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.

It is a common belief that metabolic dysfunction-associated steatotic liver disease (MASLD)—formerly known as non-alcoholic fatty liver disease (NAFLD)—is primarily associated with diet, sedentary lifestyles, and obesity. However, there are other factors as well affecting this aspect. Post-menopausal women experience a significantly higher incidence and faster progression of fatty liver disease, even when maintaining a stable body weight.

Why Menopause Increases Fatty Liver Risk

In pre-menopausal women, oestrogen plays a central role in metabolism, by promoting healthy fat accumulation in subcutaneous tissue (below the skin) rather than around internal organs, it also increases insulin sensitivity and suppresses liver inflammation.

After menopause when oestrogen levels drop, this protective function is lost, there is redistribution of fat leading to more fat accumulation around internal organs including liver thus leading to increase chances of NAFLD and also increasing insulin resistance, needless to say that with age our metabolic rate also goes down which also plays a role in this.

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Early Detection Is Key

The important part lies not only in understanding above but to go further in early detection and prevention of menopause associated NAFLD. As we know that fatty liver is a silent disease and often does not causes any signs and symptoms till very advanced stage.

First and foremost is to change lifestyle with advancing age, changing both the dietary habits and physical activity. Regular screening and monitoring is warranted with blood tests, routine metabolic panels, keeping a tab on weight, sugar and cholesterol levels and a basic ultrasound of abdomen.

For someone already diagnosed with 2nd or 3rd stage fatty liver, a simple non-invasive. Fibroscan can help monitor and assess the response to treatment.

Also read: How Menopause Changes Heart Health Risks?

Understanding The Impact Of Menopause On Liver Health

Coming to treatment part of NAFLD in post-menopausal women, it being primary a lifestyle disease so the core of management also lies around managing lifestyle. Medicines are available for treating and controlling NAFLD in conjunction with lifestyle management.

Hormone replacement therapy (HRT), when initiated early in post-menopausal women for symptomatic relief may offer secondary benefits by maintaining metabolic health. However HRT should always be initiated after proper evaluation and expert guidance.

NAFLD is a silent epidemic and primarily a life style disease, knowing about it and knowing triggering and precipitating factors helps understanding and prevention better.

Menopause being a natural biological phenomenon in every female’s life, it becomes essential for us to know how it affects our liver health and overall health as well.

By Mr. Ankur Garg, Group Director Liver Transplant & GI Surgery, Paras Health, Gurgaon

Every year, as the monsoon rolls in, hospitals and clinics across India see a familiar pattern: a sharp uptick in children and elderly patients presenting with vomiting, diarrhoea, and dehydration.

Doctors attribute this seasonal surge to a combination of contaminated water supplies, deteriorating food hygiene, and warm, humid conditions that favour the spread of viruses like rotavirus and norovirus.

Why Monsoon Fuels Gut Infections

Heavy rains and flooding routinely compromise municipal water lines, allowing sewage to mix with drinking water. Street food and produce are more prone to contamination during this period, and the humidity itself accelerates bacterial and viral growth.

Acute gastroenteritis, an inflammation of the stomach and intestines, is consistently one of the fastest rising monsoon health conditions, with rotavirus being a leading cause in children and norovirus a common culprit across age groups.

Understanding Rotavirus

Rotavirus is a highly contagious, wheel shaped virus and remains the leading cause of severe diarrhoeal illness and death in children under five worldwide. It spreads through the faecal oral route via contaminated water, food, surfaces, or close contact with an infected person, and can cause several days of intense vomiting and watery diarrhoea, putting young children at real risk of rapid dehydration.

The good news: Rotavirus vaccines, given orally in a series of doses before 8 months of age, are highly effective at preventing severe disease and are recommended as part of national immunisation programmes.

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Expert Recommended Prevention Measures

1. Water safety first

Boil or filter all drinking water during the monsoon months. Avoid ice and beverages of uncertain origin, especially from street vendors.

2. Food hygiene

Steer clear of cut fruits, chaat, and other street food that has been sitting exposed. Cook food thoroughly and eat it hot. Avoid reheated leftovers stored without refrigeration.

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3. Hand hygiene

Frequent handwashing with soap before eating, after using the toilet, and after changing diapers remains one of the single most effective, low cost interventions against faecal oral transmission.

4. Vaccination

Ensure infants complete their full rotavirus vaccine schedule on time. Vaccination substantially reduces hospitalisations and severe outcomes, even though it does not eliminate all seasonal transmission.

5. Isolate and disinfect

Because these viruses spread easily within households and childcare settings, keep infected individuals' utensils and linens separate, and disinfect surfaces regularly during an active infection.

Recognising The Warning Signs

Most cases of viral gastroenteritis are self limiting, but caregivers should watch for signs of dehydration that require urgent medical attention:

• Sunken eyes, dry mouth, or reduced tears when crying (in infants)
• Little or no urination for 6+ hours
• Lethargy or unusual drowsiness
• Persistent vomiting that prevents fluid intake
• High fever or blood in the stool

Also read: Beware! Common Mistakes New Parents Make During Their Baby’s First Monsoon

Treatment: What Actually Helps

Oral Rehydration Solution (ORS) is the cornerstone of management.

A simple homemade version consists of 1 litre of boiled and cooled water, 6 teaspoons of sugar, and half a teaspoon of salt. It can be lifesaving when commercial ORS packets are not available, though pre mixed WHO formula ORS is preferable when accessible.

