Why Women Struggle with Insomnia, Weight Gain, and Debilitating Symptoms During Perimenopause and Menopause and What to Do About It with Dr. Sarah Berry

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Dhru Purohit Show 1h 11m 3 speakers 6 chapters transcribed
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What are the common symptoms of perimenopause?

Dhru Purohit 0:00
Dr. Sarah Barry, welcome to the podcast. But I want to start off with something that I know is at the top of the minds of so many of our audience members, women, of course, in particular. And it's something that you guys noted inside of your study. So this is jumping ahead a little bit, but we're going to be zooming in and zooming out. In your study, you reported that 66% of perimenopausal women reported experiencing more than 12 symptoms, 12 symptoms. And inside of that, the most bothersome symptom reported was weight gain and slowed metabolism 31 of the participants reported having that i know for my audience that this is one of the top concerns as many of them are going through this stage and period in life.
Dhru Purohit 0:57
What are the top root drivers that are causing so many women to experience this symptom in particular of a change in metabolism?
Dr. Sarah Berry 1:07
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.

How does estrogen affect weight gain during menopause?

Dr. Sarah Berry 1:34
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.
Dr. Sarah Berry 2:35
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,
Dr. Sarah Berry 3:39
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
Dr. Sarah Berry 4:23
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

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