If you’re a woman in your 40s, 50s or even into your 60s, there’s a good chance you’ve found yourself standing in front of the mirror at some point wondering what on earth has happened to your body. There’s the meno belly, the midlife pudge, the cortisol belly, and now there seems to be an endless stream of information telling women what they should and shouldn’t be doing about it.
Stop drinking coffee. Don’t train too hard. Train harder. Fast. Don’t fast. Eat less. Eat more protein. Regulate your nervous system. Don’t exercise first thing in the morning. Do exercise first thing in the morning. Quite frankly, with so much conflicting advice being thrown at women, sometimes you just don’t know where to start.
I see this with women in my clinic. Many of them are actually eating pretty well. They are exercising to some extent. They’re intelligent women who understand health and know broadly what they should be doing, and yet they are frustrated because their body suddenly seems to be playing by a completely different set of rules. The things that worked in their 20s and 30s don’t necessarily seem to be working in their 40s and 50s.
The truth is, your body is changing. But is cortisol really the thing causing your menopause belly? The answer is much more nuanced than that.
Cortisol matters, but cortisol isn’t the enemy
Cortisol gets a terrible reputation. We call it the “stress hormone”, and somewhere along the way that has become interpreted as cortisol equals bad. But we actually need cortisol. It plays an important role in how our body responds to stress and is involved in glucose metabolism, blood pressure, inflammation and energy regulation. It also naturally rises and falls throughout the day.
In fact, cortisol is normally higher in the morning and lower later in the day. It follows its own circadian rhythm rather than simply appearing whenever we’re “stressed”.
So I don’t want women becoming frightened of cortisol. I certainly don’t want you finishing this article believing that every stressful day, hard workout or difficult meeting is making your stomach bigger. That’s just another thing for women to worry about, and we’ve already got enough of those.
What we need to understand instead is what happens when stress becomes part of a much bigger picture.
Because your body really does change in midlife
One of the frustrations I hear is, “I haven’t changed what I’m doing, so why has my body changed?” This is important because, as we move through perimenopause and menopause, changes in oestrogen affect where our bodies are more likely to store fat. Rather than carrying as much around the hips and thighs, there is a greater tendency towards abdominal and visceral fat.
At the same time, we naturally begin to lose muscle as we age, particularly if we aren’t actively doing something to maintain it. Research supports exactly what many women are seeing in the mirror: menopause is associated with a shift towards greater central and visceral fat, while ageing brings changes in muscle mass and metabolism. (Mayo Clinic)
So no, you aren’t imagining it. But equally, there isn’t one single hormone we can blame. Menopause, ageing, activity levels, sleep, nutrition, muscle mass, stress, genetics and metabolic health are all interacting. This is why I don’t believe in looking at a woman’s stomach in isolation.
We also need to talk about insulin resistance
This is another piece of the puzzle that deserves attention during midlife. Insulin’s job is to help move glucose from our bloodstream into cells where it can be used for energy. When we become more insulin resistant, our muscle, liver and fat cells don’t respond as effectively to insulin, meaning the body often has to produce more of it to manage blood glucose.
Menopause can influence this too. Declining oestrogen is associated with changes in body-fat distribution and may also contribute to worsening insulin sensitivity in some women. More recent research is increasingly describing perimenopause as a period of metabolic vulnerability, with changes in visceral fat, lean muscle and insulin sensitivity sometimes occurring even without a dramatic change on the scales. (PubMed)
That doesn’t mean that every woman with a menopause belly is insulin resistant. It means we need to stop trying to reduce midlife weight gain to one simple explanation because, again, we need to look at the whole woman.
This is where stress becomes interesting
When I’m working with a woman, I’m often less interested initially in asking, “How do we get rid of this belly?” and more interested in asking where the stress is actually coming from.
Picture the woman I work with. She may be running a business or managing a demanding career. She’s generally the rock of her family and she’s remembering the appointments, the school dates, the things that need buying, the plans for the weekend and the messages she hasn’t replied to. She’s answering WhatsApps from school, business, friends, family and communities. She might be thinking about ageing parents while simultaneously worrying about her children.
She’s possibly not sleeping properly. Her hormones are changing. She may be experiencing brain fog, anxiety, lower energy or changes in confidence, and despite all of that, she’s still expecting herself to operate at exactly the same level she always has.
Then she notices she’s gaining weight and, almost without thinking, she adds another job to the list: fix my body.
Now she’s scrutinising what she’s eating, looking in the mirror, squeezing in another workout and standing on the scales wondering why they haven’t moved. She’s feeling guilty because she hasn’t trained enough and telling herself she needs more discipline or more willpower. Suddenly everything she is doing in an attempt to become healthier has become another pressure her mind and body have to manage.
That is the piece I think we’re missing when we tell women simply to “lower their cortisol”.
This is where nervous-system work matters
Not because five minutes of breathing is somehow going to magically melt abdominal fat. It isn’t. But because stress influences so many of the things around it.
