TLDR. During perimenopause, hormonal shifts change how women’s bodies store and metabolize fat and muscle. If you’re concerned about an increase in your waistline, making changes can potentially have long term health impacts.
Hormonal shifts, particularly declines in estrogen (estradiol, E2) and increases in follicle stimulating hormone (FSH) are associated with shifts in the way the body processes and stores energy, which can often lead to an observable increase in visceral fat (Lovejoy et al, 2009, Janssen et al, 2010) and a decline in lean muscle. In addition to potentially being an annoying increase to a woman’s waistline, visceral fat is also a predictor of diabetes and cardiovascular disease in women. Visceral fat may be associated with increased inflammation, which then further is associated with cardiac and metabolic risk (Lankila et al, 1999). Paying attention and making lifestyle adjustments here if this is a concern can have long term health impacts. Increases in visceral fat particularly in the abdomen have been linked with more severe Vasomotor Symptoms (Thurston et al, 2010, Thurston et al, 2009).
It is important to note that while weight gain and central fat accumulation is common, it is not without hope for successful intervention. The American Heart Association has issued a research based statement on how early lifestyle intervention with increasing exercise, a diet low in processed food and strength training has been shown to lower increased risk for cardiovascular disease, high blood pressure and diabetes (Khoudary et al, 2020).
Stabilization over time. These changes typically stabilize within 2 years of experiencing menopause. (Greendale et al, 2019)
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You're not alone. After decades spent establishing trusted exercise routines and diets to build your body up, seeing your body respond differently can be frustrating. It can be overwhelming to think about adjusting physical activity and meal planning. After years spent finding brands, sizes and silhouettes which fit your body and your style, it can be frustrating to need to re-think your strategy for building your wardrobe. You're not alone as you navigate these changes. Women all over the world are working through similar challenges as they adapt to this new phase of life. There's no need to boil the ocean. Take on the amount which fits within your capacity during this phase.
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