Menopause Cravings: The Relationship Between Hormones & Appetite

With the persistent fluctuation of hormones during menopause, maintaining a healthy body weight can become much more challenging. This can be particularly difficult when cravings and appetite seem like out-of-control saboteurs. During menopause, many women have profound food cravings.¹ We tend to associate giving into cravings with a lack of willpower, but there are actually biological reasons behind menopause cravings.

It’s easy to confuse hunger with appetite, and many people use the terms interchangeably. However, they differ in that hunger is a true need to eat, while appetite is the desire for a specific food - like a craving for ice cream. Even though cravings are different from true hunger, they can oftentimes feel just as powerful.

Most of us have experienced an intense urge to eat a certain food right away, and it's likely food that is sugary, salty, or fatty. These urges are cravings, and they aren’t necessarily fueled by hunger pangs or an actual need to eat.¹

As women, food cravings tend to come and go throughout our monthly cycles and stages in our reproductive lives, including intense cravings during pregnancy. Estrogen and progesterone play a critical role in all of these cravings.

Following suit, menopausal food cravings are typically caused by changes in hormones. Normalizing estrogen and progesterone levels can decrease cravings by directly affecting the appetite center in the brain that regulates feelings of fullness and satisfaction.² This article will help identify why you are experiencing food cravings and how to control them, so they don’t control you.

Menopause & Food Cravings

The full Menopause Transition (MT) can span 20 years or more. The MT includes the phases of perimenopause (typically age 35-45), menopause (somewhere between 45-55), and postmenopause (the rest of your life). If you’re between the ages of 35-65, you are likely suffering symptoms related to the ongoing, steady decrease of the hormones estrogen, progesterone, and testosterone. With hormone receptors all over our bodies, it is critical to keep hormones balanced.

People don’t necessarily know to associate menopause and food cravings, so cravings are not often discussed as a symptom of menopause; but they can be overwhelmingly powerful and intrusive. In order to effectively deal with menopausal food cravings, let's better understand the science behind what’s happening in the body.

The Science of the Hormones Behind Cravings

The many hormone changes during the MT are likely making you crave particular foods in higher than normal quantities. Studies have shown that certain foods stimulate the reward regions of the brain and directly influence our food choices and eating behaviors.¹

The hypothalamus may be a tiny, pea-sized area of the brain, but it has a really important job - it regulates the release of hormones related to stress, pleasure, pain, and hunger ^{1, 2}. When we eat certain foods, the hypothalamus becomes excited and in turn creates happy, positive feelings. These good feelings make us want to keep eating those foods, regularly.

The types of foods that create this “happy brain” are called hyper-palatable foods aka comfort foods, because they are quick and easy to digest. Some of these foods are actually absorbed directly on our tongues - think hard candy.

Comfort foods are typically sweet, salty, and/or fatty. When we eat these foods, they can stimulate the release of a full array of hormones that impact how hungry or full we feel, our feelings of stress, and even our metabolic rate.

The following are hormones that play a role in food cravings:

1. Insulin

2. Cortisol

3. Estrogen

4. Progesterone

5. Testosterone

6. Leptin (causes a feeling of fullness)

7. Ghrelin (causes a feeling of hunger)

These hormones influence appetite, how much you eat, and the distribution of fat cells. If all of the hormones in our bodies are balanced, we can sit down and eat a normal meal, and leptin will be released at the right levels to tell our brain when we are full and can stop eating. Then, once the body hasn’t had any food for several hours, ghrelin is released from the stomach to signal to the brain that we are hungry again and to start looking for food.

