Obesity & perimenopausal symptoms, is there an association? ‘Gene cs loads the gun, but lifestyle pulls the trigger

Obesity is now a global pandemic. According to Lancet the prevalence of obesity has tripled in the last five decades, with persistent rise in the numbers in all countries including the Middle & low income countries. As per the Sta s cs 13-15% of adults are obese worldwide & among them 40% are women.

Body mass index (BMI) is a person’s weight in kilograms (or pounds) divided by the square of height in meters (or feet). According to CDC BMI between 18.5 to < 23 is in the healthy range, between 23 to < 30 is overweight & > or = 30 is obese. Where do you stand?

‘Body, mind, intellect & Body mass index if perfect, you are ready to conquer the unseen’

What is Menopause & Perimenopause? Absence of periods for more than a year is menopause. It usually happens between 45 to 55years of age. This can happen naturally due to the ovaries stopping functioning; or can happen a er a surgery to remove ovaries or uterus or a er chemotherapy. Perimenopause is when the symptoms of menopause have started but the periods have not stopped. These Symptoms can last for months or years.

‘Perimenopause is like a roller coaster ride with no lines & safety harnesses’

What are the common symptoms?
Menopausal symptoms are mainly due to the estrogen hormone deficiency. They include anxiety, mood swings, hot flushes, vaginal dryness & urinary symptoms. These symptoms can have a huge impact on quality of life, physical, mental & social health.

How does obesity worsen the symptoms of menopause? Menopause is a crucial period with a tendency towards weight gain, possibly due to fall in the estrogen hormone that plays a vital role in fat storage & distribution. Estrogen deficiency the well known reason for all menopausal symptoms can furthermore cause long term effects on other systems like adverse cardiovascular changes, mood disorders & osteoporosis (bone weakening); all of these could theoretically be worsened in association with obesity.

In favour of this, the recent evidence shows a positive correlation between the severity of menopausal symptoms & BMI as well as waist circumference especially in urban population owing to the urban lifestyle & increased stress levels.

Over & above obesity is one of the contraindications for oral hormonal replacement therapy which is treatment op on for all kinds of menopausal symptoms, thus restricting the treatment options to lifestyle changes & non hormonal remedies.

What are some ways for women with obesity/overweight to ease symptoms of menopause as they make efforts to lose weight?

While weight loss will definitely reduce the severity of few symptoms like urinary problems, osteoporosis; there are few important lifestyle changes that will help women in perimenopausal period to ease the symptoms.

Plenty of rest, keeping regular sleep routine, eating healthy diet, calcium rich foods like milk or yogurt or taking supplements; vit D supplements; relaxation techniques like yoga, meditation; exercising regularly including weight bearing ac vi es etc will ease the symptoms and increase the quality of life.

Women with mood swings, low mood, anxiety will benefit from a type of talking therapy called cognitive behavioural therapy. Bothersome hot flushes can be tackled by keeping the living space cool, wearing light clothes, cool shower, cold fluids, reducing the stress levels & avoiding hot drinks, caffeine, smoke, alcohol & spicy foods.

Vaginal dryness that can lead to painful intercourse, recurrent urinary tract & vaginal infections can be dealt with the use of topical vaginal lubricants & moisturisers.

If none of these lifestyle changes help, then the further options will be non-hormonal remedies or hormone replacement therapy which should be started a er careful consideration weighing benefits & risks in consulta on with the gynecologist.