Menopause is a natural phase in every woman’s life, but many don’t realize that the transition begins years before your final period. This transition is called perimenopause and can last 4–8 years. Understanding the early signs and how they impact your metabolism can empower you to navigate this stage with more compassion for your body.
What Are the Early Signs of Menopause?
The first sign is often a subtle change in your menstrual cycle. Periods may become irregular — shorter, longer, heavier, or lighter. Other common early signs include:
Hot flashes and night sweats: Sudden feelings of heat, flushing, and sweating.
Sleep disturbances: Trouble falling or staying asleep, partly due to night sweats.
Mood changes: Irritability, anxiety, or low mood.
Weight gain and bloating: Shifts in estrogen levels can promote fat storage, especially around the abdomen.
Brain fog: Difficulty concentrating or remembering things.
Hormonal changes during perimenopause cause fluctuations in estrogen and progesterone, which can impact everything from appetite to where your body stores fat.
Why Does It Feel Harder to Lose Weight?
During perimenopause and menopause, your metabolism naturally slows down. Muscle mass tends to decrease with age, which means you burn fewer calories at rest. Declining estrogen levels can also lead to insulin resistance, making it easier to gain weight and harder to lose it — especially around the belly.
Sleep disruptions and stress can compound the problem. Poor sleep alters hunger hormones like leptin and ghrelin, leading to increased cravings. Plus, chronic stress can raise cortisol levels, which encourages fat storage.
What Can You Do?
While it can feel discouraging, there are science-backed strategies to support your body:
Prioritize strength training: Building muscle mass boosts your metabolism and helps maintain healthy body composition (Lovejoy, 2009).
Balance your plate: Focus on protein-rich foods, plenty of fiber, and healthy fats to stabilize blood sugar and keep you full longer.
Get good sleep: Aim for consistent sleep routines, cool room temperatures, and stress management techniques like meditation (Mayo Clinic, 2022).
Manage stress: Yoga, walking, or talking with a therapist can lower cortisol and emotional eating triggers.
Be realistic and kind: Expect weight loss to be slower than in your 20s and 30s. Small, sustainable changes are more effective than restrictive diets (NIH, 2022).
Can You Safely Boost Estrogen Levels with Medication or Supplements?
When estrogen levels decline during perimenopause and menopause, some women consider options to replenish them. Here’s what the science says about your choices and safety.
1. Hormone Replacement Therapy (HRT)
What it is:
HRT (sometimes called MHT — menopausal hormone therapy) is the most evidence-based medical option for replacing declining estrogen. It can be taken as pills, patches, gels, or vaginal inserts.
Who benefits:
HRT is most effective for treating troublesome symptoms like hot flashes, night sweats, and vaginal dryness. It can also help prevent bone loss.
Safety considerations:
HRT is not for everyone. It can slightly increase the risk of blood clots, stroke, or breast cancer, depending on age, health history, and type of hormones used. Current guidelines suggest that starting HRT before age 60 or within 10 years of menopause onset has a better risk-benefit profile (North American Menopause Society, 2022).
Always talk with your healthcare provider to personalize the type, dose, and route of HRT for your risk factors.