Intermittent Fasting for Active Menopausal Women | Yes or No?

For active menopausal women, wondering, if intermittent fasting is right, this is for you. Because, let’s face it, we’re not immune to weight gain or belly fat. And your exercise needs may have changed while your habits have not.

I’m not going into optimal exercise & protein habits a great deal today (though I am in an upcoming Masterclass and I’ll put the link in the show notes so you can join me on June 9 for: Muscle Gain, Not Fat Loss for Older, Stronger, Slimmer).

IF Again? 

I’ve covered Intermittent Fasting (IF) at Flipping 50 for years. You can search on the site to find the blogs and podcasts already there. I’m doing this update though because as we head into summer, we all tend to be far more active.

I don’t want your summer fun sabotaged.

This is going to start off quite science geek. Hang in there.

It comes down to kisspeptin, is a neuropeptide that’s responsible for sex hormones and endocrine and reproductive function, which also plays a significant role in maintaining healthy glucose levels, appetite regulation, and body composition. It’s more sensitive in women than men. When it’s disrupted, our sex hormones aren’t produced and released the way we need them to be. [Stacy Sims,]

Intermittent fasting and keto both disrupt kisspeptin production. When your brain perceives you have a deficiency in nutrients, especially carbohydrate, women have a marked reduction in kisspeptin stimulation, which not only increases your appetite*, but also reduces your sensitivity to insulin.

*The increase in appetite may not happen from Intermittent Fasting (IF) alone, but from combination of “more” exercise and IF, especially if you’re restricting calories. IF science is NOT about caloric restriction, but a restricted eating window. However, that is often not what happens.

We’re Different 

Research shows intermittent fasting is more likely to cause impaired glucose intolerance in women, but not men.

What happens when you layer exercise stress on top of the stress of denying your body fuel? Stress hormones like cortisol rise even higher. As you keep increasing that stress, it keeps your sympathetic drive high and reduces your ability to relax. As a result, your thyroid* activity is depressed, which will disrupt your menstrual cycle if you’re still cycling or cause more symptoms if you’re in menopause.

Your body also starts storing more belly fat.

*normal test results, and typical lab tests are not enough information for thyroid – know what you want to test and interpret “optimal” levels with a health coach or a functional doctor

Unintentional Mistakes You May Make

What happens when you do an interval training session, then a strength training session, then go for a long walk? You’ve made high intensity anaerobic work an endurance event. That’s problematic, especially if you fail to eat.

As a woman in midlife, you’re more sensitive to endurance exercise’ having negative effects on cortisol. You decrease benefits of the HIIT, and the muscle boosting benefits of strength training since cortisol breaks down muscle and causes fat storage. You may be sabotaging your results.

If you’re a “more is better” thinking woman, you may struggle with weight loss because the “additive nature” of stringing all that activity together is not the same as a regular frequency dose. You would never take an entire bottle of vitamins or prescription medicine at once, right?

So now you’re likely to experience disrupted menstrual cycles, higher anxiety and stress, impaired (exercise) performance and often weight gain—not what you signed up for?!

But Diets Work for Some Active Menopausal Women?

Sometimes women will contend that these diets work so well for them. And they might for the first few weeks or months, because nearly any diet will yield some effects in the short term. The long term effects for female athletes, however, is endocrine dysfunction, increases in abdominal fat, more depression, and a backlash of subsequent fat gain.

Female athletes perform far better in a fed state. Female athletes need to eat.

If you intentionally exercise 3-5 days a week with a desired result, you qualify as an “athlete.” There does not need to be a registration fee or starting line. Active menopausal women for the most part are exercising enough to qualify as “athletes.”

Mental Flip

Keep something in mind when you see athletes or models that “appear”  thin or have bodies you envy. Many figure competitors, endurance sport female athletes, and models have thyroid, and infertility issues. Many drive themselves to adrenal fatigue.

Health isn’t their goal. Working, participating, or winning competitions is.

Women who want “thin” or are desperate for “weight loss” can fall into the same trap. Abandoning health for temporary weight loss often brings fat storage with a vengeance. Thinking, “when I lose the weight” then I’ll change, never works. What got you here will never get you there.

Safe Fasting guidelines recommended for all (except those with adrenal fatigue).

  • 3 Meals no snacks, and a minimum 12-hour overnight fast.
  • For women, the first meal should be high protein, lower in carbs and occur in the morning hours.

Beyond this, whether you’ll benefit depends a great deal on your current status.

  • Gradually increase the overnight fast to 13, 14, or up to 18 hours keeping in mind morning meals.

There is a difference between fasting and keto. Anything with calories breaks a fast. Consuming fats can keep you in ketosis where the premise is to burn fat.

An alternative to IF timing:

Alternating days of lower calories with days of higher calories is sometimes suggested. Those lower calorie days should be on low exercise days. However, the 24-hour period after a challenging HIIT or strength training workout should be plentiful in protein to benefit muscle protein synthesis and repair.

