Perimenopause Weight Gain: What You Can Do

If you have not had your period for twelve months in a row due to hormonal changes during the menopause, you have gone through the menopause.

Perimenopause, which translates as “around menopause,” is the time leading up to menopause.

On average, perimenopause lasts about 4 years, but this varies greatly from person to person. This usually happens between the ages of 45 and 55.

In this article, we explore the changes that can occur during perimenopause, including weight gain.

We also explain how you can help prevent and manage weight gain during this time.

Body changes and perimenopause

Women may experience symptoms and physical changes during perimenopause. Some examples are:

• irregular periods, which may be heavier or lighter than normal

• weight gain

• hot flashes and night sweats

• mood swings

• vaginal dryness

• brain fog

• sleep disorders

• incontinence

• joint pain

• changes in sexual function, such as low libido

Our own unpublished research, involving more than 25,000 women, found that sleep problems, night sweats, mood swings and hot flashes are the most common symptoms.

We also found that obese women are more likely to experience hot flashes, mood swings and sleep problems, as well as chills and thinning hair or dry skin, than non-obese women.

Why we gain weight during perimenopause

Studies have shown that our body composition changes as we go through perimenopause.

This includes an increase in fat mass and waist circumference and a decrease in muscle mass. Fat is also more likely to accumulate around the abdomen.

These shifts are likely due to several factors, including changes in reproductive hormones.

In fact, experts know that estrogen plays a role in energy metabolism, and studies have shown that the way the body metabolizes fat and other lipids changes during the transition to menopause.

For example, shifts in energy metabolism caused by fluctuations in estrogen can lead to the accumulation of body fat around the abdomen and an increase in ‘bad’ blood fats.

These changes, in turn, are linked to health problems such as type 2 diabetes and heart disease.

Experts call ghrelin the ‘hunger hormone’ because it helps regulate appetite. It is produced in the stomach and increases the feeling of hunger, encouraging us to eat.

Furthermore, aging itself is related to natural changes in body composition. For example, we lose muscle mass as we age, which is called sarcopenia. This results in a decreased metabolism – the amount of energy your body uses.

Both factors can contribute to weight gain.

Genetics can also play a role. For example, if members of your immediate family tend to carry excess weight around their midsection, you are more likely to do so as well.

And lifestyle factors, such as an unhealthy diet, lack of exercise and insufficient sleep, can also contribute to weight gain.

Research has shown a link between lower body weight and improved symptoms associated with perimenopause. We have also seen this in our own research.

Does HRT cause weight gain?

Hormone replacement therapy (HRT) is sometimes called menopausal hormone therapy or MHT. It is an effective way to relieve symptoms during perimenopause and menopause.

It often comes in the form of tablets, but it is also available in the form of skin patches, skin implants, or a spray or gel that you apply to your skin.

A common misconception is that HRT causes weight gain. However, research has shown that it does not have this effect.

HRT can even help prevent weight gain. In our own research we have seen that women who use HRT after menopause have lower body fat levels than their peers who do not use it.

What you can do about weight gain

There are several ways to help prevent excess weight gain during perimenopause.

Power supply

Having a healthy, varied diet rich in fresh produce can help reduce the chance of weight gain.

It’s a good idea to eat a plant-based diet that includes a variety of fruits, vegetables, whole grains, nuts, seeds, beans and other legumes.

These foods are high in fiber, which can support your ‘good’ gut bacteria and help you feel full for longer.

Try to avoid highly processed foods and keep options high in fat, sugar and salt to a minimum.

ZOE scientists are currently investigating how diet affects the symptoms of perimenopause, including weight gain.

At ZOE we believe that no food should be taken off the table. Restrictive diets don’t work because they are not sustainable. Read more about eating during perimenopause here.

Physical activity

Adding physical activity to your daily routine can be easier than you might think. It doesn’t have to be a hard slog in the gym or a marathon. Your exercise routine should be manageable and sustainable.

The most important thing is that you choose something you like. Maybe that’s a yoga or pilates session, a salsa class or a swim at your local sports centre.

Remember that physical activity also includes everyday activities such as walking, housework and gardening.

Ideally, you should aim for around 150 minutes of physical activity per week.

Research has shown that a mix of aerobic and strength-based exercises can help with perimenopause symptoms such as hot flashes and night sweats. It can also help control weight and provide mental health benefits.

Sleep

Sleep is essential for every bodily process and affects our physical and mental health.

So it’s important to make sure you get enough quality sleep. Ideally, you should aim for 7 to 9 hours per night, but your personal needs may be a little more or a little less.

What causes poor sleep during perimenopause is not entirely clear. This is an area that clearly needs more attention from researchers.

With this in mind, here are some general tips for a good night’s sleep:

• Keep your bedroom cool to mimic the drop in body temperature during sleep.

• Limit stimulating screen time before bed.

• Encourage relaxation by practicing mindfulness, breathing exercises or gentle stretching exercises.

• Avoid long naps during the day.

• Avoid stimulants, such as caffeine, later in the day.

• Keep the lights dim to promote drowsiness.

• Take a warm bath, read a book or listen to your favorite music to relax.

Gut health

Scientists have identified differences in the gut microbiome before and after menopause.

Interestingly, the relationship between gut bacteria and hormones goes both ways: your gut microbiome influences the levels of reproductive hormones, and the levels of reproductive hormones influence the gut microbiome.

For example, certain bacteria affect estrogen levels. These bacteria can ‘recycle’ estrogen and release it back into the bloodstream in the body.

Take care of your gut by keeping our nutritional tips above in mind. And if you have persistent intestinal complaints, contact your doctor.

At ZOE we understand the importance of the gut microbiome for health. Our research has identified 15 ‘good’ gut bacteria linked to positive health traits. We also identified 15 “bad” bugs linked to negative health traits, such as increased belly fat.

If you want to know what bugs live in your belly, start by taking our free quiz. With our at-home test and personalized nutrition program, you can discover how to nourish your body and the gut bacteria that call it home.

Supplements

Although many supplements claim to help with weight loss, there is no solid evidence to support this.

More specifically, the evidence that probiotic supplements can help with weight loss is limited and mixed.

Summary

Going through perimenopause can bring many physical and psychological changes.

Weight gain is common during this period. It likely stems from a combination of things, including changes in your reproductive hormones and body composition, as well as genetics and lifestyle factors.

Good nutrition, physical activity and sleep can help prevent obesity during perimenopause.

If you want to understand how to eat for your body, start with our free quiz.