This is a Specialist Weight Loss Plan designed to help women manage their weight during menopause.

Menopause is a key milestone in any woman’s life and brings with it many physical, hormonal and psychological changes including headaches, hot flushes and mood swings. Perhaps one of the most sensitive issues is weight gain due to hormonal changes (mainly a drop in oestrogen levels).

Menopause will generally occur in all women. It typically occurs in the late 40s or early 50s and is characterised by a cessation of menstruation and a variety of physical and hormonal changes. This significant life transition can bring about a range of symptoms and health considerations, impacting a woman’s overall well-being in addition to weight gain.

What is Menopause?

Menopause signifies the time when a woman’s reproductive life terminates. It marks the termination of menstruation which results in loss of ovarian function. The ovaries decrease in size and oestrogen levels drop by 80% or more. Typically, the ages that women start becoming premenopausal varies at 45-50. Menstrual periods may stop immediately or gradually over time with irregularity. Menopausal women cannot get pregnant unless they have some specialised intervention by a gynaecologist/fertility expert.

Some women can become menopausal even at a younger age. This may be due to certain conditions like cancer of the ovaries, radiotherapy, trauma to the ovaries or surgical removal of ovaries for any reason. This is called premature menopause.

Weight gain in menopausal women results from:

• Hot flushes
• Night sweats
• Sleep disturbance
• Mood alterations
• Anxiety
• Vaginal dryness
• Reduced sex drive
• Weight gain
• Altered hunger

In addition to the symptoms mentioned above women also find it difficult to lose weight.

Other symptoms and signs include:

• Headache
• Low bone mass
• Difficulty concentrating
• Sore or tender breast
• Palpitation
• Urinary tract infections
• Reduced muscle mass (Sarcopenia)
• Joint Pain
• Thinning of scalp hair
• Increased facial hair
• Dry skin
  
  

Stages of Menopause 

There are various stages of menopause, and the entire process can take a few years.The stages of menopause in a woman’s life are as follows:

• Premenopause
• Perimenopause
• Menopause
• Postmenopause

What is Premenopause and Perimenopause?

Premenopause

• Premenopause is the time before the onset of actual menopause. Women may still have periods, either regular or irregular.
• Women are also still in their reproductive years and considered fertile. 
• During premenopause, there are no noticeable changes in the body, but hormonal changes may start to occur.
• During premenopause some women may experience symptoms of menopause like sleep disturbance, altered hunger, weight gain, irregular periods and becoming tearful for unknown reasons.
  
  

Perimenopause

• Perimenopause means “around or near menopause.” 
• The most significant sign that someone is in the perimenopausal phase of the reproductive cycle is that they have noticeable symptoms.
• During this stage, women begin to experience symptoms of hormonal changes.
• These symptoms may occur due to the decrease in oestrogen and other female hormones and also in some women there may be an increase in testosterone. 
• The average length of the perimenopause stage varies between 4-6 years. 
• For some, it may only last a few months, and for others, it may go beyond the four years. During this time, it is still possible to become pregnant.

What is Premature Menopause? 

• Premature menopause may occur even before the age of 40 years. 
• Premature menopause is due to non functioning or improper functioning of the ovaries, hence also called premature ovarian failure or premature ovarian insufficiency.
  
  

This can lead to a cessation of menstruation, infertility, and hormonal imbalances. Reasons for premature menopause include:

• Genetics
• Autoimmune disorders
• Chemotherapy 
• Radiation therapy
• Surgery

What is surgical Menopause?

• Menopause that develops as a result of surgery is referred to as surgical menopause,typically the removal of both ovaries, also called bilateral oophorectomy. 
• This abrupt removal of the ovaries leads to an immediate and permanent cessation of ovarian hormone production, including oestrogen and progesterone. 
• It can have significant effects on a person’s hormonal balance and may lead to various symptoms such as 

• Hot flushes, 
• Mood swings, and 
• Long-term health concerns including loss of bone density (Osteoporosis) and increased risk of heart disease.

Medical Consequences of Menopause

Some common medical consequences of menopause include:

Hot Flushes: Many women experience hot flushes, which are sudden and intense feelings of warmth, often accompanied by sweating and a rapid heartbeat. These can be quite disruptive.

Vaginal Dryness: The drop in oestrogen levels can lead to vaginal dryness and thinning of vaginal tissues, causing discomfort during intercourse and an increased risk of urinary tract infections.

Osteoporosis: Reduced oestrogen levels can contribute to bone loss and an increased risk of osteoporosis, making bones more brittle and prone to fractures.

