Stay Slim Through Perimenopause

Peruse articles about weight gain in women over 40 and you'll find the culprit is often associated with menopause and the decline in estrogen production. But what about those of us who are in shape, years away from menopause, yet we're gradually gaining weight anyway? We work out harder than before to address our slowing metabolism, and frequent desserts and bread with dinner have become distant memories. Yet those tried-and-true methods just aren't doing the trick anymore. I still put on six pounds in the last 10 years. If this sounds like you, here's what you need to know.

First of all, those muffin tops aren't from estrogen loss or decline. In fact, you're actually estrogen dominant during perimenopause, a period of time that can last up to 15 years. "The levels of progesterone, DHEA and human growth hormone, which build up and repair muscle, are declining -- while estrogen and cortisol, the hormones responsible for breaking down tissue and muscle, are usually produced at the same rate. So even if you're already exercising, this relative dominance of the estrogen and cortisol over progesterone and DHEA can cause decreased muscle mass and fat can take its place," said Dr. Robban Sica, who practices at the Center for the Healing Arts in Orange, Conn.

Here are four strategies to counteract the change in hormone levels.

Lift heavier weights: At our age, bulking up from heavy lifting isn't an issue. So you already know to strength train three times a week. Now be sure your weights are heavy enough that you feel fatigued after almost 10 reps. Unlike the Boniva commercial featuring Sally Fields smiling while she's lifting dumbbells, by rep seven, you should be wincing and breathing hard. Hit every major muscle group and work in different planes. Also be certain to focus on core work. "Using the deepest abdominals will greatly impact your strength and body shape because working your abs properly creates a natural corset. You can lose inches," said Jae Berman, personal trainer and registered dietician at the San Francisco Bay Club.

Bioidentical hormones: Most health food stores have over-the-counter progesterone (cream) and DHEA (in pill form). "While it is optimal to be monitored by a knowledgeable physician, you can take 10-25 milligrams of DHEA and apply 1/8-1/2 teaspoon of progesterone per day, but for the progesterone, apply only during the two weeks before your period each month. If you're at the phase in perimenopause where you're skipping periods, just resume the progesterone two weeks after the missed period would have ended," said Sica.

Cut calories -- for good: Your days of looking at weight maintenance as a simple matter
of calories in and calories out are over. What ultimately worked for me was Bermans's suggestion of slashing 300 calories a day from my typical daily diet. "After the holidays, keep a food journal during a couple of typical days for you," Berman said. "It should be easy to spot the extra calories. They're usually in cheese, butter, nuts, salad dressing and alcohol. From there determine foods you can easily live without." Here's what I got rid of: two teaspoons of sugar in my coffee (30 calories) and whole-grain bagels with butter (280). I also cut back on portions. Rather than mindlessly eating handfuls of almonds and raisins, I'm careful to keep it down to a small handful (165). I make sure I put only a tablespoon of low-fat dressing on my salads; before I have no idea how much I used. Instead of sipping wine a few times a week, now I have only one (120). I hardly eat pasta or bread; before they were staples.

Be patient: It took about seven weeks for me to lose two pounds out of the six I've put on. Ten years ago, it would have taken me seven days. Stick with it.