Perimenopause Weight Gain: Why It Happens and How to Manage It

Perimenopause is a natural phase in a woman’s life that can occur for up to 10 years before menopause (one year after the last menstrual period). During this transition, hormonal changes trigger a range of symptoms, including irregular periods, hot flashes, mood swings, and sleep disturbances. One of the most frustrating perimenopause symptoms that women experience is unexpected weight gain, which is often concentrated around the belly. 

In this blog post, we’ll explore why weight gain is common during perimenopause, the factors contributing to it, and most importantly, how to manage it effectively.

Woman steps on a scale in her bathroom and throws her hands up in frustration

Why Does Weight Gain Happen in Perimenopause?

There isn’t just one cause for weight gain during perimenopause – it’s a combination of factors tied to hormonal fluctuations, lifestyle changes, and the natural process of aging. Here’s a deeper look at the top contributors:

1. Hormonal Changes:

The two primary hormones involved in weight gain during perimenopause are estrogen and progesterone. As women approach menopause, estrogen levels begin to decline, and this drop can lead to several physical changes:

  • Decreased Metabolic Rate: Estrogen helps regulate metabolism, and as levels fall, metabolism naturally slows down. This can make it harder to maintain or lose weight.
  • Fat Storage Shifts: Estrogen also influences where fat is stored in the body. As estrogen levels drop, fat tends to shift to the abdominal area, leading to an increase in belly fat.

2. Changes in Insulin Sensitivity:

During perimenopause, women are more likely to become insulin resistant. This means that their body has to produce more insulin to keep blood sugar levels stable. Higher insulin levels can promote fat storage, particularly around the abdomen. This is why many women find themselves gaining weight despite making no significant changes to their diet or exercise routine.

3. Muscle Loss and Decreased Activity:

Sarcopenia (the natural loss of muscle mass and strength with age) typically starts around the age of 30, but it becomes more pronounced during perimenopause and beyond. The hormonal changes during perimenopause, especially the reduction in estrogen and testosterone, can accelerate this process. A decrease in activity levels can further cause a decline in muscle mass, particularly if strength and resistance training are not part of a regular workout routine.

4. Stress and Cortisol Levels:

Many women experience increased stress during perimenopause due to a combination of hormonal fluctuations and life changes. Chronic stress leads to higher levels of cortisol (the “stress hormone”) which is linked to abdominal weight gain. Elevated cortisol levels can also lead to cravings for comfort foods, contributing to weight gain as well.

5. Sleep Disturbances:

Perimenopause is often associated with sleep problems, such as insomnia or frequent night sweats. Poor sleep has been shown to increase hunger hormones like ghrelin and decrease leptin, the hormone that signals fullness. Studies have shown that individuals who have disrupted sleep or a short sleep duration are more likely to gain weight. 

How to Manage Weight Gain During Perimenopause

While weight gain in perimenopause can feel like an uphill battle, there are several strategies that can help you manage your weight and improve your overall health. Working with a Naturopathic Doctor can help to analyze your symptoms, assess necessary lab markers, and develop a plan forward that is tailored to your body’s needs. You can feel like your best self throughout perimenopause and beyond, and here’s how you can get started:

1. Nutrition:

A healthy, nutrient-rich and low insulin demand diet is key to managing weight gain during perimenopause. Focus on:

  • Whole foods: Opt for whole grains, lean proteins, fruits, vegetables, and healthy fats like avocados, nuts, and olive oil.
  • Low food insulin demand foods: Foods that have a low insulin demand help stabilize blood sugar levels and prevent insulin spikes that lead to fat storage.
  • High-fiber foods: Fiber helps regulate digestion, keeps you feeling full longer, and can help manage blood sugar levels.

2. Movement:

Carving out time for movement can help to combat the effects of aging on metabolism and muscle mass. The key is to incorporate both cardiovascular and strength-training exercises into your routine:

  • Cardiovascular exercise: Activities like walking, jogging, swimming, or cycling can help you burn calories and maintain a healthy weight.
  • Strength training: Lifting weights or doing bodyweight exercises like squats and lunges can help build and maintain muscle mass, which in turn boosts metabolism.

3. Sleep:

Getting enough quality sleep is a key pillar in any perimenopause treatment plan. To improve your sleep quality:

  • Create a relaxing bedtime routine to wind down, such as reading or meditating.
  • Keep your bedroom cool and dark to create a sleep-friendly environment.
  • Limit caffeine and screen time before bed, as these can interfere with your sleep.

4. Stress Management:

Chronic stress can lead to burnout, and make you feel like you’re in a constant state of fight or flight. While some sources of stress are unavoidable, setting healthy boundaries and implementing stress management techniques can go a long way:

  • Mindfulness and meditation: Regular mindfulness practices can help lower cortisol levels and promote relaxation.
  • Yoga or deep breathing exercises: These practices help activate the parasympathetic nervous system, reducing stress and improving overall well-being.
  • Self-care: Take time to engage in activities you genuinely enjoy, whether it’s spending time with loved ones, enjoying hobbies, or taking a relaxing bath.

5. Consider Bioidentical Hormone Therapy (if appropriate):

For some women, bioidentical hormone replacement therapy (BHRT) may be a treatment option to help manage perimenopausal symptoms, including weight gain. BHRT can also help to ease symptoms like hot flashes, mood swings, and night sweats. A thorough health history, risk screening and lab work can help to determine if BHRT is appropriate for you. 

We are here to support you!

Weight gain during perimenopause is a common experience among women, but it doesn’t have to be something you struggle with alone. By understanding the factors behind the weight changes and taking a proactive approach to nutrition, exercise, stress management, and sleep, you can feel like yourself again during this phase in your life.