Menopause and Your Changing Body
By Pamela M. Peeke, MD, MPH
In our culture, menopause is frequently seen as a negative milestone, a time of loss and is sometimes viewed as a disease or medical condition requiring a cure. With messages like this from the medical establishment and the media, it's no wonder many healthy women in the midst of this transition develop negative feelings towards their bodies.
What's an average woman to expect regarding her body as she travels through her perimenopausal years (typically her mid- and late- 40s)? Should she yearn for the 30-year old physique she may once have had? Is it possible to achieve that objective? What's a healthy and realistic goal for women hoping to optimize their body composition as well as their body image as they move through the last endocrinological change in their life?
Here are some facts. An average woman can expect to gain from two to five pounds during the menopausal transition, usually ending up in the lower tummy area. The main reason women experience this weight gain is the decline of estrogen. Fat cells in the hip, thigh and buttock areas have receptors for estrogen. Estrogen, in most women, drives most fat storage to the lower part of the body. As estrogen levels begin to decline, however, estrogen loses its hold on fat storage below the waist and instead, fat starts to show up in the "pinch an inch" area of the waistline. It usually extends from the belly button down to the top of your pubic hairline. It's like a small, soft pouch. I refer to this as the "menopot" and the great news is that it is not associated with life-threatening medical illnesses.
Unfortunately, many women are at risk for greater weight gain during the perimenopause and this excess fat usually is deposited deep inside the tummy, under the abdominal muscle wall. I call this Toxic Weight since this fat is unique in its ability to increase a woman's risk for diabetes, heart disease and cancer.
A woman notices that she is fighting the tendency to shape shift from a pear to an apple. Along the way, she is may be experiencing mental frustration about the weight shifts and gains.
By menopause, most women have a rich and fulfilling life history making them prouder and wiser. However, it's tough to focus on self-acceptance and emotional well being when your body feels like it has a life of its own and is gaining weight and getting harder to manage.
A growing number of women feel less attractive as they reach menopause. Recent American Society of Plastic and Reconstruction Surgeons statistics show cosmetic surgery has risen 47 percent for 51 to 64 year old women over the past five years. The media tells mature women to focus on "slowing down the ravages of time", and "reducing telltale signs of aging". These messages can affect our ideas about ourselves. The older a woman gets the harder it is to live up to the beauty standards set by an 18 year old supermodel.
So what's the answer? Stop listening and agreeing with the media hype about negativity in the menopausal years. Reject these negative messages now. Women today have many options as they undergo natural, physical changes due to menopause. You can promote peace between your mind and body during this complex life transition.
Here are some tips to help you get started.
Physical activity has been scientifically proven to increase body confidence and sense of pleasure in life. It is also the key predictor of healthy weight maintenance.
Check your nutritional status. One of my patients summed this up eloquently when she said, "You know, when I eat crap, I feel like crap!" No kidding. Seems simple, yet so many of us aren't eating healthful foods.
Get a life! Find some activities you enjoy and start doing them. If you are lonely, seek out new forms of social support or reconnect with old friends. Make the time to do this.
Be mindful and fully present each day. Each day is a gift just for you. Grasp the moment and enjoy.
Take walks or hikes in nature. Being in nature is one of the best ways to reclaim the feelings of connectiveness to the world. Gardening can also be extremely uplifting for the spirit.
While menopause is a normal transition and a biological certainty, every woman's experience is unique. Let's take the lead from many nonwestern cultures where women look forward to the joys of aging. Drastic measures to preserve youth such as extensive cosmetic surgery are not valued in these cultures. Certainly, they should never be used as a substitute for healthy living.
Finding meaning in volunteerism and work, spending time with your family and friends, being in nature and seeing the glory in the ordinary are all roads to self and body image acceptance.
Your body is there to help you "do life" in the most meaningful way. Realizing and being thankful for this will help you appreciate, celebrate, and take care of your body.