Common Clinic Questions Series.

Why am I gaining weight in the perimenopause?

Entering perimenopause can be a challenging period for many women. As your body goes through hormonal shifts, weight gain can become a frequent concern. Knowing the reasons behind this change empowers you to take control of your health. In this post, we will discuss the primary factors contributing to weight gain during perimenopause and offer practical strategies to address these changes.

Nutrient-rich foods for perimenopause health

Hormonal Changes

Hormonal fluctuations—especially in estrogen—are one of the most important changes during perimenopause. As estrogen levels decline, your body can increase fat storage, particularly around the abdomen. Studies have shown that abdominal fat can increase by 10-15% during this phase.

To help manage weight gain linked to these hormonal shifts, focus on a balanced diet high in phytoestrogens. Incorporating foods such as flaxseeds, soy products, chickpeas, and whole grains can support hormonal balance.

Exercise is also vital. Aim for at least 150 minutes of moderate-intensity aerobic activity each week, combined with strength training 2-3 times a week. This combination helps regulate hormones and maintain muscle mass.

In addition to these lifestyle measures HRT can also be very helpful in replacing and balances oestrogen and progesterone so can be considered alongside.

Muscle Loss and Slower Metabolism

Alongside hormonal changes, muscle mass typically decreases during perimenopause. Since muscle burns more calories than fat, a loss of muscle can slow down metabolism—leading to weight gain. Research indicates that women can lose 5-10% of muscle mass per decade starting in their mid-30s.

To counteract this muscle loss, integrate strength training exercises into your routine at least twice a week. Activities such as weight lifting, using resistance bands, or performing body-weight exercises like squats and push-ups are effective. Increasing your intake of lean protein sources such as chicken, fish, tofu, and legumes can nurture muscle maintenance and growth.

Gut Health and Oestrogen Metabolism

Your gut plays an essential role in metabolizing hormones, including estrogen. An imbalance in gut bacteria can hinder estrogen processing, potentially leading to increased fat storage. A study found that gut microbiota diversity is linked to weight management, suggesting that a healthier gut might support better weight control.

To support gut health, focus on a fiber-rich diet that includes plenty of fruits, vegetables, whole grains, and fermented foods such as yogurt, sauerkraut, or kimchi. Moreover, consider discussing probiotics with a healthcare professional to further enhance your gut flora.

Increased Cortisol and Stress

Elevated stress levels can significantly contribute to weight gain during perimenopause. The body's stress response triggers higher cortisol levels, which can stimulate appetite and promote fat storage around the abdomen. Surveys show that nearly 40% of women report increased emotional eating during stressful times.

We can rarely change our stress triggers but we are more in control of how we manage stress. However, women particularly struggle to prioritise themselves and often feel guilty or can’t justify time to do these things. Remember though, if we can feel our best, more relaxed selves we are much more likely to also be a better partner, mother, colleague or friend too.

To manage stress effectively, explore techniques such as yoga, meditation, deep breathing exercises, and mindfulness practices. These methods can drastically reduce stress levels. Additionally, aim to engage in regular physical activity—it's not only good for your body but also serves as a natural stress-reliever. The key thing is to factor in a little bit of time everyday doing things that YOU find relaxing.

Insulin Resistance and Blood Sugar Changes

Hormonal shifts can lead to increased insulin resistance, making it harder for the body to process sugars. When cells become less sensitive to insulin, blood sugar can rise, which often fuels cravings for sugary and high-carbohydrate foods. This can create a cycle that complicates weight management. Studies show that women in perimenopause have a 30-50% higher risk of developing insulin resistance.

To improve insulin sensitivity, prioritize a balanced diet filled with whole, minimally processed foods. Focus on complex carbohydrates—like brown rice, quinoa, and sweet potatoes—over simple sugars. Combining regular physical activity with balanced meals can help maintain stable blood sugar levels.

Poor Sleep

Poor sleep during the perimenopause has many different causes, often due to the various symptoms such as anxiety, night sweats or the frequent need to urinate.

Sleep disturbances during perimenopause can impact weight management. Inadequate sleep has been associated with increased cravings, a drop in physical activity, and a slower metabolism. Data indicates that sleep deprivation can lead to a 20% increase in hunger hormones, making weight control more challenging.

To enhance sleep quality, create a calming bedtime routine and maintain a consistent sleep schedule. Aim for 7-8 hours of restorative sleep each night. Design your sleeping environment to be dark, cool, and quiet, helping you achieve better sleep. Magnesium supplements can also be of benefit.

HRT can also be considered because if it helps the causative symptoms then naturally the sleep improves.

Embracing Change

While gaining weight during perimenopause is common, remember that you can steer your health in a positive direction. By addressing hormonal fluctuations, preserving muscle, promoting gut health, managing stress, improving insulin sensitivity, and enhancing sleep quality, you can effectively manage and even prevent weight gain during this transformative stage. This can feel overwhelming so start by making small changes and build upon them. This will make it sustainable and that’s when you’ll see the long term benefits of your efforts.

Stay patient with yourself and celebrate your progress, no matter how small. Seeking guidance from a healthcare professional or a registered dietitian can provide personalized advice tailored to your needs. Now is the time to prioritise YOU.

Remember I’m here to support you along the way x