Heart Health: Menopause is associated with changes in cholesterol levels, which can increase the risk of heart disease. It’s important to monitor cardiovascular health during this phase.

Weight Gain: Some women may experience weight gain during menopause, especially around the abdomen. Hormonal changes and a slower metabolism can contribute to this.

Women find it very difficult to lose weight due to loss of muscle mass (Sarcopenia).

Quality of life in Menopause women

The quality of life in menopausal women can vary greatly from person to person. Improving the quality of life in menopausal women involves addressing the physical, emotional, and social aspects of this life transition. Here are some strategies that can help:

Lifestyle Modifications:

• Diet: Consume a balanced diet rich in calcium and vitamin D for bone health. Minimise caffeine, alcohol, and spicy foods that can trigger hot flashes.
• Exercise: Regular physical activity can improve mood, sleep, and overall health.
• Weight management: Maintaining a healthy weight can help manage hormonal fluctuations and reduce the risk of chronic diseases.
  
  

Stress Management:

• Practice relaxation techniques like deep breathing, meditation, or yoga to reduce stress and improve emotional well-being.
• Adequate sleep is essential adapt measures to improve your sleep hygiene. 
  
  

Regular Health Check-ups:

• Continue with routine medical check-ups to monitor your health and address any age-related health concerns.
  
  

Education:

• Educate yourself about menopause and its symptoms to better understand and manage the changes your body is going through.
  
  

Stay Active: 

• Engage in activities you enjoy, pursue hobbies, and maintain an active social life to boost mental and emotional well-being.
  
  

Cognitive Behavioral Therapy (CBT): 

• CBT can help manage mood swings and anxiety during menopause.
• Remember that the approach to improving quality of life during menopause should be personalised, as the experience varies from woman to woman. 
  
  

Weight gain in Menopausal women

Weight gain in women following menopause can compound all the physical and psychological problems faced by menopausal women.  In addition to alteration in hormone levels there is a decrease in lean body mass.  Muscles are involved in burning calories and decrease in muscle mass leads to less calories being burnt moreover there is significant alteration in Basal Metabolic Rate (BMR).  Stress is another key factor in post menopausal weight gain. Stress triggers increased cortisol production, which triggers the fight or flight response. High levels of cortisol can cause one to gain weight around the waist. There are also metabolic changes that result in the body retaining stored fat. Comfort eating to cope with psychological and bodily changes, signs of ageing and a plethora of external sources enables one to also gain weight.

Why do Menopausal women struggle to lose weight?

• Menopausal weight gain can be influenced by hormonal changes. 
• During menopause, a decrease in oestrogen levels can lead to changes in fat distribution and a slower metabolism, making it more challenging to lose weight. 
• Additionally, other factors like ageing, decreased muscle mass, and lifestyle changes can contribute to this struggle. 
• However, with a healthy diet, regular exercise, and sometimes medical guidance, women can still achieve and maintain a healthy weight during and after menopause.

Holistic management of menopausal symptoms

The holistic management of menopausal symptoms involves addressing physical, emotional, and lifestyle factors. Here are some strategies:

Nutrition: Maintain a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Flaxseed and soy are good sources of phytoestrogens, which may help reduce symptoms.

Exercise: Regular physical activity can reduce hot flashes, improve mood, and support bone health.

Supplements: Bone health depends on both calcium and vitamin D.

Sleep Hygiene: Create a conducive sleep environment and establish a regular sleep schedule to combat sleep disturbances.

Support Groups: Join menopause support groups to share experiences and get emotional support.

Lifestyle Changes: Avoid triggers like caffeine, alcohol, and spicy foods that may worsen hot flashes. Quit smoking if you’re a smoker.

Remember that each woman’s experience of menopause is unique, so it’s important to work with a healthcare provider to develop a holistic plan tailored to your specific needs and concerns.

Weight loss in Menopausal women

Weight loss during menopause can be challenging, but it is possible to lose weight with the right approach. 

Here are some tips:

Balanced Diet: Make sure your diet is well-balanced and full of healthy grains, lean meats, fruits, and veggies. Minimise sugar, processed meals, and saturated fat.

Portion control: To prevent overindulging, pay attention to portion proportions. Eating smaller, more frequent meals can help stabilise blood sugar levels.

Frequent Exercise: Include both strength-training and cardiovascular activities in your regimen. Aim for 150 minutes a week or 75 minutes a week of vigorous-intensity aerobic activity as your minimum goal.

Strength Training: Building muscle can boost metabolism. Include weight or resistance training exercises at least twice a week.

Manage Stress:  Being overly stressed can make you acquire weight. Engage in stress-relieving activities such as yoga, meditation, or deep breathing.

