There are many phases in a woman's life, menarche, menstruations, pregnancy, postpartum and menopause. Each phase comes with its own challenges, and changes the way of looking at life. However, narrowing to one, today we are focusing on weight gain after menopause. Gaining weight is a common concern for many women are approaching menopause. This period brings hormonal changes, shifts in activity levels and effects of aging. All of these contribute to weight gain. However, not everyone experiences weight gain during menopause, and individual experiences may vary greatly.

Menopause and Its Life Phases

Before diving into the specifics of weight gain, it’s helpful to understand the terminology associated with menopause:

• Premenopause refers to the period between puberty and the commencement of perimenopause.
• Perimenopause is the transitory period before menopause, characterized by fluctuating reproductive hormones.
• Menopause is defined as the absence of menstrual cycles for 12 consecutive months.
• Postmenopause is the period following menopause; typically used interchangeably with "menopause."

Hormonal Changes and Weight Gain

Hormones influence weight fluctuations after menopause, specifically how fat is distributed and how the body controls hunger.

Fat Content and Distribution

The hormonal fluctuations of perimenopause and menopause influence where fat is stored in the body:

Perimenopause: During this phase, estrogen levels fluctuate while progesterone levels decline steadily. In early perimenopause, higher estrogen levels can promote fat storage in the hips and thighs as subcutaneous fat, which generally carries fewer health risks.

Menopause: As estrogen levels drop significantly, fat storage shifts to the abdominal area as visceral fat.

This type of fat surrounds internal organs and is associated with health risks like:

• Insulin resistance
• Type 2 diabetes
• Heart disease
• Other metabolic issues

Appetite Regulation

Lower estrogen levels during perimenopause can have an impact on appetite management. A 2019 analysis found that decreased estrogen may diminish satiety signals, making you feel less full after meals. This might lead to increased calorie consumption and weight gain.

The Effect of Age on Weight

Weight gain during menopause is attributed to more than just hormonal changes. Several elements come into play throughout the aging process:

Increased fat content and decreased muscle mass: These changes affect the body's resting energy expenditure (REE), which means fewer calories are expended when at rest.

Lower activity levels: Fatigue, sleep difficulties, and menopause-related symptoms can all lead to a decrease in physical activity, further reducing REE and increasing weight.

Managing Weight Gain During Menopause

If you are concerned about weight gain during menopause, a variety of strategies can help you manage it effectively. It is usually recommended that you speak with a healthcare practitioner before developing a specific approach.

Dietary modifications

Focus on a well-balanced diet that includes less carbohydrates, more fiber, and less added sugar and salt.

Include nutrient-dense meals to boost overall health.

Physical exercise

Regular exercise helps to maintain muscle mass and reduce body fat. Strength training, aerobic, and flexibility exercises are quite beneficial.

If you have osteoporosis, see your doctor about safe activity options.

Rest and Stress Management

Prioritize sleep and relaxation to combat fatigue and stress, both of which can contribute to weight gain.

Mindfulness practices or yoga may help reduce stress levels.

The recent launch of the indigenous Td vaccine in India by Union Health Minister JP Nadda will boost immunity and reduce the risk of tetanus and diphtheria in children and adults, said health experts.

Union Health Minister JP Nadda formally launched the indigenously manufactured Td vaccine in Himachal Pradesh last week.

With the launch, the Tetanus Toxoid (TT) vaccine has been replaced with the Tetanus and adult diphtheria (Td) vaccine in India’s immunization program for all age groups, including pregnant women.

The move comes amid increasing numbers of cases of diphtheria amongst older age groups. Tetanus and diphtheria can lead to hospitalizations or even cause death. The Td vaccine will help to decrease diphtheria outbreaks.

“In keeping with global practice, India has shifted from TT, which covers for tetanus, to Td, which covers for both tetanus and diphtheria. This vaccine is indigenously manufactured and is expected to significantly reduce the risk of both these diseases in older children as well as adults,” Dr. Rajeev Jayadevan, Ex-President of IMA Cochin and Convener of the Research Cell, Kerala, told HealthandMe.

What Is The Td Vaccine?

The Td vaccine, indigenously manufactured at the Central Research Institute (CRI), Kasauli in Himachal Pradesh, is a combination of tetanus and diphtheria with a lower concentration of diphtheria antigen (d), and is recommended for older children and adults.

The use of Td, instead of TT, is recommended during pregnancy to protect against maternal and neonatal tetanus and diphtheria during prenatal care.

Vaccination during pregnancy also serves to boost immunity and increase the duration of protection in pregnant women who have not received the full set of recommended booster doses.