When a person regularly eats comfort foods, there might be an interference in this hungry-full-hungry cycle of hormones. It is almost like creating a bad radio signal, and the brain may start to process hormonal signals improperly due to “radio interference”. The result is continued cravings, even though the body has had enough food.¹

This hormonal phenomenon was observed in animals who were given very high-sugar or high-fat diets. The animals kept eating, even once they had consumed plenty of calories, which suggests that these high levels of sugary, fatty meals triggered the release of hormones that lead to the overwhelming desire for excessive amounts of these foods. This overeating is likely due to the hormonal “radio interference” that gets in the way of them feeling full or satisfied.¹

Estrogen and progesterone (and even testosterone) levels rise and fall regularly during the menstrual cycle, prompting some cravings like chocolate around menstruation. But in menopause, when estrogen and progesterone levels are low and steadily declining, it can lead to increased food cravings that don’t cease and less satisfaction after eating.¹

The good news is that normalizing estrogen levels can suppress hunger by decreasing levels of ghrelin and increasing the effectiveness of leptin.² This improvement is especially common for women who experience hormonal in menopause.^{1, 2}

Fat Cells and Hormones

A woman's appetite is very sensitive to estrogen and progesterone levels. In addition to affecting appetite and food preferences, estrogen also seems to influence where fat is stored in the body and even redistributes fat to specific areas.

Fat cells are like balloons, they expand or contract depending on how many calories are consumed. When we slim down, fat cells shrink in size, but the number of fat cells we have never decreases.³ Normal levels of estrogen very skillfully regulate how much fat the cells store and can signal the fat cells to release more fat, so it can be used as energy (metabolized) and weight loss can begin^2,3.

There are always going to be those people that seem to be able to eat anything and not gain weight. Studies have shown that these people have fewer fat cells in their bodies, while other people have more. Anyone who loses weight does so by reducing the fat in their existing fat cells - deflating the balloons, not by losing or killing any fat cells.

If we continue with the balloon metaphor, thinner people may have 50 balloons that get filled with fat, while heavier people may have 250 balloons to fill. So if each of these people eats 1,000 extra calories, that fat will be distributed across a larger number of fat cells in the heavy person. Each of the fat cells might only increase in size a little bit, meanwhile, the thinner person's fat cells will expand much more in comparison, because they have fewer cells across which to distribute the fat. As a result, the thinner person's fat cells are plumper, when compared to the size of the heavier person’s, but the heavier person still has a larger number of fat cells.

But what does the number of fat cells have to do with hormones? Plumper fat cells produce more of the hormone leptin, which stimulates our brain to feel full. So, if thinner people have plumper fat cells, and these plump cells trigger more leptin, the person will feel full with less food and more easily put their body into a fat-burning mode^{3, 4}. By increasing estrogen levels, there is the potential to signal the brain to release leptin and tell the body we’re full, in the same way as someone with fewer, plumper fat cells.

Estrogen also appears to increase the activity of brown fat or brown adipose tissue (BAT). BAT plays an important role in thermogenesis (the production of heat in the body, like the body's furnace). Thermogenesis helps regulate body temperature and how many calories you burn in a day. When estrogen levels are normal, it can stimulate BAT to burn more calories - increase your metabolic rate - and reduce the amount of stored fat.⁴

Insulin is the hormone produced in the pancreas that regulates blood sugar levels. Insulin allows the body to take the sugar (glucose) from the carbohydrates you’ve eaten and use it for energy or store it as fat for use later. If insulin is not converting food into energy properly, then you can experience cravings leading to increased food consumption. Type 1 diabetes is the result of the body not being able to properly produce and use insulin.

Estrogen and progesterone directly affect how cells respond to insulin. Thus, the changes in these hormone levels during menopause can trigger fluctuations in blood sugar levels, producing new and stronger food cravings.

Stress and Hormones

Most people can think of a time when sudden stress caused the release of cortisol and took away any feelings of hunger. After that acute stress moment, our hormone levels gradually return to normal. Chronic stress, stress that lasts beyond a moment, is to blame for many ailments, and food cravings are one of them.

Cortisol is known as the stress hormone, and it activates the “fight or flight” response. When you feel stressed, cortisol prepares the body to get away from a dangerous situation, by releasing a lot of glucose that provides immediate energy to your muscles. As such, elevated levels of cortisol increase your appetite and cravings - especially for sugary or fatty foods.^2,3 Chronic stress keeps the body in a state of craving those calorie-dense foods, and this can directly raise the body’s metabolic needs and how it uses nutrients.