Sleep Well: Aim for 7-9 hours of quality sleep per night, as inadequate sleep can disrupt hormones related to appetite and metabolism.

Stay Hydrated: Drinking enough water can help control hunger and support overall health.

Consult a Doctor for appropriate investigations and weight loss medications.

Our multidisciplinary team at The London Obesity Clinic helps ladies through this turbulent journey through extensive support and medical guidance. This team includes physicians, endocrinologists, dietitians and many others. We will look at your medical and family history, your hormone profile and reassess your diet, activity and sleep patterns. Most importantly, we will be there to support you psychologically and ensure your emotional well-being during this time.

What happens to the body around menopause?

Fluctuation in oestrogen, progesterone and testosterone is seen in menopausal women. In addition to the symptoms mentioned above some women have low libido, excess facial hair growth, sweating, fluid retention and sleep disturbance. These can have a serious impact on their confidence and self-esteem. Women around menopause have altered hunger patterns leading to weight gain.

Why do menopausal women struggle to lose weight?

In addition to changes in the hormones, lean body mass and factors related to ageing there could be several other reasons which slow down metabolism. Loss of muscle mass or sarcopenia is one of the reasons for menopausal women struggling to lose weight.

Most women would have been through several diets before menopause and succeeded. However, they find that after menopause following the same plan does not bring about the same results. This in part is due to alteration in the basal metabolic rate.

What could happen to menopausal women with a high Body Mass index?

Menopausal women who are overweight and obese are more likely to have the following medical conditions: Heart attack, high blood pressure, type 2 diabetes, stroke, cancer, non-alcoholic fatty liver disease, arthritis, sleep apnoea and several others.

It is therefore important to reduce weight and at the same time ensure weight-related medical conditions are managed at the same time.

How do you help with weight loss in menopausal women?

A comprehensive consultation by one of our specialists is followed by relevant investigations. Thereafter a 3-month intensive Menopause – weight loss plan is offered. You will have offline and online support throughout the programme. During this plan, we focus on both weight loss and also on associated weight-related medical conditions, self-esteem, confidence, sleep and relationship. You will have the option of joining a maintenance programme for up to 12 months of additional support.

Hormone Replacement Treatment (HRT) and Menopause

HRT or Hormone Replacement treatment helps menopausal women control menopausal symptoms. As mentioned above menopausal women may have a poor quality of life due to hot flushes, night sweats, anxiety, sleep disturbance and reduced sexual drive.

HRT helps maintain Bone Mineral density (BMD) and thereby can reduce the risk of fractures. Also research has shown that HRT could reduce the risk of coronary heart disease. There are some studies which shows that HRT also reduces the risk of dementia, in particular Alzheimer’s disease especially if oestrogen is commenced very early during menopause. Some women have shown to have reduced risk of type 2 diabetes and large bowel cancer when they have been on HRT.

Benefits outweigh the risks especially if HRT is used in women below the age of 60 years. Endometrial (uterus) cancer risk is increased if oestrogen only is given as an HRT in women with uterus. Breast cancer risk is increased after a 5 years use of combined HRT in women above the age of 50. Breast cancer risk is more in menopausal women who are obese and/ or who consume two or more than 2 units of alcohol a day on an average.

Deep vein Thrombosis (DVT) and Pulmonary Embolism (PE) risk is minimal and research shows the risk to be around 1.7 per 1000 women over the age of 50. However no increased risk of DVT or PE has been shown with transdermal HRT (patch or gel). Risk of coronary heart disease or stroke is possibly increased when HRT is commenced in women above the age of 60 or with a history of cardiovascular diseases like heart attack, angina, stroke, Transient ischaemic Attack (TIA).

Overall benefits outweigh the risk of using HRT. It is important to always use HRT after consultation with a doctor and have regular review with a doctor whilst on HRT.

Testosterone in Menopause

Testosterone in menopausal women is known to help when they are troubled with low sexual desire. The medical terminology for this condition is Hypoactive Sexual Desire Disorder (HSDD).

Testosterone is essential for the development of and functioning of female sexual organs. There is reduction in testosterone levels with ageing in both men and women.  In menopausal women testosterone levels can drop due to loss of ovarian function. Not all women with low testosterone complain of lack of sexual desire. Testosterone supplementation should therefore be considered only after proper assessment by a doctor. It is also important to be reviewed on a regular basis whilst on testosterone.

If you wish to see a specialist for an initial consultation and join our plan then please fill out the contact form below and we will be in touch shortly.

Watch our video on Weight Loss for Menopause