Perimenopause, menopause and postmenopause can bring changes to your appetite and metabolism. This is why it is not unusual to gain weight during the menopausal years. Here are the basics behind how hormones and menopause affect your appetite.
What makes you feel hungry or full? The two main hormones that regulate your appetite are ghrelin and leptin, so how do they work?
Ghrelin - the hunger hormone
Ghrelin is the hormone that makes your hunger pangs kick in when your stomach is empty. Therefore it’s also known as the ‘hunger hormone’, even though it has many other functions too. Ghrelin is made and released mainly by the stomach. Small amounts are released by the small intestine, pancreas and brain.
The hormone was discovered in 1999 and named after a word root “ghre” which means “grow” in Proto-Indo-European languages. This is because ghrelin stimulates growth hormone release from the pituitary gland. This is a small pea-sized gland which is a part of your endocrine system and is located at the base of your brain.
The pituitary gland is attached to the hypothalamus, an area of the brain which has a satiety center responsible for appetite control. This has to do with when and how much you eat. Ghrelin sends a signal to your hypothalamus that you need to eat by stimulating your appetite. Ghrelin also increases your food intake and your fat storage. The hormone acts on the area of the brain called the hypothalamus,
Leptin - the satiety hormone
Leptin is the hormone that tells your body you have had enough to eat. It’s also known as the “satiety hormone” or the “starvation hormone”. It’s produced by your body's fat cells. Then your bloodstream carries leptin to your brain, specifically to the same place ghrelin goes, the hypothalamus.
Leptin is used to identify how much body fat your fat cells have. When leptin levels are high it is a signal to the brain that you have enough fat stored. When they are low, it signals you need to eat. People who are thin have lower levels of leptin, while people who are overweight have higher levels.
Leptin resistance - a cause of obesity
When leptin was discovered in 1994, it raised a lot of excitement and enthusiasm for its potential to solve obesity. Unfortunately it was no miracle cure. It has been found that people with obesity tend to develop a resistance to leptin, which means that although there are high levels of leptin in their fat cells, the cue to stop eating still may not be activated. They are then more likely to overeat because their body is telling them that they are starving even when they’re not. This is because of a signalling error which results in the brain not being able to pick up the information.
Other hormones that affect your appetite are adiponectin, insulin and cholecystokinin (CCK).
How hormonal changes can affect your hunger during menopause
During the years leading up to menopause your sex hormone levels in your ovaries start to change as your body is preparing for the end of fertility. During the first years progesterone declines slowly and steadily while estrogen can vary and go up and down a lot. Estrogen levels can sometimes increase in this unpredictable and fluctuating stage, and then eventually decrease to low levels as you get closer to menopause.
These sex hormones play an important role in your appetite, the way you eat and your metabolism. Estrogen, like leptin, suppresses appetite, so as estrogen levels get lower during perimenopause your appetite may increase. Out of the three estrogens, estrone, estradiol and estriol - estradiol is the key player here. That’s also why you get food cravings before your period. Estradiol decreases towards the end of your cycle (you can find some nutrition tips to help with this here).
What happens to grehlin and leptin during menopause?
A study that looked at forty women in pre-, peri- or postmenopause has shown that ghrelin levels were higher in those in perimenopause. This explains why you may feel more hungry all the time. Estrogen levels affect leptin. During menopause when estrogen decreases, leptin sensitivity goes down, and this is another factor that can increase your appetite.
Stress hormones and your appetite
Dealing with all the new symptoms and changes during menopause can be stressful. Stress can also affect your appetite, either by causing you to overeat or undereat. According to Harvard Health Publishing, stress can shut down your appetite in the short-term. When the hormone adrenaline triggers the fight-and-flight response, eating becomes a second priority for a short time. Long-term stress increases the release of the hormone cortisol which can increase appetite, which is why you might feel like stress eating.
It’s good to know how your hormones work because it helps to see that the fluctuations to your weight are often natural. No matter what changes your body goes through during this time, it deserves your love and attention. You can take care of yourself and nourish yourself in a way that builds you up rather than restricts you.
How you can balance your hunger hormones during menopause:
Eat right and invite your friends - eating right means getting the right nutrients to keep your blood sugar levels steady. This will help you keep your moods balanced, and can help you from snacking on unhealthy food. Invite your friends. Sharing the food experience can inspire you to keep up the good habit and keep learning about the foods that do you good so you can do it again. Read Olivia’s article on Nutrition for Less PMS to get some symptom-curbing healthy food tips.
Don’t skip meals - Don’t worry if you ate fast food for lunch, just make yourself a proper healthy meal for dinner. Perhaps that could include complex carbs like sweet potatoes with protein and omega-3 rich salmon and a spinach salad filled with nutrients like potassium, magnesium and vitamins.
Practice eating with awareness - slowing down and having a moment of gratitude right before you eat can be a way of tuning into yourself, your surroundings and the meal before you. Focus fully on the taste and the sensations. This can prevent stress eating and help you create a good relationship with food, which we can always be thankful for because it keeps us alive and well.
Rest and sleep - less sleep is linked with increased appetite and weight gain. This is because when you are sleep-deprived, you have more ghrelin and less leptin. Even if your night sweats are keeping you up at night, there are strategies for better sleep. Olivia has a programme dedicated to getting a good night’s sleep, make sure to check it out.
Exercise - A study has shown that exercise curbs the appetite by decreasing ghrelin and increasing leptin in the brain. Due to leptin resistance, this may not happen for those who are overweight. According to a study, aerobics suppresses appetite more than strength training. (But there are numerous other benefits of strength training for menopausal women that you can read about here)
Be kind to yourself and treat yourself every once in a while. Maintaining a healthy lifestyle which balances your hormones doesn't necessarily have to mean complete abstinence. So don’t beat yourself up in the process. That will just lead to more stress. It’s okay to treat yourself to whatever you want every once in a while, when there is a balance on the whole.
Why is it important to eat regular meals?
Eating regular meals is important to keep your metabolism and energy levels going. If you skip meals your body will think it’s starving and produce cortisol as a stress response, which will block leptin and cause you to have more cravings. Now your survival mode is on which may push you to eat more unhealthily and impulsively. Cortisol comes from progesterone. If your body continuously uses up progesterone, it means estrogen will dominate your system. This can cause unwanted symptoms similar to PMS and those you experience during menopause. You probably have enough of those already.
Sources:
Masayasu Kojima. (2010). Discovery of Ghrelin and Its Physiological Function. Journal of Medical Sciences.
Harbindar Jeet Singh. (2001). The Unfolding Tale of Leptin. The Malaysian Journal of Medical Sciences.
Angelica Lindén Hirschberg. (2012). Sex hormones, appetite and eating behaviour in women. Maturitas.
MaryFran R Sowers et al. (2008). Change in adipocytokines and ghrelin with menopause. Maturitas.
Qian Gao, and Tamas L. Horvath. (2008). Cross-talk between estrogen and leptin signaling in the hypothalamus. American Journal of Physiology - Endocrinology and Metabolism.
Harvard Health Publishing. (2021). Why stress causes people to overeat.
Denise Mann. (2013). Sleep and Weight Gain. WebMD.
Laura Gómez Escribano et al. (2017). Review and analysis of physical exercise at hormonal and brain level, and its influence on appetite. Clínica e Investigación en Arteriosclerosis.
HRT https://hrtmedical.net/ is a therapy used to treat symptoms of menopause and andropause. It can help to relieve symptoms such as hot flashes, night sweats, and mood swings. HRT can also improve bone density, sexual function, and energy levels.