 Interview with Lyra Heller, MA Our bodies change as we age—as hard as we might fight it. For women who want to maintain a sexually active life with a partner, that may mean accommodating some physical changes. We talked to Lyra Heller, MA to learn her advice on what we can do in order to keep that libido alive. How does menopause affect sex? This is a complex question because women’s sexuality is complex. Part of your experience around sexuality and your sexual response is governed by changing hormones. The major impact centers on what menopause means to you, what it symbolizes, your relationship with your partner, and your general health and sense of wellbeing. How do changing hormones affect sex? Menopause is a process. It’s a major life transition marked by declines in sex hormones that signal the end of your reproductive years. Perimenopause is the first phase. It can begin sometime in your 40s and may extend into your mid-50s. The symptoms are related to fluctuating hormone levels that cause changes in menstrual cycle quality and frequency, hot flashes, spontaneous sweats leading to poor sleep quality, anxiety, and moodiness. You may notice some weight gain. Desire to engage in sex can be the last thing on your mind because you are tired, uncomfortable, possibly self-conscious. As estrogen levels continue to decline, vaginal dryness, which loosely translates as you don’t lubricate as well when you’re sexually aroused, may become an issue. This can result in painful intercourse, and it can produce a sense of negativity as you approach sex, because it hurts. Part of the menopausal experience is the vaginal lining tends to thin, and sometimes the walls of your vagina can narrow, so intercourse in general can be hurtful. How do your feelings and thoughts about menopausal changes affect sex? Christiane Northrup, author of Women’s Bodies, Women’s Wisdom: Creating Physical and Emotional Health and Healing says, “Thoughts are an important part of your inner wisdom, and they are very powerful. A thought held long enough and repeated often enough becomes a belief. A belief then becomes your biology. ”1 Menopause is a time of physical transformation that encompasses the aging process. Desiring an active sex life at times requires engaging in difficult and rewarding conversations with yourself and your partner because your body may not perform as before. Sounds simple enough, but it can be challenging to communicate “what turns you on.” Yet this may become a core issue. Other considerations that dampen sexual desire are:
Aging seems to come with increased aches and pains, whether from arthritis or just general physical deterioration. How can pain affect a healthy sex life? Pain hurts a healthy sex life! You don’t want to have sex when you hurt. So what happens is, you decide to control the pain. And there are pain medications that will actually reduce your desire to have sex. In fact, a lot of medications can cause sexual problems. Plus, drug combinations and mixtures of prescription with over-the-counter (OTC) medications are all capable of inducing disinterest in sex. This is where lifestyle becomes really important. If you’re suffering from a chronic health condition, the trajectory of seeking relief should start with a self-focused approach in partnership with your healthcare practitioner. Some of the major issues requiring medications that might affect your sex life can be elevated blood pressure, depression, anxiety, gut problems, and others2—these are all things that can in some instances also be helped by diet and lifestyle and becoming more physically active. With minor health concerns, a healthcare practitioner can provide guidance on what lifestyle modifications may help. Think in terms of being more proactive in how you approach your food choices, how you want to deal with the excess burden of weight, how you want to deal with blood pressure, adrenal function, and elevated blood fats—these are all capable of being modified by a healthy lifestyle. If you have had a heart attack or have coronary artery disease, do you need to be concerned with continuing normal sexual activities? Typically there is no concern as long as there is doctor oversight. If you experience shortness of breath, can’t walk very far, have poorly controlled blood pressure, those kinds of things are going to affect sexual vitality. That said, cardiovascular disease is the leading cause of death for women.3 It is important to appreciate your heart disease risk may go unrecognized even though knowledge about gender differences grows.4 New research suggests that women experiencing hot flashes before age 42 may have an elevated risk of cardiovascular disease when compared to women with late onset vasomotor symptoms (older than 42).5So heart disease is not restricted to women over 65. A baby aspirin a day may not be enough protection.6 Take your heart health seriously. If you are under the age of 65, and especially if you have a family history of heart disease, pay close attention to heart disease risk factors. The