Most people already know about menopause - the time in a woman's life when her ovaries stop producing eggs, marking the end of her menstrual periods and reproductive life.
A hundred years ago, when the lifespan of a woman was 40 years, reaching menopause would be a cause for grand celebration.
With the average lifespan of women at 76 today, menopause is more of a mid-life milestone than a celebration of old age.
Some women breeze through menopause without any symptoms, while others suffer varying degrees of discomfort - hot flushes, difficulty sleeping, mood swings, dry skin, loss of libido, irritability and others.
One of the most common, yet overlooked aspects of menopause is actually weight gain.
Many women begin putting on weight gradually when they pass their 45th birthday, not realising that they are already at the peri-menopause stage.
Only when they reach the big five-zero and have friends commenting on their body size do they realise that they've grown several dress sizes in a short span of a few years.
No, it's not OK!
For some women, looking more prosperous as they age is no big deal as it symbolises a freedom of sorts - not adhering to public perception of beauty and pride in not being stick-thin like the models in fashion magazines.
How you look, however, is not as important as the implications of being overweight.
Excess weight is known to increase the risks of high blood pressure, heart disease, type 2 diabetes, metabolic syndrome, female cancers such as colorectal and breast cancers, and more.
So, although menopause is a natural progression of life, you must watch your waist more vigilantly to avoid the diseases that can compromise your health and wellness in the next half of your life!
Why is it so easy to pile on the kilos after menopause?
Food choices and quantity can have an impact on your body size and shape, but it does not change the fact that you are a woman governed by hormones.
Oestrogen, popularly known as the "female hormone" because it affects a woman's femininity, drops drastically after menopause, resulting in a change in body shape.
This means saying goodbye to your curves, as your pear-shaped body changes slowly into an apple shape.
With less oestrogen, the body metabolises starch and blood sugar less effectively, and the extra calories end up being stored in the abdomen, hips and thighs.
Declining energy levels also discourage physical activity, leading to a loss of muscle mass.
Although some studies link genetic factors to weight gain, it is likely that the shared eating culture and diet is a far bigger connection.
As such, you may think it is normal to be overweight and out of shape if your parents and close relatives also struggle with weight problems in their old age.
While we are all unique and we each face our own weight challenges, there are some common causes of menopausal weight gain that many women struggle with.
Our hormones and fat cells are part of a complex and comprehensive network responsible for metabolism, appetite, digestion, heat regulation and detoxification.
Any breakdown in communication will result in symptoms like hot flashes, food cravings, and yes, weight gain.
There are three primary hormones in the body: insulin, adrenaline and cortisol.
Insulin controls blood sugar levels, while adrenaline and cortisol manage the stress response.
In other words, stress and food directly affect our hormones.
When we consume too much white flour, sugar and processed foods, our insulin levels will rise, and adrenaline and cortisol will increase in response to high or chronic "stress".
Whether your weakness is roti canai, bread, pasta, teh tarik, sugared coffee drinks, alcohol or dessert, if your blood glucose levels are high and you are approaching insulin resistance, or decreased insulin sensitivity, your body will convert every calorie it can into fat.
That's because even though you may be gaining weight, your cells are actually starving for the healthy nutrients they need and you may feel tired and hungry most of the time.
In addition, whether you have been diagnosed with insulin resistance or diabetes or not, many of us have insulin sensitivity and have glucose levels that are higher than they should be.
Heading into perimenopause, this is a recipe for weight gain.
Your body will store fat to ensure it has what it needs, and your sugar consumption and hormonal imbalance may lead to cravings that are hard to resist.
Lifestyle factors also play a part. With the children all grown up and with more freedom on your hands now that you're probably retired, you may eat out more often.
Problems with post-retirement finances, children, the spouse or other medical conditions may also entice you to indulge more in high-calorie, low-nutrient comfort foods that remind you of your youth or childhood days.
Stay fit, fight fat
A waistline above 35 inches is an indication that it is time you start doing something about your weight.
Here are some tips:
1. Balance your hormones with bioidentical hormone therapy and take supplements that reduce insulin resistance like magnesium, chromium or lipoic acid.
This can aid in reducing body weight.
2. Eat food that has a low glycaemic index.
3. Eat less - the older you grow, the less calories you need. After menopause, you will need 200 less calories daily, which means you need to look into your daily meals to see where you can cut down.
One easy way is to stick to three main meals and cut out the snacks and tea breaks.
Halve your rice intake and reduce sugar and salt levels.
4. Exercise more - after menopausal age, just a leisurely weekly walk in the park will no longer suffice.
Add more low-impact aerobics (such as walking, swimming or cycling) and strength training (weightlifting, gardening, yoga).
Add activity to your life as much as possible - wash the car, park the car further, take the stairs.
5. Cultivate good habits - there's no better time to stop smoking or reduce alcohol levels than now.
Eat more fruits, vegetables and wholegrains, and lean protein, and reduce high-fat, processed foods.
Don't be afraid of going outdoors to get some vitamin D from the sun.
6. Is age really a number? Only you can decide. Feel like dancing instead of walking? Prefer hiking or mountain climbing instead of yoga? Why not?
7. Join a group - Humans are social beings and we need one another to thrive, especially as you age and your family commitments are reduced. Participating in activities with people of the same age such as those from the Malaysian Menopause Society will help you stay active, happier and fitter in the long run.
Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician and gynaecologist. For further information, visit www.primanora.com. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice.
Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.