One of the biggest health challenges for women over 40 is achieving or maintaining a healthy body weight. There may be pressures from social standards to be thin; even without those standards as added pressure, there are clear health benefits to maintaining a good body mass index, or BMI. Extra pounds of body weight increase our blood pressure, magnify the stress on our knees and other joints, increase our risk for cancer and diabetes, and can even slow us down mentally. Yet, to the lament of millions of women, achieving the ideal weight becomes harder and harder after age 40.
A great place to start is to take an assessment of our own feelings towards this change in our lives. Are we looking forward to a new stage in life or feeling down about the passing of youth? Is it all affecting our primary relationship? Are the changes at work becoming just too confusing? Have the children left home? Often there’s a combination of mixed feelings. Menopause is nature’s way of taking us out of the demands of motherhood. Every month, we prepared for a potential pregnancy. After decades of putting our needs secondary to others, this is a time we can put our own needs first.
Not only is motherhood demanding, but when we’re younger, our lives are often focused on finding a mate and securing a relationship. And nature works with us. When we’re young, our bodies signal fertility and high estrogen through our waist/ hip ratio. As we move into a new stage in life, many women find these concerns are no longer in the forefront, taking a backseat to new interests in life. Some women look to hormone replacement therapy to deal with a low libido, fatigue or depression. But if we work with our bodies and allow down time from outside demands, often our libido will resurface on its own.
After menopause, it’s a good time to focus on our own needs and take on less of the role of nurturing others. We may become grandmothers and be secondary caregivers, but our role as primary caregivers often comes to a close. Creating space in our lives for our own interests is really the first step to achieving our fitness goals. Susun Weed, author of New Menopausal Years, The Wise Woman Way, recommends women take a full year to themselves to celebrate the changes in their lives and grow into this new phase. This is a good time to turn inward and devote more time toward solitary pursuits—such as gardening and reading—rather than group and family activities.
When we’re young, it’s easy to get away with not exercising. After menopause, this just isn’t the case. Daily walks and regular trips to the gym can’t be ignored anymore. It is harder to build and maintain muscle mass after menopause, but not impossible. Consistency is key.
Getting enough sunlight is also an important key to weight loss. Low vitamin D levels are associated with higher percentages of body fat. Maybe people are intuitively sensing the benefits of sunlight as they head from New England to Florida. Sunlight not only boosts our vitamin D levels, it also helps us with seratonin and dopamine; these hormones help us stay happy and motivated. Time to be in the sun is associated with leisure and time off in our culture. We don’t have time in the sun unless we make time to be outside.
Other issues related to menopause, insomnia and a lack of sleep, can make weight loss difficult as well. Sleep deprivation is an independent factor for weight gain. Not only because we reach for sugar and caffeine when we’re too tired to make it through the day, but also because it alters levels of hormones like cortisol, ghrelin and leptin. A sound night’s sleep can be harder as we get older because levels of melatonin decline while levels of cortisol increase. Melatonin signals the body to fall asleep and cortisol helps the body wake up. One approach is to take melatonin to help our sleep. It also helps our bone density as we get older. We can eat foods that contain melatonin in the evening, such as cherries or cherry juice, oats, barley, rice or pineapple. Also daytime sunlight helps keep our body’s internal time clock on a good schedule. Getting early morning sunlight helps us stay on track. Sleeping in a very dark room helps our bodies release melatonin. Exercise during the day can contribute to better sleep at night, but so does going to bed early. Often we feel drowsy at the end of the day around 8 p.m.; it’s good to work with that signal and go to bed rather than trying to get one more activity done. When we make it a late night and stay up well past 10 p.m., it’s easy to get a second wind, making sleep even more elusive.
Sometimes despite our best efforts, sleep remains difficult, especially when hot flashes are a concern. Be aware that women don’t have to suffer through the frustration of waking up every few hours during the night hot and sweaty. A naturopathic doctor can help guide you with supplements—including dong quai, evening primrose oil, black cohosh, blue cohosh and vitex—which can significantly decrease the frequency and severity of hot flashes.
As we go through menopause the dominant estrogen in our body shifts from estradiol to estrone. As the ovaries make less estrogen, we use estrogen that comes from our fat cells. This may be the reason why women often gain about 10 pounds as they go through change of life. Our fat cells are necessary to supply us with this estrogen.
We can also look to plant sources of phytoestrogen to help us through this phase. While plant-based estrogens are weaker than our own, they do have estrogen activity that can help as our own levels decline. Foods that are rich in plant estrogens include pomegranate, olive oil, flax seeds, dried apricots, dates, prunes, sesame seeds, chickpeas and non-alcoholic beer. (It is interesting to note that men who work harvesting hops for beer must wear gloves or they absorb the phytoestrogens; these can cause gynecomastia, which is the development of female breasts in men).
As our ovarian function declines, it is important to make sure that the rest of the endocrine system is working well. We might have been able to ignore a subpar thyroid or overtaxed adrenal glands before, but as we approach menopause these issues need to be addressed if we are to achieve weight loss. If you’re experiencing weight gain, fatigue, hair loss, constipation or feeling cold all the time, it’s time to look at your hormonal system.
A healthy thyroid is essential for weight loss as this gland controls our metabolism and the rate at which we burn calories. A comprehensive look at the thyroid will assess the TSH, free T3 and free T4 hormones. If your doctor suspects autoimmune activity, they may also look at anti-thyroid antibodies.
Another important measure is looking at iodine levels. Even with proper hormones, we can experience the symptoms of low thyroid if we don’t have enough iodine. By far the best dietary source of iodine is kelp or other seaweeds, but supplementation can work too. Sometimes we need to cut out foods that are goitrogens, which block the thyroid. Soy products—especially those that are not fermented—may be responsible for blocking our thyroid. Raw cruciferous vegetables may get in the way of proper thyroid function. If this is the case, stop putting kale in your smoothie and simply cook your broccoli, cauliflower or brussel sprouts.
Lastly, proper adrenal function is critical for weight loss after menopause. Our adrenal glands are busy pumping out stress hormones in reaction to our everyday lives. They also produce testosterone, which is responsible for libido; if the adrenal glands are overtaxed with stress hormones, there’s often little energy left over for sex drive. The first step is allowing for rest and stress reduction. Then supplements like vitamin C and B can help. Adaptogen herbs—such as Siberian ginseng, rhodiola, ashwaganda and dong quai—can help us recover from stress.
Like any new stage in life, menopause comes with new challenges as well as new opportunities. Weight gain does not have to be inevitable. Often this time is a new phase of independence and self-expression. However, we do need to be more vigilant with our health in order to reach our goals.