Metabolic Syndrome and Menopause

Metabolic Syndrome in Midlife

As a health coach working with women in midlife and beyond, one of the most important topics I discuss is metabolic syndrome. You may have heard the term, but what does it actually mean? And more importantly, what can you do about it if you have it?

What Is Metabolic Syndrome?

Metabolic syndrome is a cluster of conditions that raise your risk for heart disease, stroke, and type 2 diabetes. And, remember, heart disease is the #1 cause of death for women, and women are twice as likely to get Alzheimer’s Disease as men. Having one risk factor alone doesn’t mean you have metabolic syndrome—but when several show up together, it’s a sign your metabolism is struggling.

The 5 key criteria I listed (below) come from well-established, evidence-based guidelines from:

  • NCEP ATP III (National Cholesterol Education Program Adult Treatment Panel III)

  • American Heart Association (AHA)

  • National Heart, Lung, and Blood Institute (NHLBI)

  • High waist circumference (midsection weight gain, often called visceral fat):

    • > 35 inches

  • High blood pressure:

    • Normal: < 120/80 mmHg

    • Elevated / Pre-hypertension: 120–129 / < 80 mmHg

    • Hypertension: ≥ 130/85 mmHg (for metabolic syndrome cutoff)

  • Elevated fasting glucose:

    • Normal: < 100 mg/dL

    • Prediabetes / Impaired fasting glucose: 100 – 125 mg/dL

    • Diabetes: ≥ 126 mg/dL

  • High triglycerides:

    • Normal: < 150 mg/dL

    • Metabolic syndrome: ≥ 150 mg/dL (or on treatment for high TGs)

  • Low HDL cholesterol:

    • Women: < 50 mg/dL

If you have three or more of these markers, you meet the clinical definition of metabolic syndrome. That’s why it’s so important to get annual labs from your physician and track trends over time, especially during menopause and beyond when risks increase.

The goal is to catch changes early—long before blood sugar, cholesterol, or blood pressure escalate into crisis. Insulin resistance doesn’t happen overnight; it can develop silently for years. The longer it goes unchecked, the greater the impact on your arteries, heart, brain, and overall health.

What Happens After You Eat?

It’s essential to understand how your body works—especially why changes show up in midlife and beyond. The days of being a passive patient, sitting quietly in your doctor’s office, are behind us. When women connect the dots between their daily actions and long-term health outcomes, they feel empowered to make meaningful lifestyle changes.

Here’s a simple breakdown of what happens in your body when you eat a meal:

  1. You eat your meal, and your body breaks down carbohydrates into glucose, which enters your bloodstream.

  2. Your pancreas releases insulin as a result, a hormone that acts like a key, unlocking your cells so glucose can move inside and be used for energy.

  3. If everything is working well, your blood sugar rises a little, insulin does its job, and your glucose comes back down to a normal range.

But, for some women, this is not what’s happening.  When there’s too much glucose circulating, your cells stop responding to insulin as effectively. It’s like the knock on the door from insulin to the cell “lock” isn’t heard. This is called insulin resistance.

When that happens, glucose stays in your bloodstream instead of moving into your cells, leading to higher blood sugar levels, and more insulin is needed to be produced to help out, and eventually, fat storage occurs—especially in the midsection. Designing new healthy habits, such as eating whole foods, exercising, sleeping well, and managing stress to keep the insulin signals working, are the building blocks to supporting healthy metabolic function.

Why Are Midlife Women More Susceptible?

For women, hormonal shifts during perimenopause and menopause play a big role. Estrogen helps protect against insulin resistance, so when estrogen levels decline, the body naturally becomes less sensitive to insulin. That’s one reason midlife women often notice more weight gain around the middle, even if their habits haven’t changed much. Genetics also plays a role, too. Some people inherit genes that make them more likely to develop insulin resistance, high blood pressure, or abnormal cholesterol levels.

Causes of Metabolic Syndrome

  • Poor diet (high in processed foods, refined carbs, sugary drinks)

  • Sedentary lifestyle

  • Chronic stress (raising cortisol, which makes blood sugar harder to regulate)

  • Poor sleep

  • Hormonal changes (declining estrogen in midlife women)

  • Genetics and family history

Lifestyle Interventions That Make a Difference

The good news: insulin sensitivity can improve. Think of your metabolism as a muscle—it gets stronger the more you use it wisely.

Here are the key lifestyle interventions that health coaches work on:

  • Nutrition: Focus on whole, nutrient-dense foods. Include enough protein to build and protect muscle, fiber to support blood sugar balance, and healthy fats to nourish your cells. Minimize processed foods and added sugars. Stay hydrated.

  • Movement: Strength training is especially powerful because muscle tissue is highly insulin-sensitive. More lean muscle mass means more storage for glucose in the form of glycogen (the form stored in muscle cells)- essential for work-outs! Walking after meals can also help lower blood sugar.

  • Sleep: Prioritize 7–9 hours of restorative, consistent sleep. One poor night can make you temporarily insulin-resistant the next day, driving cravings and poor food choices.

  • Stress management: Chronic stress raises cortisol, which raises blood sugar. Tools like mindfulness, breathwork, or even simple breaks during the day can help.

  • Community and joy: Connection and purpose lower stress and support consistency in your habits.

Metabolic syndrome is a warning sign, but it’s also an opportunity. By tuning into your unique health equation—your sleep, nutrition, stress management, movement, community, and the support of a healthcare team—you can improve insulin sensitivity, protect your heart, and feel more energized.

Hormonal shifts in midlife may make this work more challenging, but they also make it more important. Small, consistent changes now can have an enormous impact on your healthspan—the years you live with vitality, energy, and joy.

Now is your time to work on yourself. Honing in on your unique health equation will set you up for longevity. If you are facing barriers to doing the hard work, and you are ready, schedule your complimentary 30-minute consultation today.

Jill Foos