The Td is a safe vaccine, and 133 countries are currently using it.

The Health Ministry, in a statement, said that the Central Research Institute will supply 55 lakh doses to the UIP by April 2026, with production expected to scale up progressively in subsequent years to further strengthen the Universal Immunization Program in India.

“India’s indigenous Td vaccine rollout marks a significant milestone in strengthening the nation’s immunization program by enhancing self-reliance, affordability, and supply stability,” Dr. Neha Rastogi, Senior Consultant - Infectious Diseases, Fortis Gurugram, told HealthandMe.

“Locally produced vaccines reduce dependency on imports, ensuring uninterrupted protection for adolescents and adults against tetanus and diphtheria. This initiative supports wider coverage, faster distribution to remote regions, and improved public health preparedness,” she added.

Tetanus And Diphtheria: Disease burden In India

As per the National Health Profile 2022, India has reported 1,586 cases and 22 deaths due to diphtheria in 2020, and 3,677 cases and 47 deaths in 2021.

Around 10 Indian states report the majority (84 per cent) of the cases.

As of 21 June 2024, Orissa has also reported six deaths and 21 suspected diphtheria cases. There has been more than 90 percent coverage of diphtheria vaccination in birth cohorts since 2014, but gaps in booster dose coverage are widely prevalent.

Plugging of gaps in the routine immunization, coupled with inclusion of booster doses in the national data on diphtheria vaccination, is the need of the hour.

“Diphtheria is one of the most dangerous infectious diseases known to man; it spreads easily through the respiratory route. It can cause death due to the bacterial toxin affecting the heart (Myocarditis). It is vaccine-preventable, but the immunity fades over time,” Dr. Jayadevan said.

Therefore, the Td booster shots at ages 10 and 16 are essential to maintain protection. Similarly, pregnant women should receive two doses to protect both mother and child.

Given the recent outbreaks of diphtheria in India and elsewhere, this transition is a public health priority, the expert said.

Cardiovascular emergencies remain among the most time-critical and life-threatening events in modern medicine. From sudden cardiac arrest to acute coronary syndromes and hypertensive crises, these conditions demand not only clinical excellence but also seamless systems of care. In an era where cardiovascular disease continues to dominate global mortality charts, preparedness is imperative.

Understanding Cardiovascular Emergencies

Cardiovascular emergencies encompass a spectrum of acute conditions that compromise cardiac output, coronary perfusion, or vascular integrity. These include myocardial infarction, cardiac arrhythmias, acute heart failure, aortic dissection, pulmonary embolism and cardiogenic shock. What unites them is speed: the window between reversible injury and irreversible damage is often measured in minutes.

Timely recognition of symptoms like chest pain, breathlessness, syncope, palpitations or sudden neurological deficits can dramatically alter outcomes. Delays, even minor ones, translate into myocardial loss, cerebral injury or death.

Acute Coronary Syndromes

Acute coronary syndromes (ACS) remain the cornerstone of cardiovascular emergencies. Plaque rupture and thrombosis can abruptly occlude coronary arteries, leading to unstable angina or myocardial infarction. Early electrocardiographic evaluation and cardiac biomarker guide diagnosis, but decisive action is paramount.

Rapid reperfusion, whether via thrombolysis or primary percutaneous coronary intervention, restores blood flow and salvages myocardium. Modern emergency cardiac care prioritises well-rehearsed protocols, ensuring that “door-to-balloon” times are aggressively minimised. In cardiovascular emergencies, hesitation is the enemy of survival.

When the Heart Loses Its Rhythm: Arrhythmias and Cardiac Arrest

Sudden cardiac arrest, often precipitated by malignant arrhythmias such as ventricular fibrillation or ventricular tachycardia, is the most dramatic cardiovascular emergency. Survival hinges on immediate cardiopulmonary resuscitation (CPR) and early defibrillation.

Equally dangerous are unstable bradyarrhythmias and supraventricular tachycardias, which can compromise haemodynamics within moments. Advanced cardiac life support protocols, continuous monitoring, and access to defibrillation and pacing are non-negotiable components of any emergency-ready healthcare facility.

Hypertensive and Aortic Emergencies

Hypertensive emergencies occur when severely elevated blood pressure causes acute target-organ damage, affecting the brain, heart, kidneys, or eyes. Stroke, acute left ventricular failure, and myocardial ischaemia are common and devastating consequences.

