Ask Dr. Annie K: Post-Menopause

 

I am 5 years post menopausal and feel like crap. Going through menopause was/is one of the worst thing that has ever happened to me. I went through at the early age of 43 🙁 I haven’t felt like me in years. I have always exercised and I eat a very healthy diet comprised mainly of veggies, but I’m fatter then I’ve ever been and gaining by the years. I am so tired of people telling me this is a normal part of aging! I have seen plenty of older women that still look and feel amazing. How do I know if my hormones are out of whack? What can I do if they are? I don’t like to take any medications if possible.

Love+Medicine

Thank you for asking about this very important issue, one that troubles many women. Our knowledge and understanding of menopause is pretty pathetic, considering all women go through it!

Weight gain, particularly belly fat, is a common complaint. While it is common, I agree with you – weight gain is not a “normal part of aging”. It is a potentially serious medical problem.

It sounds like you are already addressing your exercise and diet. Keep that up – don’t sit when you can stand. Keep moving. Lower your carbohydrate intake. Avoid white food.

Let’s think outside the box which may help us figure this out: 

Talk to your doctor about insulin resistance. It is common in menopause and causes similar symptoms. The job of insulin is to maintain healthy levels of sugar in your blood. When insulin out of balance, besides making you feel bloated and tired, it can make it very difficult to lose weight. This can be diagnosed with a blood test – ask your doctor to order a fasting insulin test and a lipid panel to check for high cholesterol and triglyceride levels that may further indicate insulin resistance. If left untreated, insulin resistance can lead to serious illnesses including diabetes.

Hypothyroidism is also common among menopausal aged women and could explain weight gain. Ask for a TSH level. 

Cortisol increases with stress and anxiety. Cortisol may also increase sugar levels. Request a cortisol level blood test.

Regarding hormones being “out of whack” – that may indeed be true. Measuring hormone levels are not clinically helpful because they fluctuate so much. While hormone replacement may be beneficial for some symptoms of menopause, there is little evidence of its usefulness in the treatment of weight gain. Because of the potential risks, the decision whether or not to start hormone therapy should be made very carefully with your doctor. 

The North American Menopause Society (NAMS) may be a useful resource to you, particularly if you are looking for a menopause specialist in your area. You have legitimate concerns and you need to have someone who will listen and help you get through this difficult time.

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