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Why women should eat less, move more and consider wearing transdermal HRT patches during menopause

November 25, 2008

Weight and appetite experts from around the world met at a conference in Bangkok earlier this year to discuss sex differences in obesity. One line of discussion looked at factors leading to women's weight gain during menopause, and how it might be avoided.

Co-chairs of the conference, Dr Amanda Sainsbury-Salis from Sydney's Garvan Institute of Medical Research and Dr Jennifer Lovejoy from the University of Washington, Seattle have summarised the conference consensus for the December issue of Obesity Reviews. The paper is now available online.

"One of the most interesting things that came out of the conference - with applicability to large numbers of women - was the discussion about why women gain weight during menopause," said Dr Sainsbury-Salis.

"So many women get confused when they start to gain weight during menopause, because their eating habits haven't changed."

"What the research shows clearly is that menopause causes a dramatic and sudden reduction in physical activity levels. Just prior to menopause, women halve their amount of activity compared to pre-menopause levels."

"So one reason women gain weight in menopause is because of a reduction in energy expenditure. Combine this with unchanged eating habits and weight gain is almost inevitable."

"We don't know exactly why menopausal women stop moving as much. But we know it's not because of their age and the lifestyle constraints happening at that time of life. Research suggests it's directly related to the lack of oestrogen, which has dramatic effects on signals the brain sends to the body. We're doing research to see what causes these effects and whether or not they continue long-term.

"A lot of women ask whether they can actively counteract that tendency. In fact, it's been shown that women who maintain or increase their level of physical activity during menopause tend to come out the other end without gaining weight."

"Another thing, when physical activity levels drop and your energy needs are less, it's really important to stay in tune with your hunger signals because you just don't need to eat as much in order to feel satisfied."

There was a related discussion about hormone replacement therapy (HRT) at the conference. Garvan's Professor Lesley Campbell, also Director of the St. Vincent's Diabetes Centre, was an invited speaker at the conference and put forward her view that HRT can actually help protect women against harmful abdominal fat gain and the development of heart disease and Type 2 diabetes.

"During menopause, most women experience redistribution of fat, often gaining weight around the middle," said Professor Campbell. "As we have demonstrated in our research, abdominal fat is a risk factor in the development of cardio-metabolic diseases, such as diabetes. Prior to menopause, women have a lower risk of heart disease than men. Menopause equalises that risk. Women taking HRT appear to maintain their pre-menopausal risk levels."

"It's also worth mentioning that around 10 years ago, Garvan endocrinologists made a very significant breakthrough discovery that is known by surprisingly few women and GPs. They found that taking HRT by wearing transdermal patches - so bypassing the liver - may be better for women than taking HRT orally. "

So the overall take home message for women in menopause is eat less, move more and if you're on HRT, consider transdermal patches.

Research Australia

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