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On the occasion of today’s World Menopause Day, Mrs. Lina Pashou, Assistant Professor of Endocrinology at the Medical School of the Greek University of Athens highlights the changes that take place in the body and weight and the points that every woman of this age should pay attention to
One of the most remarkable phenotypic changes in women after menopause, namely the last menstrual period, is weight gainwhich is mainly related to accumulation of central abdominal fat. Studies have shown that waist circumference, that is, the belly grows by 4 centimeters during the transition to postmenopausal life. Body mass index is also significantly higher, by about 1 kg/m2. These phenomena begin after the age of 40 in the average woman, but they mainly concern the first 5 years after the last period.
What happens at this age is a decline in ovarian function and a decrease in endogenous estrogen concentrations, which is even more steep immediately after menopause. In addition to estrogen, women also have androgens, such as testosterone. Androgen concentrations in this phase do not decrease as much, so the relationship between the hormones changes and so the physical phenotype becomes more male-like as females get older. The that is, older women have the “apple” phenotype compared to younger women who have the “pear” phenotype. From a pathophysiological point of view, the reduction of estrogen levels relative to androgens leads to a significant reduction in energy expenditure from fat oxidation, without necessarily significant changes in energy intake.
At this age she needs more attention to diet and exercise daily. Specifically, a small reduction in calories, of the order of 200-300 per day, is important. Care is also required in the intake of carbohydrates, such as breads and sweets, to limit hyperinsulinemia that also leads to central obesity. Regarding exercise, the brisk walking 30 minutes per day is beneficial. It is an aerobic exercise that helps burn fat. In addition, it maintains muscle mass and can provide psychological well-being. The latter is important for maintaining normal levels of cortisol, another hormone that when chronically elevated can also lead to central obesity. Finally, in appropriate women, hormone replacement therapy reduces abdominal fat deposition by increasing fat oxidation, while also improving insulin sensitivity.
*The Lady Stavroula (Lina) Paschou is an Assistant Professor of Endocrinology at the School of Medicine, EKPA