In our culture today, women* fear weight gain, at all costs, as well as aging.
Perimenopause and Menopause are two words that conjure up fear in the hearts and minds of most women* and also people who are assigned female at birth.
Diet culture promotes middle-aged female bodies as problematic, and they become a target for both the dieting and anti-aging industries, with many falling prey to chronic dieting, body dissatisfaction, and even eating disorders.
Why should this normal, natural occurrence in mid-life be so misunderstood?
How sad that our culture cannot acknowledge women’s bodies changing through all stages of life: from puberty, through pregnancy, into midlife, and then as we age. Our bodies are meant to change. We generally gain an additional layer of body fat around the middle, which is directly related to reduced levels of estrogen leading up to and through menopause. Our bodies need this extra layer of body fat, as these cells produce additional estrogen for healthy functioning. This is perfectly normal and natural.
*I am using the term “women” in this introduction to refer to any individual with female anatomy, or who undergoes the process of perimenopause and menopause with diminishing levels of estrogen. I want to acknowledge people who may not identify as female but who go through these physical changes, and they will be referred to as *people* in the blog post written by Kimmie Singh, MS, RD, below.
Trying to understand menopause can feel overwhelming.
Written by: Kimberly Singh, MS, RD
It is extra difficult to grasp when you are right in the middle of these mid-life changes. The times around menopause, perimenopause and postmenopausal are transition periods that often align with major life transitions such as divorce, children leaving the home, new health concerns, and more. When external changes are completely out of your control, having a better understanding of what is going on inside your body may bring a sense of calm. As you prepare to embark on the journey that is menopause, I hope this explanation can provide helpful information about what is happening in your body.
Some background on hormones and anatomy can help explain this process.
Estrogen and Its Role in Perimenopause
Estrogen is one of the main hormones among people that are assigned female at birth. Estrogen has a central role in sexual and reproductive development. It also influences a lot of other functions of the body, including bone health, fat storage, and brain chemistry. So as estrogen levels change, there are other changes that you may experience. Ovaries produce a couple of hormones, including estrogen. It is normal for estrogen levels to fluctuate throughout the month as related to the menstrual cycle.
Perimenopause begins when the ovaries start reducing how much estrogen they produce. This is a normal part of the aging process. This occurs alongside an overall decline in ovarian function. People that are perimenopausal still have menstrual cycles and are still typically able to get pregnant. Perimenopause oftentimes starts when people are in their 40s; however, it may begin in their 30s. The average time span of perimenopause is 4 years, but keep in mind that the length of perimenopause is different for each person and for some people it may only last for a few months. Those experiencing perimenopause may struggle with symptoms such as irregular menstrual periods, severe PMS symptoms (including increased anxiety, depression and mood swings), short-term memory problems, and difficulty concentrating, often referred to as “brain fog.”
What are the Symptoms of Perimenopause and Menopause?
Those experiencing perimenopause may struggle with symptoms such as irregular menstrual periods, severe PMS symptoms (including increased anxiety, depression and mood swings), short-term memory problems, and difficulty concentrating, often referred to as “brain fog.”
Towards the end of perimenopause, people start to have many of the typical symptoms associated with menopause as estrogen levels start to further decline. Common symptoms include hot flashes, night sweats, vaginal dryness, emotional changes, urinary incontinence, difficulty sleeping, and short-term memory issues. Between 35-50% of perimenopausal people experience hot flashes, over 40% struggle with sleep problems, and about 10-20% struggle with serious mood disruptions. These symptoms typically persist into menopause. Perimenopause ends at the start of menopause.
When Does Menopause Start?
The average age of menopause in the United States is 51 years old. Menopause is marked by the absence of menstrual periods related to the ovaries not producing eggs and estrogen. Menopause may occur as a natural part of the aging process or in a more sudden way after an event damages the ovaries or causes them to stop producing estrogen. Menopause may occur as a result of surgery that removes the ovaries, chemotherapy, or radiation therapy. Menopause is literally the day that marks the absence of a menstrual period for 12 consecutive months. In addition to the symptoms that start towards the end of perimenopause, menopause is oftentimes accompanied by metabolism changes and weight gain in the mid-section. As menopause comes to an end, the symptoms that started in perimenopause may start to alleviate.
What is Post-Menopause and What Kind of Support would be Helpful?
Post-menopause is the years after menopause, and most uncomfortable symptoms do improve. Having lower estrogen levels may increase the risk of developing osteoporosis and heart disease. It is important to find a supportive healthcare team that can support you during this time. Consuming at least 1200 mg of calcium per day can be protective against bone loss. If walking is a form of joyful movement for your body, it can also help prevent osteoporosis-related fractures and improve heart health. Hormone therapy is also an option to help reduce the risk of postmenopausal-related health conditions. If you are unsure if you are experiencing post-menopause, a doctor can check with a simple blood test that examines your follicle-stimulating hormone (FSH) level.
The confusion about what is going on in your body during these changes can make it difficult to know how to best nourish yourself and remain embodied. Learning about ways to become more attuned to your body throughout these transitions can help you improve your health and maintain a healthy relationship with food and body.
Thanks to Kimmie for this great information.
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Erica Leon is a Registered Dietitian and practices from a Health at Every Size (HAES®) lens. She is certified as an eating disorder specialist and is passionate about helping women at midlife, menopause and beyond to make peace with food and body image.
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