DEAR MAYO CLINIC: I recently turned 50, and I walk about 1 mile daily and work out two to three times per week. I believe I am beginning to go into menopause, as I have not had a period in a few months. Also, I have noticed the number on my scale rising, even though I have not changed my diet or activities. I've heard weight gain is common in menopause. As I enter this stage of life, what can I do to maintain my weight other than continuing to work out and eat well?

ANSWER: You are certainly well on your way to a warding off midlife weight gain with your healthy lifestyle. Weight gain is often an issue as women move into menopause, even for those who eat well and exercise regularly. Over the next several years, you may find it more difficult to stay at your current weight, and that you'll need to increase your activity level and be more diligent about your eating habits.

A woman is considered to be in menopause when she's gone a year without a period. Menopause usually happens in the late 40s or early 50s. The final years leading up to menopause are called perimenopause. They are characterized by menstrual irregularities. During perimenopause, many women start experiencing a variety of symptoms that come with menopause, including weight gain.

This weight gain happens in part due to hormone changes. Declining levels of the hormones estrogen after menopause and testosterone with aging contribute to a loss of muscle mass, which leads to fewer calories being burned at rest and with exercise. The hormonal changes also affect where fat is stored, leading to a tendency for fat accumulation around the midsection.

In addition to hormone changes, other symptoms of menopause, such as hot flashes, sleep problems and mood changes, can interfere with a woman's ability to adhere to healthy lifestyle measures. That can contribute to weight gain. Genetic factors also may play a role. If your parents or other close relatives experienced weight around the abdomen as they got older, you're likely to do the same.

Considering all these changes, maintaining the same level of exercise and calorie intake you have always had may no longer be enough for weight maintenance as you head toward menopause. You may need to add more exercise to your regular routine.

For most healthy adults, experts recommend moderate aerobic activity, such as brisk walking, for at least 150 minutes a week or vigorous aerobic activity, such as jogging, for at least 75 minutes a week. Strength training is recommended at least twice a week. If you want to lose weight or meet specific fitness goals, you might need to exercise more.

Check your eating habits, too. Choose fruits, vegetables, and whole grains, particularly those that are less processed and contain more fiber. Avoid or limit sugar-sweetened beverages, such as soft drinks, juices, energy drinks, flavored waters, and sweetened coffee or tea. Cookies, pie, cake, doughnuts, ice cream and candy should only make occasional appearances in your diet, if you include them at all. Limit alcohol, as it also adds empty calories.

Though things may seem a bit overwhelming as you move into this new stage of life, keep in mind that positive lifestyle changes can reap many health rewards as you get older. Staying at a healthy weight lowers your risk for a variety of health concerns, including high blood pressure; heart disease; Type 2 diabetes; and certain kinds of cancer, such as breast, endometrial and colon cancers. In addition, avoiding excess weight as you age can make it easier to stay active over time. And that can help you look and feel better in the long run.

If you have questions about menopause symptoms or changes you experience in perimenopause, talk with your health care provider. You also can seek out a women's health specialist who can offer details about possible treatments that may ease symptoms and make this significant life transition easier to manage. — Dr. Jacqueline Thielen, Women's Health Clinic, Mayo Clinic, Jacksonville, Florida

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Related Articles 

• Mayo Clinic Q and A: Spotting, perimenopause and menopause published 12/21/20
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• Women’s Wellness: Fitness tips for menopause published 9/19/19
• Women’s Wellness: Menopause misconceptions published 5/16/19
• Women’s Wellness: Is there a connection between menopause and high blood pressure? published 1/17/19

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