Whether you have already gone through menopause or starting to experience it, you might have some questions around what is actually happening during this process. The short answer...a lot! The transition to menopause, known as perimenopause, takes place over a period of several years. As the ovaries gradually reduce estrogen production, there are many hormonal fluctuations as the body adjusts to the inevitable shut-down of the ovaries.

As you all  know, a woman is officially in menopause when she has not gotten her period for 12-months straight. At this point, the ovaries have significantly reduced production of the hormones estrogen and progesterone, ending a woman’s child-bearing years.

There are significant physiological and metabolic changes occurring at this time that directly affect your body composition. So, if you feel like it's been more difficult than it was 10 or 15 years ago to lose weight or get a hold on weight management, it’s not your imagination. That also being said, it's important to remember that your body is a beautiful vessel guiding you through this transition, be kind to yourself and know that you still have the power to put your health in your hands. 


Aging, in and of itself, has been associated with weight gain and changes in metabolism. In general, as you age, lean muscle mass decreases while fat mass accumulates.  Part of this change is due to the natural change of your metabolism as you age. Another significant factor is lifestyle. Women tend to become less physically active as they pass from their 40’s into their 50’s.  A decrease in physical activity means less calories burned, which inevitably leads to increased weight and fat mass and muscle mass loss. Another culprit is not adjusting caloric intake to compensate for the reduced metabolism.


Estrogens often referred to as the “female hormones,” are responsible for your sexual and reproductive development. Produced primarily by the ovaries in women, estrogen levels plunge when your ovaries stop releasing eggs. Reduction in estrogen has a few negative effects on the body’s propensity to store fat. Animal studies have shown that lower estrogen only increases appetite and food intake, it is also associated with changes in weight and fat distribution. Coupled with estrogen’s negative effects on the metabolism, which may reduce the rate at which your body burns calories and the efficiency in how your body handles starches and blood sugar, the end result is increased fat storage.


Commonly known as the “stress hormone”, the primary function of cortisol is to help you respond to stress. When cortisol prepares the body for a stressful situation, it often signals the breakdown of muscle tissue to release energy. Chronic stress, which results in a continuous release of cortisol, has been associated with fat deposition in the middle section of women. This leads to a vicious cycle as abdominal fat leads to more cortisol production and cortisol continues to promote fat in the abdomen.

To compound the issue, a study found that women in perimenopause and early menopause experience elevated nighttime cortisol levels. The study concluded that nighttime production of cortisol is associated with biological changes rather than actual environmental stress. This means that proper sleep and stress management may be important tools to prevent fat storage around the belly.

Fat Distribution

This leads to one of the most common complaints women have about their bodies after menopause is the loss of their waistline.

While a decline in reproductive hormones (follicle-stimulating hormone, luteinizing hormone, estrogen, and progesterone) has not yet been directly linked to weight gain, several studies shows that menopause does play a role in many midlife women’s transformation from a pear-shaped figure (wide hips and thighs with more weight below the waist) to an apple shaped figure (wide waist/belly with more weight above the hips).

One study investigated how menopause affects body composition and abdominal fat distribution.  The study concluded that this period of life is associated with increased total fat mass. Another key finding confirmed, “the menopause transition appears to promote the selective accumulation of fat in the intra-abdominal compartment.”


Leptin is known as the “satiety” hormone.  Produced by your fat cells, the hormone leptin determines the amount you eat, calories you expend and even how much fat your body stores. Leptin levels are based on an individuals’ fat mass and its primary purpose is to protect you from starvation.

Low levels of leptin signal your brain to increase feelings of hunger which trigger you to eat more while your body burns less energy.

Overall, women have higher leptin levels than men, which makes sense due to women naturally carrying a higher percentage of fat than men.

It has been found that leptin levels decrease significantly in menopause regardless of the amount of fat mass. This explains why so many women report an increased appetite during menopause.


Don’t panic! Your body is going through a transition and while this is nothing like what you've experienced before, it is normal and natural. Consider this a fun adventure and make it a priority to put you and your health first. Staying active and eating healthy are the cornerstones to a woman’s health and they should be even more so during the menopausal transition and afterwards. It's also essential to have your doctor test your hormones, adrenal glands and thyroid to see if there are any imbalances that could be adding to the mix.

These specific issues can then be treated with the appropriate treatment and care needed for balancing you! 

I would love to hear from all of you. What was your experience like during menopause? Are you going through it now? What questions do you have for me?

xox, Dr. G