Menopause

Changes in the body and keeping healthy

For many women, the menopause and ageing go together. Changes in the body including weight gain, wrinkles, grey hair and aching joints do not merely coincide with the menopause; they remind women that they’re ageing. Staying healthy by keeping fit and eating well becomes increasingly important. Here, women talk about how they adapt to physical changes and what they do to keep healthy.

Weight gain
Many women complain about putting on weight and losing their figure around the menopause. Changing hormone levels and a slowing of the body’s metabolism partly explain expanding waistlines. Many women acknowledged that lack of exercise, eating and drinking too much, a more sedentary lifestyle, and giving up smoking had all contributed to weight gain. Some women noticed they put on weight while on HRT. Weight gain is common in the menopause because after the age of 40 the Basal Metabolic Rate (the rate at which calories are burnt off) slows down. HRT can only partly help to stop this so women can still gain weight on HRT (see ‘Hormone replacement therapy (HRT)’).

 

Dr Sally Hope talks about weight gain during the menopause

Dr Sally Hope talks about weight gain during the menopause

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Now the sad truth is everyone puts on weight, even my dog has put on weight now she’s had a hysterectomy. And the average weight gain in the menopause is two kilos and I certainly notice I put on weight much more easily than I did. I think one’s metabolism really does change although there’s very annoyingly little data on this but again that’s just a little prod to make us be healthier, perhaps take a bit more exercise, a little bit less carbohydrate, make sure our calcium is good and stay fit, slim, beautiful and healthy.

So has the weight gain got to do with losing oestrogen? Is that why we put on weight?

I think it must. But the other thing you’ll notice is your shape actually changes. It’s not so much overall weight but sadly, we go from being Marilyn Monroe, well, I never had a Marilyn Monroe figure but the hourglass Victorian sort of breasts going in at the hips, sorry, breasts, going in at the waist, out at the hips, Marilyn Monroe or hourglass figure of a nubile, fertile woman goes and your breasts shrink and your hips shrink and your legs shrink but your tummy gets bigger. Your tummy falls out so you sort of go from looking like Marilyn Monroe to looking like a toffee apple on a stick. And that’s somewhat depressing and one has to work very hard to keep one’s tummy in and diet accordingly.

 

Marcia has put on weight around her midriff. She talks about her ‘fifties stomach'

Marcia has put on weight around her midriff. She talks about her ‘fifties stomach'

Age at interview: 46
Sex: Female
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Weight, I seem to be putting on weight and I don’t have a lot of chocolate or crisps or anything like that. I have quite a balanced diet, in fact I probably don’t eat enough because of my lifestyle but I do find that I am putting on weight particularly around my midriff, nowhere else it just seems to be all coming onto my stomach and I’ve tried exercise, I’ve tried really monitoring my food but I’ve noticed that I call it like the fifties stomach and it starts to come from underneath your breast bone and just kind of just permanently looking like you’re four months pregnant.

And does that bother you?

Yeah, I think it does bother me because everyone wants to be trim but if I was over eating I would say “Oh, well it’s because I’m over eating” but it is just the feeling of not having any control over it because you’re trying not to overeat and you’re trying to live a kind of healthy life and it’s still getting bigger, it’s a bit frustrating.

 

Susan lost her vitality along with her thin, boyish figure

Susan lost her vitality along with her thin, boyish figure

Age at interview: 55
Sex: Female
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Well, just that loss of the youthfulness and I suppose being gay I like my kind of almost gamine type and this is very personal to me. I like my almost androgynous look. When I put on weight there was no denying my womanness, that was me. This is me. This is a gay woman talking and a woman who enjoyed looking kind of boyish, thin, young all of that. So that to lose, to kind of put on weight that was the first thing and just feeling not as physically fit because I would be quite a physical type person and I would have enjoyed sports and all the rest. So I kind of let myself go a little bit. There was a wee bit of that I should of kept up that sort of thing. Whereas instead I think I began to adopt behaviours that were just not good for me. As I say, eating too much, maybe drinking too much, not exercising as much as I should have, doing things that were because I was more preoccupied with the way I felt. I let and then as a result my physical and one impacted on the other. The heavier I got the more down I got about that, the more down I got the more I ate and drank, the more I ate and drank, so that there was a bit of a cycle there. There was a bit of a cycle of that kind of destructive behaviour type stuff. That our lifestyle stuff that I can see then was no good for me and I’ve come out of that and can look back and see that I’m in a place where I want to change and improve all of that.

