By Rachel Kramer, MD, Obstetrician and Gynecologist, Virtua OB/GYN and Exuberan by Virtua - Voorhees

Menopause is a mixed bag of little surprises. While most women look forward to saying goodbye to tampons and pads, far fewer are excited to experience other symptoms like hot flashes, sleeplessness, or brain fog. And it's probably fair to say that weight gain is the least popular and often least expected "side effect" of this hormonal shift. 

Considering many women struggle with their weight on a good day, it's not surprising that this is a top complaint from women going through this transition.

The biology of menopause

During your mid- to early 40s, your ovaries stop producing as much estrogen, elevating your FSH (follicle-stimulating hormone). While your FSH increases, other hormones like estrogen, progesterone, and testosterone decrease.

A decrease in testosterone can lead to weight gain and decreased energy. And, not surprisingly, estrogen loss has far-reaching effects beyond hot flashes.

• It contributes to reduced tissue elasticity and vaginal dryness, which can cause pain with sex.
• It affects desire and interest in sex.
• It contributes to memory loss or other mood changes such as irritability and depression.
• It affects calcium balance, which can lead to bone loss.

But why weight gain?

You may be frustrated if you have healthy habits, but your body doesn't change the way you'd expect. That's because estrogen is a crucial player in maintaining weight balance. Estrogen loss can change how your weight is distributed—directing fat accumulation to your waistline. It also lowers your metabolic rate and can affect your sleep habits. All these issues combined create the perfect scenario for weight gain.

When you aren't sleeping well, you tend to feel hungrier during the day and compensate for your fatigue by increasing carbohydrate intake. Excess carbohydrates are converted to and stored as fat. Your body finds this especially handy since fat releases more of the extra estrogen it is missing.  

You're never too young to prepare

As you enter your late 40s, it's essential to make sure regular exercise becomes part of your routine. Ideally, 30 minutes, 4-5 times a week, can help you stay healthy.

Find exercises that interest you so you stay committed. Include cardio exercises like walking or swimming, as well as upper and lower body weight training, to prevent muscle and bone loss and maintain joint health.

As your hormones shift, you’ll already have a head start. And don't forget to reinforce all your hard work by eating lean proteins, vegetables, fruit, whole grains, and low-fat dairy (or non-dairy substitutes) to support good health. 

You also can talk to your OB/GYN about managing your menopause challenges with hormone replacement therapy, including bioidentical hormone replacement.

Gain control of your menopause symptoms

• You deserve to feel like yourself again, and BHRT might be the solution. Call 856-325-5601 to schedule your consultation with Exuberan by Virtua.
• Learn more about all your menopause treatment options.