Aortic dissection, though less common, is among the deadliest cardiovascular catastrophes. Sudden tearing chest or back pain, pulse deficits, and blood pressure differentials demand immediate imaging and surgical consultation. Here, precision in diagnosis and blood pressure control can mean the difference between life and sudden death.

The System Behind The Save: Integrated Emergency Cardiac Care

Effective management of cardiovascular emergencies extends beyond individual expertise. It relies on an integrated ecosystem, trained emergency teams, rapid diagnostics, catheterisation laboratories, cardiac intensive care units, and post-event rehabilitation.

Hospitals that invest in protocol-driven care pathways, continuous staff training, and advanced cardiac technology consistently achieve superior outcomes. Equally vital is public awareness: early symptom recognition and prompt presentation to medical facilities significantly reduce mortality.

Preparedness Is The New Prevention

While prevention remains the long-term strategy against cardiovascular disease, preparedness defines survival during emergencies. From ambulance services equipped with defibrillators to hospitals offering round-the-clock cardiac intervention, readiness saves lives.

Cardiovascular emergencies do not announce themselves politely. They arrive uninvited, escalate rapidly, and punish complacency. In these moments, excellence is measured not in intent but in response.

Kidney disease rarely announces itself loudly. Many people discover it only after significant damage has already occurred. According to Dr Mitesh Makwana, Consultant Nephrology at Manipal Hospital, who wrote in The Week one often overlooked factor is gender. Biology, hormones, social behavior and access to healthcare all influence how kidney disease develops, progresses and is treated.

Globally, research published in The Lancet and the International Society of Nephrology estimates that chronic kidney disease affects roughly 1 in 10 adults. Yet the pattern is not the same in men and women.

Biology And Hormones Shape Risk Differently

Although kidneys perform identical functions in both sexes, the way they age and respond to stress differs.

Dr Makwana explains that estrogen in women appears to protect kidney filtration units by reducing inflammation and scarring. Testosterone, on the other hand, increases activity of the renin angiotensin aldosterone system, which raises blood pressure inside the kidney and increases protein leakage in urine.

This partly explains a common observation in nephrology clinics. Women develop chronic kidney disease more frequently, but men tend to reach kidney failure faster.

A large European CKD registry analysis has shown that men progress to end stage kidney disease nearly 1.5 times faster than women once damage begins.

Certain conditions are also gender linked:

Women: lupus nephritis, recurrent urinary infections, pregnancy related kidney injury

Men: IgA nephropathy, polycystic kidney disease, hypertension related kidney damage

Pregnancy adds another unique risk. Preeclampsia, gestational diabetes and severe hypertension can permanently damage kidneys. Women who already have protein in urine face higher chances of fetal growth restriction and pregnancy complications.

Infections And Anatomy Matter

Women experience urinary tract infections far more frequently because the urethra is shorter and closer to the anal canal. Repeated infections can gradually scar the kidneys.

However, when infections occur in men, they are often detected late and tend to be more severe. Clinically, men with untreated infections are more likely to present with advanced kidney damage.

Lifestyle Differences Affect Diagnosis Timing

Lifestyle habits significantly influence outcomes.

Dr Makwana notes that men commonly delay health checkups, smoke more and consume higher amounts of alcohol. This increases risk factors like high blood pressure and diabetes, the two leading causes of kidney failure worldwide.

Women face a different challenge. Many prioritize family health over their own and ignore fatigue or swelling until daily functioning is affected. Studies from rural India have also shown that anaemia and malnutrition during pregnancy increase the risk of acute kidney injury in women.

Despite different behaviors, both groups often reach hospitals late, missing the window for early treatment.

Chronic Diseases Behave Differently In Men And Women

Diabetes and hypertension account for nearly 70 per cent of kidney failure cases globally, according to the Global Burden of Disease study. But progression varies.

Women often show mild or borderline abnormalities in early tests, delaying diagnosis. Men experience faster decline once disease begins, making early monitoring critical.

This is why nephrologists stress gender sensitive screening rather than a one size fits all approach.

Treatment Gap And Transplant Imbalance

Gender differences continue even after diagnosis.

Across many countries, women donate kidneys more often but receive fewer transplants. Social factors, economic dependency and delayed referrals contribute to this imbalance.

Women are also less likely to start dialysis early and more prone to complications such as low blood pressure during sessions due to vascular access challenges.

Why Early Screening Matters

Kidney disease is preventable or controllable when detected early. Screening becomes especially important for:

• diabetics
• hypertensive patients
• pregnant women with high blood pressure
• people with family history of kidney disease

Simple urine and blood tests can prevent dialysis or transplant in many cases.