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The following article was published in Your Health Magazine. Our mission is to empower people to live healthier.
Alan Terlinsky, MD, FACP
Weight Gain Through Menopause
Nu-Living Weight Management
. http://www.nu-living.com

Weight Gain Through Menopause

Women 35-59 years old commonly experience weight gain and an expanding waistline as they transition to menopause. They wonder whether these physical changes are caused by hormones or arise from lifestyle or normal aging.

US Government health statistics report that 68% of women, ages 40-59, are overweight and obese. Almost 40% of women reaching menopause have developed the high-risk cardio-metabolic syndrome (MS) consisting of hypertension, abnormal cholesterol, blood sugar elevation and deep abdominal fat accumulation. MS confers increased risk for diabetes, stroke, heart attack and reduced longevity.

The Study of Women Across the Nation (SWAN) is a prospective, multi?center, multi?ethnic, multi?disciplinary longitudinal study of the natural history of the menopausal transition. SWAN was initiated in 1997 with 3,302 premenopausal or early perimenopausal 42?52 year-old women enrolled, and it is still ongoing.

Endocrinology research findings from SWAN have provided new information explaining the weight and body composition impact of the menopause. Primarily, it is hormonal factors associated with the aging human ovary that produce the physical changes endured by women at midlife.

Studies from SWAN have detailed the body composition changes of menopause. Women lose lean muscle tissue and gain body fat. There is a change in anatomic fat deposition from the premenopausal buttocks and thighs location to the deep abdomen increasing visceral fat (VAT) that surrounds organs such as the liver.

Women lose their waistlines and transform from a gynecoid (woman-like or “pear-shaped”) to an android (man-like or “apple shaped”) body configuration. The VAT is endocrinologically active, interacts with the liver and produces biological effects leading to diabetes, hypertension, high cholesterol, coronary artery disease, high mortality and reduced longevity.

Cessation of estrogen production is the hallmark of menopause. The women studied by the SWAN were evaluated yearly and had extensive testing of their reproductive hormones including estradiol, progesterone, testosterone, free estradiol, free and bio-available testosterone, SHBG, and DHEA. Researchers analyzed multiple variables including age, ethnicity, lifestyle, smoking status, body composition, muscle mass, superficial fat, deep visceral fat, resting energy expenditure, and menopause status.

Medical scientists concluded that the body composition changes experienced by menopausal women are not due to aging; they are due to changing hormonal interactions. Estrogen and SHBG declines and active testosterone increases. A more male-like reproductive hormone milieu occurs, decreasing the estrogen to testosterone ratio (E/T).

The decreased E/T signals fat cells located on the thighs and hips to give up fat while fat cells in the abdomen actively build fat. Moreover, the new E/T ratio stimulates brain centers to slow down daily energy expenditure. Appetite is stimulated and spontaneous physical activity declines.

SWAN demonstrated that replacing estrogen transdermally reduces fat buildup and abdominal redistribution. Women choosing not to use hormones at menopause can decrease hormonal related body changes by reducing caloric intake and increasing physical activity including weight training. Women must make this intervention very early in the menopause transition process, perhaps by their late thirties, for maximum effect.

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