I’m in my late 40s, something I say out loud with a bit of incredulity and slight disbelief (read: Can. Not. Believe. It.). Based on my chronological age, I’m very likely right smack in the middle of peri-menopause… that time when women’s bodies are making the transition between fertility and infertility. Oddly, until now I hadn’t put myself in this category, although it makes perfect sense. It probably explains the night sweats that I try to blame on my husband (who runs hot at night), which is so obvious until he’s traveling out of town for days on end and they still happen. Or the extra weight that seemingly ‘all-of-a-sudden’ made an appearance – even though I haven’t made any significant changes to my diet or exercise. I hadn’t really connected the dots until it dawned on me that there might be some connection between all of this and some less-than-pleasant changes in my cycle. Clearly, it’s well past time to take a look at what’s going on with my body and how I should be responding to it. If this is true for me – I’m sure I’m not the only one.


During peri-menopause, which typically starts in our 40s but can begin as early as mid-30s, hormone levels in our bodies are rising and falling unevenly in comparison to earlier in our lives. Our cycles aren’t as predictable as they may have been. They lengthen, they shorten, sometimes we skip periods for a month or two…  or many. We may experience sleep problems, hot flashes, issues with our sex drive or sex itself as changes in hormone levels impact the ability of our bodies to secrete the necessary fluids to make what was once wonderful, mildly uncomfortable (or worse). We may experience heavier bleeding, cramps, fibroids, and more intense PMS. Not to mention the crazy mood swings. As if all of this isn’t unpleasant (or even frightening!) enough, we can wake up one day having gained an extra 10 or 15 pounds whose mysterious arrival seems to have no apparent explanation. Once we’ve gone through 12 months with no menstrual period, we’re considered fully menopausal. The average age for this is 51.[1]

I’m assuming that many of you are walking the same path I am. (Or you have, are about to be, or maybe it’s way out in your ‘some-day.’) And, like me, you may have been in a minor stage of denial, yet wondering, ‘what is going on with this extra weight?’ (Among other things!) More importantly, ‘how do we slow this ship down and get her turned around?’ We have a lot of life left – arguably some of the best and most creative years – and don’t need to be stymied by the lethargy, health issues, and the negative hit to our self esteem that extra weight can cause, especially when all the usual ways of combating it don’t seem to have the same result they used to. And for those of you who have put this in your rear-view, you, too, can read on. There is a little something here for all of us.

There are so many resources out there to help navigate this time of life. Some great, some not so great, some you can easily understand/follow and some that require advanced degrees in subjects you may never pursue. I’m going to share a couple of the highlights I’ve gleaned to get you started. From here you can decide if you’d like to work with one of  our nutritionists, and/or dig deeper on your own – and what other aspects you may wish to learn more about. For our purposes today, we’re going to focus on a few things we can do to maintain, or even lose, the extra pounds that seem to so easily cling to our beautiful frames. In doing so, we may find ourselves unwittingly helping to take the edge off some of the other symptoms that are cropping up.

What I’m about to say next isn’t magic and will probably sound very familiar. It boils down to what we eat and how we move our bodies. We need to get our blood sugar under control to better manage our insulin response and reduce inflammation – and put on some muscle to burn the calories we’re taking in. Simple, right? It may seem so, but we’ve got some things working against us.

Food and Alcohol. A critical component to watch is (over)consumption of starchy/sugary foods and alcohol. Both of these can cause blood sugar to rise very quickly, immediately followed by a rush of insulin. Large amounts of refined carbohydrates consumed on a regular basis that are not used for energy in the short term are stored as fat. The resulting excesses in blood sugar can also cause inflammation in the blood vessels. As time passes (months, years) you may start to outwardly notice the after-effects in the form of increased belly fat. Starting to sound familiar? What you don’t see is the potential to set yourself up for insulin resistance that can eventually increase your risk for type 2 diabetes.[2] While menopause likely did not cause this process to start, it will definitely exacerbate it, making it seem more than coincidental that the weight would show up just as you realize, like I did, where are you are at in the… ahem… continuum of your experience as an adult female.

