Intermittent fasting in menopause: it might help with more than weight management.

Last week I received a very kind email asking if I would consider sharing my thoughts on intermittent fasting, particularly in the context of menopause.

It’s a topic that comes up frequently, and understandably so.

So I thought it might be helpful to give you a balanced overview - what intermittent fasting actually means, where the potential benefits may lie, and a few things to be mindful of if you’re considering it.

Then you can decide whether it’s something that might work for you.

What do we mean by intermittent fasting?

Intermittent fasting isn’t just one approach. It covers several different patterns of eating and fasting.

At the simplest level, it could be something many of us already do - a 12-hour overnight fast.

For example, eating your evening meal at around 7pm and then not eating again until 7am the following morning.

For most people, that kind of overnight break from food is very manageable.

Some people extend that window.

You may have heard of:

16:8 fasting
A 16-hour fast with an 8-hour eating window.

18:6 fasting
An 18-hour fast with a 6-hour eating window.

There are also other variations such as:

Alternate-day fasting

Eating normally one day and fasting the next.

The 5:2 approach
Eating normally five days per week and significantly restricting calories on two non-consecutive days.

During fasting periods, zero-calorie drinks are typically allowed - things like water, herbal teas, black coffee, or black tea.

Where might intermittent fasting help?

One of the reasons intermittent fasting receives so much attention is because it may offer a number of potential benefits - several of which are particularly relevant during menopause.

Weight management and visceral fat

Weight changes are one of the most common concerns during the menopause transition.

Hormonal shifts can affect where fat is stored, sometimes leading to an increase in visceral fat - the fat that accumulates around the abdominal organs.

Time-restricted eating patterns, such as 16:8 or 18:6 fasting, appear to be particularly helpful in reducing visceral fat.

It’s not entirely clear whether the benefits come purely from overall calorie reduction or whether the fasting window itself plays a role. But research suggests that intermittent fasting can support weight management for many people.

Insulin sensitivity and blood sugar regulation

During menopause, the body may become less sensitive to insulin.

This can influence blood glucose regulation and sometimes contributes to increased cravings or

fluctuating energy levels.

Intermittent fasting appears to improve insulin sensitivity, making it easier for the body to regulate blood sugar.

There is also evidence that fasting can reduce cortisol levels in some individuals, which may have a positive effect on stress-related hormonal patterns.

For some women, this combination can contribute to improvements in things like:

• cravings
• mood stability
• anxiety
• frequency of hot flushes

Hormonal influences

Another hormone sometimes mentioned in relation to intermittent fasting is DHEA.

DHEA naturally declines with age, but it is important because it acts as a precursor hormone, meaning it can be converted into both oestrogen and testosterone in the body.

Some research suggests intermittent fasting may increase levels of DHEA, which could potentially support hormonal balance during menopause.

Cardiovascular health

Cardiovascular risk increases after menopause, largely because we lose some of the protective effects of oestrogen.

Intermittent fasting has been associated with several markers of improved cardiovascular health,

including:

• reduced LDL cholesterol
• lower blood pressure
• improved endothelial function

The endothelium is the lining of our blood vessels, and healthy endothelial function is important for maintaining good circulation and overall cardiovascular health.

Brain health and cognitive resilience

Another area of growing interest is the potential impact of intermittent fasting on brain health.

Research suggests fasting may increase production of a protein called brain-derived neurotrophic factor (BDNF).

BDNF supports neuronal health and cognitive resilience. Some researchers believe this may play a role in protecting against cognitive decline, although much more research is still needed in this area.

Inflammation and chronic disease

Post-menopause, we may also see increases in inflammation and oxidative stress, both of which are associated with conditions such as osteoporosis, arthritis and other chronic diseases.

Intermittent fasting appears to influence certain inflammatory pathways, via pathway modulator nuclear factor kappa B.

This protein complex plays a central role in regulating immune responses and inflammation. Over-activation has been linked with several chronic conditions including arthritis, inflammatory bowel disease and certain cancers.

Some studies suggest intermittent fasting may help regulate these inflammatory processes.

A few important considerations

While there is promising research around intermittent fasting, it is important to approach it thoughtfully.

First and foremost, the eating window becomes more important than ever.

Because you may have fewer hours to eat, it becomes essential to ensure your meals contain adequate nutrients.

This means paying particular attention to:

• protein intake
• dietary fibre
• hydration
• overall nutrient density

It is also essential to maintain regular physical activity, particularly strength-based exercise, to protect muscle mass and support bone density.

Timing matters

There is also the practical question of when your eating window sits during the day.

Some people prefer eating later in the day for social or lifestyle reasons.

However, earlier eating windows tend to align more closely with our circadian rhythms, which may offer metabolic advantages.

There isn’t a single right answer here - it often comes down to what works best for your lifestyle.

Blood sugar considerations

If you have diabetes or pre-diabetes, intermittent fasting requires additional care.

Long fasting periods can increase the risk of hypoglycaemia (low blood sugar), so it’s very important to discuss any fasting approach with your healthcare professional before starting.

Hormone sensitivity

Another consideration is that for some women who are particularly hormone sensitive, fasting can sometimes increase that sensitivity and exacerbate symptoms.

If you do decide to try intermittent fasting, it’s important to monitor how you feel rather than pushing through discomfort.

What works very well for one person may not suit another.

Sustainability matters

One of the biggest questions I always ask with any dietary approach is:

Is this sustainable long term?

If it isn’t something you can realistically maintain, it risks becoming just another short-term diet.

And we all know where that can lead - the familiar cycle of losing weight and gaining it back again.

If you want to try it…

If intermittent fasting is something you’re curious about, start gently.

You might begin with a 12-hour overnight fast.

For example:

Dinner at 7pm
Breakfast at 7am

If that feels comfortable, you could gradually extend the fasting window to 14 or 16 hours.

But there is absolutely no requirement to push further if that begins to feel stressful or uncomfortable.

As always, focus on:

• balanced meals
• adequate protein
• fibre-rich foods
• good hydration
• regular exercise

And if you have any medical concerns, speak with your healthcare professional first.

Final thoughts

Intermittent fasting can be a helpful tool for some women during menopause.

For others, it may not be the right fit - and that’s perfectly fine.

There are many ways to support your health during this stage of life.

The key is finding an approach that works for your body, your lifestyle and your long-term wellbeing.

If you’re interested in learning more about evidence-based strategies to support your health during menopause, we’ll be covering a range of topics at Menofest on March 31.

Five experts will be sharing practical guidance on different aspects of menopause - from nutrition and hormone therapy to movement, pelvic health and more.

It’s designed to give you clear, trustworthy information you can actually use.

You’ll find full details in the link.

And as always, if you have questions about anything discussed here, you’re very welcome to reply to this email.