Stress can affect sleep. Poor sleep affects energy. Low energy can affect how much we move. Being exhausted changes the choices we make around food. Feeling overwhelmed can lead us towards wine, food, scrolling, caffeine or simply pushing ourselves harder.
Poor sleep itself can influence appetite and food intake. Studies looking at sleep restriction have found changes in eating behaviour and increased calorie intake, particularly later in the day, and sleep difficulties are already incredibly common through menopause.
So it becomes a web. Stress affects sleep, sleep affects energy, energy affects movement and our capacity to make good choices. Menopause changes body composition and fat distribution. Losing muscle affects metabolic health, and then feeling uncomfortable and frustrated with our changing body creates more stress.
Round and round we go.
That is why I don’t believe the answer is to tell a stressed woman that she just needs to do another thing to fix herself.
You probably don’t need more abdominal exercises either
When our stomach changes, the natural reaction is to attack the bit we don’t like. More sit-ups, more cardio, eat less, train harder. But one of the biggest conversations we need to be having with women from 40 onwards isn’t actually about burning calories. It’s about muscle.
As we age, maintaining and building muscle becomes increasingly important. Resistance training has been shown to improve strength and physical function in postmenopausal women, and it needs to be part of the conversation around long-term health, not simply something women do because they want more toned arms.
I also believe we need to stop assuming we should train exactly as we did in our 20s. That doesn’t mean women over 40 should stop lifting weights or avoid challenging exercise. Quite the opposite. Strength becomes incredibly important. But it does mean learning to work with your body rather than constantly pushing against it.
There may be times when you feel strong and capable of doing more and there may be times when your energy, recovery, sleep or menstrual symptoms tell you something different. For women who still have a menstrual cycle, that can mean becoming much more aware of how they personally feel through different parts of the month rather than blindly following the same programme every single week.
And when periods become irregular or disappear altogether in menopause, we need another way of understanding how to train and recover. That is a whole conversation in itself, and one I’ll come back to separately.
Food matters, but that doesn’t mean eating less and less
The other thing I want women to move away from is the assumption that every changing body needs more restriction. Particularly when you’re exercising, strength training and trying to maintain muscle, your body needs to be properly fuelled.
Protein becomes especially important because preserving muscle is part of protecting our strength, function and metabolic health as we age. For me, that means thinking about protein across the day and including a good source with meals rather than surviving on coffee until lunchtime and then wondering why you’re exhausted, ravenous and reaching for everything in sight later.
I also don’t want women frightened into thinking they must train fasted because somebody online told them fasting burns more fat. Current research comparing fasted and fed resistance training doesn’t show a clear advantage for muscle or strength either way, and the evidence is still limited. (PubMed)
So again, there isn’t one universal rule. I am much more interested in whether the woman in front of me is properly nourished, recovering, building muscle and actually has enough energy to live her life.
But sometimes she is already doing all of that
And this is where my work goes deeper.
I can give a woman information about food. I can tell her about protein. I can talk about sleep, resistance training and recovery. But what if she’s already doing most of those things? Or what if she knows exactly what she should be doing but repeatedly finds herself doing the opposite?
Then we have to look underneath the behaviour.
Is her self-worth tied to achievement? Does she believe resting means being lazy? Is she looking after everyone else before herself? Does she feel guilty prioritising her own needs? Does overwhelm automatically lead to food, wine, scrolling or working even harder? Does she continually tell herself she’ll slow down once everything else is finished, except everything is never finished?
That’s where transformation stops being simply about knowing what food to eat or what exercise to do. We need to understand the patterns, beliefs and emotional responses that may be unconsciously driving the behaviour in the first place.
You can give somebody the perfect plan, but if the person underneath that plan still believes she has to earn rest, keep everybody happy, be everything to everyone and constantly achieve in order to feel good enough, eventually those patterns will find their way back in.
So is cortisol causing your menopause belly?
Not on its own, and that’s actually good news because you don’t need another hormone to fear or another part of your body to battle.
Instead, look at the bigger picture. Look at how well you are sleeping, whether you are eating enough nourishing food, whether you are getting enough protein across your day, whether you are maintaining and building muscle, moving regularly, fuelling yourself properly rather than constantly restricting, and whether you are actually recovering from your exercise.
Then look at what is happening outside of food and exercise too. Are you running on empty? Is your life permanently operating at a level of urgency? Are you always the one carrying the mental load? Are you continually putting yourself at the bottom of the list? And underneath all of that, what patterns may be keeping you there?
Cortisol isn’t your enemy, and your changing body isn’t your enemy either. But your body at 45 or 55 isn’t necessarily going to respond in exactly the same way it did at 25.
Perhaps menopause isn’t asking you to fight your body harder. Perhaps it’s asking you to understand it better, fuel it differently, train it differently, protect your muscle, prioritise recovery, understand your metabolic health and look underneath the behaviours at what is really driving them.
So yes, let’s talk about cortisol. But let’s stop trying to blame one hormone for everything that’s happening in a woman’s body, because the answer was never going to be that simple.
And neither are we.
Book a complimentary call to discuss your own concerns
With love,
Zoë x
Women’s Transformation Architect
Creator of The HER Method™