risk factors for heart disease are the same as for premature estrogen decline associated with early perimenopause: smoking, physical inactivity, overweight, standard American diet.7 Be proactive. Talk with your doctor. Are there any options out there that can help with libido?Experiencing perimenopause and libido is different from experiencing postmenopause and libido. Perimenopause is a rollercoaster ride of fluctuating hormones. Hot flashes and night sweats reduce your sleep. With the exception of some women whose sex drive may increase during perimenopause, you’re tired or irritable or anxious. If you’re depressed, it may worsen. You may feel old and ugly. As the extreme symptoms subside, if your libido is still hovering around zero, see a doctor to discuss possible interventions. There are several noteworthy methods: vaginal lubricants, moisturizers, and topical hormones. Water-based vaginal lubricants have a short-term effect on dryness. Vaginal moisturizers differ in that they have a longer-term effect and are prescribed on a regular basis—daily or every 2–3 days, depending on the extent of the dryness. Hyaluronic acid vaginal gel may improve symptoms of vaginal dryness, comparable with the effect of topical estrogen therapy. Both are recommended to reduce friction contributing to painful intercourse. Low-dose vaginal topical estriol, a weak estrogen, is an effective way to kindle sexual desire in some women and reduce vaginal dryness. The effect is different from oral hormone replacement therapy (HRT). Topical estriol seems to exert local as opposed to systemic effects. There are other topical hormones available that your doctor can prescribe, as well. If want to be sexually active throughout life, you can. It is a choice—a healthy, rewarding choice. Libido can be nourished. Discovering your capacity for creativity, curiosity, and experimentation is critical to being “turned on.” Grappling with the physical changes of menopause stimulates the need to explore your beliefs and feelings about what is means to be sexually intimate as we age. This can involve venturing into uncharted waters on the adventure of a lifetime. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. REFERENCES:
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 By Robert Silverman, DC, DACBN, DCBCN, MS, CCN, CNS, CSCS, CIISN, CKTP, CES, HKC, FAKTR In a perfect world, we would garner all the vitamins and nutritional minerals we need from the foods we eat. We’d also be able to maintain robust, resilient immune systems to fight against all toxins and disease. Unfortunately, that’s not the world we live in. The nutrients we need to maintain our day-to-day health, like magnesium, vitamin D, and omega-3 fatty acids, are also critical for maintaining our health over the long term.1 Yet Americans on average get about 11 percent of their daily calories from low-nutrient fast food.2 Even when we skip fast food and junk food, we aren’t always as careful about our diet as we should be. Stress and poor lifestyle behaviors, including smoking and alcohol use, reduce our ability to absorb nutrients. Taking a daily multivitamin can help when your food isn’t as nutritious as it should be, but is that enough—even if you lead a generally healthy lifestyle? Aside from specific dietary needs that should be addressed with your functional health practitioner, here are five instances when I recommend leveraging the power of supplements. To aid healthy sleep patterns Among the many reasons to get a good night’s sleep is the link between sleep deprivation and negative health consequences. For example, people with high blood sugar often don’t sleep well. There’s evidence that not sleeping well can increase your risk of developing more serious complications. When choosing supplements for quality, restorative sleep, look to ingredients that help ease tension, support deep sleep, and promote physical regeneration during sleep. L-theanine enables the body to produce other calming amino acids, such as dopamine, GABA, and tryptophan and helps support concentration, focus, deep muscle relaxation, and improved quality sleep. Ashwagandha, another sleep-supporting supplement, contains active constituents called glyco-withanolides, which mimic certain corticosteroids, supporting healthy cortisol levels and the circadian rhythm. The best-known ingredient, melatonin, supports sleep onset, quality of sleep, increased REM time, deep sleep, and dreaming—all factors that lead to better quality sleep and produce greater mental, physical, and emotional rejuvenation. Melatonin can decrease the amount of time required to fall asleep, increase the number of sleeping hours, and support daytime alertness. I recommend taking just 5 mg of melatonin, as taking too much can impair the body’s natural production of it and may cause us to become dependent on the artificial form. Magnesium, a calming nutrient, can also help induce a deeper sleep, especially when taken together with calcium. Research from the Biochemistry and Neurophysiology Unit at the University of Geneva, Department of Psychiatry indicates that higher levels of magnesium helped provide better, more consistent sleep.3 Other natural supplements containing lavender oil work to encourage a restful night’s sleep by modulating the metabolism of melatonin and promoting relaxation.4 To support your brain health Getting consistent, sufficient sleep lays a solid foundation for your brain’s health, but how you feed your brain plays a critical role in its wellbeing over time. By combining a brain-healthy diet with nutritional supplements, you’ll provide your brain with the fuel it needs for optimum levels of functioning. Here are four supplements I’d recommend to support brain health:
