Menopause: When it all goes barrel-shaped

Today holistic health consultant Giselle Cooke is sharing her insight into menopause relief.

I have been caring for menopausal women in my practice for over 30 years now and the most constant lament I hear from these women is not about losing their femininity, but more about losing their waistline. It is bad enough handling the embarrassing and menacing hot flushes, disturbed sleep and vaginal dryness, which causes sex to be anywhere from uncomfortable to sheer torture but to also have to watch an extra five to ten kilos of weight creep on with the menopause in spite of best efforts to exercise and eat well can be quite demoralising.

Having completed this rite of passage myself a few years ago I feel well-placed to understand and empathise with the body changes that accompany the menopause and rob us of our luscious sexuality. The extra fat that is laid down in our tissues, especially around our waist giving us a "barrel shape" at this time is for good biological reason - to provide reserves of hormone substrates from which we can draw in the future to manufacture oestrogens when our ovaries retire.

After the menopause 40% of our sex hormones are derived from our adrenal glands, being converted from the youth-giving hormone, DHEA. For this reason, women who arrive at the menopause - and let's face it, you can never be certain when it will affect you between the ages of 35 and 55 - you do not want to be utterly exhausted with no DHEA reserves in your adrenals as back up.

I am also familiar with menopausal women having slightly high total cholesterol levels - around 5.5 to 6.5. mmoVL. Most GP's recommend a cholesterol lowering regime to these women, but this can be detrimental since cholesterol is required for the synthesis of progesterone, DHEA, testosterone and oestrogen. I think this is an appropriate cholesterol elevation to support menopausal hormone production. Women have no reason to be concerned about a high cholesterol causing risk for heart disease if their "good" cholesterol (HDL) is optimal as compared to their "bad' cholesterol (LDL) and their LDL:HDL ratio Is less than 3.

Fattening stuff to avoid with menopause

  • Alcohol: this is the worst thing to drink if you want to minimise weight gain throughout the menopausal years. Alcohol provides empty calories, slow clearance of oestrogen and metabolic waste from the tissues and causes fatty infiltration of the liver, all of which contributes to the "barrel" shape of abdominal obesity.
  • Caffeine: interferes with Phase 1 liver detoxification, leading to waste accumulation in the liver and the tissues, causing fluid retention and cellulite. It also contributes to DHEA depletion and adrenal exhaustion.
  • Aspartame: found in most commercial "diet" foods and drinks, it poisons the liver and causes fatty liver disease. It slows fat burning by the liver as well as contributing to fluid retention, puffiness and cellulite deposition. Aspartame also destabilises blood sugar levels, leading to sweet cravings.
  • Certain prescription drugs which impact upon the liver: unless they are essential, avoid long term use of medications which slow liver metabolism, such as paracetamol, anti-depressants, statin drugs (to lower cholesterol and proton pump inhibitors (to manage acid reflux). The last group of drugs, known as PPl's, interfere with our metabolic activity by impairing protein digestion, leading to low percentage lean muscle mass in comparison to body fat. They also cause progressive bone loss for the same reason, which may lead to osteoporosis.
  • Avoid pharmaceutical HRT: which contains a combination of oestrogens that are neither tailored to your needs, nor balanced, whilst containing synthetic progestins rather than natural progesterone. They are not recommended to be taken for more than twelve months due to the significant risk they carry for causing cardiovascular disease and female cancers. Tailor-made, natural, bio-identical hormone troches and topical creams provide the ideal hormone correction for the individual woman and can be prescribed for you by doctors who have trained in natural HAT formulating and dispensed by compounding pharmacies thoughout Australia.
  • Stress: try to avoid this assiduously at this time of life and you will have a smaller waist! Imploded anger and frustration increases fat deposition in the liver and chronic stress produces high levels of cortisol hormone, which increases abdominal fat stores whilst sacrificing lean muscle from important large muscle groups such as the glutes (buttocks). Our metabolic rate is influenced significantly by chronic stress, which down regulates thyroid function to slow our fat burning capacity. Lower post-menopausal levels of progesterone and 7-keto DHEA lead to slower metabolic rates, whilst lower testosterone levels reduce lean muscle mass, which slows our overall metabolism.

The importance of exercise for menopausal women

Of course the old adage "Calories in = Calories out" still holds basically true. I have personally found that I had to reduce my calorie intake from carbohydrates significantly if I wanted to minimise weight gain during the menopause. I also found that I have had to double the time my exercise sessions to achieve significant fat loss. Going the distance works better than going hard at this stage of life. Competitive training and aggressive activities such as boot camp and kickboxing can increase weight by elevating testosterone and cortisol levels in the body. Magically I have also found the best solution to burning fat stores and you can do it while you sleep! Yes, good quality and quantity of sleep reduces serum leptln levels, a hormone which makes you hungry. Sleep and meditation serve to stabilise cortisol levels, detoxify the tissues and assist elimination, which leads to fluid and waste clearance from storage.

How to stay slim through menopause

  1. Find a happy medium in all aspects of your life
  2. Anger and frustration can make you fat! Go for endurance exercise rather than intensive training to optimise your fat burning
  3. Keep your diet nutrient-dense and clean to avoid toxin accumulation and to provide optimal nutritional intake for prime metabolic activity
  4. Balance your hormones with the right amount of exercise, sleep, fun and relaxation

Best superfoods and herbs for the menopause

Phyto-oestrogen 19 are the superfoods of the menopause - they downregulate excessive oestrogen stimulation of the tissues which leads to hot flushes, fluid retention and fat deposition. They are found In beans, legumes, lentils, sprouts and all soya products (I recommend miso and tofu being the least processed forms of soy).

Natural fat-burning chemicals are found in green tea - epigallocatechin gallate (EQCG) is a powerful antioxidant that is responsible for green tea's thermogenic  properties.

Herbal medicines are a safe and effective first step, so I helped to formulate Hivita Menosoy to manage menopausal symptoms naturally. Wild yam improves progesterone levels to assist the thyroid (metabolism) and improve mood, Passion Flower has a calming, mellowlng effect on the nervous system and red clover and soy reduce oestrogen-dominant symptoms, such as hot flushes, insomnia, full breasts and fluid accumulation.

Finally, 7-kelo DHEA: Enhances the activity of three thermogenlc enzymes that stimulate fatty acid oxidation In the liver - fatty acy1 CoA axldase, malic enzyme, and glycerol-3-phosphate dehydrogenase. These enzymes drive the liver cells to bum fatty acids for energy, which causes a lowering of triglycerides in the liver.