Hot flushes, night sweats and changing periods tend to dominate any discussion about menopause. They are certainly part of it, but for many women some of the more surprising changes are the ones nobody mentioned beforehand.
Your waist can change even though the number on the scales hasn’t moved very much. Maintaining muscle becomes harder. Cholesterol and blood glucose can begin to creep upwards. Bones need more attention, sleep can become increasingly erratic and a digestive system that behaved perfectly well for years may suddenly become rather less cooperative.
Then there is the gut microbiome. We hear a great deal about hormones during menopause, but considerably less about what may be happening to the trillions of microorganisms living in the intestine and how their activity might relate to some of these other changes.
Menopause is therefore about far more than managing symptoms. It occurs at a time when the body is changing metabolically too, and understanding those changes gives us an opportunity to think about the decades that follow.
The change around the middle
One of the changes women frequently notice is where they carry weight. Falling oestrogen is associated with a shift towards greater abdominal and visceral fat, the fat stored around the internal organs. You can therefore find that your clothes fit differently even when your weight hasn’t altered dramatically.
Visceral fat matters because it is metabolically active and is associated with insulin resistance, blood lipids and inflammatory activity. This is also one reason I am far less interested in weight alone during menopause than I am in what is happening to body composition.
At the same time, muscle becomes easier to lose. Muscle helps us remain strong and mobile, but it also plays an important metabolic role, including in glucose regulation. Maintaining it through midlife and beyond becomes increasingly valuable.
This is one of the changes we should talk about much more. Menopause shouldn’t automatically trigger another diet. For many women, preserving muscle and improving body composition are more useful goals than simply trying to make the scales go down.
Bone and muscle deserve more attention
Oestrogen plays an important role in bone turnover, and bone loss accelerates after menopause. Most women know something about osteoporosis, but we are generally much less good at thinking about bone health before there is a problem.
Adequate calcium, vitamin D, protein and weight-bearing exercise all matter. Resistance exercise becomes particularly useful because it supports muscle as well as bone.
Protein deserves more attention too. Rather than concentrating on a long list of foods women should or shouldn’t eat, I would make adequate protein, plenty of different plant foods and good-quality fats the foundations. Fibre remains important for the gut, although women experiencing significant bloating or bowel changes may need to increase it according to tolerance rather than simply adding enormous quantities overnight.
Nutrition at this stage of life should support muscle, bone, metabolic health and the gut rather than becoming another exercise in restriction.
The gut can behave differently too
Bloating, constipation, changes in bowel habit and altered tolerance to foods are all reported by women during the menopausal years. Hormonal changes may affect gut motility, but the microbiome itself is also receiving increasing attention.
Research hasn’t identified a single microbial pattern that suddenly appears at menopause, and that isn’t particularly surprising. Our gut microorganisms are influenced by age, food, medication, alcohol, sleep, exercise, stress and numerous other factors.
What scientists are becoming interested in is what those microorganisms are doing.
Gut bacteria break down components of our food and produce metabolites that interact with the intestinal lining, immune system and metabolism. Short-chain fatty acids such as butyrate are one example, while bile-acid metabolites and compounds produced from plant polyphenols are also being studied.
This matters because some of the biological areas influenced by microbial activity - metabolic health, intestinal barrier function and inflammatory signalling - are also particularly relevant as women move through menopause and into later life.
What about postbiotics?
For years, gut-health supplements have largely centred around probiotics: live microorganisms intended to provide a health benefit. Postbiotics give us another option because they provide inanimate microorganisms and/or their components with demonstrated health benefits, without depending upon live bacteria remaining viable.
This is particularly interesting as microbiome research moves towards understanding not simply which microorganisms are present, but what they produce and how those microbial components interact with the intestinal barrier, immune system and metabolism.
The Postbiotic Company’s Women’s Wellness formula combines its AYA BIOME™ fermented turmeric postbiotic with ingredients selected specifically for women’s health, including S-Equol and vitamins D3 and K2. For women already paying attention to nutrition, exercise, bone and metabolic health, a well-researched postbiotic can be considered as another way of supporting gut and healthy-ageing health through midlife.
The years after menopause matter
Perhaps one of the biggest changes we don’t talk about is perspective. Menopause can feel all-consuming while symptoms are at their worst, but it is a transition into a stage of life that may last another thirty or forty years.
That makes muscle worth protecting now. It makes bone worth thinking about before a fracture. It makes changes in waist circumference, cholesterol and blood glucose worth noticing, and it gives us good reason to pay attention to a gut microbiome that continues to interact with our metabolism, immune system and diet throughout life.
We cannot prevent every change that accompanies ageing, nor should we try to turn menopause into a medical problem that needs fixing at every turn. We can, however, use nutrition, movement and appropriate supplementation to support the body through it.
Postbiotics add another tool to that approach, particularly for women who want to support gut and healthy-ageing biology without relying solely upon live bacteria.
Those are the menopause changes worth talking about.
Kate Arnold, Nutrition Consultant to The Postbiotic Company
This article is for general information and educational purposes only and is not intended to replace individual medical or nutritional advice. Food supplements should not be used as a substitute for a varied, balanced diet and healthy lifestyle. If you are experiencing menopausal symptoms, have a medical condition, are taking medication or are considering HRT or nutritional supplementation, please seek advice from an appropriate healthcare professional.
