Nutrition & Hormone Imbalance in Perimenopausal and Menopausal Women
During this session, dr. Shendy Ardaneswari and dr. Juwalita Surapsari explored how hormonal changes during perimenopause and menopause influence metabolism, body composition, and nutritional needs. The discussion highlighted the importance of maintaining muscle mass, adopting sustainable eating habits, and understanding when medical support may be appropriate. Participants also learned about weight management options, including GLP-1 medications, and why personalised care matters during midlife.
Key Takeaways
01. Hormonal Changes Begin Before Menopause
Perimenopause can begin 7 to 10 years before menopause, often while menstrual periods are still occurring. During this transition, hormone levels fluctuate and may affect several aspects of physical and emotional health.
Menopause is confirmed after 12 consecutive months without a menstrual period, followed by postmenopause, when reproductive hormone levels remain lower and generally more stable.
The timing of menopause varies between women and may be influenced by genetics, family history, smoking, certain medical treatments, and other health and lifestyle factors.
02. Hormonal Changes Affect More Than Your Menstrual Cycle
Estrogen, progesterone, and testosterone influence several systems throughout the body, including metabolism, muscles, cardiovascular health, sleep, and emotional wellbeing.
In a study of Indonesian women aged 40 to 65, the presentation highlighted:
52.8% reported joint and muscle pain.
51.8% experienced sleep problems.
32.1% experienced moderate to severe hot flushes.
Because symptoms vary widely, recognising changes in your sleep, energy, mood, and physical health can help you better understand your midlife transition.
03. Your Body Composition Can Change Even When Your Weight Stays the Same
Declining estrogen levels can influence how the body stores fat, maintains muscle, and responds to insulin.
During midlife, women may experience increased abdominal fat, reduced muscle mass, and changes in metabolic health, even when their overall body weight remains relatively stable.
These changes may contribute to increased risks of insulin resistance, type 2 diabetes, and cardiovascular disease.
The number on the scale does not tell the whole story. Paying attention to muscle health, waist measurements, and relevant health markers can provide a more complete picture of wellbeing.
04. Your Nutritional Needs Change During Midlife
Changes in metabolism and body composition mean that eating habits may need to evolve during perimenopause and menopause.
The session highlighted several nutritional priorities:
Protein: Helps maintain muscle mass and strength.
Calcium and vitamin D: Support bone health.
Fibre: Supports digestion and metabolic regulation.
Appropriate energy intake: Helps meet nutritional needs according to body composition and activity levels.
Rather than following a restrictive diet, focus on balanced meals that provide sufficient nutrients.
Supplements may be appropriate in certain circumstances, but individual requirements should be discussed with a healthcare professional.
05. Avoid Extreme Diets and Focus on Sustainable Eating Habits
Some common eating mistakes during midlife include continuing the same eating patterns without considering changing nutritional needs, consuming insufficient protein, and following overly restrictive diets.
Extreme dieting can make it difficult to meet nutritional requirements and may contribute to muscle loss.
The speakers encouraged a more realistic approach that prioritises food quality, balanced nutrition, and consistency.
Healthy eating should support your body's changing needs rather than become another source of stress.
06. Protect Muscle Mass, Not Just Body Weight
Maintaining muscle becomes increasingly important as women age, particularly when hormonal changes make muscle preservation more challenging.
Three important elements support muscle health:
Adequate Protein: Provides the building blocks needed to maintain and repair muscle.
Strength Training: Helps preserve muscle, reduce age-related muscle loss, and support bone strength.
Rest and Recovery: Allow the body to recover and adapt to physical activity.
A healthy weight-management approach should consider strength and muscle preservation alongside changes in body fat.
07. You Do Not Need to Wait Until Symptoms Become Severe
Sleep disturbances, mood changes, fatigue, and changes in eating or physical activity may all affect quality of life during perimenopause and menopause.
These concerns deserve attention even if they do not seem severe.
If symptoms begin interfering with your daily activities or wellbeing, consider discussing them with a healthcare professional.
Early conversations can help identify appropriate lifestyle changes, medical assessments, or treatment options.
08. Medical Weight Management May Be Appropriate for Some Women
Healthy eating, physical activity, strength training, and adequate sleep remain important foundations of weight management.
However, some women may benefit from additional medical support after an individual assessment of their weight, medical history, risk factors, and previous weight-management efforts.
Medical treatment should complement lifestyle changes rather than replace them.
A healthcare professional can help determine whether additional support is appropriate based on individual health needs.
09. GLP-1 Medications Require Medical Supervision
GLP-1 medications, including semaglutide, may be prescribed for eligible individuals as part of medically supervised weight management.
These medications help regulate appetite and feelings of fullness. However, menopause alone is not a reason to begin GLP-1 treatment.
The session highlighted that weight-management medication may be considered for individuals with:
BMI of 30 kg/m² or higher, or
BMI of 27 kg/m² or higher with a weight-related health condition.
Eligibility, potential benefits, side effects, and contraindications must be evaluated by a doctor.
Maintaining adequate nutrition and continuing strength training are also important, as weight loss can involve the loss of muscle alongside body fat.
10. Medical Support Should Be Personalised and Monitored
Effective medical weight management involves more than receiving a prescription.
The session introduced a supervised approach that includes an initial medical consultation, treatment when clinically appropriate, ongoing monitoring, and nutritional support.
This allows healthcare professionals to assess progress, monitor treatment responses, and adjust recommendations based on individual needs.
The goal is to support metabolic health and long-term wellbeing rather than focusing solely on weight reduction.
What You Can Do Next
Begin by paying attention to changes in your body beyond the number on the scale.
Consider your energy levels, sleep quality, muscle strength, eating habits, and physical activity. These can provide useful insights into how your body is responding to hormonal changes during midlife.
Focus on building sustainable habits by including sufficient protein and fibre in your meals, incorporating strength training into your routine, and allowing adequate time for rest and recovery.
If you are experiencing persistent symptoms, concerns about metabolic health, or difficulties managing your weight, consider speaking with a qualified healthcare professional.
Medical treatments, including GLP-1 medications, should only be considered following an appropriate assessment and with professional supervision.
Hormonal changes can influence your metabolism and body composition, but understanding those changes allows you to make more informed decisions about your health. Focus on nourishment, strength, and sustainable habits that support your wellbeing throughout midlife.
These takeaways are based on dr. Shendy Ardaneswari and dr. Juwalita Surapsari's presentation at Rise & Bloom 2026 and are intended for educational purposes. Individual nutritional needs and medical treatments should be discussed with a qualified healthcare professional.
