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A spare tire I don’t need – fat and menopause

Posted in Health, and Women's issues

Spare tire“Do you know where you get your hormones from?”

Perched on my doctor’s table, I mumble something about ovaries.

“Yes, you get them from your ovaries, your adrenal system and fats. So, when your hormones drop during menopause and maybe there is an imbalance in your adrenals, your body starts storing fat trying to balance things out. But it doesn’t have to be that way. Anyhow, you are not menopausal yet so let’s talk about what you can do in the meantime”.

At 51,  I have reached the median age when women enter menopause, and I am approaching this milestone with a mixture of dread, denial and compulsive research.

My ob-gyn, much less patient and indulgent than my GP, when I asked her what I should do once I entered menopause, looked at me with surprise in her eyes and said “As I am not recommending Hormone Replacement Therapy, you will have to deal”. Well, yes, thank you, I get it, like the millions of women before me, since the beginning of time. But I like to feel in control.

For someone who never wanted children, I am surprisingly attached to that time of the month. From the Sunday afternoon, age 13, when my mother handed me a wad of cotton wool as all the pharmacies were closed and she didn’t think I could handle a tampon, I have always taken it in my stride, never ashamed of it: it marked the passage of time nicely, every 28 days; it let me know everything was working fine and reminded me I was, indeed, a woman of childbearing age. Mostly, I am having a hard time wrapping my head around the idea of not bleeding anymore because of the horror stories I have heard from other women: my mother still has hot flushes at age 76; tales of permanent insomnia; dried up skin and other body parts; loss of libido; mood swings etc etc. Sofagirl would tell me there is a drug for everything but I don’t do drugs, I would rather grin and bear it, happy to indulge my need for a natural approach.

A change is gonna come (this is Boston - we don't get pretty foliage in LA)
A change is gonna come (this is Boston – we don’t get pretty foliage in LA)

So, while I wait for the time to come, I arm myself with research from reputable sources, to understand what I have coming.

Among the body changes most women lament is a widening girth, an unwanted muffin top that makes its appearance even on skinny bodies. Why is that?

Different reasons come into play:

  • As we age, our muscle mass diminishes while fat increases;
  • Our metabolism slows down – whatever calories we needed daily in our 30’s, in our 50’s we typically need 200 to 300 less.
  • Hormone levels fall and our bodies, especially  female ones, start storing fat around our bellies, as a protective measure.
  • Stress often leads us to eat more.

Unfortunately, the risks associated with abdomen fat (technically called visceral fat) include the usual suspects: increased heart disease, diabetes and certain cancers.

All the experts, including my doctor, fall back on the same advice:

  • Eat a bit less and make sure to include some of the good fats, such as nuts, avocado and olive oil.
  • Exercise. Regularly.
  • Check your adrenal system for imbalances.
  • Try and control stress which, translated, means “Enjoy life”.

“I did notice that, on the days leading to my period, I enter a state of anxiety unusually high even for my standards” I volunteer to my doctor.

Well versed with my anxiety standards, he reassures me it’s not my imagination, he knows I am probably emotionally brittle in those 48 hours when my hormones drop.

“If it spirals out of control and you start lashing out like a dragon, come back and I will give you something for it. For now, just observe and try to be happy”.

Me on a bad day
Me on a bad day

I go home partly cheered up. I peer in the mirror. The loss of collagen on my face, a by-product of aging, is showing. Those Lauren Hutton-like cheekbones I always wanted are making an appearance. Frankly, they don’t look that flattering now. A bit of weight around the middle and on my face might be what the doctor ordered after all.

If you would like to read more on the subject, I sourced most information from the Mayo Clinic and Harvard Medical School (and my ever patient doctor)

Photos found in the public domain and C&S copyright

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  1. I’ve still got a couple of years to go until I need to seriously revise my cake intake. I’m dreading the prospect 🙁

    October 2, 2013
    • Cake is good. Sometimes I will have cake in lieu of dinner. Does wonder for my morale.

      October 2, 2013
  2. My girl Iman tells me she weighs 6kgs more than her ‘ideal’ weight when she was a model – because she looks and feels better on it. Sofia Loren always said that when you get to 50 you have to choose between face and figure. We’ve seen it in ourselves: the minute we get too thin – we look haggard. So that’s an easy one. Besides – you could put on 5kgs and still be super skinny.

    Yep – I am all about the drugs – at least those that make you feel better. Recreational – you know I can’t be assed with. And I get what you are saying about wanting to embrace a natural approach – but if that means that 5, 6, 10 or 20 years of your life are mostly miserable … where’s the upside? My existence is shitty – but, hey, all good – because it’s naturally shitty?

    If your concern in taking HRT is that your womb/ovarian/breast cancer risk is increased, I get that too … the research is huge on this subject. And does indicate a link. But to what extent and for whom needs to be clarified. Womb/Ovarian cancers seemed to have no marked causal link to HRT – but Breast Cancer is a bit more evident.

    An overview study in 2012 looked at 23 large studies that monitored the effects of using HRT for a year or more. It supported earlier findings that combined HRT increases the risk of breast cancer in women over the age of 65. There’s a summary of this research on the Cochrane library website, see below.

    Indications in the UK arm of the study were that combined HRT could be cited as the cause of breast cancer in 3% of the women affected. Oestrogen only HRT added another 1%. Then there are all the other genetic/environmental factors that come into play. Which may have heightened the cancer risk independently of HRT. So it’s a crap shoot – with fairly low odds.

    Women who have had breast cancer are not usually prescribed HRT because studies have shown that it can increase the risk of re-occurence. But some breast specialists will prescribe it if a woman with breast cancer is having very severe menopause symptoms that nothing else has helped. (See the Cancer Research UK website below.)

    And I think that says it all: if the severity of menopausal symptoms are so debilitating that life is all round miserable and will continue to be so for an indeterminate period: HRT could be the way to go. Even if it increases your risk of cancer. Being in a permanent state of abject and sweaty anxiety is no way to live.

    At least not for me.

    The great thing is we can chart how we do over the next decade. See you on the sofa my hot flush friend.

    October 2, 2013
    • I am being such a chicken about it. I suppose it’s just a symptom of my reluctance to accept old age. I read a lot about HRT and, in truth, the research is indeed mixed and it all comes down to you and your doctor. Other than breast cancer survivors, it’s a mixed bag of results depending on so many different factors. I hope it won’t be so bad but my ob-gyn did tell me that how our mothers went through menopause is a good predictor on how we will do. I will make sure to have some Campari always handy.

      October 2, 2013
      • silvia

        You are not a chicken, you are scared that a) it is something you can’t control, b) all your efforts to get the perfect shape will vanish.
        Sofagirl is right if you get 5 kg you’ll look as great as you do now and in addition you’ll get back an important part of your body I told you it’s a shame it’s missing.
        On the other hand I found omeopathic treatments excellent for perimenopausal symptoms and I’m with you if more natural options work than fine, if they don’t there is always old allopathic remedies we can turn to.
        In my family there are no cancer cases, my mom was on HRT for several years and she’s doing fine.

        October 3, 2013

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