Women’s Health, Weight and Hormones During Menopause

Women’s Health, Weight and Hormones: Navigating Perimenopause and Menopause

Perimenopause and menopause are significant transitions in a woman’s life, and many women notice that their body begins to respond differently to food, exercise, sleep, and stress during this time.

Strategies that may have worked well previously can suddenly feel less effective.

This stage is not simply a hormonal transition - it also involves metabolic and physiological changes that can influence body composition, energy levels, appetite, and overall wellbeing.

Rather than focusing on restriction or rapid weight loss, this stage often requires a more individualised and sustainable approach to health.

Why Weight Management Can Feel Different During Menopause

Menopause is associated with declining levels of oestrogen and progesterone, and for some women, changes in testosterone levels as well.

These hormonal shifts can influence:

• body fat distribution
• muscle mass
• resting metabolic rate
• appetite and cravings
• recovery and energy levels

Many women notice an increase in abdominal fat accumulation, even if their overall weight has not changed significantly. At the same time, there can be a gradual reduction in lean muscle mass, which may contribute to changes in metabolism and physical function over time.

Weight changes during menopause are often less about a lack of effort and more about changes in body composition and physiology.

Common Symptoms During Perimenopause and Menopause

Hormonal fluctuations during this stage can affect both physical and psychological wellbeing.

Symptoms may include:

• fatigue or reduced energy
• brain fog or difficulty concentrating
• sleep disturbances
• mood changes or irritability
• joint aches and stiffness
• increased abdominal weight gain
• reduced exercise tolerance
• stronger cravings for refined carbohydrates or sugary foods

These changes can affect motivation, consistency, and overall quality of life.

Why Restrictive Dieting Can Sometimes Make Symptoms Harder

During perimenopause and menopause, overly restrictive or poorly balanced diets may sometimes worsen symptoms rather than improve them.

For some women, aggressive calorie restriction may contribute to:

• low energy and fatigue
• difficulty concentrating
• poorer recovery from exercise
• increased hunger and cravings
• reduced muscle mass
• irritability or disrupted sleep

This is one reason why a highly restrictive or “one-size-fits-all” approach is often difficult to maintain long term.

The Importance of Preserving Muscle Mass

One of the key priorities during menopause is maintaining muscle mass while supporting overall metabolic health.

Muscle plays an important role in:

• supporting metabolism
• maintaining strength and mobility
• supporting bone health
• improving glucose regulation
• supporting healthy ageing

Approaches that focus solely on rapid weight loss may increase the risk of muscle loss, particularly when protein intake is inadequate or resistance training is absent.

A more supportive approach may include:

• a moderate and sustainable calorie deficit, where appropriate
• regular protein intake across the day
• resistance or strength training several times per week
• adequate sleep and recovery
• stress management strategies

A More Supportive Nutrition Approach

Nutrition during menopause should support overall wellbeing, not just focus on the number on the scale.

A balanced approach may include:

• adequate energy intake to support daily function
• protein-rich meals to help preserve muscle mass
• fibre-rich foods to support satiety and digestive health
• nutrient-dense foods that support bone, brain, and cardiovascular health
• regular eating patterns to support appetite regulation and energy levels

Lifestyle factors such as sleep quality, stress, work demands, and physical activity patterns are also important considerations.

Is There a “Best” Diet for Menopause?

There is currently no single dietary approach proven to be universally superior during menopause.

Research continues to explore approaches including:

• higher protein diets
• lower carbohydrate diets
• intermittent fasting
• Mediterranean-style eating patterns

However, the most effective approach is usually one that is:

• individualised
• nutritionally adequate
• realistic
• sustainable long term

Medical history, symptoms, lifestyle, preferences, and personal goals should all be considered when developing a nutrition plan.

Physical Activity and Long-Term Health

Regular physical activity becomes increasingly important during and after menopause.

In addition to supporting body composition, exercise may help:

• maintain muscle and bone strength
• support cardiovascular health
• improve balance and mobility
• reduce falls risk
• support mental wellbeing

Both aerobic exercise and resistance training play important roles in long-term health.

Current Australian guidelines recommend:

• 150 minutes of moderate intensity activity per week

or

• 75 minutes of vigorous intensity activity per week

alongside regular muscle-strengthening exercise.

Bone Health After Menopause

Oestrogen plays an important role in maintaining bone density, and declining hormone levels can increase the risk of osteoporosis over time.

Important strategies for supporting bone health include:

• adequate calcium intake
• maintaining vitamin D levels
• regular weight-bearing and resistance exercise
• maintaining muscle strength and mobility
• avoiding smoking and excessive alcohol intake

Bone health is an important consideration in long-term healthy ageing.

Sleep, Stress and Sustainability Matter Too

Weight and health outcomes during menopause are influenced by more than nutrition alone.

Poor sleep and chronic stress may affect:

• appetite regulation
• food cravings
• motivation for physical activity
• recovery and energy levels

For many women, sustainable progress comes from addressing lifestyle factors alongside nutrition and exercise.

Key Takeaway

Perimenopause and menopause are natural life stages, but they can bring significant changes to body composition, metabolism, and overall wellbeing.

Rather than focusing on restrictive dieting, a more supportive approach may involve:

• preserving muscle mass
• supporting bone health
• prioritising adequate nutrition
• building sustainable movement habits
• supporting sleep and stress management

With an individualised and balanced approach, women can support their long-term health, strength, and quality of life throughout this transition.

About the Contributor

This article was written by Dr Somayyeh Firouzi, Accredited Practising Dietitian from Optimum Diet, who has a special interest in women’s health, perimenopause, and sustainable nutrition care.