In this article, I’ll be explaining these changes and looking at what we can do.
Metabolic changes at menopause
During the menopause transition, hormonal fluctuations trigger a variety of internal metabolic changes. These can affect how the body processes energy, stores fat, and regulates blood sugar and cholesterol.
Some of the key changes include:
1. Increased fat storage
Oestrogen plays a role in fat distribution in the body, and as levels change, fat tends to be stored more centrally, around the belly. An increase in visceral fat (fat surrounding the internal organs) is linked to a higher risk of developing conditions like type 2 diabetes and heart disease.
2. Reduced insulin sensitivity
Insulin regulates blood sugar, and during menopause, the body becomes less sensitive to insulin, meaning it becomes less effective at controlling blood glucose levels. This can lead to higher blood sugar levels and insulin resistance.
3. Changes in lipid metabolism
The changes in oestrogen also impact the metabolism of lipids (fats), leading to changes in cholesterol levels. If you are someone who has regular cholesterol checks, you may have noticed a jump in your LDL (“bad” cholesterol) and a decrease in HDL (“good” cholesterol) during the menopause transition, even with the same nutrition and movement patterns.
4. Blood vessel changes
The endothelium is the inner lining of our blood vessels, and this changes too at menopause, “ageing” our blood vessels. This change is where the timing of if – and when – we start HRT is quite key, in being able to access the potential benefits for our heart health.
5. Increased inflammation
Inflammation is a natural process that helps the body heal, but long-term inflammation can contribute to the development of various conditions, including heart disease. Background inflammation levels increase during the menopause transition.
“During the menopause transition, hormonal fluctuations trigger a variety of internal metabolic changes.”
6. Gut microbiome changes
Research has also suggested that menopause alters the gut microbiome, the community of organisms in the digestive tract. This shift also influences metabolic health, particularly linking to inflammation levels.
Why these changes matter
Understanding these internal metabolic changes is vital because they offer insights into how menopause can affect our health in ways that go beyond our symptoms. For me, the menopause transition is a crucial time to step-back, and assess our overall health, as what we do now will play a significant role in all the years to come.
How to mitigate the metabolic changes of menopause
The good news is that many of the metabolic changes associated with menopause can be managed effectively with proactive health measures.
Here are a few strategies to improve metabolic health during and after menopause:
Stop smoking
I know I don’t need to tell you about the health risks of smoking. This really is a key time to look at stopping.
Nutrition
We know that women who follow a whole food plant-based diet have lower inflammation levels, a more diverse gut microbiome and a lower risk of heart disease and diabetes. Focus on what you can add – more plants, more variety of different plants, and perhaps some extra herbs, spices, extra virgin olive oil, nuts and seeds. Menopause is a time where many women naturally reduce their alcohol intake, as it can significantly impact many symptoms, but if you are someone who drinks more than 14 units/week, again this is a really good time to look at cutting back.
Movement
In terms of movement, I like to incorporate weekly cardio, strength and restorative movement to feel good, improve insulin sensitivity, and lower inflammation. Aim for at least 150 minutes of moderate-intensity exercise each week. Isometric exercises like planks and wall sits have been shown to be particularly great at lowering blood pressure.
Manage stress, prioritise rest
Ongoing stress can worsen insulin resistance, increase inflammation, and disrupt sleep. Prioritising rest and incorporating stress-management techniques, such as meditation, breathing exercises, yoga, and mindfulness, can help mitigate the negative effects of stress on metabolism and overall health.
Support your sleep
Sleep is another critical factor, as poor sleep quality, which is particularly common during menopause, can exacerbate metabolic changes. Cut back on alcohol and caffeine, prioritise morning daylight, and stick to a regular routine.
Have regular health checks and understand your individual risk
Monitoring key health markers, such as blood pressure, cholesterol, and waist-to-height ratio. Regular check-ups help you to get to know your numbers and spot trends. Aim for optimum numbers, rather than good enough!
This is particularly important if we have additional risk factors for cardiovascular disease, such as a family history or migraine, aswell as any female-specific risk factors like PCOS, gestational diabetes, high blood pressure in pregnancy, and early menopause, amongst others.
Consider hormone replacement therapy (HRT)
For some women, HRT can help manage the metabolic changes of menopause. Oestrogen has a protective effect on cardiovascular health when started within 10 years of the onset of menopause.
Understanding the changes
While menopause brings about visible changes, the internal metabolic shifts are just as important to recognise.
These changes can increase the risk of longer-term health conditions like heart disease, stroke, and dementia.
However, by understanding these changes and taking proactive steps, you can optimise your health and wellbeing during the postmenopausal years.
This article was originally published on Rethink Menopause.
