritable mood.
No wonder it’s called The Change.
But there are options to address these issues and your health professionals can help to navigate this if they have knowledge about menopause treatments.
HRT (or hormone replacement therapy) is one such treatment that had a bad reputation and has now had more research conducted and there are more bioavailable options.
Research by Dr Louise Newson, the UK GP who specialises in menopause, shows that women on HRT have numerous benefits:
- Less visceral fat
- Lower glucose and insulin levels
- Differences in gut microbiome
I have found that HRT can benefit mood, improve appetite and cravings and reduce hot flushes (or flashes) and reduce brain fog.
Ask your GP or see if a referral to a specialist is right for you.
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