To feed your gut We all know the old adage: “go with your gut.” But it turns out listening to your gut is much more than following your natural instinct. To support your gut’s health, start first with prebiotics—ingredients that induce the growth of beneficial microorganisms in your gut. You’ll also want to consume foods packed with probiotics. The combination of prebiotics and probiotics can help keep your microbiome in a healthy balance, with a good diversity of intestinal bacteria in your gut. When you have plenty of good bacteria, the harmful ones get crowded out. Your digestion also improves, because your ability to absorb macronutrients and micronutrients is better when your beneficial bacteria are diverse and balanced. To properly rehydrate after exercise After exercising, proper fueling requires more than just replenishing calories and fluids; it also involves consistent and adequate electrolyte support. Electrolytes are substances that are utilized by the body to create electrically charged fluids. Many bodily functions depend on electrolytes, especially in muscle and nervous system tissue. Major electrolytes found in the body include sodium, chloride, potassium, magnesium, calcium, phosphate, and bicarbonate. The right rehydration supplements are scientifically designed to help support fluid balance; supply sodium and potassium to help replenish the electrolytes lost during exercise; deliver key electrolytes to help replace those lost through sweating during exercise, activity, or hot weather conditions; and support hydration during exercise.5 Whether you practice health-forward habits—like consuming gut-healthy prebiotics and probiotics and exercising regularly—or your diet consists of mostly empty calories and low levels of nutrients, incorporating supplements can help. In our fast-paced, modern world, supplements provide the support our bodies need to keep up—and sustain our health for the long run. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. References:
 Inflammation is a popular buzzword these days. But what causes it exactly? How can you know you have it, and if it’s something your body does naturally to help you heal, then what’s the big deal?
We’ve all been there: It’s late, you’re tired, and you don’t feel like turning the lights on just to cross a room…then bam! Shin finds coffee table. The resulting egg-shaped lump is formed when blood flow increases to the area, bringing with it neutrophils and macrophages as part of the immune response. Symptoms of this acute inflammation are typical: redness, swelling, heat, and pain. The swelling that occurs as fluid collects in the area is also called “edema.” The symptoms last for a limited period of time—minutes to days—as the body heals itself. Acute inflammation vs. chronic inflammation When the body isn’t given enough time, or if the body is unable to resolve the immune response due to deficiency of certain nutrients, it can lead to chronic inflammation. This can also be caused by untreated infectious pathogens such as bacteria or viruses, as well as the adverse effects of long-term exposure to pollutants or chemicals, including smoking.1,2 Stress and obesity are also known factors that lead to chronic inflammation.3,4 Common symptoms of chronic inflammation include:
What can we do?While acute inflammation is one way your body can heal itself, chronic inflammation should be avoided, as a prolonged inflammatory response can cause damage to healthy cells and tissue. Consider adopting a few simple ways to decrease inflammation. If you have been experiencing the symptoms described herein and are concerned you may have chronic inflammation, make an appointment with your healthcare practitioner. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. References:
 By Robert Silverman, DC, DACBN, DCBCN, MS, CCN, CNS, CSCS, CIISN, CKTP, CES, HKC, FAKTR
