Peri menopause… how did I go from slim

[IvorCutler]

to a big fat mess.

I’m feeling very down. 4 years ago I was a size 8, now I’m a 12, verging on 14. I want to make clear that I don’t think everyone who is a 12-14 looks fat or a mess, people can look amazing at any size. I just look like shit.

I don’t feel my habits have changed much in 4 years, I walk a little bit less but still manage 10k steps most days. I strongly suspect I’m going through peri menopause (about to turn 38 and my mum started the menopause at 40).

Does anyone have any tips for fitness/weight loss at this stage of life? I’m ratty a lot of the time and I have zero energy in the evenings. Is it possible to lose weight now or am I fecked? Please help, I’m feeling completely deflated.

Losing weight as we age is harder. Fluctuating hormones will not only make you gain weight, they will inhibit weight loss irregardless of any diet and exercise you are doing.

One of the first tells of (my) perimenopause was gaining 15 kilos in less than a year and being unable to shift it even though I was eating my 'macros' and exercising like a demon. The magic bullet was HRT (in addition to diet and exercise). It was only when I started HRT did the weight start to come off.

Thank you @MorganBrocklehurst that sounds exactly like my gain… I’m going to go to the doctor and discuss HRT.

Thyroid!
I’ve been around women’s health (admittedly mostly on these boards) to have got very good at armchair diagnoses.
Get to the GP and ask for bloods. They’re still doing them by phone so you won’t necessarily have a wait.
Don’t assume it’s peri menopause, could it also be your contraception? Again via these boards and friends I know of many who have ballooned on certain methods.

Be advised most GPs are hopeless with HRT - I went through the menopause prematurely and had several GPs all tell me I was too young and my bloods indicated I wasn't perimenopausal when I had nearly every single menopause symptom going.

Read the NICE guidelines as HRT should be prescribed based on symptoms, not bloods, the latter of which are only a snapshot of the time the bloods were taken anyway. Maybe start with Louise Newson who does digital consultations and will tell your GP what you need/they will prescribe on the NHS.

Be advised that GPs can prescribe the 'wrong' HRT, I know this from experience as I was prescribed incorrectly and gained even more weight as a result (along with my other symptoms getting worse). Also, later, when I was on the correct HRT, my hormones shifted again and the weight gain returned, almost a stone in two months (along with other symptoms too). My doctor re-jigged my prescription and the weight came off and my other symptoms went.

Did you increase the dose of your HRT @MorganBrocklehurst ? I've only started putting on weight since I started on HRT! (which may have coincided with the perimenopause starting for me).

@Etinoxaurus

Thyroid! I’ve been around women’s health (admittedly mostly on these boards) to have got very good at armchair diagnoses. Get to the GP and ask for bloods. They’re still doing them by phone so you won’t necessarily have a wait. Don’t assume it’s peri menopause, could it also be your contraception? Again via these boards and friends I know of many who have ballooned on certain methods.

Given some of my symptoms - weight gain, tiredness, hair falling out (to name a few), I thought it was my thyroid initially as many of the symptoms are similar. However, a malfunctioning thyroid and perimenopause often go hand-in-hand, along with adrenal fatigue, another issue most GPs I've come across dismiss.

Anyway, and either way, yes, OP should get her thyroid tested but she must insist on a full thyroid panel, something that isn't done as standard.

@Itsnotdeep

Did you increase the dose of your HRT *@MorganBrocklehurst* ? I've only started putting on weight since I started on HRT! (which may have coincided with the perimenopause starting for me).

Why would I increase my dose of HRT? HRT is a cocktail of different hormones given at varying levels.

Chances are if you're still gaining weight/experiencing symptoms, your levels aren't right. I can't tell you if they're too high or low, unfortunately.

With regards to me, I actually needed to massively lower the dose of oestrogen as my body was still producing its own (and too much was responsible for the weight gain - additionally, I've always been horribly sensitive to oestrogen anyway and why I've never taken hormonal contraception). I was also taking a pretty high dose of progesterone and a small dab of testosterone too. Interestingly, I'm now post-menopause and still super sensitive to oestrogen, so only use the minimum.

HRT is really individual and why I always advocate seeing an actual specialist or going to a menopause clinic rather relying on your GP (unless they specialise in menopause and women's health).

This is all very helpful, thank you so much.

I did have my thyroid checked last year and it was fine! The only thing that came back was a very low iron count (I take iron now).

Thank you @MorganBrocklehurst - of course I would only change the dose with my specialist, not alone. I just wondered what your experience was as I was also wondering whether I was taking too much oestrogen given my periods were still regular when I started and I had very few signs of perimenopause.

