Dr. Sarah Berry

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566 appearances 3 recordings 3 series first heard Nov 2024 last heard 18 Dec

Dr. Sarah Berry’s voice in public audio — every appearance, attributed to the second.

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Recordings per month over the last 12 months — 1 in all, peaking in Dec 2025 with 1.

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Dhru Purohit Show · Why Women Struggle with Insomnia, Weight Gain, and Debilitating Symptoms During Perimenopause and Menopause and What to Do About It with Dr. Sarah Berry · 6 Nov 2024 podcast

Estrogen. Estrogen loss, estrogen decline, estrogen fluctuations. But not estrogen only affecting our body weight and our metabolism, but affecting so many other areas that then interlink with this. You know, our metabolism, our body weight isn't just about how we metabolize food or what we're eating. It's so multifactorial and it's so interrelated to the other pillars of health.

So our stress, our sleep, our physical activity, as well as what we eat. And we know that menopause impacts all of that. So we can deep dive a little bit into why. One thing just to pick up on, Drew, is actually it was over 80% of our women said that they were experiencing weight gain or slowed metabolism. Wow. That is huge.

And when we think about perimenopause, often people think about hot flashes, hot flushes, night sweats. That's the least common symptom. So as you said, one of our most common symptom was this weight gain and slowed metabolism. So there's different things going on here. We need to step back and firstly think, well, what is the role of oestrogen in our body?

The role of oestrogen is to impact a whole wide range of different processes, different physiological processes, different neurological processes in our body. We actually have oestrogen receptors over nearly every single cell in our body nearly. So oestrogen impacts so many different processes in our body.

And this is why when you go through the menopause transition, which involves the loss of oestrogen, then you have such wide reaching impacts across your body. One of the things that oestrogen does, it has quite an important role in how and where we deposit fat. So where we deposit adipose tissue cells, these are fat tissue cells.

And really simply put, what happens is, is when you've got a good amount of oestrogen, so your premenopausal, the oestrogen kind of directs the fat around your hips. So we typically say, premenopause women have this pear shape look. So they have their fat around their bottom and their hips.

Now, as your oestrogen declines during the peri and postmenopause, you've no longer got that kind of protective effect of oestrogen driving the fat to sit there. It's then repositioned around your belly. What we know is that a fat around the belly, which we call visceral fat, and we call it visceral adiposity, if you have too much fat around the belly,

We know that that's associated with really unfavorable metabolic effects. It's involved with inflammation. It's involved in insulin resistance, et cetera. It's metabolically very active, but in a quite harmful way.

And we actually know that postmenopausal and perimenopausal women are five times more likely to have that central visceral adiposity, so that fat around the belly compared to premenopausal women. So that's one thing that's happening. But what we also know is in addition to that, oestrogen's impacting lots of other areas. It's impacting our brain.

So it's impacting our perception of hunger and fullness. And there's some evidence now emerging that actually food that would have kept us full when we were premenopausal

isn't keeping us quite so full now because it's impacting our hunger this is new area of research you know we don't know conclusively yet but it's quite interesting what's coming out regarding and we hear anecdotally people say this you know i'm 47 i'm perimenopausal lots of my friends are talking about this they say oh but i'm eating exactly what i used to eat but i'm still hungry all the time it's changing our perception and

We've then got the fact that most, and again, we see 85% of women have sleep disturbances if they're perimenopausal. So you've got people not sleeping well. When you don't sleep well, we know that the reward centers in your brain are heightened. So what happens is, is the next day after you've had a bad night's sleep, your brain needs a quick fix. It needs a dopamine hit.

And so it's driving you to go and select foods that we know aren't very healthy. The refined carbohydrates, the pastries, the white bread, etc. And then what we also know is if you've had a bad night's sleep, your blood glucose response following a bad night's sleep is more unfavorable compared to if you've had a good night's sleep.

So that just shows how you've got all of these different things kind of intersecting. And then you've got things like anxiety, depression, low mood. Now, I don't know about you, Drew, but when I'm feeling fed up, the last thing I want to do is exercise. The last thing I want to do is think about eating a really healthy diet or not having that glass of red wine in the evening.

So you've got like this perfect storm of symptoms, lack of sleep, the estrogen driving your fat tissues to be in different areas. And all of this culminates in weight gain. And all of this culminates in different ways in how you metabolize food and your metabolism.

Yeah, absolutely. So one of the things we looked at, and this is in 70,000 women who we asked them lots of questions about their menopause symptoms, the impact they were having on their quality of life. And then we also collected lots of health data. So we collected data on their microbiome, their blood glucose responses to food, their BMI, their health history, etc.

And then we looked at how do people's symptoms differ according to lots of these other factors. And what we found was that people, as their BMI increased, so as their body mass index, so they would be predicted to therefore have more adipose tissue, more fat tissue, as that increased, their menopause symptoms got worse. And it was kind of in a stepwise progression.

So every time their BMI went up by a few points, so did their menopause symptoms go up. But this is what's really challenging. You know, ask a peri- or post-menopause or overweight woman will just go and lose weight and she'll probably throw her coffee at you. Because it's so challenging. So you're in this kind of vicious cycle where the...

living with obesity or living with being overweight is making your symptoms worse those symptoms for most people are then going to make it harder for people to lose weight and so i do think there has to be an element of being kind to ourselves as well as peri and postmenopausal women that look it is harder it is tougher it is a perfect storm the odds are stacked against you but having said that

there is still hope. There are still things we can do about it.

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