Take a freelancer, an office worker, and an orthodontist; what do they all have in common? They spend the majority of their workday sitting. Worse, they all likely take part in sedentary out-of-office behaviors, too—like watching TV, playing video games, or scrolling through social media. According to the World Health Organization, physical inactivity ranks fourth on the list of leading preventable killers, with an estimated 3.2 million people dying each year as a result.1 The Centers for Disease Control reports that we spend 75 cents of every healthcare dollar on chronic conditions linked to sedentary behavior. Why? When we sit, muscles in our lower body turn off and automatically adopt positions that shut off our glutes as well as our trunk and spine muscles. As a result, we experience compromised body function, increased blood sugar levels, and joint and soft-tissue injuries; injuries can vary from neck and back muscle soreness all the way to chronic illness. Thankfully, there are a number of ways to prevent, and/or reduce, the adverse effects of sitting that almost every professional can start doing today. Take a stand Standing desks are becoming increasingly common in the workplace, and with good reason. Seated office workers have more musculoskeletal injuries than any other industry sector worker. Those who sit for more than nine hours each day are also prone to developing chronic diseases such as diabetes and heart disease.2 If acquiring a standing desk is not an option for you, there are inexpensive desktop converters that enable you to convert your current desk to a standing desk. Especially for those who aren’t sure if they can manage standing up all day, desktop converters are an easy way to try out this new way of working. Sit ergonomically While standing is better than sitting, if you have to sit, do so in an ergonomic manner. To start, practice good sitting habits. When sitting at a desk, your feet should be flat on the floor, and the height of the chair should allow your thighs to angle down slightly. This position allows you to place your weight through your “sitting bones,” rather than rounding your lower back and causing your shoulders to round and your posture to slump forward. As for your keyboard height, set the keyboard high enough so that your elbows are bent approximately 90 degrees. If the tray is too low and cannot be adjusted, place the keyboard on your desk. Finally, the mouse should be placed at the same level as the keyboard. A great way to improve your posture while sitting is swapping out your office chair for an exercise ball. While seated on an exercise ball, you engage your core muscles to support your back and maintain proper posture. Plus, it’s nearly impossible to slump forward into that slouching position without risking losing your balance. Schedule regular breaks In a recent study published in the journal Sports Medicine, researchers compared the effects of individuals sitting for prolonged periods with those who took breaks from sitting and engaged in light to moderate activity.3 The results of the study suggest that taking a break from sitting every 30 minutes and incorporating even light activity had significant effects. In those individuals who took breaks, physical activity of any intensity was shown to reduce their concentrations of glucose and insulin in the blood up to 9 hours after eating a meal. So whether you sit or stand, taking breaks from your desk every 30 minutes should become part of your normal routine. Remember, even a quick walk to the break room or bathroom will help. Better yet, a 20-minute walk around the office block promotes blood flow that brings important nutrients to all spinal structures and reduces blood glucose and insulin levels. If remembering to take twice hourly breaks seems unrealistic, put your smartphone to use. Download an app—such as Stand Up! or Sitting Timer—to remind yourself to take breaks from your desk. It may not be possible to get up every time the reminder goes off, but it will help you be more cognisant that you’ve been sitting for a while—and that your health depends on your taking sufficient breaks. Stretch at your desk If you don’t have time to leave the office on regular intervals, take your break at your desk and stretch. Depending on the amount of space you have in your work area, a variety of stretches, like ankle and wrist rolls, a hands-over-head stretch, head rolls, and shoulder rolls, can all help relieve the stress sitting causes your body. If you have room to move around a bit, try these stretches and exercises:
Those who want to reverse the negative effects of sitting should start right away. Switching to a standing desk, taking regular breaks, prioritising short busts of light activity, and stretching can all help expedite the body’s ability to recover from long hours spent sitting. Mild back and neck soreness may be just an inconvenience now, but sustained sitting habits can lead to chronic health problems down the road. The time to take a stand against the sitting epidemic is now. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. References:
 A growing to-do list, meetings that drag into the late evening, financial strains, relationship issues, trouble sleeping: When it comes to stress, many men struggle to find an outlet. Yet, without the right coping mechanisms, chronic stress can deeply, and adversely, affect men’s health.1
