How to Fix Menobelly – Part 2

Fixing menobelly is not an easy feat as there are many possible causes. In this article I explore the various hormones that play a role in Menobelly and the strategies to relieve their effects. Remember to stay tuned for Part 3 where I will look at altered gut health as a possible cause of menobelly. 

Permanently high FSH / Follicle Stimulating Hormone. An overlooked cause of menobelly.

Basically, the brain didn’t get the memo that the ovaries have retired and therefore keep sending FSH messages in hope they will wake up and start making Estrogen.

Follicle Stimulating Hormone / FSH was previously thought, by the medical world ‘only’ to stimulate the ovaries to produce Estrogen (and the testicles to make sperm).

Recent studies have shown that there are FSH receptors in bone and fat cells, brain areas like the hippocampus and cortex and that FSH can block liver degradation of LDL cholesterol, which results in the medically accepted menopausal increase in LDL and total cholesterol.

FSH is shown to increase fat cell formation, and increase fat storage, particularly in visceral fat (the fat stored around the internal organs)

Conversely, blocking FSH has been shown to reduce body fat and promote the development of brown/beige fat involved in thermogenesis (heat production) and energy burning. 

Study 2018 – FSH, Bone Mass, Body Fat, and Biological Aging

Strategies

• Measure your FSH via a blood test

– Before puberty: 0 to 4.0 mIU/mL.

– During puberty: 0.3 to 10.0 mIU/mL.

– Pre-menopause / After puberty: 4.7 to 21.5 mIU/mL.

– After menopause: 25.8 to 134.8 mIU/mL.

• In postmenopausal females, a high FSH level is generally considered to be above 30 mIU/mL.

The only known strategies to lower FSH.

• Increasing Estrogen aka Menopausal Hormone Therapy

– Both Estriol and Estradiol can lower FSH

– Study 2001 – Estrogen replacement therapy in postmenopausal women: a study of the efficacy of Estriol and changes in plasma gonadotropin levels

Vaginal Estriol can lower FSH

• Ashwagandha

– Study 2021 – Effect of an Ashwagandha (Withania Somnifera) root extract on climacteric symptoms in women during perimenopause: A randomized, double-blind, placebo-controlled study.

• Blocking FSH receptors which will block the actions of FSH

– Using specific peptides (short chains of amino acids) are gaining attention and focus

– The A 9-mer peptide derived from the human FSHβ subunit of the FSH hormone has been shown to successfully block the FSH receptor

– Block the receptor = block its effects on bone and fat cells, etc

– Study 2020 – Identification and in vivo validation of a 9-mer peptide derived from FSHβ with FSHR antagonist activity.

High Cortisol

Many propose that high Cortisol is the leading cause of menobelly.

Cortisol, known as the ‘stress’ hormone increases when the body needs to make more energy to fix a ‘problem’.

Whether that ‘problem’ is physical, mental, emotional, real or in your head is of no consequence, more Cortisol will be produced.

Cortisol is a catabolic hormone, which means it’s a tissue breakdown hormone.

It breaks down proteins in muscle, skin and bone to release glucose.

This extra glucose then floods the bloodstream so cells can burn it to make more energy (so you/your body can fix the ‘problem’).

Estrogen is also a problem fixer, and has anti-cortisol properties, which help the body counteract some of the negative effects of Cortisol.

As Estrogen decreases, so does its cortisol-controlling superpowers.

This means the menopausal decline of Estrogen reduces a female’s ability to ‘fix’ the usual day to day ‘problems’, increasing the need for more Cortisol, (which breaks down more tissue and floods the blood with more glucose).

This is referred to as Cortisol Dominance.

Higher Cortisol levels = menobelly.

BTW – due to the lower Estrogen daily things that were never previously a stress/a problem can now become one.

Strategies

Reduce your daily stressors

• You can change / remove everything apart from your children

– what do you need to change or remove?

• Stress coping strategies

– Yoga

– Tai Chi

– Meditation / Mindfulness – Research suggests that regularly practicing mindfulness lowers cortisol levels.

