Disclaimer time again: I am writing this as I would a diary entry in the hope that I am not the only one going through this and that someone else might gleam some insight or advice while they read, if not a giggle! As always, I will try not to get too technical as I describe things but, I will include informative bits and pieces in light of what has helped me as well as my patients. This is of course not to be taken as medical advice, hence, if you are reading this and would like some help then please get in touch to book a formal consultation.

So, muffin top, spare tyre blah blah to the many other anecdotes there are, but I think you get the picture. That is, this band of extra fat around our middle that seems to creep up on us from nowhere, right when we are starting to notice hormonal changes, hot flushes, insomnia, depression etc, as if those weren’t enough?? As much as I have joked with friends and colleagues about this, it is a serious matter as I have felt and still feel the effect this extra ‘layer’ has had on my confidence, and my dress size! I have found myself reaching for elasticated waist bands or walking around with my top button on my jeans unfastened and, eventually buying a size up to not feel squashed in pants – sigh!

For some women that I have spoken to, it is not a consistent phenomenon, rather an exaggerated bloating feeling that can last all day. Or, it can be triggered by certain foods or even emotions (stress especially!) that again last all day or even a few days. For me, I honestly thought that my clothes were shrinking in the wash….wtf! I was making every excuse and ready to replace my washing machine that was only 2 years old, blaming the washing powder, the hard water, anything but perimenopause 😫 because like so many other women who look after themselves, I was eating well, exercising, early to bed etc. But, once again I had to stop and really look at what is really going on and how it is another consequence of hormonal changes.

So, what to do? First I am going to explain a little about the physiological aspect of this. Again I will try not to get too technical so that you don’t lose interest but I would like to shed a little light on this as western medicine unfortunately does not always facilitate this.

Let me make it clear that when I talk about hormonal changes in peri- and menopause, I am not only talking about oestrogen, progesterone and other reproductive hormones, even though they are the main culprits, they are not the only ones affected. One hormone that is often missed or overlooked – and this saddens and frustrates me to no end as it should be highlighted in big capital letters – CORTISOL! Cortisol is our primary stress hormone that is produced mainly in our adrenals glands, and is integral in how our bodies respond to perceived stress.

When we are going through times of stress our bodies enter a ‘flight or fight’ response which generates a cascade of physiological and hormonal responses so that we can get out of trouble so to speak. Accompanying this response, our bodies secrete increased amounts of cortisol (as well as adrenaline) into the bloodstream because now the only priority the body has is survival. As a result, digestion, reproduction and elimination take a back seat because we don’t need any of these functions when we are trying to survive. Instead, cortisol increases glucose availability in the bloodstream and to the brain, increases blood pressure and in doing so, provides energy for the body to be able to deal with this impending stress.

Normally, our bodies are meant to return to ‘rest and relaxation’ after we are out of the dangerous or stressful situation BUT, because we are surrounded by stressful situations more often than not (and remember it is our perception/reaction to stress be it good or bad), our bodies are no longer able to or, are slower to regulate themselves back to rest. What happens next is that due to this perpetual ‘stress response’ our bodies start to deposit fat in the midsection as an almost comfort blanket if you will, to use in times of stress or danger as energy/fuel! So it basically becomes our energy reserve!

And that ladies is why at peri-or menopause we find ourselves struggling with that extra weight because it is as a result of a long period of stress response or living in that fight or flight stage for too long at a time. Now there are some who suggest lowering carbs, raising protein, intermittent fasting, weight training etc etc and, of course this may help in some cases but until we look at how our bodies are functioning at a metabolic level (digestion, absorption and elimination) and support our hormonal balance, we are not going to resolve this. And who wants to be driving themselves crazy with hectic exercise and diet regimes that only add on more stress? I have found that small steps as long as they are consistent, and this is key – consistency – go a long way.

So how do we do this? Well, it starts in the mind really, as it goes back to how we perceive stress! So practicing mindfulness – and this can be anything from meditation or yoga to journalling, having an honest to God conversation with a trusted (and non-judgemental) friend, not to mention a good laugh (Jeez I need a good laugh!). It can also include getting rid of things that don’t serve you, be it people, possessions, attitudes etc.

And lets not forget gratitude. Now I know what some may be thinking (not this again – eye roll) and when I first read about keeping a gratitude journal I did an eye roll too, really. But hand on heart, I can honestly say that it has helped me hugely! I mean HUGELY. Once I read back all the little things that help me to live, smile, eat well and support me, I started to get it, finally. I relaxed more and I let go of things that I would normally take to heart or feel personally affected by. It takes a while of course as changing habits takes effort and patience (and time!) but I love my gratitude journal now.

