Many moms can recall pre-motherhood days when, to prepare for the life ahead, she gobbled up every parenting book, mom-to-be article, motherhood blog and advice from every experienced mom she knew. Though lots of us accumulated knowledge in advance and knew it would be difficult, nothing can prepare a woman for the physical, emotional and psychological challenges that are the reality of motherhood. As a mom of soon-to-be 17 and 12 year old daughters, I’ve known this for seventeen years. I now know the same is true of menopause.
Hot flashes, night sweats, headaches, moodiness and sleep disruption, you name it, I’ve experienced it, to one degree or another, over the last five years. I knew this was coming. I also knew, once it started, there would be no one who could tell me how long it would continue. I knew, but knowing doesn’t make it any easier.
I also knew women are more susceptible to weight gain, particularly around the abdomen, leading up to menopause through to a few years post-menopause. But, I assumed I was immune to that. After all, I eat a balanced, healthy diet and exercise six days a week. I’m a trainer, I have all the answers to that problem. Or, so I thought.
Let’s begin with the low-down on menopause mayhem. Menopause marks the time when a woman stops producing the reproductive hormones estrogen and progesterone and, therefore, ceases to release eggs and loses the ability to become pregnant. One has officially reached menopause when she hasn’t had a menstrual period for twelve consecutive months. The time before menopause, when she’s symptomatic but still experiencing (irregular) periods, is known as perimenopause. In the U.S., the age range for menopause is early 40s to early 60s with an average age of 51. Perimenopause can last anywhere from a few months to ten years with an average length of four years.
While it’s true the decrease in reproductive hormones is directly related to the common symptoms, that doesn’t tell the entire story. The human hormonal (endocrine) system is complicated and entirely interdependent. Consequently, major changes in the reproductive hormone levels necessarily means major disruptions in all hormone function. Which means the following disruptions can be expected from perimenopause through to menopause and, in some instances, into post-menopause:
- Insomnia, sleep disruptions and poor sleep quality
- Disordered body temperature regulation
- Bone density and muscle mass loss
- Disrupted insulin function
- Reduced tissue elasticity and moisture
- Decreased nutrient absorption (especially calcium)
These changes make the following more likely:
- Increased appetite, decreased satiety
- Slower metabolism
- Increased instances of moodiness, anxiety and depression
- Hot flashes/night sweats
- Increased post-exercise soreness and longer recovery
- Forgetfulness, distraction and inability to concentrate
- Hair loss or unusual hair growth
- Dry skin
- Vaginal dryness, decreased libido
This combination of changes leads to a high likelihood of increased fat mass, particularly in the abdomen. Even if she leads an active lifestyle and consumes a healthy diet. If perimenopause lasts less than a year, this is manageable. But for the average four-year perimenopause experience, and those who go beyond that, this predicament can raise her risks for osteoporosis, diabetes, high blood pressure and cardiovascular disease in the long run.
Hormone replacement therapy (HRT) used to be the solution. But evidence suggesting HRT increases risk for breast cancer leads doctors to recommend other solutions. Consult the average medical professional, and the advice is to exercise more (at a higher intensity and more minutes per week) and reduce calorie consumption. Really?! Hormonal changes that I can’t control slow my metabolism, increase my appetite while making me more tired, more sore when I exercise and for days longer than before and the advice is to eat less and workout more?
Enter Wendy Sweet, Ph.D., a 30 year veteran in the fitness industry, who has studied menopause through the lens of fitness. (Her article here caters to fitness professionals working with the female population, but any woman going through this transition could benefit from her wisdom.) Ms. Sweet points out doctors can only use the latest study evidence to guide them when advising patients. The bulk of diet and exercise studies lump all adults (ages 18 through 65), male and female, together. While the last few decades have seen studies that hone in on the child, adolescent, teen and elderly populations, there are only a handful of middle-age, female specific diet and exercise studies.
If a 30 year old male has gained unhealthy abdominal fat as a result of poor habits the obvious advice is to shift from unhealthy behaviors to more healthy habits. It makes sense to teach him to exercise at high intensities often, reduce unhealthy food and increase healthy food consumption. But, should we expect the same proscription for a person who has fit habits but has gained abdominal fat due to natural, normal physiological changes beyond her control?
Dr. Sweet contends the few studies we do have on the menopausal population show that telling an active 45 year old, perimenopausal woman to exercise more vigorously, more often is the absolute wrong advice. The studies indicate the hormonal changes that disrupt sleep is what causes the increased muscle and joint soreness after exercise and the delay in exercise recovery. Meaning, increasing the intensity and volume of exercise will lead to over-training, which will exacerbate the lean mass loss, fatigue and disrupted sleep she’s already experiencing. In many cases, these women give up exercising all together out of exhaustion, discouragement and feelings of hopelessness.
The better advice is to start with acceptance that our bodies will physically change and that it’s natural. Instead of trying to maintain or regain the weight or waist measurement we had in our 20s and 30s, we need to focus on keeping a healthy waist-to-hip ratio. We do that by consuming a well-balanced, nutrient-rich diet; minimizing time spent sitting; engaging in regular, moderate intensity cardiovascular and strength training and getting as much sleep as possible.
And, for goodness’ sake, cut ourselves some slack! That’s the way to manage the mayhem.