How can men reduce the stress in their lives?No matter the source, chronic stress has significant effects on the body. Studies have linked it to a variety of health issues involving mood, sleep, appetite, and more.1 And while researchers have yet to pinpoint the specific ways long-term stress affects the heart, and other systems, men under seemingly constant pressure are also more likely to eat unhealthy foods, adopt a sedentary lifestyle, and smoke.2 Fortunately, men don’t have to let stress get the better of them. There are a number of strategies men can leverage to take charge of their wellbeing. Here are four stress-busting tips men should know about:
Accordingly, we suggest that men look into the following dietary supplements:
References
 When you’re stressed, so is your thyroid
Everything seems to be going wrong this morning—you’re out of coffee, traffic is bad, and you can feel tension from the tips of your toes to the top of your head. Maybe you’re under constant pressure at work or can’t catch a break on your bills. Stress is a part of your life, and when it’s ongoing, it can affect everything—including your thyroid. Learn why this is significant and what you can do to help reduce the effects of stress on this important gland. Your thyroid: The regulator of body functions Sitting squarely at the front of your neck is the thyroid gland, a butterfly-shaped powerhouse of your body’s metabolism. As part of your endocrine system (a collection of glands in the body that produce hormones), the thyroid regulates many body functions including, but not limited to:
How stress affects the thyroid The effect of stress on thyroid health is like a game of dominos: When one tile falls, the rest typically follow. Stress impacts the thyroid by influencing how other hormones balance with it. For example, cortisol (the “fight or flight” hormone) can surge due to chronic stress. This surge can cause problems with thyroid hormone production,1 pressing this important gland to work harder to produce and release more thyroid hormones, leading to an imbalance. Consequently, if the imbalance becomes chronic, it can contribute to the risk of developing a thyroid disorder.2 Another example of hormonal imbalance is insulin resistance, wherein the body resists insulin production, resulting in increased blood sugar levels. This leads to other associated health problems. Several of these conditions often occur with hypothyroidism (when the thyroid doesn’t make enough of its hormones). The result? Increased products of dysregulated sugar metabolism, which lead to lower levels of thyroid-stimulating hormone (TSH) in the blood.3 Insulin resistance can also contribute to thyroid enlargement and nodules.4,5 Chronic stress has also been shown to increase the risk of developing an autoimmune thyroid condition.2By affecting the immune system through the nervous and endocrine systems, chronic stress can “flip a switch” and increase the risk of autoimmune thyroid disorders for people who have a genetic predisposition.2 Don’t stress about your thyroid If you’re concerned about chronic stress and how it may affect your thyroid, ask your healthcare practitioner for more information. He or she is the best person to consult about stress and thyroid health. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. References:
 By Whitney Crouch, RDN & Kirti Salunkhe, MD
What is stress? Stress can be defined as a constellation of events, starting with a stimulus or stressor that causes a reaction in the brain leading to the stress response commonly known as the “fight-or-flight” reaction that can affect many body systems.1 Unfortunately, stress is a fact of life that we all experience at some time or another. Stressors that are acute, or short-lived, are often physical or physiological. Psychological or emotional stress is usually chronic in nature. The immune system and stress The immune system is made up of cells, tissues, and organs working together as the body’s defense mechanism to protect us from illness. Scientists say short-term stress (lasting from minutes to a few hours) may be beneficial for our immune health, as it stimulates immune activity and prepares us for possible periods of longer stress—a “fire drill” of sorts. However, chronic stress is actually harmful.2 White blood cells (WBC) are critical for the body’s immune response to foreign invaders. These cells are produced, and stored, in many areas of the body including the spleen, bone marrow, and thymus (a small gland found behind the sternum and between the lungs).3 There are two types of WBCs associated with the immune system: Phagocytes, which actively attack foreign organisms, and lymphocytes, which remind the body to recognize previous invaders and help destroy them.4 The main phagocyte is the neutrophil. Neutrophils primarily fight bacteria and infections. The main lymphocytes are the B lymphocytes or B-cells and T lymphocytes or T-cells. B-cells start out and mature in the bone marrow. T-cells start out in the bone marrow but mature in the thymus. These two cell types are the “special ops” of the immune system and have specific functions. B-cells make antibodies to fight bacteria and