Lydia Robertson is a GP with a special interest in the menopause

Many women will experience a change in their body shape during the perimenopause and menopause.

It is usually due to fluctuating hormone levels. This time in our lives can be pivotal for your future health. If we can reflect on your food choices, exercise and lifestyle we can have a huge impact on your wellbeing as we age.

Oestrogen levels fluctuate in the perimenopause which can impact you in several different ways.

As your bodies start to notice a decline in oestrogen from your ovaries, it can try and obtain it from different sources. Fat cells produce a weak type of oestrogen. You can therefore start to develop cravings for carbohydrate rich and sugary foods which will then turn into abdominal fat in a bid to increase oestrogen levels in our body. Because of this, some women start to develop a “spare tyre” around their middle.

Stress and insulin resistance is also supported by oestrogen and can be impacted by menopause. An increase in cortisol (your stress hormone) causes the body to release glucose for energy. If this energy is not used it is laid down as fat.

Lower levels of oestrogen can often cause joint pains. This is because oestrogen acts as an anti-inflammatory in your joints. Women can therefore find it harder to exercise. This can impact weight management as well as psychological wellbeing.

Oestrogen deficiency during perimenopause and menopause can also disrupt sleep patterns. This can be due to hot flushes and night sweats as well as disruption to melatonin (your sleep hormone) and cortisol. Poor sleep can affect your mood as well as increase food cravings and lead to weight gain.

It is important to maintain a healthy weight. Women who are overweight or obese are more likely to develop health issues such as metabolic syndrome, type 2 diabetes, cardiovascular disease and breast cancer. These conditions can really impact our health in later life.

It is important to take a holistic approach to maintaining a healthy weight. Including good nutrition, exercise, stress management and prioritising sleep as well as social connection and purpose. For many women hormone replacement therapy (HRT) can play an important part in this holistic approach. By replacing the hormones that have declined through your perimenopause and menopause it can help you to feel better and allow you to address these lifestyle issues.

We also know that there is good evidence that starting HRT within 10 years of your menopause or before the age of 60 reduces your future risk of cardiovascular disease and osteoporosis.

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