The Biological Connection Between Menopause & Metabolic Health

To mark Menopause Awareness Month, we teamed up with Elektra Health—a women’s health company helping women navigate the hormonal transition of menopause with education, community, and care—to discuss the connection between perimenopause, menopause, and metabolic health. 

If you missed our webinar, keep reading further to learn more about how women’s metabolic health may shift as they transition into and through menopause.

Last week, we polled our community on Instagram to ask if they’ve experienced weight gain as a symptom of perimenopause or menopause. The majority of respondents—74%—told us they had, which immediately signalled to us this topic was worth going deeper on with our members. To kick off the event, we polled attendees to learn a bit more about their experiences with the stage of menopause. Here’s what we learned from the evening’s attendees:

• 95% did not feel prepared in knowing what to expect during perimenopause and menopause. 
• 73% discuss menopausal symptoms with their family and friends. 
• 67% are  planning to seek a form of treatment to lessen menopause symptoms. 

The conversation—led by Calibrate clinician, Kristin Baier, MD, and Elektra Health’s, Elizabeth Poynor, MD, PhD—that followed was empowering and informative, fueled by questions submitted by our community on Instagram, as well as attendees of the event. Read more to learn about metabolic health and weight gain during menopause.

Why does weight gain happen during perimenopause and menopause?

Answered by Dr. Poynor, Elektra Health 

Fluctuating estrogen levels during perimenopause and menopause impact our metabolic system which leads to insulin resistance, an increase in fat storage, and decreased muscle mass. Additionally, during these life stages women are also experiencing a variety of life stressors that elevate cortisol levels. High levels of cortisol or stress hormones can impact our sleep and appetite by affecting the balance of leptin and ghrelin (the hunger hormone), promoting cravings for fast-digesting carbs and sugary foods.

Is there any way to prepare for perimenopause or menopause?

Answered by Dr. Poynor, Elektra Health 

Education, education, education! Women should be anticipatory and proactive when it comes to care, not reactive.

Why do we gain weight around the abdomen during menopause? 

Answered by Dr. Baier, Calibrate 

Because the body is becoming more insulin resistant during perimenopause and menopause, women may begin to experience weight gain. Even women who don’t gain weight begin to notice that fat shifts away from the thighs and hips, redistributing to the abdomen in the form of visceral fat. This leads women to have an increased risk of cardiovascular and metabolic disease post-menopause.

Why does visceral fat pose the biggest risk to our metabolic health?

Answered by Dr. Baier, Calibrate 

Visceral fat is stored within the abdominal cavity and can increase the risk of cardiovascular disease and affect cells sensitive to insulin. Consistently high insulin levels can cause our bodies to develop a tolerance, making us less sensitive to the hormone over time. Being sensitive to insulin is important to our body’s overall function and our metabolic health because it helps glucose in our blood enter cells in our muscle, fat, and liver, where it’s converted and used for energy. 

Estrogen and insulin work closely together. Estrogen helps us maintain insulin sensitivity. As our estrogen levels start to decline, we begin to lose some of that insulin sensitivity. This causes our pancreas to start pumping out more insulin to control our blood sugar even if our diet and activity level are the exact same. When we have higher insulin levels due to a decrease in estrogen (or a diet made up of highly processed carbohydrates or sugar), our body receives a signal to store visceral fat.

Are there any foods that can help with any symptoms or weight gain for menopause? 

Answered by Dr. Baier, Calibrate 

Focus on nutrient-dense foods to optimize hormonal responses. Typically when insulin sensitivity starts to decline, women should consider foods lower in fast-digesting carbs. The American diet has roughly 300 grams of carbs a day, and a majority of that comes from processed foods and sugars. This can cause a spike in glucose—and then a subsequent spike in insulin—promoting the growth of visceral fat cells. To help diminish that insulin response and control glucose levels, focus on incorporating healthy fats, protein, fiber, and slow release carbs. Check out Calibrate’s recipes for healthy and balanced meal options.

