Try This – 5 Things Every Woman Needs to Know

Women are living longer, but they’re also living sicker.

In fact, get this….

Many women spend the last 20 years of their life in poor health!

But according to expert Dr. Mary Claire Haver, it doesn’t have to be this way. 

Dr. Mary is a board-certified OB-GYN who knows just how tough perimenopause and menopause can be. When she started to struggle with weight gain, sleep troubles, and other concerning symptoms, she went on a journey to figure out what was going on with her body and how she could help women who were going through the same thing. 

If you or any woman you know has hit ages 40, 45, 50, 55, or 60…you might know what I’m talking about! Sometimes, these shifts in hormones can even happen in a woman’s 30s! 

And the worse part is, no one tells women to expect these changes or how to navigate them.

Well, Dr. Mary is here to change that. There are five things she wants every woman to know as they navigate perimenopause, menopause, and beyond.

5 Big Takeaways on Perimenopause, Menopause, and Beyond 

1. Eating Less And Working Out More Is Not the Solution  

When women get to their late 30s, they might start to feel less resilient to life’s many stressors. Processed food, toxins, lack of movement, lack of sleep, and alcohol can all have an even bigger impact on their health than before. Why? A massive shift in hormones. 

When estrogen starts to decline, which can happen in a woman’s 30s, there are full-body effects including changes in heart, skin, gut, brain, and muscle health. One of the first things women start to notice is that they put on weight more easily. These changes can occur through perimenopause, menopause, and even after, and the old tricks of just exercising more and eating less DO NOT always work. 

So what does work? 

As we get older, our muscle mass changes—for both men and women! As our muscle mass decreases, our basal metabolic rate also shifts, making our body respond to calories differently.

For women, a drop in muscle mass, which occurs with a drop in estrogen, means that women’s bodies are more prone to weight gain and belly fat. So instead of overdoing cardio and other strenuous workouts, Dr. Mary recommends focusing on building muscle through resistance training and protein (more on this later) to increase the amount of calories our body can handle as we age. She also focuses on upping specific nutrients that support healthy weight, sleep hygiene, and reducing inflammation. 

Let’s talk about how to do this… 

2. Focus on Combating Visceral Fat 

Women going through perimenopause and menopause can see a massive uptick in visceral fat. 

If you’re not familiar with visceral or “active” fat, it’s the type of fat that surrounds your organs, making it really dangerous. A pre-menopausal woman has around 8 percent visceral fat, but after menopause, that number can triple! And it all comes back to inflammation that estrogen used to keep at bay. 

This type of fat, when left unchecked, can lead to cardiovascular disease and increase the risk of heart attacks, stroke, and diabetes. 

How can women target visceral fat? 

1. Increase fiber. Women who get 25 grams of fiber or more a day have less visceral fat, according to Dr. Mary. 
2. Eat fruits and veggies, but skip the added sugar. Dr. Mary also explains that women who have less than 25 grams of added sugar a day have less visceral fat.
3. Be strong, not skinny. When we work on building our strength, our body can handle more calories, and we prevent things like insulin resistance, which is a huge culprit of visceral fat.

Which brings us to our next point… 

3. Build Muscle 

Dr. Mary shares that she and many other women believed that cardio was the best thing to do to shed pounds and stay lean. As she went through her own journey with menopause, she realized how important it was to build muscle and that muscle held the key to keeping weight in check. 

This comes down to two main practices: resistance training and eating enough protein. 

For Dr. Mary, progressive overload was the key. This is a type of strength training that focuses on increasing the intensity of the workouts over time, either in reps or weight or both. If you’re new to strength training, I recommend working with a trainer who can teach you the best technique and help you determine which weight is best for you. The key is to be able to lift heavier over time. 

Now, let’s talk about protein. 

The Women’s Health Initiative, which had a lot of flaws, did have a pretty interesting finding according to Dr. Mary. According to the study, women who ate 1.5–1.75 grams of protein for every kilogram of body weight or ideal body weight had the lowest frailty scores. Frailty is something we want to prevent as we age. Once an elderly person experiences a fall, fracture, or broken bone, it could significantly change the course of their life, even leading to death. 