Higher levels of cortisol from chronic stress can increase the storage of fat cells and redistribute them from the hips, breasts, and thighs to the belly.¹ Chronic stress can cause a persistent elevation of hormones, and the storage of fat in this new way can lead to numerous health problems: ²

• Elevated blood pressure

• Chest pain, heart disease

• Immune system problems

• Skin conditions

• Muscular pain (headaches, back pain, neck pain)

• Sleep disruption, insomnia

• Anxiety, depression

How Chronic Stress & Fatigue Affects Eating Patterns

Stress eating, or emotional eating, is one type of craving. It’s common to reach for cookies or a bag of chips, after a challenging day or in anticipation of a big event. Stress also creates a chain reaction of behaviors that can negatively affect eating habits and lead to health problems down the road.

For example, fatigue is not only a symptom of chronic stress, but is also one of the most common symptoms of menopause. When tired, the body searches for energy to revitalize itself, and the easiest way to do that is by eating carbohydrates, which our bodies can convert to fuel almost immediately. But these simple sugars only provide a short-term boost of energy and are often followed by a crash. This can become cyclical, leading to more cravings, and so on. ^3,4,5,8

Chronic stress and the resulting behaviors can lead to the following:

• Craving comforting foods that are high in fat and calories, but low in nutrients.²

• Disrupted sleep, leads to more fatigue and increased cortisol levels.² Poor sleep is associated with imbalances in leptin and ghrelin levels and may lead to overeating.¹

• Increased caffeine or high-calorie snack food intake to try to combat fatigue.

• Accumulated belly fat, can lead to an increased risk of type 2 diabetes, cardiovascular disease, and certain breast cancers.^2,6,7

Tips to Help Control Stress and Stress Eating

• Make time for yourself. What do you enjoy doing? Be sure to take proper care of yourself by practicing work-life balance and making time for fun activities with friends that balance out other stressors. Maybe mental health counseling is in order?

• Regular exercise. Physical activity will help to lower blood pressure and cortisol levels. The longer the duration of exercise, and the higher the intensity of a workout, the more likely it is to curb appetite. ^1-3,8

• Seek to maintain a healthy diet. A balanced diet can provide the extra energy needed to cope with stress.

• Mindful eating. Stress-eating is not very thoughtful. Eating quickly without noticing what or how much we’re eating can prompt us to eat more than we need. Try to slow down and focus on the meal.

• Meditation and/or deep breathing techniques. Stress can lead to fast, shallow breathing and erratic thoughts. Whenever you feel stressed, breathe slowly, focusing on each breath to help you calm down. Yoga is a great option for exercise, mindfulness, and deep breathing.

• Sleep well. Aim for 7-9 hours of sleep a night.

Conclusion

The menopause transition is spread out for decades. If you’re between the ages of 35-65, you are likely suffering symptoms related to the ongoing, steady decrease of the hormones estrogen, progesterone, and testosterone. It is critical to keep hormones balanced, because they affect many systems in the body, including hunger and appetite.

Estrogen and progesterone can increase or decrease menopause cravings and appetite, cause fat cells to store more or less fat, and signal fat cells to release more fat so it can be metabolized by the body. Estrogen also increases the activity of brown fat, which can induce the burning of more calories.^2-4

Comfort food cravings can be overwhelmingly powerful and intrusive. Bioidentical hormone replacement therapy (HRT) can help replace declining menopause hormones and bring them into balance. Among other symptoms this can improve, it can help reduce cravings that perpetuate stress and unwanted weight gain.

Bioidentical hormones are plant-derived and functionally indistinguishable from the hormones that your body naturally produces. To effectively deal with menopausal food cravings, contact Winona today for your free online consultation with a physician.

“This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment."