To begin our series, “Hormones and Weight Gain,” I would first like to mention that whether you have a few pounds to lose, many pounds to lose or perhaps you just want to maintain your figure through peri-menopause and beyond; it can be done! You can manage your weight. However, if you have struggled and fought with your weight and not been successful, well I am so sorry that you have had to go through that experience. My heart goes out to you. I have sat across the desk from countless women and seen the discouragement and frustration on their faces. Excess weight impacts our self-image and self-confidence. I do wish our culture would not glorify skinny figures and magazine beauties. Where does that leave us normal girls? Oh well, I can’t solve that or address the deep seated emotional wounds some of you have due to weight issues though I wish I could do so. I can certainly say - it is just not fair. It is not fair how women are treated by some physicians or so called well meaning friends with their (inaccurate) comments such as, “you just need to push away from the table” or “you just need to exercise more”. Also not fair is the metabolism changes that occur with peri-menopause, menopause and post-menopause. The margins do change; we just can not get away with eating the same way we did in our younger years. I personally cannot fix the emotional scars and society’s biases, but I can share with you the science and physiology related to metabolism and how to address them.
Hormone Imbalance Prevents Weight Loss
What causes the underlying metabolic problem that we all face? Imbalances in ANY hormone will directly affect your metabolism triggering two mechanisms; number one weight gain and secondly block weight loss efforts. Optimal levels (not just normal or barely enough) of well-balanced hormones regulate everything from reproduction, affect emotions, promote general health and the rate at which we burn calories or store fat. Hormonal imbalances begin to occur when women reach their mid-thirties and increase in severity through menopause. According to the American Census Bureau in 2003, there are 57 million women in the US between the ages of 35-65. An estimated 75% of women in this age range have some form of hormone imbalance. Since hormone imbalance directly affects metabolism, you can be eating right and exercising and not successfully lose or maintain your weight.
Before we continue, I would like to clear up a myth. Some women have been led to believe that taking hormones make you fat. This simply is not true. Taking hormones or I should say correcting hormone deficiencies by using bio-identical hormones does not cause weight gain. (I do mean in appropriate doses of course.) Research studies such as the PEPI Trial, have demonstrated the effect of taking replacement hormones on weight in addition to other health related issues. None of the groups of women on hormone replacement in any of the published articles of the PEPI Trial gained weight. Another study found that post-menopausal women NOT taking hormones have a higher percentage of body fat than women who do take hormones.1
In summary, it is the lack of hormone balance that can cause weight gain. Additionally, excessive levels of certain hormones, such as cortisol or insulin, cause increase in weight. Hormone balance helps you loose excess body fat more readily.
Declining Progesterone
Since each and every type of hormone imbalance affects our metabolism, we will cover each hormone one by one. The best place to start is with progesterone since progesterone is the first hormone that becomes out-of-balance. Progesterone deficiency typically begins around age 35. This can lead to physical, gynecological or emotional symptoms related to progesterone deficiency such as:
Physical symptoms or related conditions:
• Weight gain
• Low body temp
• Headaches
• Hypothyroidism
• Hair loss
• Fluid retention
• Allergies/Sinusitis
• Bone Loss
Gynecological symptoms or related conditions:
• Breast pain/cysts
• PMS
• Fibroids
• Heavy cycles
• Irregular cycles
• Endometriosis
• Cramps
Emotional symptoms or related conditions:
• Anxiety
• Depression
• Irritability
• Tendency to be stressed easily
Progesterone Deficiency Slows Metabolism
Specifically related to weight gain and metabolism, progesterone plays several crucial roles.
1. Progesterone works with thyroid hormone; it helps carry thyroid hormone into the specific thyroid hormone receptors in order to be utilized. We all know that our thyroid controls our metabolism but with out adequate progesterone we may not use our thyroid hormone effectively. The result is storing the calories we eat as fat versus burning them for energy.
2. We need progesterone to help keep our estrogen in balance. With progesterone deficiency estrogen dominance occurs. This is called a low progesterone-to-estrogen ratio on lab tests. Why should we be concerned about estrogen dominance? In regard to weight, when you have estrogen dominance, insulin can be released more rapidly and more often. This in turn can lead to food cravings and fat storage.
3. Estrogen dominance from a lack of adequate progesterone inhibits the conversion of thyroid hormone, T4, into T3. This is really important because we need our T4 to convert to T3 because T3 is the active form of thyroid hormone that gives us effects of the wonderful properties of the thyroid hormones. Specifically, we need optimal T3 levels to keep our metabolism revved up to a normal level, not slowed down.
4. Women that tend to gain a lot of water weight before their period are progesterone deficient. This is because progesterone is a diuretic and without optimal progesterone we can bloat and accumulate premenstrual water weight gain.
5. Progesterone is also thermogenic, which means that it raises the body temperature and slightly increases metabolism.
Beyond our discussion of weight, progesterone is truly an amazing hormone that helps protect against heart disease and breast cancer, addresses many menstrual cycle problems, improves mood and sleep, is a bone building hormone and is a powerful weapon against PMS. Since progesterone plays important roles in our metabolism, we need to have optimal levels and to make sure that our estrogen and progesterone are nicely balanced. As with any hormone, a deficiency creates symptoms while an excessive level causes symptoms as well. Too much progesterone may impede weight loss while normal levels enhance weight management. Women make an average of about 15-25 mg of progesterone during the 2nd two weeks of their cycle. Most physicians that prescribe progesterone typically start with 20mg of progesterone cream. It is important to know your hormone levels. Hormone testing, such as saliva testing can take the guess work out of hormone balance.
Key Points Regarding Progesterone and Metabolism
In summary, I truly hope you are beginning to understand some key points in regard to losing and managing your weight. Here is what we have learned so far:
• An imbalance (excess or deficiency) in any hormone interferes with metabolism.
• Balanced hormones facilitate weight loss and control.
• Taking hormones does not cause weight gain.
• Progesterone is the first sex hormone that declines and does so in our thirties.
• Progesterone deficiency triggers numerous symptoms including weight gain.
• Excessive progesterone levels may slow metabolism.
• The solution is to have a normal progesterone level and proper progesterone balance with estrogen.
• Hormone testing can identify hormone imbalances.
I do hope you will join me next week at http://hormonemakeover.blogspot.com/ as we continue this discussion focusing on the role estrogen plays with our metabolism.
Donna White
http://www.donnawhitehormonemakeover.com/
BHRT Clinical Educator, Signature Wellness
http://www.signaturewellness.org/
Author, Speaker
1 Kritz-Silverstein D, Barrett-Connor E. “Long-term postmenopausal hormone use, obesity, and fat distribution in older women,” JAMA 1996 Jan 3;275(1):46-9.
The material in this blog is designed to provide information in regard to the subject matter covered. It is not intended to substitute for personalized medical advice from a licensed medical doctor and is only intended as general information and should not be used in any way to diagnose, treat, cure or prevent any disease.
