How to handle the menopause - eat less, get more active and wear HRT skin patches

The latest advice to women going through the menopause is eat less, get more active and consider wearing hormone replacement therapy (HRT) skin patches.

The advice from Australian scientists follows research and discussions on the factors which lead to women gaining weight during menopause, and suggestions on how it might be avoided.

At a conference in Bangkok earlier this year, weight and appetite experts from around the world discussed sex differences in obesity, and women's weight gain during menopause was one of the topics.

Dr. Amanda Sainsbury-Salis from Sydney's Garvan Institute of Medical Research and Dr. Jennifer Lovejoy from the University of Washington, Seattle co-chaired the conference and presented a summarised consensus of the conference.

Dr. Sainsbury-Salis says one of the most interesting results of the conference was the discussion about why so many women gain weight during menopause and she believes many women become confused when they start to gain weight during menopause, because their eating habits haven't changed, but research shows prior to menopause a dramatic and sudden reduction in physical activity levels occurs where women reduce by half their amount of activity compared to pre-menopause levels.

Dr. Sainsbury-Salis suggests one reason women gain weight in menopause is because of a reduction in energy expenditure and combined with unchanged eating habits - weight gain is almost inevitable.

Why menopausal women become less active is unclear, but scientists suspect it is directly related to the lack of oestrogen, which has a dramatic effect on signals the brain sends to the body.

According to Dr. Sainsbury-Salis it is not because of their age and the lifestyle constraints happening at that time of life, as many women question whether they can actively counteract that tendency and it has been shown that women who maintain or increase their level of physical activity during menopause tend to go through the phase without gaining weight.

Dr. Sainsbury-Salis says more research is being conducted to see what causes these effects and whether they are long-term - she points out that when physical activity levels drop, energy needs are less and it is important to remember not to eat as much to feel satisfied.

Professor Lesley Campbell, from the Garvan Institute who is also the Director of the St. Vincent's Diabetes Centre, says that HRT can help protect women against harmful abdominal fat gain and the development of heart disease and type 2 diabetes.

Professor Campbell says during menopause, most women experience redistribution of fat, and often gain weight around the middle - a plethora of research has shown that abdominal fat is a risk factor in the development of cardio-metabolic diseases, such as diabetes.

Professor Campbell says prior to menopause, women have a lower risk of heart disease than men but menopause equalises that risk and women taking HRT appear to maintain their pre-menopausal risk levels.

Professor Campbell says a decade ago, Garvan endocrinologists made the very significant breakthrough discovery that taking HRT by wearing transdermal patches - so bypassing the liver - may be better for women than taking HRT orally.

So the new message for women going through the menopause is eat less, move more and if you're on HRT, consider transdermal patches.

The summary is published in the December issue of Obesity Reviews and is available online.