Empowering Women’s Metabolic Health: Perimenopause and Beyond
In our previous post, Weight Loss Drugs and Natural Alternatives, we explored the pros and cons of weight loss drugs for women facing metabolic health issues. But more importantly, we emphasized a broader goal: helping women understand the underlying causes of metabolic breakdown and using sustainable lifestyle and nutrition strategies to restore balance.
The first step toward fixing your metabolism is learning to assess and track your metabolic health markers. But before diving into the specifics, let’s clarify what we mean by “metabolic health” and “metabolic breakdown,” particularly for women navigating perimenopause and beyond.
Understanding Women’s Metabolic Health: From Balance to Breakdown
Healthy metabolism ensures balanced blood sugar, healthy levels of cholesterol, blood pressure, and weight management. Your metabolic health is shaped by genetics, environmental factors, lifestyle choices, and age. As we age, a gradual decline in metabolic health is common.
For many women, the first sign of metabolic decline is abdominal weight gain. Other signs include rising cholesterol or blood pressure or noticing that your fasting glucose is creeping up near 100 mg/dL. These changes are part of a larger condition known as metabolic syndrome.
Metabolic syndrome starts with insulin resistance, where the body struggles to manage blood sugar efficiently. Elevated insulin levels lead to high blood pressure, increased blood sugar, abdominal fat, and abnormal cholesterol levels. Even if you have just one of these symptoms, it may be an early sign of metabolic syndrome, which becomes more difficult to reverse if left unchecked.
The Link Between Perimenopause and Metabolic Health
If you’re in your late 30s to mid-50s and experiencing unexplained weight gain, rising blood pressure, or higher cholesterol, you may wonder if hormones are to blame. You’re right: hormonal changes during perimenopause play a role in these shifts. However, the bigger culprit is insulin. Elevated insulin levels drive the metabolic breakdown associated with perimenopause, and your risk for metabolic syndrome significantly increases during this time, particularly in the 6 years before and after your final menstrual period.
In fact, statistics show that 32% to 58% of women post-menopause have full-blown metabolic syndrome. This is why proactive steps to maintain metabolic health during perimenopause are critical for reducing your risk.
Beyond BMI: Accurately Assessing Metabolic Syndrome
Metabolic health cannot be assessed by BMI alone. Women with low BMIs can still have high levels of visceral fat and metabolic dysfunction, while those with higher BMIs can be metabolically healthy. Instead of relying on BMI, it’s essential to consider the five diagnostic criteria for metabolic syndrome:
- Waist circumference ≥ 35 inches (U.S.) or ≥ 31 inches (international).
- Blood pressure over 130/85 mmHg.
- Fasting glucose over 100 mg/dL.
- Triglycerides over 150 mg/dL.
- HDL cholesterol below 50 mg/dL.
If you meet three or more of these criteria, metabolic syndrome is advanced, meaning it’s time to act. Early detection is key to reversing these trends before they escalate into serious health conditions.
A Functional Medicine Approach to Metabolic Health in Women
At our practice, we focus on early detection of insulin resistance and metabolic syndrome in women, starting with a comprehensive assessment of metabolic health markers. Screening women aged 35+ (or younger with a family history or symptoms) allows us to intervene early and reverse metabolic decline before it progresses.
Our functional medicine panel for assessing metabolic health includes the following optimal ranges:
| Marker | Ideal Value |
| Total cholesterol | Below 200 mg/dL |
| LDL cholesterol | Below 100 mg/dL – but depends on the details about the LDL |
| HDL cholesterol | Above 60 mg/dL |
| Total cholesterol:HDL ratio | Below 3.0 |
| Triglycerides | Under 80 mg/dL |
| Fasting insulin | 2–5 IU/dL |
| Hemoglobin A1C: | 5.0–5.3 % |
| Fasting glucose | 75–85 mg/dL |
| Glucose two hours after a meal | Under 140 mg/d |
| C-Reactive Protein | Under 1.0 mg/L |
We also assess symptoms that often accompany metabolic imbalances, such as fatigue, brain fog, irregular periods, weight gain, and sugar cravings—all of which may indicate issues with blood sugar regulation and insulin resistance.
The Hidden Dangers of Metabolic Syndrome for Women
While weight gain may be the most visible sign of insulin resistance, the hidden risks of metabolic syndrome are far more concerning. Conditions like type 2 diabetes, Alzheimer’s disease (also called “Type 3 Diabetes”), osteoporosis, PCOS, and fatty liver disease are directly linked to poor metabolic health.
Moreover, cardiovascular disease—the leading cause of death in women—is closely tied to metabolic syndrome. Early detection and intervention can reverse these trends, potentially preventing life-threatening conditions.
Six Steps to Reclaim Your Metabolic Health
We use a functional medicine approach to empower women to take control of their metabolic health. Here are the six personalized steps we follow:
- Assess and track your metabolic markers to establish a baseline and monitor progress.
- Identify and treat the root causes of metabolic decline, such as insulin resistance and gut microbiome imbalances.
- Monitor blood sugar with tools like a continuous glucose monitor (CGM) or finger-prick tests to understand your body’s unique responses to meals.
- Improve lifestyle factors such as exercise, sleep, and stress management to support metabolic health.
- Optimize nutrition to build lean muscle mass and manage weight effectively, with a focus on the right macronutrient balance.
- Personalize supplementation to correct nutrient deficiencies and enhance your metabolism.
These steps require time, dedication, and ongoing support. Through individual appointments, lab testing, and group programs, we provide the education and guidance needed to restore metabolic flexibility and long-term health.
Ready to Take Control of Your Metabolic Health?
If you’re ready to take the next step toward reclaiming your health, we’re here to help. Together, we can address the root causes of metabolic imbalance and guide you towards improved well-being.
Related posts:
- Weight Loss Drugs, Women, and Natural Alternatives
- Fatty Liver: A Hidden Culprit Behind Perimenopausal Weight Gain
Dr. Laura Paris provides Acupuncture and Functional Medicine care at her two clinics in Santa Cruz (Capitola) and Monterey, California. She also works with patients remotely in the United States through telehealth Functional Medicine appointments. Learn more about Laura here, and contact her office here.
