Weight Gain in Menopause: Where Did That New Tummy Come From?

Fat weight gain around the midsection is something that normally occurs in many women around the time of menopause. Please note that I said normally, not inevitably. Understandably, this new tummy makes women very unhappy. Adding injury to insult, it has been clinically proven that midsection fat increases a woman’s risk for breast cancer, heart attacks, type 2 diabetes, Alzheimer’s dementia, and high blood pressure, as well as high cholesterol levels.

In response to this midsection fat weight gain, women are typically advised by their physicians to “lose weight.” They are told to modify their diet, increase exercise or both. Sound familiar? Have you tried to lose your new tummy by changing how you eat and exercise? Are you frustrated and resigned because you have tried everything and it hasn’t worked?

The reason it hasn’t worked is not because you haven’t given it your all. It’s because the advice is wrong; it misunderstands the physiology underlying your newly acquired fat.

The truth is, you will never permanently get rid of this type of fat weight by decreasing caloric intake or increasing the amount of exercise you do. You could lose it for a few months, but it will always come back. In fact, decreasing calories or increasing exercise actually makes this type of fat weight gain worse because these weight loss methods cause further hormone imbalance.

In simplest terms, your new midsection fat weight gain is caused by your body’s response to your menopause, not by how much you eat or exercise. Therefore, the only way to counter this type of fat weight gain is to properly treat your menopause.

To put this in perspective for you, let’s start by understanding the physiology of why menopause triggers weight gain around the middle.


The Physiology of Fat

As explained in other articles in this series, menopause is the permanent loss of your sex hormone system. It is the time in your life when your body is no longer able to produce adequate levels of the sex hormones estradiol (the estrogen made in your ovaries) and progesterone.

Most people (and many physicians) think that sex hormones are only important for reproduction and physical beauty. This is far from true. In fact, these hormones play a number of important roles in your body, some of which I have noted here. They affect memory and mood because they are neurotransmitters and they affect the levels of other neurotransmitters. They help your immune system to work by modulating the inflammation that occurs in your body. They also are important in regulating digestion. In addition, balanced sex hormone levels affect the body’s ability to respond to insulin, improving insulin sensitivity. This helps you rebuild and repair tissue. For more information about the myriad ways in which the loss of your sex hormones affect your health, read: Blame it on Menopause.

Because of its importance in performing these other critical functions, when you lose the ability to produce sufficient estradiol and progesterone, your body looks for other ways to make them – especially estradiol.

Production of more progesterone is not as critical an issue as is the production of more estradiol because your adrenal glands are a secondary source of progesterone production. At any given moment the levels of progesterone in your body are at least 1,000 times that of the levels of estradiol. Unlike the production of estradiol by the ovaries that usually ends up at “zero,” the production of progesterone from the adrenal glands is life-long. So, the loss of the sex hormone system is really more about the loss of the hormone estradiol than it is the loss of progesterone. However, once you do begin to restore estradiol (see below), you will need to make sure that you also supplement with progesterone (especially if you have a uterus) to maintain the right balance between these two hormones.

So, what is the connection between fat cells and estradiol production? Well, as I have explained in previous articles, all of the systems and sub-systems of your body are interrelated and interdependent. When one system or sub-system is compromised or out of balance, the other systems and sub-systems of the body try to compensate for this imbalance. Fat production due to low levels of estradiol is a great example of this fact. Unfortunately, the degree of technical information and detail required to accurately explain everything that happens exceeds the scope of this article. Suffice to say, through a number of processes that involve other hormones such as insulin, ACTH, and the stress hormones adrenaline, cortisol, and DHEA, the body works to produce more estradiol. It does so by producing another type of estrogen called estrone that can then be converted to estradiol. The production of the estrone by conversion of DHEA occurs in fat cells. So, to enable this conversion, the body produces more midsection fat. Again, please remember, this is a very simplified explanation of a very complex process, but the point remains:

Your midsection fat weight gain is caused by your body’s stress response to insufficient amounts of estradiol.

And here’s the bad news – despite all the physiologic magic that takes place among all of these hormones and hormone systems, the body still cannot produce the amount of estradiol you need. You still have a hormone imbalance and a new tummy!


Now, Let’s Trim That Waistline with HBTx

So, if you understand the relationship between midsection fat weight gain and your sex hormone levels, then you also understand that getting rid of your newly acquired midsection fat is not simply a function of diet and exercise.

The fat weight gain is going to happen regardless of how little you eat and how much you exercise. In fact, if you over-exercise or under-eat, it can actually make things worse. That said, proper diet and exercise are extremely important to your health and metabolic balance. In the case of menopause, you must also restore your sex hormones. By doing so, the body no longer needs to build fat in order to produce estrone to convert to estradiol.

How do you restore your missing sex hormones? The only way to effectively and safely restore your missing sex hormones is with supplemental bioidentical estradiol and progesterone administered in a bioequivalent manner, through a protocol known as Hormone Balancing Therapy or HBTx™. See: “Treat the Problem Not Just the Symptoms With Bioidentical Hormones”.


A Final Note

Whenever you lose a hormone system, your metabolism is affected. This is equally true for menopause. One of the first signs of menopause is fat weight gain around the middle. This is the same fat weight gain that numerous studies have shown to increase a woman’s risk for breast cancer, heart attacks, type 2 diabetes etc. To be absolutely clear, your risk for breast cancer increases when you lose your sex hormones.

Ironically, many women avoid “taking hormones” for fear that doing so will increase their risk for breast cancer. There is validity in this concern depending on how a woman supplements her lost sex hormones. Certain traditional approaches to sex hormone replacement, often called HRT, which use hormone drugs instead of bioidentical hormones, and do so in a continuous combined instead of a bioequivalent manner have, in fact, been shown to increase the risks both for breast cancer and for heart disease! So please be sure to read more and understand why HBTx is both effective and safe and why other methods fail to treat the cause of menopause and, in doing so, actually accelerate the aging process and increase long-term health risks.


To your health and happiness,

Diana Schwarzbein, MD