Although I have no personal experience in this area of a women’s life yet, I have a few nervious clients who’s slowly approaching menopause.  I promised them I will do some research, but I was surprised to discover that there’s very little scientific research around women and hormones. Interesting, considering that the hormone replacement therapy (HRT) market reached a value of US$ 4.2 Billion in 2018.

What Is Menopause?

Clinically speaking, menopause is defined as 12 months without a menstrual cycle.  The period before that, is called perimenopause of which the time span differ between women. During perimenopause, women can experience common symptoms like hot flashes, night sweats, vaginal dryness and decreased bone density.   

Other symptoms people often relate to menopause includes mood changes, drop in libido, fatigue, bloating and weight gain. However, according to Dr Michael Boroditsky, a genycologist in Winnipeg, these are not necessarily specific to menopause. These symptoms can manifest in any person who age and are not eating well or exercising.  And therefore, not necessarily menopause related. 

As mentioned, hormones in women is still very much an under researched topic. There is no scientific evidence that indicate what hormone levels a woman should have at even given time in her life. And to make it even more complicated, hormones fluctuate a lot during a person’s lifespan.

Estrogen Is Just One Of The Many Hormones in your body

For any women to function optimally, they need all 3 hormones present in their body. Progesterone, testosterone and estrogen.  All 3 of these hormones are made by a healthy young woman.  But when you are perimenopausal, all 3 of these hormones are influenced.

According to Dr Ken Berry, the first hormone to play havoc with your body is testosterone.  Unfortunately, many MDs out there still reason that a woman don’t need testosterone. You need to manage testosterone because you have testosterone receptors in your heart muscle!

Signs and symptoms of low testosterone 

A loss of muscle mass and as a result – slower metabolism.

The 2nd hormone is progesterone.  The misconception here is that if you do not have any symptoms or a uterus, you don’t need to test it. Surprisingly, you have progesterone receptors in your brain. Therefore it’s important to test for progesterone as well.

Signs and symptoms of low progesterone levels

Increase in anxiety and depression.

Increase in the hunger hormone, ghrelin which causes a dramatic increase in hunger and cravings. 

The 3rd hormone involved is estrogen.  Estrogen is involved in bone and cholesterol metabolism. It regulates food intake, body weight, glucose metabolism and insulin sensitivity.  

Signs and symptoms of low estrogen levels  

A shift in body fat from hips and thighs to the belly.

A rise in insulin resistance which causes weight gain.

Mood Swings and Hot Flashes

Impaired production of leptin and neuropeptide Y, hormones that help regulate appetite and weight balance. Headaches or exacerbation of migraines

Depression, trouble concentrating and Fatigue

You need all 3 hormones to feel like a complete woman! Not just one. To learn more about these hormonal shifts, this is a good read.

What do we know about menopause and ketogenic diets?

The short answer…not much. In women with PCOS, more and more evidence are surfacing that a low carb and even a ketogenic diet, can have benefits in getting women regular or helping women to conceive.  

Though the scientific evidence is weak in terms of advantages of a ketogenic diet for post-menopausal women, there is no scientific evidence that a menopausal woman should not eat a ketogenic diet. According to some clinicians, a ketogenic diet can definitely improve your hormones.  

Anecdotal evidence has shown that women who start a ketogenic diet during perimenopause, tends to manage their signs and symptoms better. The ketogenic diet is also an anti-inflammatory diet and reliefs inflammation in your body. If not managed, inflammation can magnify the signs and symptoms of menopause, like joint pain and insomnia. 

How can a ketogenic help postmenopausal woman?

With a ketogenic diet, ketones are produced and can help post-menopausal women in several ways.  

Because ketones are a better fuel source for the brain, it provides better mental clarity.  You can learn more about the advantages of a fat-fuelled brain here.  

A ketogenic diet helps to reversed insulin resistance and provides more energy, thus proving to have an impact on hormone levels.

What if your weight loss has stalled or you’re gaining weight on a ketogenic diet?

Weight gain in menopausal women is very common for the reasons listed above. 

If you are perimenopausal and your weight loss on a ketogenic diet has stalled, you should have your hormone levels checked.  If your doctor is only checking estrogen, you should educate your doctor on the other 2 hormones or find a new doctor.  

For more information, watch this short video from Doctor Eric Berg on why women struggle to lose weight during menopause.

Should you consider hormone replacement therapy?

With hormone replacement therapy in the news recently, both Dr Boroditsky and Dr Lindsay McBride says that women need to understand that hormone therapy is not required.  Menopause is a natural process that our bodies are meant to go through.  And I tend to agree with them.   

Our lives evolve around instant gratification. We want to get rid of inconvenience. Fix the problem as in yesterday.  Also keep in mind that when pharmaceutical companies design new drugs, the cost are astronomical.  

We are talking about a median of $41, 117 per patient and $3,562 per patient visit. Depending on the length of the trial and type of trail, patients might need to visit the clinic at least 4 times a year.  Let’s say the company are doing a trial on 2500 women over a 5-year span, we are talking about a clinical trial budget of just over $103 792 000.  And yes, it’s correct – I’ve seen these types of budgets.  

And how do they recuperate these costs?  You and I need to pay for that.  So, they go to doctors and promise them some kickbacks, if the doctor prescribe their specific hormone replacement therapy to patients.  The doctor just merely follow the pharmaceutical company’s advice and direction.  

You don’t have to take drugs. 

How can you manage symptoms during menopause?

Here are the low carb physicians’ top 10 tips for women over 40, to lose weight during menopause.  

  • Get the right amount of protein. It should just be enough. Don’t’ go overboard.  About 0.8 g of body weight.
  • Eat moderate fat and the right kinds of fat. A keto diet doesn’t mean you now have to indulge of fat.
  • You can try intermittent fasting. I discuss intermittent fasting for beginners here.
  • Watch out for sneaky carbs and sugar. They are everywhere.
  • Cut the alcohol and sweeteners.
  • Do weight Lifting weights becomes more important than ever
  • Get enough sleep and reduce stress. Insomnia and stress are related to increase in cortisol which increase fat accumulation around your waist.
  • Be realistic. The goal teaches you to win. But the process teaches you to play the game.

From what I could gather, menopause don’t need to be all gloom and doom. Though it’s a natural process, it’s a transition into a new phase of your life. If you belief it’s a health problem as appose to a liberation, it will become a health problem for you.

Here’s some additional reading that might just help you to decide how you want to approach this journey.

Ageing, Performance and Health

Fitness Tips for Menopause: Why Fitness Counts

Enjoy the read!