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"I'm in Perimenopause, why can't I lose my belly fat?"
"My diet and lifestyle haven't changed, but nothing I do can budge this belly fat!
I don't understand!"
This is a common complaint from the majority of our perimenopausal patients. Perimenopause and menopause are such mysteries to many, especially, in the midst of the changes. The confusion about how to navigate this causes women to do things that actually make the matter worse. Here is a simple understanding as to what is happening, and how best to manage it.
Declining Estrogen and Cortisol Rise:
Estrogen and Cortisol (the primary stress hormone) exist in a delicate balance thorughout the reproductive years. But as estrogen declines in perimenopause and menopause, the balance is disrupted and cortisol levels tend to rise in its absence. Additionally, the adrenal glands, which produce cortisol, are also responsible for producing small amounts of estrogen after menopause. When the adrenals are already overburdened by chronic stress, this compensatory pathway is compromised, compounding the problem.
Estrogen plays a protective and buffering role in the stress response system by:
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Dampening cortisol release from the adrenals;
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Reducing inflammation in the brain and body;
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Supporting serotonin and dopamine production;
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Regulating the HPA (stress) axis;
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Promoting restful and restorative sleep;
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Supporting thyroid function and metabolism.
When estrogen withdraws, the nervous system loses one of its most important calming
regulators — making everyday stressors feel bigger and harder to recover from.
Cortisol & Weight Gain:
Cortisol is essential in small amounts. It helps to regulate blood sugar, reduce inflammation, and provide energy. But when elevated over time, it works against the body in several important ways.
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It drives fat to accumulate in the abdomen, where fat cells have more cortisol receptors;
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Cortisol raises blood glucose, increasing insulin secretion and promoting fat storage;
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Prolonged high cortisol breaks down muscle tissue, slowing metabolism over time;
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It increases appetite for high-calorie, high-carbohydrate foods.
Common Mistakes Women Unknowingly Make:
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Reducing calories-this stresses the body which interprets it as starving, and causes blood sugar to drop. Cortisol responds to raise blood sugar and promotes the deposition of fat.
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Stressing out more-learning to manage stress is hugely important at this time. It will support your adrenals, and calm cortisol production.
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Over exercising-exercise is absolutely important, however, too much of any good thing can become harmful, cause more stress and inflammation and contribute to the problem. It is like beating a dead horse.
The Good News and the Bad News:
We are living in a time where there is tons of new information available about the process of perimenopause and menopause, which is very helpful as it lets women know that they are not going crazy. The down side of this is we are experiencing a fire hose of stuff coming at us, not all of it is consistent, and much of it isn't appropriate for every individual. It can be confusing and overwhelming to manage without some support and guidance. Here are a few things to consider:
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Evaluate your diet-begin to calculate your protein intake. It is recommended that we try to achieve about .8 grams of protein per pound of body weight each day. Animal protein provides about 7 grams of protein per ounce. Ideally this is high quality protein in the form of animal protein, dairy, eggs, nuts and seeds, protein powder (the less processed the better-grass fed whey, bone broth protein powder, etc)
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Eat at regular intervals. Stabilizing your blood sugar will prevent drops that trigger cortisol release, but also eliminates the stress on the body when blood sugar drops. Avoid or minimize processed foods which trigger more hunger and cause us to overeat.
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Get adequate sleep-when we don't get enough, we tend to eat more or less well, which exacerbates the issue.
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Avoid or reduce alcohol intake
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Exercise regularly, but don't overdo it. Balance hard workouts (weight/resistance training, with walking, yoga, tai chi (things which calm the nervous system and manage stress) and together these will help you to feel physically stronger as well. Building muscle will increase metabolism to support a healthy weight.
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Manage your stress: consider acupuncture and massage as ways to slow down and support your nervous system.
Pro Tip:
Set yourself up for success and don't try to do everything at once! Take one step at a time, or two if it isn't too much. As you are able to be more consistent with your new habits, you can build on them. Trying to change too much at once is overwhelming, and often leads to more frustration.
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