Zinc supplementation (around 20 mg daily for 10 to 14 days) is recommended for children under five, as it has been shown to reduce the duration and severity of diarrhoeal episodes.

Antibiotics are not effective against viral gastroenteritis and should only be used if a bacterial cause, such as cholera, is confirmed by a doctor. Inappropriate antibiotic use can do more harm than good.

Continue feeding. For breastfed infants, continue breastfeeding throughout the illness. For older children and adults, small, frequent sips of fluids and bland, easily digestible food are better tolerated than large meals.

When to See a Doctor

Seek medical care promptly if there is persistent high fever, visible blood in the stool or vomit, signs of moderate to severe dehydration, or if symptoms do not improve within 2 to 3 days, particularly in infants, the elderly, or anyone with underlying health conditions.

By Dr. Geeta Malkan Billa, Director of Gastroenterology & Hepatology at Dr. L. H. Hiranandani Hospital

Urinary tract infections are common. A lot of people get them every year. When you have a tract infection you might feel a burning sensation when you go to the bathroom you might have to go to the bathroom a lot and your lower belly might hurt. These symptoms can get in the way of your life. You might want to try to make the pain go away on your own. Taking medicine without prescription is not a good idea.

Taking antibiotics when you do not need them can be bad for you. Urinary tract infections can become harder to cure when the bacteria get used to the medicine. This is called resistance and it is a big problem for everyone’s health. When this happens, you might get tract infections repeatedly and you might have fewer choices, for treatment. That is why it is so important to go seek medical attention at the earliest.

Causes Of UTIs

Most Urinary Tract Infections are caused by bacteria that are usually in the digestive tract and then get into the urethra. Things like not having water, not keeping yourself clean having something wrong with the urinary system or having a weak immune system can make it more likely for bacteria to grow.

If you take the medicine or stop taking it too soon the strong bacteria will live and get stronger. Over time these bacteria will not be affected by the medicines, which makes them very hard to treat. This is what happens when you have a Urinary Tract Infection that is resistant to drugs. Urinary Tract Infections, like these are very tough to deal with.

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Signs And Symptoms To Watch Out For:

Recognizing the early warning signs helps prevent the infection from spreading deeper into the body. Common signs of a UTI include:

• A strong, continuous urge to urinate, even immediately after emptying the bladder

• A burning or painful sensation during urination

• Passing small amounts of cloudy, dark, or unusual-smelling urine

• Visible blood in the urine, giving it a pink or reddish tint

• Pelvic pain or pressure in the lower abdomen

• Fever, chills, lower back pain, or nausea, which often signal that the infection has reached the kidneys

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Tips For Prevention:

Preventing tract infections is always better than treating them especially now that we have a lot of antibiotic resistance. If you do simple things every day you can reduce the risk of bacteria getting into your urinary system.

Here are some things that can help:

1. Stay well hydrated: Drinking water is very important for urinary health. When you drink fluids during the day it helps wash away bacteria from the urinary system. This lowers the chance of getting an infection.

2. Prioritize good personal hygiene: Doing things to stay clean can help lower the chance of a UTI. It is best to wipe from front to back after going to the bathroom. This keeps bacteria from the stomach area from moving into the system.

3. Don’t delay urination: Going to the bathroom regularly helps stop bacteria from growing. If you hold your urine for long it can create a place where bacteria grow faster. This makes it more likely to get an infection.

4. Be cautious with intimate hygiene products: Products that have smells, like sprays or douches can hurt sensitive areas. They can also change the balance of bacteria that protect the body. This might make UTIs more likely.

5. Wear breathable fabrics: Choosing cotton underwear and clothes that're not tight helps keep the area dry. A dry and cool place is not a home, for bacteria. This lowers the chance of getting an infection.

Also read: Can You Flush Out A UTI By Drinking More Water?

Diagnosis And Proper Medical Evaluation

Accurate diagnosis is essential before starting any medication. Diagnosis start with an evaluation and a simple urine test called a urinalysis to check for bacteria white blood cells and red blood cells.

In cases a urine culture is also done. This test finds the strain of bacteria causing the infection and tests it against different medications to find out which antibiotic will work best. For people who have recurring UTIs imaging tests, like ultrasound or CT scans might be used to look at the structure of the urinary tract and find any blockages or problems that are there.

Treatment Options

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Urinary tract infections or Urinary Tract Infections can usually be treated with antibiotics. You must take all the antibiotics even if you start to feel better so that you can be sure the Urinary Tract Infection is gone and you do not get sick again.

Medicines also help with the pain and discomfort you feel when you urinate, such as burning or feeling like you must go to the bathroom all the time.

In some cases, Urinary Tract Infections may recur due to underlying conditions such as kidney stones, urinary tract blockages, an enlarged prostate or structural abnormalities of the system. When these factors are identified, treating the root cause becomes essential.

Procedures such as kidney stone removal, stent placement or corrective surgery for urinary tract abnormalities may be recommended to prevent repeated Urinary Tract Infections.

Prevention and early intervention remain the effective strategies, in managing Urinary Tract Infections. Being aware of the warning signs and getting care at the onset of symptoms and avoiding unnecessary antibiotic use can significantly reduce the risk of recurrent Urinary Tract Infections and serious complications.

With diagnosis and appropriate treatment most Urinary Tract Infections can be successfully managed, safeguarding both urinary health and overall well-being.

By Dr. Arif Akhtar, Principal Consultant - Urology, Robotics and Renal Transplant, Manipal Hospital, Gurugram