Women said their weight ‘crept up’ over time and their body changed shape. They found it difficult to shed excess pounds even when they ate sensibly. Some felt they were in a constant frustrating battle with their body to lose weight. While diets, slimming classes and exercise helped some women, others said they lacked the willpower to keep their weight in check despite good intentions. They could not find the time or motivation, especially when trying to cope with menopause symptoms.
 

Christina despairs at her weight gain

Christina despairs at her weight gain

Age at interview: 52
Sex: Female
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I’m two stone overweight and I mean some say, “Well, it’s a mixture of your thyroid and the menopause as well.” But the joking matter, trying to cope with it in a light-hearted way is everything’s going south. But it doesn’t help when having had an emergency c-section as well I’ve got an overhang of stomach and you just feel absolutely grotty. I’m going on holiday in five weeks time to Benidorm for five days and now I brought out my shorts yesterday to try on, which fitted me last year, and I don’t scoff and I’ve been on diets and I’m on the Wii fit and keeping occupied and get fit, and I burst into tears because none of them fit. And even a size sixteen didn’t fit. So it just seems to have expanded even more and not knowing the reason for and then you just say, “Oh well, it’s your time of life and you expand.” So it’s harder to lose. Put it that way.

Have you talked to the doctor about it?

I have. He said, “You’re within a limit. We’ve taken a cholesterol and the cholesterol’s okay.” But he said it’s just one of the problems that again he, it’s just one of the problems of menopause.

But more often than not they’ll say well, it’s a mixture and we can’t block things off or allocate blame to different things and plus as you get older you do gain weight because your metabolism is slowing down and everything else and I’m thinking, “I just want my life back and I want to feel good about myself.” And I’m going through all these hot flushes and night sweats and everything else. Night sweats, I would think I would lose buckets of weight and it doesn’t happen. You’ve still got your cellulite and your overhang and your lumpy bits and everything else and you call them your wobbly bits but they’re not very nice in a swimming costume. So you’ve gone then from a bikini to swimming costume, to swimming costume with tummy control. And breathe in girls but it’s mad. It really is mad. And it doesn’t help when people say, “Oh, you don’t look overweight.” Or anything else but I know. I said, “You don’t see me first thing in the morning looking in the mirror. I do.”

Not all women put on weight during the menopause. Keeping fit with regular exercise and eating a balanced diet helped some to maintain a healthy weight. However, many found it difficult to accept a changing body shape. One woman, recently divorced, was terrified of dating again and having to reveal ‘all these lumps and bumps and bits that spill over’. Another despaired that she no longer felt ‘girly, pretty or feminine’ no matter what she wore. Some women complained that their clothes no longer suited them and had difficulty finding fashionable clothes for their age group (see ‘Getting older’).
 

Janice is disappointed with her body image and wants to feel attractive

Janice is disappointed with her body image and wants to feel attractive

Age at interview: 59
Sex: Female
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It’s certainly much more difficult to lose weight, absolutely. I think it’s stubborn. So again, your body image doesn’t fit in with what we’re told we should look like in films or whatever. So you’re left a bit disappointed with your own body image. There’s only the Dove one perhaps which might celebrate older women but apart from that you’re just often you feel like you’re at society with your nose pressed up against the window. That you used to be in that shop. You might have been actually in the window as window dressing. You’re no longer window dressing.

I think the main thing is in partly you can discard having to dress up and attract men. That’s a big plus. You can actually dress for yourself and although that’s like saying a conflict with wanting to be attractive but it’s not to attract, the attraction I want to have is not to attract men. I just want to feel attractive as a person. It isn’t to attract the opposite sex like it might have been when I were younger. So perhaps that is a bonus that you can dress to please yourself and in a way feel comfortable in your own skin but still that conflict’s there. It never seems to go away, that loss because that’s the only way I can term it, as a bereavement.

