Why Is My Body Changing?

We’ve seen it with our mothers and grandmothers; the decline in their ability to carry groceries, use the vacuum or dig in the garden. These everyday activities start to cause joint aches and pains or aggravate low back pain as women age. How unfair, as it’s such a great stage of life when women have more time to follow their interests and dreams. Younger women have no idea how much they may miss their oestrogen one day! So what’s going on after menopause that causes women to back off physical activity and distrust their body’s ability to perform tasks?

The natural decline of post-menopausal oestrogen is associated with decreased bone density, muscle mass, strength and oh, yes, increased visceral fat. After the 30’s, muscle mass gradually declines in women and this loss speeds up after the 50’s. Loss of muscle mass is associated with low physical activity, presence of inflammation, too high or low BMI (body mass index) and decreased leg strength, balance and power.

Prior to menopause, fat is stored around the buttocks and hips and less in the abdominal area due to the ‘protective’ effect of oestrogen. The onset of menopause sees decreased activity in muscle enzymes leading to increased storage of fat in muscle, with less ability to burn the fat. Increases in abdominal fat put post-menopausal women at a higher risk of developing type II diabetes.

What helps reduce the decline of muscle mass in post- menopausal women?

  1. Physical activity, especially weight training is the best strategy to keep muscle mass and reduce fat being deposited in the muscles (this unwelcome fat replaces contractile muscle fibers that burn energy).
  2. Protein intake (wide range of animal, vegetarian sources) is important for post-menopausal women to prevent or at least slow down muscle loss.
  3. Vitamin D has an association with muscle function and deficiency has been implicated in wasting of Type II muscle fibers (fast twitch, strength). Vitamin D is produced by the skin and affected by age, season, geographical latitude and skin pigmentation. Pfeifer et al concluded that post- menopausal women (mean age 74 years old) taking vitamin D with calcium improved their body sway and gait performance compared to a group who only took calcium supplements. Vitamin D is also important in maintaining bone mineral density as well as muscle function and strength.
  4. DHEA is a steroid hormone precursor (body converts into male and female hormones) that may contribute to increasing muscle mass, decreasing fat and improving glucose and insulin levels. A steep decline in circulating DHEA happens between the peri to post menopausal years. For more information http://www.nlm.nih.gov/medlineplus/druginfo/natural/331.html
  5. Increased oxidative stress in women has been associated with significant weight gains at menopause. Oxidative stress increases with menopause as the body produces free radicals, which are not destroyed when the anti-oxidant system is deficient.
  6. Inflammation is an important issue for women, as the hormonal transition at menopause seems to stoke the fires. Chronic inflammation lies behind heart disease, arthritis, cancer, inflammatory bowel disease, osteoporosis, depression, neurological and auto immune diseases.

Lifestyle changes to break the grip of inflammation involve diet revision to limit or cut trans fats and refined carbohydrates; taking omega 3’s; taking a high quality multi vitamin/mineral supplement; getting regular sleep; using probiotics and exercising regularly.

To sum up, current evidence shows physical activity is associated with a slower loss of muscle size. Improved levels of protein intake help to maintain muscle mass by slowing protein muscle breakdown and improving muscle protein synthesis. Increased oxidative stress seems to be related to lower oestrogen levels and lower vitamin D levels are associated with loss of muscle mass and bone density.

If menopause has taken your body prisoner and you need to break out, speak with your general practitioner about running tests for BMD, hormonal levels, inflammatory markers, muscle mass, insulin, glucose, vitamin D and DHEA levels. But before you race off to start an exercise program or hire a personal trainer, please read the following article on exercise in the menopausal years.

References

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Dionne IJ, Kinaman KA, Poehlman ET. Sarcopenia and muscle function during menopause and hormone-replace- ment therapy. J Nutr Health Aging 2000; 4:156-61.

Carville SF, Rutherford OM, Newham DJ. Power output, isometric strength and steadiness in the leg muscles of pre- and postmenopausal women; the effects of hormone replacement therapy. Eur J Appl Physiol 2006;96:292-8.

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Pansini F, Cervellati C, Guariento A, Stacchini MA, Castaldini C, Bernardi A, et al. Oxidative stress, body fat composition, and endocrine status in pre- and post- menopausal women. Menopause 2008;15:112-8.

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Schaap LA, Pluijm SM, Deeg DJ, Visser M. Inflamma- tory markers and loss of muscle mass (sarcopenia) and strength. Am J Med 2006;119

Tseng, Lisa A. BA; El Khoudary, Samar R. PhD, MPH; Young, Elizabeth A. MPH; Farhat, Ghada N. PhD; Sowers, MaryFran PhD; Sutton-Tyrrell, Kim DrPH; Newman, Anne B. MD, MPHThe association of menopause status with physical function: the Study of Women's Health Across the Nation