Weight Gain During Menopause

Patients during perimenopause often ask me why they suddenly have weight gain in spite of no change of their diet and how they can lose weight. Women gain an average of 12-15 pounds during menopause and the fat accumulate around the stomach. The reason can not be explained simply with lack of estrogen because estrogen treatment can not reverse the weight gain. As you age, your muscle mass decreases and you can't lose weight with exercise because the muscle is the main place to burn calories. Also women exercise less around menopause. Other factors such as divorce, the death of a spouse, children leaving also contributes to weight gain. Since estrogen replacement therapy doesn't work, there is no magic to lose weight except that normal weight loss methods. Since your metabolism goes down, you should start to eat about 200 to 500 fewer calories a day around perimenopause to lose weight. Then you need to fast walk at least 30 minutes a day in the morning before breakfast at lease 5 times a day. To recover muscle mass, you should weight training twice a week because muscle gain increases burning of calories.

I don't recommend perimenopausal women have hormone replacement therapy to decrease menopause symptoms because of the side effects such as blood clots. If necessary, you can have it for the short term (up to 5 years). There are other options except hormone replacement therapy such as prescription medications and alternative medicine. Lifestyle & home remedies also help reduce your symptoms.

1. Prescription medications

Low-does antidepressants: Effexor, Prozac, Sarafem, Paxil, Celexa, Zoloft. They help decrease hot flashes. They could cause increase of appetite, resulting in weight gain. They could also cause loss of sex drive. Wellbutrin doesn't cause weight gain or loss of sex drive. Remeron could cause increase of appetite, but doesn't cause loss of libido.

Neurontin: It reduces hot flashes.

Bisphosphonates such as Fosamax, Actonel, Boniva: They prevent or treat osteoporosis.

Selective estrogen receptor modulators such as Evista: They also prevent or treat osteoporosis.

Vaginal estrogen: It helps reduce vaginal dryness and some urinary problem.

2. Alternative medicine

Vitamin E: It help decrease mild hot flashes. For safety, you should not take more than 400 IU.

Herbs such as black cohosh, dong quai, licorice, chasteberry, evening primrose oil and wild yam: They could help your menopausal problem, but there are no scientific evidences they are effective.

Yoga: It may help reduce hot flashes.

3. Lifestyle & home remedies

Dress in layers, avoid hot beverages, spicy foods, alcohol, hot weather, a warm room

For vaginal dryness, over-the-counter vaginal lubricants such as Astroglide, K-Y jelly and moisturizer such as Replens, Vagisil. Stay sexually active.

Avoid caffeine

Use relaxation techniques. There are many books and tapes available.

Do Kegel exercise to strengthen the pelvic floor for some forms of urinary incontinence.

Eat a balanced diet.

No smoke.

Regular exercise: Moderate exercise for at least 30 minutes a day.