You might want to call it comparing pears and apples. Before women go through menopause, many of them carry more of their weight below the waist. This pear-shaped body type includes wide hips and thighs. During menopause and thereafter, pears often shift to apples, with more weight moving to the waist and belly.

What is this change in body shape about?

Some women refer to the change in body shape that can occur during perimenopause, menopause, and beyond as the great migration. Quite simply, it involves the redistribution of fat and body composition, with body fat storage shifting to the sides and front of the abdomen.

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As estrogen levels decline, fat cells in the abdomen store more fat. This results in an increase in belly fat and a decline in lean body mass. Weight gain is often but not always part of these changes. One concern is that excess weight gain at midlife increases the risk of cardiovascular disease, type 2 diabetes, high blood pressure, some types of cancer, and osteoarthritis. Weight gain also is a source of frustration and stress for the women now faced with unwanted belly weight.

How to manage changes in body shape naturally

First of all, it’s important to mention that changes in body shape and weight during the menopausal years can be challenging even when women make huge efforts to reverse it. These changes can begin when women are in their mid-to-late 40s and continue into postmenopause.

According to Dr. Fatima Cody Stanford, an instructor in medicine at Harvard Medical School, “Women often assume that they are the source of the problem when it comes to anything regarding their weight.” However, she notes that hormonal fluctuations and other bodily shifts associated with menopause are involved.

That does not mean, however, that women have no tools to take on the challenges of body changes. Some turn to hormone therapy, but it is not recommended, as it is associated with significant health risks, including a greater chance of developing breast and other hormone-related cancers as well as heart disease. Therefore, an understanding of the natural choices women can make can empower them as well as protect their health. Here are a few tips.

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• sleep problems are more common during menopause, and this contributes to weight gain. Too little sleep can result in too much fat around the midsection. Adopt better sleep habits.
• stress management practices such as meditation, visualization, yoga, tai chi, and deep breathing are highly recommended to keep stress under control.

When should you see your doctor?

If you are experiencing significant weight gain or encountering symptoms or health issues that are having a negative impact on your quality of life, consult your healthcare provider. He or she can examine you for the possibility of an underlying health problem.

Bottom line

Changes in body shape beginning with perimenopause can be challenging physically and emotionally. You can learn to embrace the changes while also taking natural steps to manage and live with them in a healthy way.