Changes in skin and hair
Having good skin can help women feel younger than they really are. One woman said she’d ‘escaped lightly so far’ thanks to inheriting her mother’s good skin; another was relieved that Caribbean people ‘don’t look old at fifty’. For other women, however, wrinkles and dry skin became more noticeable around the menopause as skin starts to lose its tone and elasticity. Lines, wrinkles, bags under the eyes, and sagginess can make women look older and more haggard. Some women accepted these changes as part of ageing, and used simple, inexpensive moisturisers on the skin. Others turned to more expensive products targeted at older women, which claimed to reduce the appearance of wrinkles and make them look younger.
 

Rose follows a good skincare routine but knows that nothing will get rid of her lines and wrinkles

Rose follows a good skincare routine but knows that nothing will get rid of her lines and wrinkles

Age at interview: 50
Sex: Female
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At that particular time in my life it was all around the fact that I was no longer going to be able to have children, now it’s more along the lines of “Gosh the wrinkles and things are coming along much faster now than they ever did”. I’ve always been a little bit vain I suppose in that I’ve always been told that I don’t necessarily look my age and I don’t think that I did whereas I think in the last couple of years going through the menopause suddenly I’m starting to find a) I look my age but b) I actually feel my age now too, which I didn’t use to. And that’s all quite difficult to come to terms with.

Oh yes, I’ve spent many many pounds over the years. I have to say I think they’re brilliant for keeping your skin nice and soft brilliant for that feel good factor. The reality is once the lines and wrinkles start to come in, I’ve tried all sorts of creams at all sorts of prices and none of them have banished any lines or wrinkles that I’ve accumulated. What they do do is they soften them and they make me feel better, I’ve learnt to buy the ones that I particularly like that smell nice, that make me feel good when I put them on. But none of them are going to get rid of the lines and wrinkles. I have to look at those as, “That’s what I’ve acquired through my life, each one tells its own story, quite a few stories have been told in the last five years” and I put it down to life experience. But yes I still follow a good skincare routine. I do think it’s important. I do cleanse, tone and moisturise twice a day. I don’t go to bed with my makeup on. And I think that’s had again a benefit for my skin over the years.

Hair also changes as women age, becoming thinner, wirier, and more brittle as well as going grey. As a visible reminder of ageing, grey hair is not always welcome. One woman’s grey hair has catapulted her into late middle age, turning her into a ‘version of my mother’. Another bemoaned the loss of her ‘beautiful red hair’, highlighting the link between hair colour, appearance and age. Many women are reluctant to go grey naturally. There is a tension between ‘growing old gracefully’ and retaining the colour and vibrancy of youth.
 

Eileen mourns her glossy black hair

Eileen mourns her glossy black hair

Age at interview: 59
Sex: Female
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Oh that is one thing actually that does get me, the hair. The fact that my hair was black and now it’s not. It sort of fades a bit before it greys, it goes quite faded and you just think “but I did like my hair”. It was kind of if I stood with the light behind me in a disco I was a red head because there was so much red in my hair but it was this beautiful glossy black and that is one thing I do regret the fact that as you get older your hair colouring does change and of course your face skin tone changes with it as well. But that’s probably not as noticeable as the fact that the hair is changing.

So is that your natural colour that you have now?

This is much lighter than my natural colour, mostly, I do give it a little help because it, I think once it’s got to the stage of being all white, that’ll be fine but at the moment it’s not, so I will carry on giving it an occasional rinse just to brighten it up slightly.

 

Deborah is ready to go grey though she knows it will age her ten years

Deborah is ready to go grey though she knows it will age her ten years

Age at interview: 48
Sex: Female
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I think I’m ready to go grey, that’s a big thing for me somehow about colouring my hair. I’m fed up of colouring my hair and I know that it would immediately make me look ten years older. So there’s something very physical and kind of stereotypical and immediate about that aspect of my appearance, that’s kind of an issue for me.

