Women's Metabolism: Health, Hormones, and Healthy Aging

1. Hormonal Decline: Women enter menopause, ceasing hormone production, while men only reduce production, without a comparable "andropause."
2. Muscle Mass: Women naturally have less muscle mass than men, and this mass degrades more quickly with age, leading to sarcopenia. Since muscles are responsible for our energy expenditure, less muscle means a slower metabolism.

A slow metabolism can cause more than just weight gain: it affects nail and hair growth, intestinal function, memory, sleep, and increases the difficulty of losing weight.

Beyond Weight: Understanding Health and Disease

It's a myth to think that being overweight is merely an aesthetic issue. Dr. João Ricardo Aguiar emphasizes that overweight and obesity are diseases that significantly increase the risk of heart problems and various types of cancer. Even with normal laboratory tests, a person is already at risk, and changes in tests usually appear when the disease is already advanced.

Similarly, thinness is not synonymous with health. Underweight individuals can have high cholesterol, diabetes, or low lean mass, which also indicates a health problem.

Eating Disorders: Binge Eating and Anorexia

Among the most common eating disorders are binge eating disorder and anorexia. Binge eating, characterized by repeated episodes of excessive food intake, is usually linked to weight gain and a feeling of loss of control. Anorexia, on the other hand, is more common in young people and in professions that require a specific weight, or in people with body image distortion.

Treatment for these disorders is multidisciplinary, involving endocrinologists, psychologists, and psychiatrists, as they are often associated with other problems such as anxiety and depression.

Female Hormone Replacement: A New Perspective

Hormone replacement is a topic that still generates many questions, but the doctor explains that it is a necessity for modern women. In the past, women had more children and menstruated less. Today, with greater longevity and fewer pregnancies, women menstruate much more, and their eggs deplete earlier. Replacement, therefore, aims to improve the quality of life for menopausal women who are active and productive.

The benefits are vast: more energy, better muscle mass, improved sleep quality, libido, self-esteem, and reduced anxiety and depression. The idea that your grandmother didn't need hormones doesn't apply, as they lived in a different biological and social context.

Attention to the term "bioidentical": Dr. João Ricardo clarifies that this term is a marketing appeal and has been proscribed by the Federal Council of Medicine. Testosterone is testosterone, and the difference is merely misleading advertising.

Contraceptives and Menstruation

When using hormonal contraceptives, women are not actually menstruating, but rather experiencing withdrawal bleeding. The choice to bleed or not is personal and does not impact ovulation, which is already inhibited. Various contraceptive options are available to meet individual preferences.

Hormone Therapy for Transgender Women

For transgender women (XY individuals who identify as XX), hormone replacement should be started as early as possible to feminize the body, promoting breast development and other feminine characteristics. It is crucial that exams like mammograms and Pap tests (if transition surgery has occurred) are performed. However, the doctor must also monitor biological male organs, such as the prostate, as the transgender individual still carries their biological formation. The SUS (Brazil's public healthcare system) already offers treatment and support for transsexuality, recognizing the importance of adequate follow-up due to the high suicide rate in this population.

Nutrition and Physical Activity: Your Essential Allies

For a healthy life, nutrition is fundamental. Dr. João Ricardo advocates for the "farmer's market diet": natural foods, with protein present in all three main meals (breakfast, lunch, and dinner). Carbohydrates are an energy source but should be combined with protein. The Brazilian dietary pattern, rich in carbohydrates at breakfast, for example, is inadequate.

If it's difficult to reach the necessary amount of protein, protein supplements such as Whey Protein (milk whey protein), albumin (egg protein), or meat protein can be allies. Protein deficiency causes loss of lean mass, affects hair and blood, and is a risk, for example, for those who use weight loss pens without supervision, leading to hair loss.

Intermittent Fasting and Caloric Deficit

Intermittent fasting is not a magic formula. What leads to weight loss is a caloric deficit, meaning consuming fewer calories than you expend. Fasting helps reduce the eating window, but if there's excessive consumption during that period, there will be no weight loss. The body is smart: when losing weight, it increases hunger and reduces energy expenditure to protect itself, which makes maintaining lost weight difficult. Therefore, changing habits is crucial.

Exercise: Muscle Contraction is Key

Physical activity is essential. For seniors, the most important thing is not lifting heavy weights, but rather resistance training with load, which can be done with resistance bands, light weights, or even bags of rice at home. The essential element is muscle contraction. Aerobic exercise is important for weight loss in those who already have lean mass, but it does not replace strength training for muscle maintenance and gain.

Allergies, Intolerances, and the Dangers of the Internet

Food allergies and intolerances are more commonly diagnosed today, perhaps due to increased attention and the growing consumption of ultra-processed foods. Dr. João Ricardo differentiates:

• Intolerance: Bloating after eating, usually due to a lack of digestive enzymes (e.g., lactose intolerance).
• Irritability: Diarrhea or constipation (e.g., Irritable Bowel Syndrome).
• Allergy: Symptoms like itching.

Precise diagnosis is made by a doctor and may require specific tests, with treatment involving the exclusion of the food from the diet. Medicine evolves, and what was not studied before is now a reality.

Beware of "Weight Loss Pens" and Online Charlatanism

Weight loss pens are fantastic tools for doctors who know how to prescribe them, but they have become a danger in the hands of those seeking self-medication. Without professional supervision, improper use can lead to serious problems, and counterfeits are abundant in the clandestine market.

The doctor vehemently warns against online charlatanism. Many "specialists" offer "recipes for success" and miracle cures without scientific evidence. Always seek serious professionals who don't promise magical solutions but rather possibilities and personalized guidance.

Vitamins and Anabolics

Most essential vitamins and minerals can be obtained through a balanced diet, with the exception of vitamin D, which usually needs to be supplemented due to lack of sun exposure. Vitamins C and B12 may also require supplementation in specific cases (intense training, vegetarians/vegans, post-bariatric surgery). An excess of certain vitamins, like D, can be harmful.

As for anabolics, their use in women is dangerous, as it accelerates undesirable processes such as hair loss, oily skin, and hair growth, in addition to greater health risks. Their use is restricted to specific groups, such as athletes, and always with strict medical supervision.

Myths and Truths About Metabolism

To debunk popular beliefs, Dr. João Ricardo Aguiar responded:

• Does eating carbohydrates at night make you gain weight? Myth. It depends on your total daily caloric expenditure.
• Do thin people always have a fast metabolism? Not always.
• Can very severe caloric restrictions slow down metabolism? Truth. The body perceives the reduced intake and lowers expenditure.
• Do some foods speed up metabolism and help with weight loss? Truth. But they are only auxiliary, not the main solution.
• Can overweight people indeed have a fast metabolism? Truth. This indicates they are consuming far more calories than their body expends, even with an active metabolism.

The Secret to Aging Well: Preservation and Discipline

To age healthily and without worries, the key is preservation and discipline. Take care of your body today: avoid pollutants, tobacco, excessive alcohol, sleep well, and stay active. Don't put off self-care for "later," because time doesn't turn back.

Discipline means doing what needs to be done, even without desire. Controlling your mind is fundamental to maintaining healthy habits. When seeking professional help, look for serious doctors who offer treatment possibilities, not "milacles." Remember: prevention in medicine is everything, and every year of your life counts towards a healthier and more fulfilling future.