The goal is to maintain strong muscles and bones as we age to keep our weight healthy and prevent injury. 

Here’s my guide on building muscle. 

4. Many Menopausal Women Are Deficient in These Nutrients

Focusing on nutrition is absolutely critical throughout the stages of a woman’s life. Dr. Mary noticed that many of her own menopausal patients were deficient in four specific nutrients: fiber, vitamin D, omega-3 fatty acids, and magnesium. 

Let’s talk about each of them. 

Fiber: Not only does fiber help with our digestion and gut microbiome, but it also helps with blood sugar control, which becomes really important as we age. Dr. Mary recommends 25–30 grams of protein for perimenopausal, menopausal, and post-menopausal women. 

Vitamin D: This vitamin is so critical for women as it helps with bone health, reduces the risk of breast cancer, supports a healthy and stable mood, and can support vaginal health as well. It’s really hard to get all the vitamin D we need from the sun or food, so Dr. Mary says most will have to supplement. Work with a doctor to test your levels and find out how much vitamin D you need. Some people need less and some need a lot more to correct deficiency. I take about 4,000 IU a day, but that’s because I tend to get low quickly. Others I know take about 2,000 IU per day for maintenance. 

Omega-3 fatty acids: So many of the changes that occur as women move into menopause have to do with inflammation. Dr. Mary loves omega-3 fatty acids because they help to reduce inflammation in the body and support heart health. Most doctors recommend 1,000–3,000 mg of combined EPA and DHA. 

Magnesium: This miraculous mineral has so many benefits for women, including sleep support, heart support, bone support, mood support, and more. Magnesium also decreases as estrogen decreases, so it’s likely women will need to supplement with magnesium, which for the most part is safe! Always choose a high-quality magnesium. More on this here. 

5. Hormone Replacement Therapy Can Fight Heart Disease 

The Women’s Health Initiative, which was well intentioned, did a huge disservice to women. It caused women to fear breast cancer more than any other disease and overlook the numerous potential benefits of hormone replacement therapy (HRT). Dr. Mary explained some of the pitfalls of this study. 

First of all, it was only done on women over 60, so the population studied was older and might have already gone through menopause. They also excluded any woman who had hot flashes, which is a huge majority of women going through menopause. Through this observational study, they thought they saw an increased risk of breast cancer, but what they saw was an increase in relative risk vs absolute risk, which is important to note! An immediate halt was put to the study before doctors even had the chance to review the results. 

What the data actually shows is that if hormone replacement therapy is used within the first 10 years of menopause, one can decrease their risk of cardiovascular disease by 50 percent each year! 

Typically, when a woman is told she has high cholesterol, she’s recommended a statin. Dr. Mary shared that there’s not a single primary study that shows that statins can benefit women to prevent heart attacks, but HRT has been shown to protect a woman’s heart if she’s given it at the right time. 

Of course, there are so many nuances when it comes to HRT. Here are some important things to note: 

Find a doctor who will have a conversation with you about HRT, because not all doctors will. Go to menopause.org and look for certified practitioners. You want to make sure your doctor is open to the conversation. 

You are NOT a good candidate for HRT if… 

1. You have undiagnosed vaginal bleeding. 
2. You have an active hormone-sensitive cancer such as breast, ovarian, or endometrial cancer. 
3. You have an active deep vein thrombosis. 
4. You’re struggling with severe, active liver disease. 
5. You’ve had a stroke. 

Dr. Mary explains that HRT is better for prevention than treatment. The closer you take HRT to menopause, the better! 

If you’re interested in HRT and want to learn more, Dr. Mary dives into types of hormone replacement therapy and what to consider in our recent podcast episode, #1 Menopause Doctor: Biggest Myths On Weight Gain, Diet & Exercise For Women with Dr. Mary Claire Haver.

I hope you find our conversation as fascinating as I did! 

If you know anyone who is navigating changes through perimenopause, menopause, and post-menopause, please share this newsletter with them. 

Here’s to your health,
Dhru Purohit