I can only speak from personal experience. I’m peri menopausal (51) and lost 4 stone over lockdown. For the first time in over 14 years I weigh what I did before I had children.

I’m very strict about what I eat. Low carb, high protein. I log everything I eat and stick to 1200-1400 calories a day to lose and 1600-1800 to maintain. I drink very rarely, maybe once a month if that. I feel so awful the next day it’s not worth it unless it’s a special occasion.

I exercise every day. Running x4, walking on non running days about 4-5 miles, swimming x2-3 and strength training x2-3. Yoga and Pilates too if I can fit it in but not always. I weigh myself every day, of course my weight fluctuates but anything more than a few pounds take note and reevaluate.

It looks exhausting when written down but now it’s habit it’s easy. I do a lot early in the morning before work so it’s mostly done before I used to start my day. Sleep is also very important, I make sure I get 8 hours. The benefit I get in terms of how much better I feel is worth the effort. I want to feel good and keep my health and mobility for as long as I can.

@Dentistlakes this is promising. I'm now 43 and with two young children am noticing the baby weight went and is coming back. I've started strength training which I did in my 30s and I hope it works!

@Itsnotdeep

Thank you *@MorganBrocklehurst* - of course I would only change the dose with my specialist, not alone. I just wondered what your experience was as I was also wondering whether I was taking too much oestrogen given my periods were still regular when I started and I had very few signs of perimenopause.

This could actually be the case. I know for me, my periods were regular and this, coupled with my age, was why the many GPs refused to believe I was menopausal even though I had all the other symptoms!

The many GPs I saw were incapable of reading my bloods properly which clearly showed my oestrogen levels were wonderful. What wasn't were my progesterone levels which were non-existent. But they insisted on giving me oestrogen which just made all my symptoms worse. It was only when I saw a specialist that things were sorted out.

The reason you were given oestrogen is because everyone thinks that is what is deficient and needs to be topped up. This isn't always the case for a minority of women. It might be that like me, you don't need it at all (at least initially), and just need a big dose of progesterone. (I needed 400mg a day, so a Mirena wouldn't have worked for me either - which is also a common solution for perimenopausal women). Or you might need a smaller dose of everything you're on and a little testosterone to balance things out. However in this instance, testosterone is really difficult to get on the NHS. This is why I am so vocal about women seeking out specialist help!

Fingers crossed you get it all sorted.

@MorganBrocklehurst

Where can we get this specialist advice?
I'm concerned my GP hasn't got much knowledge in this area, and I find it all so confusing!
I'd happily pay for private advice/testing to ensure I'm on the correct treatment path.

[quote shouldhavewouldhave]@MorganBrocklehurst

Where can we get this specialist advice?
I'm concerned my GP hasn't got much knowledge in this area, and I find it all so confusing!
I'd happily pay for private advice/testing to ensure I'm on the correct treatment path.

[/quote]
If you're in London, drop me a message and I'll send my specialist's details. Otherwise, Louise Newson (who I mention in a previous post) is a good place to start - she consults digitally and will let your GP know what HRT you need, and they can then prescribe it for you on the NHS.

The HRT I take is not available on the NHS and is costly, but it's the best money I have ever spent.

Thank you @MorganBrocklehurst . I was told when I first had tests that my oestrogen levels were the level of a teenager! I always had a progesterone shortage though and needed this to get pregnant as my luteal phase was just so short. (I don't tolerate progesterone well though and would love to not take this).

I have a prescription (now on the NHS) for testosterone.

I have also seen a private consultant so will speak to him about all of this.

@Itsnotdeep

I've always had high levels of oestrogen and was told as a teenager never to touch the pill. So many dismiss the idea of oestrogen dominance, but that is indeed the case with many of us as our hormones aren't aligned. Progesterone is something that many women don't get on with either. I did not get on well with the progesterone prescribed by the NHS (or the oestrogen for that matter). I'm fine with the one my private consult prescribes as it is a different formula. Indeed, for the first year, my HRT consisted of progesterone only. Oestrogen and testosterone were only added in a few years later when my body had stopped producing either.

The NHS' approach to HRT is far too one-size fits all, so those who don't get on with standard prescriptions are often left with HRT that doesn't do what it is supposed to do, and no real specialist help either - am glad you see someone privately.

Anyway, keep pushing and get the HRT cocktail that makes you feel great!

I take hrt and thyroxine but still experienced weight gain especially around my middle.
Only thing that worked for me was keto then low carb.
I lost 2.5 stone. Now I keep a very close eye on what I eat and walk about 6 miles a day.

