As estrogen levels drop during menopause, women may experience a range of symptoms, including chronic inflammaging, weight gain, muscle loss, sexual dysfunction, and cognitive issues like memory loss or difficulty concentrating.

The decline in estrogen also increases the risk of more serious health problems. For example, estrogen typically helps regulate metabolism by reducing food intake and boosting energy expenditure. Without it, women become more vulnerable to metabolic disorders, especially when combined with poor sleep or stress.

Sleep disturbances, like insomnia and sleep apnea, are common during menopause and can worsen issues like insulin resistance, which is a risk factor for diabetes and may force you to manage your diet and blood sugar levels. Studies also show that poor sleep has a stronger link to metabolic syndrome (a cluster of conditions like high blood pressure and blood sugar) in women, who need more sleep, than in men.

Some surveys suggest that approximately 80 percent of people have trouble sleeping at least once per week, or they wake up feeling exhausted. As you get into your thirties and forties, you have more difficulty falling asleep, waking up more often at night, and — in general — not necessarily spending as much time in restorative sleep. And that only intensifies with each passing decade.

On average, research suggests you lose about two to five percent of deep sleep every decade after your 20s. And then, once you hit your sixties, deep sleep can decrease by as much as 50 percent. But sleep loss is not inevitable.

Research suggests that the more you exercise and increase your body temperature, a sign of an accelerating metabolism, the more your body compensates by spending extra time in slow-wave sleep.

What is metabolic syndrome?

Metabolic syndrome (MetS) isn't a single disease, but a collection of risk factors that significantly increase the likelihood of developing cardiovascular disease. These factors include abdominal obesity, high blood pressure, high blood sugar, low levels of "good" HDL cholesterol, and elevated triglycerides. To be diagnosed with MetS, according to the International Diabetes Federation (IDF), a person must have abdominal obesity plus at least two additional criteria.

The human metabolism is a deeply complicated system, as the picture below, which is a visual representation of what we know so far to be the full range of metabolic processes, shows. Originally thought to stem from insulin resistance, MetS is now seen as a sign of broader metabolic dysfunction caused by chronic low-grade inflammation (inflammaging), often triggered by nutrient, hormonal, and energy imbalances.

Our bodies constantly juggle energy needs—breaking down nutrients to fuel our cells while storing and repairing tissue when needed. This balance, known as immunometabolism, is tightly regulated by hormones, circadian rhythms, and the immune system. As we age, our ability to maintain this balance weakens, increasing the risk of chronic diseases and physical or cognitive decline.

For women in midlife, menopause brings additional challenges. The hormonal changes that occur during the menopausal transition (MT) can cause shifts in body composition, particularly around the abdomen, even without significant weight gain.

Before menopause, you’ll store more fat on your hips and thighs rather than on your stomach.

This increase in abdominal subcutaneous fat (under the skin) and visceral fat (around the organs) is closely linked to inflammation and the development of MetS.

To make it worse, sleep disturbances, which are common during menopause, can increase daily food intake, raise stress levels, and worsen metabolic issues, making it essential for women to focus on both diet, exercise, and sleep quality as they age.

Prevention

Several studies have established the relationship between dietary patterns and MetS risk in postmenopausal women. The Framingham Nutrition Study found that women who consumed more total fat, saturated fat, monounsaturated fats, and alcohol and less fiber and micronutrients, such as calcium, selenium, vitamin C, vitamin B-6, folate, vitamin E, and β-carotene excluding vitamin B-12 had a higher risk (2–3 times!) of abdominal obesity and overall MetS during a 12-year follow-up period.

In a cross-sectional study of 4984 Korean women aged 30–79 years, traditional healthy diets, such as more intake of seafood, seaweeds, grains, dairy products, fresh vegetables, and fruits, and less consumption of fast foods, animal fats, sweets, and fried foods were associated with a reduced risk of MetS.

The prevalence of MetS in postmenopausal women was significantly lower in women who ate a healthy diet, full of fresh fruits and vegetables and high quality protein, than in those who ate a Western diet.

A warning about calorie restriction

While you might be tempted to heavily restrict your calories to lose weight, a low-calorie diet for extended periods may lead to negative health effects, particularly related to thyroid function and stress hormone levels.

Research shows that women who restricted their calories to 1,200 per day experienced a significant increase in cortisol, the body's primary stress hormone. Elevated cortisol levels are linked to weight gain, fatigue, and high blood pressure, meaning that the very diet intended for weight loss might actually contribute to weight gain. Holding that diet for a long period of time can exacerbate the metabolic damage further.

Additionally, long-term low-calorie dieting is associated with reduced thyroid function. One study found that prolonged calorie restriction can lead to lower levels of the thyroid hormones T3 and T4, which are crucial for regulating metabolism. A drop in these hormones is a hallmark of hypothyroidism, a condition that can slow metabolism and cause fatigue, brain fog, and weight gain.

If you’ve been heavily restricting your calories without any progress, experts recommend a method called reverse dieting, where you slowly increase calorie intake to boost your metabolism—ideally under the supervision of a registered dietitian.

The Sleep Connection

Prioritizing restful sleep in addition to maintaining a quality diet during menopause is vital for hormonal balance and overall health. Quality sleep not only helps regulate metabolism, reducing the risk of metabolic syndrome, but also supports optimal organ function, reduces chronic inflammation, and prevents stress induced binge eating during the day.

If your sleep is regularly interrupted by vasomotor symptoms like hot flashes and night sweats, our Terra cooling device might be perfect for you. Terra detects a hot flash before it happens and adjusts your sleep temperature to keep you dreaming and comfortable, so your waking hours are free of the side effects of poor sleep.

ADDITIONAL NOTES

On average, research suggests you lose about two to five percent of deep sleep every decade after your 20s. And then, once you hit your sixties, deep sleep can decrease by as much as 50 percent. But sleep loss is not inevitable.

Research suggests two behaviors can help offset the typical sleep decline that occurs when you get older.

To offset the age-related sleep decline, focus on revving up your body temperature with exercise and cooling down when you sleep.

Research suggests that the more you exercise, the more your body compensates by spending extra time in slow-wave sleep.

If you’re looking to improve your rest, studies found that 60 minutes of vigorous exercise was all that was needed to upgrade slow-wave sleep. Any exercise can work as long as you push the intensity.

Resources

https://pubmed.ncbi.nlm.nih.gov/31941004/

https://pubmed.ncbi.nlm.nih.gov/30401550/

https://pubmed.ncbi.nlm.nih.gov/36678314/

https://pubmed.ncbi.nlm.nih.gov/30179134/

https://www.semanticscholar.org/reader/c2502833e8704e716df1160f9a67e8755c61d25a