The female cycle is a wonderous and complex process. The cycle spans from prepuberty to menopause, marked by significant hormonal and physiological changes. In prepuberty, reproductive hormones are low, and the ovaries are inactive. Puberty initiates with hormonal surges, leading to the first menstrual period (menarche) and the development of secondary sexual characteristics. The reproductive years are characterized by regular menstrual cycles involving the follicular phase, ovulation, the luteal phase, and menstruation (if pregnancy does not occur).
As women transition into perimenopause, hormonal fluctuations cause irregular cycles leading to menopause. This period is defined by the cessation of menstruation for 12 months, signalling the end of reproductive capability, with lasting changes in hormone levels and associated physical adjustments post-menopause.
But what happens after menopause that leads to the accumulation of fat, especially around the abdominal area?
STUBBORN BELLY FAT
After menopause, women experience significant hormonal changes due to a decline in the production of certain hormones. Estrogen helps regulate body fat distribution, promoting fat storage in the hips and thighs. With lower estrogen levels after menopause, fat distribution often shifts to the abdominal area, resulting in increased belly fat that’s hard to get rid of as our metabolism naturally slows down with age—meaning the body burns fewer calories at rest.
Muscle mass declines with age as well, especially after menopause, due to reduced physical activity and hormonal changes. Since muscle burns more calories than fat, losing muscle mass leads to fewer calories burned, promoting fat gain.
Hormonal shifts after menopause can also lead to an increase in insulin resistance, which means the body has a harder time processing sugar effectively. Insulin resistance can increase belly fat due to the body storing excess glucose. Finally, cortisol—the stress hormone—tends to promote fat storage, especially in the abdominal area. Postmenopausal women may experience more stress due to life changes, which can lead to elevated cortisol levels and greater abdominal fat accumulation.
Why are so many women unable to lose that belly fat?
A menopause journal survey of 23 women attempted to identify the barriers to weight management and perceived risk factors associated with weight gain during menopause. While most women could correctly identify the factors that lead to menopausal weight gain, they had not taken active steps to correct those factors. Most of these women had employed relaxed attempts to reduce weight, versus active attempts. This study also showed that menopausal symptoms such as stress and mood swings were barriers to the behaviour management needed for effective and long-term weight maintenance.
Estrogen
A major culprit of postmenopausal weight gain is estrogen. Studies reviewed the mechanism behind estrogen’s role in resting energy metabolism. What they found was that estrogen impacts brown adipose tissues in positive ways that influence resting energy metabolism, leading to a reduction in weight and prevention of weight gain. In postmenopausal women, the study showed that the balance of estrogen and additional progesterone helped increase resting energy metabolism and reduce weight gain, especially around the abdomen.
Protein
Another area of focus in the studies concerns protein in menopause and beyond. These studies describe the Protein Leverage Effect: This effect is the main challenge for weight gain. They describe two age-related phenomena that happen in muscles and contribute to energy-balance change:
- Anabolic protein resistance
- Increased protein breakdown, which is estrogen-dependent and particularly relevant during menopause.
When protein is broken down in the body, we’re triggered to eat more. However, in our current dietary environment, we’re exposed to more hyper-palatable foods and tend to choose foods that taste better or make us feel better over nutrition; we don’t get enough protein without also increasing our intake of fats and carbohydrates. This leads to a surplus in caloric intake without sufficient protein—leading to more weight gain.
Cortisol
Cortisol changes during this phase of life also contribute to women's eating habits, weight gain, and the predilection for weight gain around the abdomen. Studies show that both stress eating and being postmenopausal significantly contributed to the depressive symptom-weight association. In another study that looked at cortisol and the sleep cycle, it was found that the loss of circadian rhythms affected cortisol regulation; this led to sleep dysfunctions, lowered energy, and changes in abdominal fat distribution.
BATTLING BELLY FAT
How do we support ourselves to prevent weight gain and support other areas of health affected by the natural changes in our hormones? The main areas we can work on to address these health concerns include diet and eating, exercise regimens, and sleep protocols.
Diet & Eating
Diets high in sugars, refined carbs, and unhealthy fats can lead to weight gain, particularly in the belly area. Achieving a protein intake of 1.5 g per kg per day for the total caloric intake is a good starting place. In a study specifically looking at yogourt (which tends to have sufficient protein), there was less weight gain in those who had a higher intake.
The take-home message with regards to food and diets is to keep protein levels up while keeping the total caloric intake needed balanced. Restrictive diets, skipping meals, and over-eating tend to lead to more caloric intake and weight gain in the long term.
Physical Activity
Aerobic and resistance training is necessary for weight maintenance. It’s recommended that adults should aim for at least 150–300 minutes a week of moderate-intensity activity, or 75–150 minutes a week of vigorous-intensity aerobic activity. Additionally, full-body muscle-strengthening activities should be included two or more days per week.
Attention should be given to the fact that postmenopausal women may require sustained effort and weight loss may be slower. Additional support can include meditation, nature walks, and grounding practices that can help reduce the effects of stress on the body which cause weight gain or weight management issues.
Sleep
Sleep disturbances are common in postmenopausal women, leading to changes in the physiological functions of hormones. This can cause disruptions in energy, food selection, and eating habits, leading to increased weight. Supportive measures with talk therapy and networking can help.
To make an impact on weight gain and its prevalence in postmenopausal women, a comprehensive approach is needed. Understanding your baseline health status through physical exams and blood work can help direct a treatment plan, and diet and lifestyle are integral components of reducing that stubborn belly fat.