viruses and T-cells directly attack invading organisms.4 Acute stress and the immune response One of the most familiar reactions to acute stress is the “fight-or-flight” response. This physiological reaction usually occurs during an emergency or a fearful mental or physical situation.3 When a threat is perceived, there is a release of hormones to prepare you to either stay and deal with the threat or to run away to safety. It represents choices our ancient ancestors made when faced with dangerous situations. Nowadays, it’s more likely those dangerous situations are ones leading to a wound or infection, but our body reacts the same way.3 During periods of short-term stress, our sympathetic nervous system releases “stress hormones:” epinephrine (adrenaline) and norepinephrine (noradrenaline), as well as corticotropin-releasing hormone (CRH), adrenocorticotropin (ACTH), and cortisol from the adrenal glands.3 These work together to prepare the body for “fight-or-flight” by increasing alertness, focusing the mind, elevating heart and breathing rates, as well as increasing blood flow to skeletal muscles and brain.4 Interestingly, research has shown acute stress activates the immune system. Immune activation is critical to respond to immediate demands of a stressful situation that may lead to a wound or an infection. Acute stress triggers immune cells and stimulates production of proteins known as cytokines. The two major types of cytokines are: pro-inflammatory cytokines and anti-inflammatory cytokines. The pro-inflammatory cytokines process the pain often found with inflammation; the anti-inflammatory cytokines work by controlling, or limiting, the spread of inflammation. Both are necessary for normal healing.3 While acute, or short-term, stress acts as an “immune stimulator,” readying the body’s immune system for an adverse situation, situations involving long-term or chronic stress actually suppress and dysregulate the body’s immune responsiveness, leading to illness and poor outcomes.3 Chronic stress and the immune response Just as we all have differing genetic and biochemical composition, we also have varying perceptions of stress and individual responses to how we process and cope with it.5 Occasionally, there can be a crossover between the mind and body, as in the “fight-or-flight” response. A mentally stressful situation may require a physical response or action, but what about those psychological or emotional stressors that may be difficult but don’t actually pose any pressing physical dangers? Stressors related to pressures of a work project requiring focused concentration over long days and nights, or the continual emotional drain from a difficult relationship or other similar circumstance? Studies have shown prolonged mental stress can adversely affect regular lifestyle routines, including decisions we make about sleep, nutritional intake, and exercise and can even persuade us to use poor judgement regarding alcohol and drug intake.5,6 These studies have also shown the adverse effects (acute and chronic) that mental and emotional stress places on physical health and wellbeing and have been directly linked to suppression of the immune system.5 How acute mental stress affects physical health was seen in a recent study of college students during their final exams.7 To understand the link between mental stress and changes in blood biomarkers, researchers took blood samples and administered questionnaires about anxiety and depression to 24 college students during finals week. Baseline values had been established by prior blood draws and questionnaires completed midsemester. When compared to baseline levels, during finals week, there were elevations in pro-inflammatory cytokines along with increased reports of anxiety and stress.7 Other studies have noted increased stress can lead to prolonged wound healing time with reduced levels of anti-inflammatory cytokines and increases in pro-inflammatory cytokines.6 Multiple studies have evaluated the immune response in conditions of long-term and emotional stress. These conditions are similar to those found with caregiving of an ill or elderly relative, experienced after a difficult divorce and have even been reported as related to loneliness.7-9 Findings from these studies showed links between emotional stress and increased risk for viral illness, reemergence of latent viruses (Epstein-Barr, herpes simplex, and cytomegalovirus), and onset of autoimmune disease.5,10,11 Other studies have shown long-term psychological stress was linked to detrimental cardiovascular health12-14 as well as increased risk for immunologic conditions including inflammatory bowel disease, allergies, atopic dermatitis, and celiac disease.15-18 Even the most vulnerable members of the population, our children, can be affected by psychological stress that results in a reduced immune response. Investigators evaluated children who had a history of recurrent colds and flu and reported higher levels of psychological stress. The data demonstrated the children had reduced salivary immunoglobulin ratios (IgA/albumin). A reduction in this ratio supports a potential link between reduced immune function with a greater susceptibility to colds and flu.19 Lifestyle approaches to stress management While the effects of stress can be useful on some occasions, adverse effects of stress can play a role in both acute and chronic illness. While there are a number of strategies that come into play with stress management, evidence supports the benefits of lifestyle modification and improved dietary or nutritional intake as a part of a comprehensive strategy. Recommended lifestyle modifications:
This information is for educational purposes only. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. References:
Whitney Crouch, RDN, CLT Whitney Crouch is a Registered Dietitian who received her undergraduate degree in Clinical Nutrition from the University of California, Davis. She has over 10 years of experience across multiple areas of dietetics, specializing in integrative and functional nutrition and food sensitivities. When she’s not creating educational programs or writing about nutrition, she’s spending time with her husband and young son. She’s often found running around the bay near her home with the family’s dog or in the kitchen cooking up new ideas to help her picky eater expand his palate.  It is not a myth that men can lose weight faster than women.1 The inherent physiological differences between the sexes play a big role when it comes to losing weight, especially in the initial stages.2 Men possess characteristics that may favor greater weight loss as compared to women.3 To understand the reasons behind this, we must consider the sex differences in energy metabolism, hormonal profiles, and behaviors that may contribute to the differences we see in the ability of the sexes to lose weight.
Body composition—women have a higher fat percentage Men and women show significant differences in the amount of body fat and lean muscle tissue they carry, with men having more lean tissue and women having greater fat mass.3,4 Lean tissue is more metabolically active than fat; thus more lean tissue contributes to a higher resting metabolic rate.3 This means that in general, men burn more calories than women, even at rest. Higher levels of testosterone in men are largely responsible for the variance in body composition, since testosterone is critical for building and maintaining muscle mass.5 On the other side of things, estrogen also contributes to the gender differences in body composition, namely fat mass.6 From the onset of puberty through to menopause, women maintain a higher percentage of body fat, which was evolutionarily there to support the ability to reproduce.6 Evidence shows that estrogen acts on the liver and adipose tissue, preferentially promoting postprandial conversion of fuel into fat tissue—and which may make fat loss more difficult for women.3 Fat distribution—men “appear” to lose more weight Not only is there a difference in the percentage of body fat and lean mass between genders, there is also a difference in the distribution of body fat.2 This relates back to the differing hormonal profiles of men and women and the locations of receptor sites for these hormones.3 For example, estrogen receptors are higher in the subcutaneous tissue in the buttock, hip, and thigh regions in women, which explains why women hold excess fat in these locations.3 Men, on the other hand, have a pattern of central obesity, where the fat tissue is mainly visceral, abdominal fat.2 When weight loss is controlled between the sexes, it has been found that men lose more intra-abdominal fat than women, whereas women lose more subcutaneous fat.7 Fat loss around the abdomen is generally more noticeable, so even if weight loss is similar, it appears that men are losing more weight, even if they are not. Emotional eating—women are more likely to turn to foodAlthough both men and women struggle with overeating, women are more likely to turn to food to cope with stressors than men, which is thought to be due to the greater intensity of expressed emotions by women.8,9 This may present as another challenge for women to lose weight. Women are more likely to report eating in response to emotions like anxiety, anger, frustration, and depression.10 Interestingly, even the stress caused by the desire to be thin and dissatisfaction with body size is positively correlated with emotional eating.11 Women who experience higher levels of emotional stressors have more episodes of binge eating, resulting in weight gain and further impairing self-esteem, adding to the existing emotional strain.8 Since women, in general, are more prone to experiencing more intense emotions, emotional eating may be contributing to the inability to lose weight as easy as a male counterpart. Other contributing factorsBody weight is predominately controlled by diet and physical activity, but there are underlying factors that can also contribute to enhanced weight gain or difficult weight loss.12 For women struggling to lose weight, it