Bones, muscles and joints
Some women noticed changes in their muscles and joints around the menopause as muscle tone and strength waned. Joint stiffness and pain made them feel old.
 

Susie feels less nimble and thinks her body is deteriorating with age. (Video clip in Cantonese,...

Susie feels less nimble and thinks her body is deteriorating with age. (Video clip in Cantonese,...

Age at interview: 51
Sex: Female
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I don’t know, but at this age your body starts to deteriorate, and all the bad things just start coming out so you are not young and strong. There are some people who are 40 years old and look very old, like grandmothers, and there are people who are 70 who are really fit and healthy, so everybody is different.

You were talking about the body deteriorating, how do you feel about getting older?

How do I feel about getting older?

Yes, you talked about the body deteriorating…

Deteriorating? I get tired easily now, the bones just seem a bit stiffer, used to be very nimble, could just bend over to pick something up from the floor, but now it’s really difficult. I just feel really tired.

As well as generalised aches and pains, serious conditions like arthritis and rheumatism can also start during the menopause and can need medical treatment (see ‘Family, health and life events’). As oestrogen levels fall and bones become thinner, the risk of osteoporosis increases. In the past this encouraged some women we talked with to use HRT.
 

Nancy began HRT in her early 40s to reduce the risk of osteoporosis

Nancy began HRT in her early 40s to reduce the risk of osteoporosis

Age at interview: 59
Sex: Female
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I think they examined me, I can’t remember very much about the examination, I think they probably did some kind of scan but I can’t really remember what and then they did the bone scan and found that I had some deterioration, the bone density wasn’t what it should be for my age. And that’s when they suggested that I might go onto HRT, especially as I was quite young to have had the menopause.

What did they tell you about HRT at that stage?

I really can’t remember what I was told by them and what I read myself because I did read about it quite a lot and I really can’t remember which is which. I think they were pretty good about it, they gave me quite a lot of information including possible risks. But although I wasn’t really very happy about taking it, they did say that I really should because of the bone density because they said that I’d have reasonable bones for much longer because they said if you were much older we might think twice about it because looking at the sort of prospective length of life you’ve got left but they said at your age then really you want to keep good bones for as long as possible. Which all sounded like good advice really.

The risks associated with long-term HRT use, however, mean that it is no longer prescribed long term to prevent osteoporosis, except for women with an early menopause (see ’Early (premature) menopause’). Other women can much improve bone density by eating a diet rich in calcium and vitamin D, not smoking and taking regular weight-bearing exercise (see our website on ‘Osteoporosis’)

Keeping healthy
Some women see the menopause as an opportunity to reassess their lives and become more in tune with their needs. They said they had become more aware of their health, and the importance of a good diet and exercise. As well as eating lots of fruit and vegetables, women found walking, swimming, cycling, exercising at the gym, playing sport, and doing yoga helped them keep fit (see ‘Non-HRT and lifestyle options’). Some women took supplements such as iron tablets to correct anaemia due to heavy periods and calcium to protect their bones.

 

Dr Sally Hope believes the menopause is ‘a great time' to start exercising and eating better

Dr Sally Hope believes the menopause is ‘a great time' to start exercising and eating better

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And all the rest of us who are going through the menopause need to look at our bones and there is a brilliant website, the National Osteoporosis website, Stay Healthy, and we know that actually the menopause is a very good time in our lives because it’s a time when women are open to changing their lifestyle for a healthier one.

Even I’ve started exercising and eating better and so it’s a great time to lose weight, if you’re slightly overweight, to gain weight, if you’re underweight, because you need a BMI of around 20 to 24, because if you’re too thin and scrawny you’ve got a risk of osteoporosis. To stop smoking, smokers have an earlier menopause, that’s why they’re all wrinkly and old than the rest of us. Unfortunately, reduce your alcohol intake because one of the sad things the Million Women Study showed that if you regularly drink two or more units a day you double your risk of breast cancer and that received no publicity at all. It was all headlines on Radio Four about HRT but an equal risk of alcohol never got that publicity and I think certainly a lot of women seem to drink a lot more than they used to. And I think that’s very important. Similarly, obesity doubles your risk of breast cancer and again that got very little publicity. So you can actually lower your risk of breast cancer by healthy eating, healthy exercise, being a healthy weight and not only does it reduce your risk of breast cancer but it improves your mental wellbeing. It improves your bones because we know that twenty minutes exercise a day, weight bearing, so carrying the shopping back from the Co-op, improves your bone density, reduces the risk of osteoporosis and also helps your cardiovascular system. So it really ticks all the boxes.