I feel your pain OP. I'm peri and have put on a stubborn half a stone in the last 6 months and gained a lot more belly fat. However I used to be very disciplined about my food intake and exercise. I had to limit my calories as I'm quite petite and followed a similar regime to @Dentistlakes but this definitely slipped wfh and in lockdown!

I'm now on HRT and I'm not sure if it will make things easier with regards weight loss (that and going back into the office = less snacks!)

Surgical menopause, on HRT.

When I started ballooning I starting tracking what I ate on My Fitness Pal. You really do, unfortunately, need a lot less calories as you get older. I lost around 3 stone by sticking to 1,300-1,500 calories.

I’m slimmer now than I was in my very active younger days!

I had early menopause due to chemo and Tamoxifen. I've not gained weight. I exercise a lot more and eat better and less. Also don't drink alcohol.

I put on weight despite eating really healthily and exercising loads. Have recently been trying the 800 fast diet. Still hardly losing weight. Am blaming HRT rather than perimenopause.

@MorganBrocklehurst I sound really similar to you. I really react badly to progesterone too - hate it. It bloats me, I feel murderous and I feel unwell. I've never got on well with progesterone or oestrogen. Do you mind sharing which progesterone you take instead? I'm going to speak to my specialist about this - you're right, you should feel brilliant on HRT and I just feel exhausted, my sleep is fucked and I'm putting on weight!

@Itsnotdeep

The NHS prescribes norethisterone which is a synthetic progestin. The progesterone I take is derived from yams and engineered to match the body's own progesterone. I believe the NHS does prescribe something similar, but because I don't get my HRT from the NHS, I can't comment for certain.

And no, it's not the progesterone that bloats me, it was the excess oestrogen in my body. Now I'm on the smallest dose, I don't bloat. Also, is it inflammation or actual bloating? During menopause, a lot of women suddenly find themselves with food intolerances and unable to digest food properly which results in bloating. It might be worth adding in some probiotics too.

If your sleep is fucked, then that is definitely a sign your current HRT cocktail isn't right. Or, it might just be that you will need some melatonin, one that works in two parts - first to get you to sleep, then more kicks in to keep you asleep. Progesterone induces sleep too, so you should be taking this in the PM. I take melatonin at around 9:30pm, progesterone (in the form of a lozenge) and a dab of oestrogen (on my forearm) an hour later. Twice a week, I also use Vagifem (a pessary) before going to bed. In the morning, just a dab of testosterone, again on the inside of my forearm. At each stage, it took a few goes to get the levels of everything correct. For me, it was always sleep and my body odour that were most indicative of the cocktail firstly not being correct, and then, correct. But, as I have said previously, perimenopause, menopause and HRT is so highly individual, that we all have different needs.

Lastly, are your adrenals supported? Adrenotone by Designs for Health is really good as an additional supplement.

Good luck! Keep pushing until you feel great!

I'm 60 and gave up on losing weight when I reached menopause. It was too hard and didn't seem worth it. I resigned my self to being a dumpy little old woman.

4 months ago I found out I had high blood pressure. I hate doctors so didn't want to go on medication so I decided to try and tackle it by revising my diet which was rubbish, full of fatty foods and junk.

I cut out nearly all processed food and have two healthy mostly veggie meals a day to ensure I eat my 5 a day. I'm not obsessive about it. I don't calorie count, just eat small portions. I still have the occasional pizza, biscuit, meal out or small steak and I love a drink 3/4 days a week but on the whole my diet is pretty healthy now. I've always exercised and have never smoked so no changes were needed there. Within 4 months my BP has dropped from dangerously high to an average of 125/75 which is brilliant. I've also lost 8 kg without even trying and my BMI is back within the healthy zone for the first time in a decade. I am genuinely slimmer and fitter now than I was pre menopause.

If I carry on as I am and keep my BP low and lose a couple more kilos I'm going to treat myself to a thread lift!

Amazing @Everydaydayisaschoolday fair play to you! I also have high blood pressure so I’m interested in your diet! I’m feeling quite reassured by these posts that weight loss isn’t futile.

I’ve never carried weight well, I’m 5’8” and look best at 8 and half stone, even though that’s technically underweight. I’m 11 stone now and I just look like pure lard. My ideal weight is clearly unobtainable at this point but I would settle for 10 stone and no double chin!

Can you fit in some weight training? It helps to burn more energy than just cardio and it’s good for us anyway - strength, posture etc

Sleep is the key to weight management I think. If you’re tired you will snack. If your sleep is not great then you need to work out why - oestrogen can help, but it could be all sorts