– Breathing exercises

– Adaptogens – are substances used in herbal medicine believed to help us resist disease and enhance our body’s resilience to physical and mental stress and promote homeostasis, such as plants and mushrooms that help the body respond to stress, anxiety, fatigue and overall wellbeing.

– Buy yours here

Optimize Sleep

• Chronic sleep issues, including insomnia, sleep apnoea, and irregular sleep habits (like those of shift workers), will contribute to high Cortisol levels.
• Focus on developing a regular bedtime and sleep schedule
• 7-8 hours per night from 21.30 / 22.00 as many nights as possible
• Bright light first thing in the morning and dimmed light in the evening
• Sleep aids, such as

– Cannabis/CBD oils 

– Magnesium

– Mushrooms like reishi, cordyceps

Cortisol Awakening Response / CAR

• Is the programmed, optimal rise in Cortisol levels during the first 30-45 minutes of waking.
• A healthy CAR in the morning is generally associated with a healthy decline in cortisol levels in the evening, according to Science Direct
• A blunted or abnormal CAR may disrupt this normal rhythm, potentially leading to higher cortisol levels in the evening and or difficulty sleeping. 

Strategies to increase CAR

Optimize Sleep

• Consistent Sleep Schedule

– Aim for the same bedtime and wake time each day, even on weekends, to regulate your body’s natural circadian rhythm.

• Quality Sleep

– Ensure a dark, quiet, and cool sleep environment.

– Consider using blackout curtains, earplugs, or a white noise machine.

• Limit Caffeine and Alcohol

– Avoid caffeine and alcohol, especially in the evening, as they can disrupt sleep and affect cortisol levels.

Light Exposure

• Morning Light

– Get natural sunlight or bright light exposure, directly in your eyes shortly after waking

– This helps regulate your body’s natural ‘clock’ and thereby cortisol rhythm.

– Minimize Nighttime Light:

– Reduce exposure to bright screens (phones, tablets, TVs) at least two hours before bed, as artificial light can interfere with cortisol production during the night.

Stress Management

• Mindfulness and Meditation:

– Practice mindfulness, meditation, or deep breathing exercises to calm the nervous system and reduce stress. –

– Adaptogenic Herbs – consider incorporating adaptogens like ashwagandha, rhodiola, or holy basil, which may help the body adapt to stress.

• Reduce Caffeine Intake:

– Excessive caffeine can overstimulate the adrenal glands and potentially negatively impact the CAR.

Diet and Hydration

• Balanced Diet

– Ensure a balanced intake of macronutrients and prioritize stress-reducing foods like fatty fish, nuts, and leafy greens, according to Number Analytics.

• Stay Hydrated

– Drink plenty of water throughout the day to support overall bodily functions.

Supplements

• Vitamin C and B Vitamins – can be beneficial for adrenal support and overall health.
• Magnesium – important for various bodily functions and may help with stress and sleep.
• Consider other supplements like L-theanine, GABA, or phosphatidylserine

Consistency is Key

• Daily Routine

– Maintain a consistent daily routine, including wake-up and sleep times, mealtimes, and exercise.

– Be Patient and Consistent, it takes time to adjust your body’s natural cortisol rhythm.

Exercise regularly

• Cortisol levels temporarily increase after high intensity exercise, but regular exercise generally helps decrease levels by improving overall health and lowering stress levels
• Study 2023 – Endocrine responses of the stress system to different types of exercise

Maintain optimal body weight

• Obesity may increase Cortisol levels and high Cortisol levels can cause weight gain
• Watch your intake of added sugars and Omega 6 fatty acids

– Diets high in added sugars, refined grains, and omega 6 fatty acids may lead to higher Cortisol levels.

– These foods can trigger an inflammatory response and disrupt blood sugar regulation, which can activate the body’s stress response, which will lead to increased Cortisol release.

High Insulin

Insulin is the ONLY hormone responsible for decreasing blood glucose levels by helping glucose into muscle and fat cells.

Insulin also dictates if cells store or burn fat and makes it biochemically impossible to burn fat.

Chronically high Insulin reinforces the effects of Cortisol, making menobelly even more pronounced.

Insulin Resistance is a condition where muscle, liver and eventually fat cells become less responsive to insulin, leading to higher blood glucose levels and for a longer period of time. 

