How are menopause and your hormones affecting your hunger?

Do you feel more hungry or crave more at different times of the month? Is that even a thing - YES!!!!!!!

Way back in the 1920s, researchers confirmed something that women have known first-hand for a long time: We eat different amounts during different phases of our menstrual cycle.

But while many women have personal experience with it, you rarely hear about the underlying physiology. Instead, you get comments like:

“It's just hormones.”

“Women get cravings. “It is what it is.”

“You need to be more disciplined, stop making excuses”

Sometimes you just want to eat and eat and eat

"Explanations" and comments like these come across as patronizing and worrying, by not discussing the specifics, it can lead women to feel like it's all in their heads. But there is a physiological explanation behind this.

We eat less when oestrogen is high

When oestrogen drops and progesterone increases, we eat more and experience more cravings for chocolate, sweets, and salty foods (and food in general).

Who can resist chocolate?

Knowing specifics — like which parts of your brain and which appetite hormones are affected by your sex hormones — can help you come up with some strategies for dealing with the monthly appetite fluctuations you'll likely experience. 

Sex ed 101 – the Menstrual cycle

For most women, the menstrual cycle takes about 28 days and goes through two phases: follicular and luteal. Obviously as you enter perimenopause, this routine and structure goes out of the window but the basic principles are still the same as they're dictated by your estrogen levels.

The follicular phase lasts from day 1 of menstruation (bleeding) to ovulation (release of the egg) about 14–15 days later. The luteal phase lasts from ovulation until the next menstruation (so typically from about day 14 to day 28). These phases are regulated by two hormones, oestrogen and progesterone, as their levels rise and fall throughout the cycle.

In short, the menstrual cycle changes how quickly you feel full and how rewarding you find food!

You'll feel less hungry in the first 2 weeks due to high estrogen and then the cravings and hunger hit in weeks 3 & 4

Overeating, cravings, and estrogens

To more fully understand the effect of hormones on our appetite, we need to talk about the role of estrogens. There are actually three types of estrogen: 

1. Estrone

2. Estradiol

3. Estriol. 

Of the three, you've probably heard of the big one, estradiol (most commonly referred to when people say 'oestrogen'. It's the most understood and the one most involved in hunger and fullness, including how much you eat at each sitting and how much you end up eating in a day.

Estradiol goes up during the follicular phase, peaking right before ovulation, and then goes down during the luteal phase. As I mentioned earlier, the more oestrogen (in this case, estradiol), the less you eat and the lower your appetite. There's usually no difference in how often you eat, but estradiol affects your meal size. When more estradiol is present, you will feel full and satisfied sooner, so you're likely to eat smaller meals during this time.

When estradiol goes down, in the luteal phase, your appetite increases and it can take longer to reach a point of satiety at each meal, which means you're more likely to eat larger meals during. Some studies found that women ate on average 240 more calories per day during the luteal phase, compared to their intake during the follicular phase. Some studies show it may even be as high as 600 more calories per day!

Additionally, while food cravings can happen at any time throughout the cycle, those cravings are stronger and happen more frequently with lower estradiol.

Trying to ignore cravings is hard - telling you especially when your hormones are that's what you want!

What type of food do you crave? Fat? Carbs? Protein? It seems that cravings don't show up in the same way for everyone. Some studies found women ate proportionally more protein at lower estradiol levels. Others found women ate more fat. Still others found that women ate more carbohydrates. So, it's hard to say. Scientists have no idea, and the answer is likely a lot more complicated. It could depend on preferences or perhaps on environmental demands.

Estradiol and your brain

There are parts of the brain that have sensors for estradiol (oestrogen receptors). The presence of estradiol can reduce your food intake and make you feel more content after a meal (increased dopamine binding). When estradiol decreases, those parts of your brain start telling you that you're not quite full, and you don't feel quite as content after a meal.

Lower estradiol has a direct effect on your brain. You're not lacking discipline or being “bad” when you have stronger cravings and eat more food. What you're experiencing is a very real response to neurological signals.

How potent is estradiol? Injecting estradiol right into certain parts of your brain regularly can decrease how much you eat. Over time, it results in lower body weight and lower weight set point. Interesting... but I wouldn't recommend it.

Hunger and fullness hormones: Ghrelin and Leptin

Ghrelin is released to tell you that you're hungry, leptin is released to tell you that you're full

While you have estradiol acting directly on your brain, influencing your hunger cues and making you feel a greater reward for eating, it also works indirectly on the brain. Estradiol modifies how hunger and fullness hormones work. Two of the most well-known and understood hormones, ghrelin and leptin, change depending on how much estradiol is around.

Ghrelin makes you feel hungry when your stomach is empty. The more ghrelin there is, the hungrier you feel. If it's been a while since you ate, your stomach makes ghrelin and tells your brain, “Hey, how about some food?” As you eat, you make less ghrelin. Eventually, your brain stops getting the “I'm hungry!” message.

Estradiol decreases ghrelin's hunger cue partly in your brain and partly by suppressing how much ghrelin your body makes. More estradiol = less ghrelin = less hungry = less food consumed.

Another hormone that regulates your appetite is leptin, which makes you feel full and satiated after you eat. Estradiol helps you feel fuller faster by increasing the potency of leptin. Again, if you feel like you're never full or satisfied at certain times of the month, there's a tangible physiological reason behind it.

Now that you know, here's what you can do

Most women know their cycle changes how they eat, but many experience a disconnect about why. These hormonal changes have a real impact on your body's way of detecting when you're full and what you want to eat. Yet, many women tie it to a lack of willpower, like it's their fault for not being disciplined enough. They end up feeling guilty and beating themselves up for wanting to eat more.

That's the problem.

We need to acknowledge this information and talk about it. It's normal biology, but there are steps you can take to help navigate those higher-appetite days.

It helps to know that as estradiol goes down, you will feel hungrier and not quite as full, and you may have cravings. Similar to telling someone who is hopped up on adrenaline to “just relax” after a stressful incident, telling a woman to “just be more disciplined” isn't helpful. It isn't about discipline.

We've identified that the problem is neurological, so what can you do to solve it?

1. Eat slowly. Really slowly. Set a timer and take 20 minutes or more. This will feel painfully slow, but it takes a while for ghrelin to decrease and for CCK to get to your brain. Slowing down will help you manage how much you eat at a meal so you can eat enough for your needs. (This is a good habit to practice regularly, not just during that time of the month!)

2. Keep track of what you want to eat during your luteal phase and be prepared. If you want chocolate, eat chocolate. Find the best version, have it available, and eat it very slowly. Trying to white-knuckle a craving rarely ends well. Planning is usually more helpful than abstaining completely. Dark chocolate (70%) is the best as it contains magnesium, definitely try to avoid white and dairy chocolate. 

3. Try to get seven to nine hours of sleep . Sleep deprivation can mess with our hormones and tends to make us eat more, so try to keep things a little easier on yourself. Go to bed and get up at the same time every day to maintain your 24 hr circadian rhythm and be in control of your melatonin. 

4. Manage your body messing with your expectations when estradiol is low. Make sure you plan for what you know is coming. Things like planning meals, eating from smaller plates, eating with smaller utensils, and if possible, avoiding all-you-can-eat buffets on days when you have low estradiol.

5. Track your morning body temperature: a drop in estradiol is related to an increase in body temperature. Regularly take your temperature when you wake up, before you do anything else, and write it down. A jump in temperature means estrogen is falling (start of the luteal phase).  

Sometimes, it's really not our fault that we just want to sit on the sofa and eat - but we all know that's not good for us so don't take advantage, but, on the other hand, don't be so hard on yourself. You're female after all!