Menopause and obesity. Clinical case.

Menopause is an emotional and physical challenge, and despite all the information available to us, it's difficult to trust and feel supported. At beDona, we want to help you with personalized support tailored to your needs. In today's article, Dr. Elisa Llurba, gynecologist, obstetrician, and director of beDona, shares a clinical case of menopause and obesity.

Current symptoms:

A 49-year-old patient consulted beDona due to perimenopause of the past 3 years. She has periods every 2 or 3 months, which are very heavy and last 15 days. She experiences periods of frequent hot flashes, wakes up at night sweating profusely, and is concerned because she has gained 10 kg in the last 3 years and has not been able to lose weight despite trying a couple of diets; her weight indicates obesity (body mass index > 30).
She eats the same as always but admits that she snacks between meals and has a particular craving for sweets.
She feels that she is no longer the woman she once was, that she has lost interest in social life and sex, partly because she feels unattractive and because she is always tired.
He has never done any sport, although he goes on long hikes with his partner on weekends.
In a recent blood test, she presented a fasting glucose level of 110 mg/dl and an HbA1c of 5.91 TP3T; both parameters indicate pre-diabetes with probable insulin resistance. Vitamin D levels were suboptimal.

Case assessment:

Perimenopause
Obesity
Pre-diabetes.
Vitamin D deficiency

Treatment:

We recommend lifestyle changes. We'll start with your diet, so we'll refer you to our dietitian and nutritional coach at beDona., Meri Rafael, which starts a specific diet to learn how to eat properly with anti-inflammatory foods based on a diet rich in prebiotics, fruit and vegetables.
We prescribe exercises from our beFIT program which allow you to gradually start toning exercises and we recommend walking 30-40 minutes every day.
We recommend hormonal treatment to maintain estrogen at adequate levels, prevent perimenopausal symptoms, and regulate your periods.
Semaglutide is administered intramuscularly once a week for 9 weeks. Semaglutide mimics the action of a natural hormone called GLP-1, which is produced in the small intestine in response to food intake. Semaglutide helps control blood glucose levels by stimulating insulin release, reducing glucose production in the liver, slowing gastric emptying, and, in some cases, suppressing appetite.
Metformin is used to regulate blood glucose levels. Metformin helps control blood glucose levels by reducing glucose production in the liver, improving insulin sensitivity, and affecting intestinal glucose absorption.
Vitamin D has multiple effects on the body, but during menopause its role in promoting bone health by regulating calcium metabolism is especially important. It also plays a role in cardiovascular regulation, making it particularly important for this patient, as she is a woman at high cardiovascular risk due to her obesity, menopause, and pre-diabetes.

Follow-up visit at 9 weeks:

Lola is happy; she has lost 10 kg and feels much better. She no longer experiences hot flashes and sleeps better. The anti-inflammatory diet has helped her rediscover how to eat, and she feels less bloated and is no longer hungry all the time. Her latest blood test shows improved blood glucose and vitamin D levels. Therefore, it has been decided to discontinue semaglutide, but continue metformin, hormone therapy, and vitamin D. In addition to continuing this lifestyle, we recommend increasing the type of toning exercises, performing strength training four times a week for 30 minutes and cardiovascular exercise (walking) for at least 60 minutes three times a week.

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If you would like one of our professionals to assess your case, you can schedule an individual visit at beDona.,

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