 

Joyce eats well and sees exercise as a chance for some 'me' time

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Joyce eats well and sees exercise as a chance for some 'me' time

Age at interview: 48
Sex: Female
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I need exercise for several reasons. One is that it’s my own down time. It might not be for very long but it’s the time that nobody can get hold of me, and I do something purely and simply for me. So that would normally take the form of either going to the gym and spending an hour in the gym. I like swimming because I don’t run anymore I love walking and I have a couple of circuits near where I live, that are four and five miles long, and I’ll quite happily on a Sunday morning put my training shoes on, and go out for a power walk and run. In the summer I like horse riding and in the winter skiing is my passion. And I only learnt to ski about three years ago and I’ve already been once this year and I’m going again in a fortnight which will be fantastic.

I suppose it really made me think about my diet and my lifestyle, how could I ensure that my body was as healthy and resilient as possible to being able not to be susceptible to cancer? And I know that sometimes that’s really difficult but I’m very conscious about my diet. I eat a lot of fruit and vegetables, and I like to think I know all of the antioxidants that exist, do you know what I mean? I do a lot and I’m interested and I read about keeping yourself fit and healthy.

 

Cheryl finds having a dog is ‘a wonderful excuse' for getting exercise

Cheryl finds having a dog is ‘a wonderful excuse' for getting exercise

Age at interview: 54
Sex: Female
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Have you made any changes to your diet and lifestyle?

Ah, no. I don’t think I have really. I eat the same, because I eat well and I probably shouldn’t drink quite as much as I do but that’s one of the pleasures of life isn’t it with friends especially. So no I don’t think I’ve really made a lot of difference.

Exercise?

Exercise, we lost our last dog five years ago and we’d had her for a good fifteen years and we had a bit of a break when we had lots of holidays and we just felt that we couldn’t replace her. But then a year ago we decided we needed to have another one for both our sakes, that we wanted to ensure that we got out every day and it’s a wonderful excuse and living here in the countryside and it’s marvellous so, yes we both get plenty of that exercise. I don’t swim a great deal. I have done pilates and I’m probably going back to that after Easter because there’s a class in the village. I’ve done belly dancing, but apart from that not a lot.

Women stressed the importance of having regular checks with their GP or practice nurse for blood pressure, cholesterol and diabetes. They also urged women to attend routine breast and cervical screening (see our sites on ‘Breast cancer’, ‘Breast screening’, ‘Cervical cancer’ and ‘Cervical screening’).
 

Nancy's breast cancer was found on a routine mammogram

Nancy's breast cancer was found on a routine mammogram

Age at interview: 59
Sex: Female
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You got breast cancer in 2007?

Yes.

How was that diagnosed, I mean was it a routine scan?

Just a routine scan. Really important to turn up for your routine scans I think.
Had a routine scan, didn’t expect there to be anything wrong, because there never was and then I got the letter, come back for another appointment to [hospital name]. there’s probably nothing wrong but there was and when I saw the x-ray I couldn’t imagine how they could do anything other than remove the breast because it was like tiny little specks of white, it was like stars in a night sky really in all of the ducts so really there was nothing else they could do. But they were precancerous so I was very lucky again, if I hadn’t turned up for that scan it would have been an absolutely devastating illness I think.

Changes in the body can have a detrimental effect on how women think about themselves during the menopause as well as reminding them they are getting older. Adapting to these changes and staying healthy through diet, exercise and health checks can help lay a good foundation for later life. The topic ‘Getting older’ looks in more detail at how women feel about the transition from youth to later life.

Last reviewed July 2018.
Last updated July 2018.

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