may be important to explore some of these other potential factors. Polycystic ovarian syndrome (PCOS) PCOS is one of the most common endocrinopathies affecting 6-18% of reproductive aged women.13Of these women, approximately 50% are overweight or obese, specifically carrying excess weight in the abdominal region.14 Due to the underlying insulin resistance found in most women with PCOS, it can be a challenge to lose weight effectively, even after appropriate dietary and lifestyle changes.15 Thyroid disorders Thyroid hormones play a critical role in the regulation of body weight through controlling energy expenditure.16 It is well known that thyroid dysfunction, namely hypothyroidism, leads to a lower resting metabolic rate, and weight gain is a primary symptom of the disorder.17 When considering the prevalence of hypothyroidism in men and women, women are 4-6 times more likely to be affected, and the incidence continues to rise.18,19 This means that an underlying thyroid disorder should be considered in a woman who is unable to lose weight. Furthermore, if a thyroid disorder is identified but a woman still has symptoms or is not losing weight, an alternative management strategy may be needed; many patients are underreplaced with levothyroxine therapy or do not receive the expected results.20 Interestingly, it has been found that improving TSH levels are not associated with weight loss; rather it is the free T3 and total T3 that are the most significant predictors associated with the greatest changes in body weight and resting metabolic rate.21 Unfortunately, most practitioners test TSH only. This may suggest that a simple TSH measurement may not be enough in a women struggling to lose weight, and more comprehensive testing may need to be done in a woman with suspected hypothyroidism. Combined hormonal contraceptive use It is very common for a woman to be using combined hormonal contraceptives, like the pill, vaginal ring, and the patch.22 Although their effects on weight and weight gain is debated, there is some evidence that suggests combined hormonal contraceptives may contribute to weight gain in some women by causing fluid retention and increasing storage of body fat.22 However, weight gain and weight loss are both noted as side effects of hormonal birth control, and not all women are effected.22If a woman is using hormonal contraceptives and is struggling to lose weight, this should be explored as a possible cause. Fluctuations in the menstrual cycle Female hormones are much more complicated than male hormones; the fluctuations in luteinizing hormone (LH), follicle-stimulating hormone (FSH), estrogen, and progesterone throughout a woman’s menstrual cycle influence her caloric intake, cravings, exercise performance, and ability to build lean muscle mass.23,24 It has been found that in the second half of a woman’s cycle, her luteal phase, women are more likely to have dysregulated eating habits, with an increase in binge-like episodes.23During this half of the cycle, woman also have greater cravings for sweet foods.23 Moreover, these hormonal variations influence the ability of a woman to build lean body mass.24 Prior to ovulation, muscle strength is increased, and this phase of the cycle favors a gain in muscle mass, which contributes to a higher metabolic rate and further weight loss.24 Fluid retention that also can occur at times in the menstrual cycle can create the illusion that a woman is carrying more body fat.25 As reviewed, there are many physiological differences between the sexes that contribute to the ability to lose weight. Body composition and fat distribution clearly differ between genders, but one must also consider the effect of emotions, hormonal variances, and certain underlying conditions that may make it more challenging for a woman to lose weight compared to a man. Now, although it is true than men can lose weight faster than women, research shows that after about six months of a weight-loss program, the results even out and become similar between the sexes.2 This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. References:
Bronwyn Storoschuk, ND Bronwyn Storoschuk, ND is a board-certified naturopathic doctor trained at the Canadian College of Naturopathic Medicine. Prior to attaining her ND, Dr. Storoschuk completed her Bachelor of Science (Honours) in Kinesiology at Queen’s University in Kingston, Ontario. She currently works in private practice in Toronto, Ontario. One of her practices is located within an integrative fertility clinic, where she provides naturopathic care to individuals undergoing assisted reproductive technology (ART). Dr. Storoschuk integrates evidence-based medicine with the understanding of the body’s natural physiology and innate healing wisdom. She is passionate about empowering women to take control of their hormonal health and has a clinical focus in hormone balance, reproductive health, and fertility.Dr. Storoschuk is a paid consultant and guest writer for Metagenics. |
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