Disrupted sleep is a common symptom during menopause. How does that impact our weight? 

Answered by Dr. Baier, Calibrate 

Due to a decline in estrogen levels, sleep is often impaired during menopause. During deep sleep—when quality, restorative sleep occurs—hormones have the opportunity to reset. Without quality sleep, ghrelin increases, making us hungrier the next day. Women might also experience a spike in cortisol, causing the body to dump more glucose or sugar into the bloodstream, producing more insulin.

The methods I’ve used to lose weight in the past are no longer working. Why? 

Answered by Dr. Baier, Calibrate 

As the metabolic system shifts, and fluctuating estrogen levels makes us sensitive to insulin resistance, we are unable to process nutrients the same way. After the age of 30, we also start to lose muscle mass. Muscle is a metabolically active tissue that helps with the management of glucose levels and insulin sensitivity. Our metabolic rate is decreasing as well, so exercise, specifically resistance training, becomes extremely important to maintain muscle mass. 

Weight fluctuations throughout the course of our lives affect our metabolic rate. Calibrate’s One-Year Metabolic Reset can help get all of these hormonal changes and adaptations in place to reset the body’s metabolic rate and help lower its set point—the weight our body fights to maintain.

Are there any nutritional or lifestyle changes that women in perimenopause or menopause can do to lessen the severity of hot flashes?

Answered by Dr. Poynor, Elektra Health 

An overall healthy lifestyle that includes healthy nutrition, exercise, and good sleep will lessen the severity of hot flashes. Before entering these life stages, you can also rely on services like Elektra Health that provide community and coaching to put these interventions in order to lessen the severity of these symptoms. 

Would hormone replacement therapy or estrogen supplementation help with weight loss?

Answered by Dr. Baier, Calibrate 

Like a lot of other topics in women’s health, hormone replacement therapy (HRT), more specifically for weight loss, needs to be studied more. The recommendation would be to defer to a gynecologist for more information.

Answered by Dr. Poynor, Elektra Health

Clinical evidence shows that HRT is safe and effective for most women experiencing symptoms of menopause, including hot flashes, night sweats, and vaginal symptoms. However, as with all treatments, the decision to use HRT or not should be individualized to a person's specific medical history and needs. We recommend speaking with a board-certified medical provider, like Elektra's clinicians, who are trained in menopause medicine.

What about women who are in chemically induced menopause as a result of cancer treatments for hormone-positive breast cancer?

Answered by Dr. Poynor, Elektra Health 

Weight gain can also occur as a result of chemically induced menopause due to cancer treatments for hormone-positive breast cancer. Tamoxifen, an estrogen modulator that can treat or prevent breast cancer, is used in young women who have not yet gone through menopause, while aromatase inhibitors (AIs) are used to treat post-menopausal women, have had their ovaries removed, or have chemically induced menopause through Leuprorelin. Weight gain has been associated with the use of Tamoxifen, but not with AIs. 

The webinar was hosted by Calibrate clinician Kristin Baier, MD, and Elektra Health’s Elizabeth Poynor, MD, PhD. Dr. Baier is a double board-certified physician specializing in obesity medicine and family medicine. Her focus is on weight loss and metabolic health through a combination of lifestyle interventions and medication. Dr. Poynor is a gynecologic oncologist and advanced pelvic surgeon with over 20 years of experience in menopause, sexual health, and cancer.

For more evidence-based menopause expertise and care, check out Elektra Health’s free 21st Century Guide to Menopause  and all Calibrate members are invited to join Meno-morphosis, a new first-of-its-kind virtual menopause wellness community that includes evidence-based solutions from top menopause experts and direct 1:1 text support for lifestyle changes and everything menopause throws at you. Use code* CALIBRATE20 to unlock early access and 20% off. 

*Code non-transferrable & exclusive to Calibrate members only

Interested in learning more about Calibrate’s whole-body metabolic reset? Learn more and save your spot for Calibrate’s Metabolic Reset. You can also follow Calibrate on Facebook and Instagram to stay up-to-date on future events!