The flip side of this is what some people are saying as becoming f*cktose intolerant! I love this and will probably get a t-shirt made, lol. But even though being mindful and having a positive attitude is great, sometimes you have to draw a line. And lets face it, sometimes it is important to say no to other people’s bullsh*t, no to the impossible standards of social media and other places that leave us anxious, depressed and knackered! Instead, let us change how we care for ourselves, lets respect ourselves by saying no when we honestly don’t want to and love ourselves (bloody hard I know!) but we owe it to ourselves to try!

Another absolute must is SLEEP! We cannot forget how important it is to rest and recover, and this again can mean different things to different people. Insomnia is increasingly an issue that people come to see me for, and most of the time it is stress related. Studies show that insomnia raises our cortisol levels (especially for those that work night shifts – I’ve been there) and so getting into a regular sleep routine is imperative. Nothing drastic is needed here but, as an example, I stay away from social media after a certain time, that is 7pm or, I switch the TV off earlier than normal, I practice deep breathing or just think of something positive or that I am grateful for. I love using essential oils like clary sage, lavender or patchouli in a hot bath or just on my pulses. I cannot say enough about an epsom salt bath, even in the height of summer. It is wonderfully helpful and grounding to the mind and body and gently detoxing for the body too, so a double whammy there! Yay!

When it comes to what we eat or drink, there are obvious ones to cut down on such as caffeine. Until about 2 years ago I was one of those annoying people that could have a double espresso after dinner and sleep great but if I do that now I think I could probably go for a 10 mile hike – forget it! So now I try to not have coffee (which I love in case you hadn’t guessed) after 5pm and it certainly helps. Other things which you may want to consider that I have noticed have helped me is how I distribute carbs and proteins. Now, if you had told me this 5 years ago I would have happily told you to piss off as I have always been a happy carb-girl. I am after all European so it is bread with every meal – except it isn’t anymore – sigh! I try to not have any carbs at night, with my carb-rich meal being at lunchtime as I find that that is when I am at my hungriest (anyone else?) and that is working out well for me in that I don’t get the evening bloat nor the morning after bloat.

There has been a lot of press recently about increasing protein as we transition into menopause, and I for one have done it slowly to get my body accustomed to it, and for now its working out well! I will write more about this in due course.

In terms of lowering your cortisol naturally, these have been proven time and again to support the body’s nervous system. First is Omega 3, studies have shown that increasing omega 3 in the diet led to an increase in resilience to stress and lowered cortisol levels and inflammation markers after periods of stress. Please make sure your sources of omega 3 are pure and be aware of ‘fish oils’ due to the increase in plastics and mercury in our oceans. Secondly is Ashwagandha, which is a wonderful herb that has been receiving substantial press recently and rightfully so. It has been used in Ayurvedic traditions for hormone balancing, anxiety, immunity support, physical endurance, diabetes management and much more. Studies have shown that it significantly reduced anxiety and stress levels, insomnia and fatigue.

Another wonderful herb is Siberian ginseng, a powerhouse of a herb increasing resilience and used for decades by Russian and Chinese athletes for recovery from physical training and stress. Studies have shown that it has a direct action on the hypothalamus (the area of the brain that initiates the cascade of reactions to stress that prompts the release of cortisol) improving its sensitivity, improving glucose metabolism and reducing blood pressure.

Magnesium is the next one and a mineral that most of us are lacking in due to our busy lifestyles. Low levels of magnesium have been linked to higher stress response or lower resilience to stress and then, coming full circle, it is also believed that high levels of continued stress lowers magnesium levels in the body, Aaarrrrggh! What is confusing for most is that magnesium is available in different forms (glycinate, malate, citrate etc) and some are better utilised than others when it comes to cortisol, fatigue or insomnia. In this case we need to consider magnesium glycinate as this is the one that has been shown to promote deeper and restorative rest and relaxation as it is in this state that our cortisol can naturally lower.

Vitamin C is another vitamin that needs attention as most people overlook this vital vitamin thinking that they get enough in their diet. This is all good and well except that when our bodies or minds are in a state of stress (be it good or bad) our bodies require and use MORE vitamin C as it controls our hemodynamic reserve (this means how our blood flows through our body), it maintains our immune function, which is why it is used widely during cancer therapy, and plays a huge antioxidant role in our bodies (in times of stress our bodies are vulnerable to oxidative cell injury).

Are you beginning to see the link between stress and our body’s response to it? It is HUGE and I haven’t even scratched the surface here believe me! I know that I said I wouldn’t get too technical and I hope I haven’t bored anyone to death but at times a more detailed explanation is needed.

In closing, I have found this ‘belly fat’ to be the hardest symptom to deal with so far because it is the one that is a daily reminder of the transition that I am entering, and how I need to step up for myself and my clients if I want to see a lasting change. Don’t get me wrong, I have no plans for a 6 pack or wearing crop tops as I am truly over that one but to FEEL GOOD and FEEL HEALTHY is what I am aiming for, for myself and my clients. We can do this ladies!

Next up, the dreaded blood tests! Are you thriving or just surviving?