Weight management during menopause or premature ovarian insufficiency (POI) can be a significant struggle for many women. Systems that once worked may no longer be effective, leading to frustration and distress.
The narrative that weight control is merely about diet and restricting 'bad' foods is oversimplified.
This blog will explore how an imbalanced oestrogen, primarily decreased, affects various biological pathways that can lead to weight gain.
Key factors influencing weight during menopause include:
1. Types of Oestrogen:
Menopause often brings a change in body shape, shifting from a pear to an apple shape, indicating an increase in visceral fat. This change results in varying types of oestrogen produced from these different locations, broadly speaking;
- Abdominal oestrogen = oestrone E1.
- Ovarian oestrogen = oestradiol E2.
These oestrogens interact with two types of oestrogen receptors: ESR1 and ESR2.
Oestrone, E1 attaches to ESR2.
Oestradiol, E2 attaches to ESR1.
ESR1 plays a more significant role in regulating metabolism.
As ovarian function declines during POI, menopause, or after a hysterectomy, the production of metabolism supporting E2 decreases.
2. Leptin:
Leptin, the hormone that signals fullness, is released by adipose tissue.
It regulates food intake and energy utilisation by signalling the brain to inhibit overeating and control energy stores. The body's leptin levels correlate with fat storage:
higher fat means more leptin, curbing hunger.
less fat means less leptin, increasing hunger.
The regulation of leptin levels is a complex process that involves feedback mechanisms between fat cells, the brain, and other hormones.
Leptin, like oestrogen, also works by acting on a receptor.
Leptin resistance, (where the brain doesn't receive signals to stop eating despite sufficient energy stores) can disrupt normal feelings of hunger.
We can feel hungry for three different reasons;
- Leptin levels are low.
Which might occur if we're fasting frequently, not eating sufficiently, or dealing with issues like excessive insulin or fatty liver disease.
- Leptin resistance.
This occurs when the brain stops receiving accurate signals about energy reserves due to the receptors not functioning correctly. This typically happens when there's an abundance of fat stores, a situation more common in individuals with obesity or specific health conditions.
- Genetic factors.
Variations in the genes related to leptin receptors can make them less sensitive, which can be further influenced by environmental factors.
Oestrogen is critical in influencing leptin signalling, so it promotes a feeling of fullness.
Hence, low oestrogen can lead to increased hunger and reduced motivation for physical activity.
Furthermore, aging naturally increases leptin levels and resistance, contributing to weight gain independently of oestrogen levels.
3. Ghrelin:
Ghrelin, is the 'hunger hormone'. It stimulates appetite and fat storage and is regulated by meal timing—increasing before meals and decreasing when full.
Oestrogen suppresses ghrelin.
So its decline can make us feel hungrier, often noticeable in the pre-menstrual phase and throughout perimenopause.
Have you ever noticed ?
In the week before your period – you may notice that you have increased cravings and hunger – this is the drop in oestrogen – the same thing happens through perimenopause – it's so just not willpower.
Genetics also plays a role. Variants in specific genes, like NYP, can influence eating behaviours, making some more susceptible to stress eating, binge eating, and erratic dieting. Lower oestrogen levels can exacerbate these tendencies.
4. Oestrogen and blood sugar:
Oestrogen has a significant influence on the way our bodies handle glucose uptake by cells, which is a crucial aspect of how the body uses sugar for energy.
Fluctuations in oestrogen levels, whether on the lower or higher side, can affect adipose tissue's function and the body's sensitivity to insulin, a hormone that regulates blood sugar levels.
Maintaining optimal insulin sensitivity and glucose metabolism requires maintaining a balance in oestrogen levels.
Understanding oestrogen’s impact on blood sugar is vital, particularly for women going through menopause or those with hormonal imbalances, as it can guide dietary and lifestyle interventions to maintain healthy blood sugar levels and reduce the risk of diabetes and other metabolic conditions.
Menopause and POI pose unique challenges to weight management due to these fluctuating hormone levels and genetic factors.
Oestrogen receptors and associated mechanisms can adapt over time, but this requires stability—something that is often lacking during perimenopause, with oestrogen levels unpredictably spiking and plummeting.
If you have been through a surgical oophorectomy – your receptors and oestrogen levels may be exceedingly confusing, so it is not remotely surprising that weight gain happens.
Understanding genetic predispositions can provide insights into personal challenges and guide individualised strategies for support, which may include nutritional choices, stress management, and exercise.
With this knowledge, we can better navigate the complexities of weight management during this phase of life.
Next week, I will talk about what we can do to support these processes, regardless of whether or not you know your genetics.
Please schedule a complimentary call with me to discuss your experiences. This conversation is an opportunity to explore your symptoms and the possible ways to manage them with absolutely no obligation. Remember, understanding and then addressing your symptoms is vital to finding relief and improving your daily life.
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