One of the first things to be absorbed in the gut is alcohol. The negative effects and potential dangers during both peri-menopause and menopause may outweigh any health benefits that have been found to be associated with that glass or two of wine in the evening. For some, it can trigger those uncomfortable hot flashes that are so common during this time. For a quick read on the pros and cons, take a look at what the North American Menopause Society has to say on their website.

The good news is that if you are a regular drinker, stopping may result in fairly rapid weight loss – and your hot flashes may be drastically reduced or go away entirely as alcohol has been shown to interfere with estrogen metabolism and can cause almost immediate imbalance in the hormones.[2]

Now that we’ve talked about what you shouldn’t eat, here are a few words about what you should. Whole foods. Minimally processed. Vegetables, fruits, lean protein, whole grains. Foods rich in omega-3 fats, which will help decrease inflammation while helping to improve cellular function throughout your entire body. Micronutrients like vitamin C, vitamin B6 and magnesium also help to fight inflammation. The very best and most bioavailable sources of these nutrients are found in whole, unrefined foods  that are low to moderate on the glycemic index. Some of us even take supplements to increase the amounts.

Stress. We need to find a way to break up with stress. Unreasonable? Perhaps we can at least find ways to make peace with the life events and daily struggles that cause it. When the hormones that help us fight it are depleted (in particular cortisol and serotonin), our bodies are looking to make up for them. One way we can do this is by consuming the dreaded refined carbohydrate or running to that glass or two of red wine. We’re most vulnerable and more apt to make poor food choices in the late afternoon when the levels of these hormones are particularly low.[2] Take a look at your own eating patterns to determine where the intersection between stress and mindless eating might be occurring. Becoming aware of your own stressors and finding ways to address them outside of the kitchen are a step in the right direction.  Sometimes finding a great counselor or nutritionist/counselor-in-one like we have here, can help you on your path toward stress management.

Exercise. Examining our relationship with exercise is one of the most wonderful things we can do to help us manage our weight, menopausal symptoms and ensure vitality as we age. Our skeletal muscle burns blood sugar effectively by design. Building and maintaining muscle through regular exercise has benefits that far exceed our discussion here. A 2008 study showed that moderate physical activity had a greater impact on improved health-related quality of life, such as protecting the bones and heart than hormone therapy.[2] The Physical Activity Guidelines for Americans recommend 150 minutes of moderate activity (e.g. a brisk walk or gardening) or 75 minutes of vigorous activity (jogging, lap swimming, jump roping) per week. 150 minutes could equate to a 30-minute walk in the morning or after dinner 5 times per week. You can even break this up into 10-minute increments if that fits in better with your schedule! Add 2 days of muscle strengthening activity (get in the gym and push some weight around or do some bodyweight exercises) to further bolster your beautiful muscle.

If you are already active and find that you don’t seem to be seeing the same results, change it up! Try activities that are new – or that aren’t a part of your regular routine that engage different muscles as well as a different part of your brain. Now is the time to explore!

Bottom Line. Keep your blood sugar balanced throughout the day. Eat protein with each meal. Eat enough healthy fat foods like avocado, nuts, fish, and meats. Don’t be as concerned with calories as you are with portion sizes. Don’t lose patience with yourself, your body is changing and it’s likely to be slower to respond. Keep in mind the positive impact of antioxidants, meditation, relaxation and regular exercise. And don’t feel that you have to go it alone. Talk to health professionals who specialize in this mysterious and interesting phase of life. Consider engaging people to join your team that can support your medical, nutritional, physiological, and even psychological needs on your terms. For me, I’m going to continue reading as much as I can and research, research, research. But I’m fully aware that at some point this may not be enough. So I’m also working to identify who will be on my team when the time comes. Who will be on yours?

-by Samantha, over 40 Bastyr University student intern, 2016.


  1. Menopause – Mayo Clinic. Mayoclinic.org. 2016. Available at: http://Mayoclinic.org/diseases-conditions/menopause/basics/definition/con-20019726. Accessed August 3, 2016.
  2.  Northrup, MD C. The Wisdom Of Menopause. 3rd ed. Christiane Northrup, Inc.; 2012: Chapter 7.