Insulin resistance is partly due to declining Estrogen levels during menopause, as Estrogen helps improve insulin sensitivity

Science has shown that Fasting and Postprandial (after a meal) blood glucose levels are higher in post-menopausal women

Study 2022 – Menopause is associated with postprandial metabolism, metabolic health and lifestyle: The ZOE PREDICT study.

Strategies to improve Insulin sensitivity

• Replace Estrogen

– Consider ERT/ Estrogen Replacement Therapy

– Talk to a Menopause Hormone Expert about your choices

• Monitor blood sugar levels

– CGM or standard blood sugar monitors

– Blood sugar should be between 4 – 7 mmol/L or 72 – 126 mg/dL (as much as possible)

– The higher the blood sugar the higher the Insulin

– Discover which foods and lifestyle choices increase your blood sugar and make the necessary changes

• Build muscle

– Muscles are glucose (and fat) sinks – the more muscle tissue you have the better blood glucose and triglycerides you will have

– I. strength training

– Muscle need protein approx. 25-35g per meal

• Increase omega-3 fatty acids.

– Research indicates that omega-3 supplements may improve insulin sensitivity in people with metabolic conditions such as diabetes.

• Decrease omega 6 fatty acids

– Research suggests that omega-6 fatty acids may contribute to fat accumulation and insulin resistance

• DON’T do Intermittent Fasting/IF if you’re menopausal

– Ladies we are not small men and most of the IF research has been done on white men

– Men and women have different hormonal profiles and metabolic processes, which could influence how their bodies respond to intermittent fasting. 

– Menopause brings about hormonal shifts, and IF can potentially disrupt these further, affecting energy levels, mood, and overall well-being.

– Women need breakfast – skipping breakfast can lead to negative health consequences, particularly for women – such as increased stress hormone / Cortisol levels, disruptions to hormone regulation, even increase weight gain. 

– Eating breakfast is linked to better cognitive function, stable blood sugar levels, and a reduced risk of metabolic issues like heart disease and diabetes. 

– If you still want to follow a feeding window regime aka Time Restricted Eating, start with breakfast at breakfast time and don’t eat after 5/6pm

• Eat carbs last

– Eat fats and proteins first, wait 10 minutes before eating the carbohydrate part of the meal

• Focus on lower glycaemic carbs or foods with lower carbs per gram weight

– Track your nutrition here

• Focus on simple sugars, such as fruit
• Keep fats under control – 7 – 20g per meal
• Diet in general

– Eat for strength not for size

– Fats approx. 7 – 20g per meal – olive oil, oily fish, avocados

– Carbs approx. 20-30g per meal – fruit and cooked veggies

– Protein approx. 25-35g per meal – animal protein is superior.

Low Thyroid

The interplay between Estrogen and Thyroid hormones is complex and can impact Thyroid function in various ways, including:

Hypothyroidism

• Low Estrogen levels can contribute to or worsen hypothyroidism, an underactive Thyroid, causing symptoms like fatigue, weight gain, and depression.
• Declining Estrogen can lead to higher TSH levels, indicating the pituitary gland is working harder to stimulate the Thyroid gland and it production of hormones T4 and T3
• Symptoms of declining Estrogen can overlap with or exacerbate symptoms of Thyroid dysfunction, such as fatigue, mood changes, and sleep disturbances.
• On the other hand, high levels of Estrogen can also contribute to symptoms of hypothyroidism, as Estrogen stimulates the production of Thyroid Binding Globulin / TBG, a protein that binds to the Thyroid hormones T4 and T3 in the bloodstream, making them inactive. This means that while total Thyroid hormone levels may appear normal, the amount of free, usable thyroid hormone available to the body can be reduced, leading to hypothyroidism symptoms.
• Low Thyroid hormones can affect Estrogen metabolism, by slowing down the liver’s ability to break down and eliminate Estrogen, so more comes back into circulation leading to higher Estrogen levels
• All in all, hypothyroidism slows down metabolism increasing fat storage, which due to lower Estrogen will be menobelly fat

– Blood testing

– TSH

– Free T4

– Free T3

– rT3

– Anti-TPO

– Anti-TG

– Estradiol

– Cortisol

– Comprehensive Thyroid Testing

Strategies

• Consider hormone replacement therapy

– Thyroxine (T4)) – prescription from doctor

– Thyroid Complex

– Estradiol/Estriol

Satiety Hormones
Leptin

• Produced by fat cells
• Primarily signals the brain about body fat stores
• Primarily exerts its effects on the Hypothalamus where it

– signals satiety

– regulates appetite

– can influence GLP-1 release

– regulates energy expenditure

– regulates body weight.

