Have you noticed that you eat more at certain points in your cycle? Maybe premenstrual l syndrome kicks in and chocolate is suddenly your best friend! Or perhaps you are perimenopausal and your jeans are steadily getting tighter.

If you have polycystic ovary syndrome, out-of-balance hormones may be making it a struggle to lose weight. We all know that our female hormones can have a big effect on our mood and well-being. They also play a role in our weight.

Jane’s story

Fast approaching her fortieth birthday, Jane, my normally upbeat client, suffered with mood swings. Because of COVID and new regulations, her job was particularly stressful at this time (2020). But minor things—that she would normally have taken in her stride—seemed to upset her, and she found herself being short-tempered with her colleagues and her partner. On top of that, she was having hot flashes when she had her breakfast cup of tea.

They weren’t terrible but seemed to be triggered by hot drinks. However, she really needed her morning cuppa! Also, she was gaining weight. To start with, this hadn’t bothered her much. She’d always been accepting of her body.

But her belly was now uncomfortably large, raising the health risks. She asked herself whether the situation might be related to menopause, even though her periods were still fairly regular. Jane was right that changes in her female hormones were causing her hot flashes and mood swings. As she was now perimenopausal, her estrogen levels were dropping, triggering her body to store belly fat.

How your female hormones affect your weight?

Oestrogen interacts with the messengers that regulate your food intake. It reduces the appetite-stimulating effect of some of them and increases the appetite-reducing effects of others. In other words, when estrogen is higher, your appetite is less.

As a result, you are likely to eat more when your estrogen levels are low. This is generally around menstruation and immediately after ovulation. (Ovulation typically occurs on day fourteen in a twenty-eight-day cycle.)

Your main female hormones are estrogen and progesterone. Your levels of these change throughout your cycle, but it is important they are within the correct range. Hormones do not act in isolation.

They have a knock-on, or secondary, effect on other hormones— your estrogen levels, for example, affect how sensitive you are to insulin. It is not just the levels of hormones that are important but their ratio to each other. Estrogen is responsible for the traditional female shape, where weight is stored around your bottom and thighs.

As just mentioned, female hormone imbalances can contribute to weight gain. However, being overweight can in itself lead to hormone imbalances, as fat cells can produce estrogen. This can result in estrogen dominance, where the ratio of estrogen to progesterone is too high.

Estrogen dominance is common in premenstrual syndrome and as women approach and go through the menopausal transition. It is possible to have estrogen dominance but low estrogen if your estrogen and progesterone levels are both low.

Premenstrual syndrome (PMS)

PMS occurs at the point in your cycle when your progesterone levels rise. If you have PMS, you may crave carbs or overeat. Women with PMS appear to be particularly sensitive to progesterone. The interaction of hormones and neurotransmitters implicated in PMS is complex and may involve serotonin, the ‘feel-good neurotransmitter.

neurotransmitter. When your serotonin levels drop, this can cause PMS-like symptoms and you may crave carbs, foods like chips, and pastries. Some researchers suggest that overeating these foods is an unconscious attempt to raise your serotonin levels and make yourself feel better. (We look at this in more detail in the future.)

Menopause and perimenopause

In menopause, your periods stop permanently. It is considered to be complete when you have gone a year without a period.

As with Jane, as you approach menopause, your ovaries produce less estrogen. Hormonal changes do not happen suddenly.

They occur over many years leading up to this time—a state called perimenopause. As your estrogen levels decline, your body holds onto fat, particularly around your abdomen. The more belly fat you carry, the more estrogen it produces.

You might not like the weight gain, but it is your body’s way of looking after you, as long as it is a moderate amount. You still need estrogen to protect your bones and your heart.

Polycystic ovary syndrome (PCOS)

PCOS is associated with hormonal imbalances. The greater the imbalance, the more likely you are to carry excess weight. Approximately 50 percent of women with PCOS are overweight or obese, storing fat particularly around their belly.

PCOS is linked to insulin resistance, which we looked at in a previous article. If you are insulin resistant, it is harder for insulin to transport sugar into your cells. Your body, therefore, releases more insulin, which encourages your body to store fat. Insulin stimulates your ovaries to produce testosterone.

In response to insulin, women with PCOS produce more testosterone than other women. Testosterone is a male hormone, normally present only at low levels in women. If you have PCOS and higher free testosterone levels, you are more likely to be obese with weight around your belly. Whether the higher testosterone contributes to obesity or vice-versa is not clear. Either way, balancing your hormones and losing weight are linked.

Quick questionnaire—Are your female hormones contributing to your weight?

If you answer Yes to three or more questions, then your female hormones may be making it harder for you to lose weight. If you have a diagnosis of PCOS, then your hormones will be contributing to your weight.

Do you have hot flashes or night sweats?

Do you have vaginal dryness or declining libido?

Do you have mood swings?

Are you in your mid-thirties-plus and struggling with your weight?

Have you noticed changes in the quality of your hair?

Do you have a lack of energy, joint pains, or headaches?

Do you have a time of the month when you get anxious or irritable? 

Is there a time of the month when you get bloated or suffer from water retention or breast tenderness?

Is there a time of the month when you feel depressed or cry for no reason?

Do you have sugar or other cravings at a particular time of the month? 

Do you have excessive hair on your face, chest, back, or buttocks?

Do you have irregular periods or no periods (but are of reproductive age)? 

Do you have oily skin or acne?

Key things you have learned in this article

Your female hormones interact with appetite-controlling hormones. If your female hormones are not in balance, you may want to eat more.

If you crave sugary foods or carbs premenstrually, this may be your body’s attempt to make you feel better by raising your levels of serotonin, the ‘feel-good’ chemical. 

As you approach menopause, your estrogen levels drop. Your body then stores fat around your belly, as this fat can produce estrogen to offset declining levels.

Polycystic ovary syndrome (PCOS) is linked to insulin resistance, which makes it harder to lose weight. If you have PCOS, the greater your hormonal imbalances, the more likely you are to be overweight. You are also more likely to store this weight around your belly.

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