• Leptin receptors are also present in the brainstem influencing appetite and reward pathways. 

Leptin Resistance

• During menopause, when Estrogen levels decline, Leptin levels can also decrease, potentially contributing to increased appetite and changes in body fat distribution. 
• Estrogen is known to influence Leptin signalling, and its reduction can lead to Leptin resistance, where the body and brain don’t respond to Leptin’s signals as effectively. 
• This can result in increased fat storage, particularly around the abdomen, and potentially affect appetite regulation. 
• Decreased leptin levels, along with other hormonal changes during menopause, can affect

– Appetite regulation

– Lead to increased hunger and food intake. 

Strategies

Diet

• Consider The Leptin Diet

– Eat 3 meals a day

– No snacking

– A substantial breakfast, a good lunch and a smaller dinner no later than 6pm. 

• Prioritize protein and fibre

– A high-protein, high-fibre diet can help regulate leptin and promote satiety. 

• Avoid / Reduce the intake of processed carbohydrates and added sugars

– These can contribute to inflammation and leptin resistance. 

• Increase healthy fats

– Such as avocados and fatty fish, like sardines and anchovies rich in omega-3s. 

• Limit fructose intake

– Fructose, particularly HFCS from added sugars, can negatively impact leptin sensitivity. 

Lifestyle Changes

• Prioritize sleep

– Aim for 7-9 hours of quality sleep per night

– Sleep deprivation can disrupt leptin levels and increase hunger hormones

• Regular exercise

– Stop relying on cardio – Stacy Sims says forget everything you know about exercise when you reach 45 

– Lift heavy weights, 30 second sprints and box jumping

– Physical activity can improve leptin sensitivity and overall metabolic health. 

• Manage stress

– Stress negatively impacts many hormones, including leptin. 

Leptin resistance

If you experience persistent hunger despite feeling full, you may have leptin resistance. 

Diet

• Consider the Female Version of Time Restricted Eating

– Breakfast between 6am – 8am

– Lunch between 11am and 2pm

– Dinner between 5pm – 6.30pm

– This can potentially reset leptin levels and help improve insulin sensitivity  

• Prioritize whole foods

– Fresh produce that you process in your kitchen

– Fruits, vegetables, lean proteins, and healthy fats. 

• Increase fibre intake

– Fibre can improve leptin sensitivity through blood sugar regulation

– Fruits contain both soluble and insoluble fibre.

• Eat a high-protein breakfast

– Can help stabilize blood sugar and promote satiety. 

• Be mindful of portion sizes

– Avoid overeating to prevent further leptin resistance. 

• Eat 3 regular meals and no snacking

– This helps maintain stable blood sugar levels and prevent extreme hunger. 

• Consider Omega 3 supplements

– Omega-3 fatty acids, may also help improve leptin sensitivity

– Such as fish oils –

• Limit exposure to environmental toxins:

– Plastics

– UPF / Ultra Processed Foods

– Other endocrine disruptors, such as pesticides, personal care products, etc

GLP-1 – Glucagon-like peptide-1

• Is a natural incretin hormone primarily released from the gut during the intake of food that plays a role in regulating blood sugar levels and appetite by

– Increasing feelings of satiety

– Slowing the emptying of the stomach

– Stimulating the release of Insulin – thus decreasing blood glucose.

• GLP-1 – Glucagon-like peptide-1 agonists, also known as weight loss drugs, such as

– Wegovy, Ozempic, Mounjaro

• Combining microdoses of GLP-1 with MHT for best weight loss results including a decrease in menobelly is presently being studied.

 In Part 3 I dive into menopausal gut health as a possible cause of menobelly.