If IF options begin to feel like a “diet” and you’ve crossed a threshold where the energy reserves are low enough your body’s stress adaption kicks in, fat storage is more likely. You can’t both store and burn fat.

NOTE: Caffeine elevates cortisol and can also spike blood sugar. In midlife, more susceptibility to stress and cortisol may make “nothing but coffee” ‘til noon a fat bomb.

Recall that as mentioned, the body sensing low fuel reserves will increase cortisol, and fat storage.


During menopause insulin sensitivity commonly decreases (making you more insulin resistant) and may be encouraged by IF and or keto alone and amplified when combined, especially in active menopausal women.

Other Solutions:

Mediterranean Diets tend to be easy to stick to, and support heart health, as well as optimal weight. I recently interviewed Dr Steven Masley where we discussed it. 


Effects of intermittent fasting on health, aging, and disease. de Cabo R, Mattonson MP. New England Journal of Medicine, December 2019.

Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical TrialJAMA Internal Medicine, May 2017.

Alternate-day fasting in nonobese subjects: effects on body weight, body composition, and energy metabolismAmerican Journal of Clinical Nutrition, January 2005.

The Obesity Code, by Jason Fung, MD (Greystone Books, 2016).

Intermittent fasting interventions for treatment of overweight and obesity in adults: a systematic review and meta-analysis. JBI Database of Systematic Reviews and Implementation Reports, February 2018.

Metabolic Effects of Intermittent FastingAnnual Review of Nutrition, August 2017.

Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with PrediabetesCell Metabolism, May 2018.

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8 thoughts on “Intermittent Fasting for Active Menopausal Women | Yes or No?”

  1. Alice E Putney

    I am always so confused with differing opinions on IF for menopausal women. Just watched podcast with Dr. Mindy Pelz author of “The Menopause Reset”. She promotes IF for women and promotes not eating until late morning, i.e. 11 AM. Your advise is don’t skip breakfast. Well I work out at 9 AM, not sure if I should work out fasted or have breakfast before.

  2. Debra Atkinson

    Breaking your fast will reduce your cortisol and elevate your blood sugar so you can exercise harder, and or perceive it is not as hard. What you feel is “hard” in a fasted state is often slower, less weight and therefor reduced intensity. If you are exercising hard regularly studies show either more effort and energy expended or the same during exercise fed, not fasted – all ages. Cortisol is high in the morning (peaks at 8). Exercise increases cortisol further. Cortisol breaks down muscle tissue. Women in menopause are already more susceptible to negative effects of stress with less estrogen to stimulate muscle. Fasting can work, but turning the dial so you stop eating sooner so you can still fast(always having a high protein meal right before beginning that fast if you struggle with muscle tone), and eating something prior, and a high protein meal immediately after if it’s your first full meal. Check podcast with Dr Felice Gercsh here on fasting and when to break the fast. (search icon) If you’re an active woman exercising regularly without results – let your body tell you – it’s data. Is it working for you?

  3. Gabriela Benfeito

    What if I feel like I have more energy for my workouts before I eat, am I still causing damage??

  4. Hi Gabriela,
    Track it. If you have always worked out this way – what has happened to your body composition? The numbers don’t lie. What has happened with body fat, lean muscle in pounds? And measuring your cortisol (saliva testing is gold standard) can also be helpful to know… if you’re not getting results, you’ve got a benchmark. Make a change. Track it and retest. Test, don’t guess. A Smart Scale is a must.

  5. Now I am even more confused about intermittent fasting. Felice says the body is made to eat during the day, in the morning. However all the research on intermittent fasting says it is good for longevity, etc. And she also says to lose weight you should exercise on an empty stomach and then eat. But you say, Otherwise.

  6. Debra Atkinson

    Great questions. Fat burning is not improved fasting vs fed in menopausal women. (according to research) SO, if you are stressed, finding fat deposits in belly and life is throwing you curve balls, you’re going to do better by STOPPING the breakdown of muscle prior to exercise if it is intense at all. Can you easily go for a walk or do yoga without? Probably, yes.
    But here’s what is MOST important.
    1) is what you’re doing now working? Are you getting results you want?
    THEN.. it is or isn’t working.
    2) TEST you. It’s the only way to know. Fasted is fasted.. no calories and no artificial including stevia sugar. But I would test.. using a CGM ( if possible so you know what your Blood sugar is before, after, and after hour by hour with exercise and with food.
    Muscle breakdown… from fasting, from stress + exercise… means all you may be doing is trying to break even. The best goal is to increase muscle. Burning fat is illusive. You CAN successfully gain muscle (and or stop losses) with the right habits.

  7. Debra Atkinson

    YES.. you are absolutely (as women especially meant to EAT) that simply means you start fasting at 5pm instead of 8.. as most programs suggest. And remember INTERMITTENT… doesn’t (and won’t necessarily help your metabolic flexibility) if you do the same thing daily. So.. do it 3 days a week or 5 and not on weekends… so it fits your lifestyle.

    Personally, I prefer to be done eating by 5 ish.. I am up early, so only fast about 12 hours most days. If I want a longer fast.. It’s going to happen only if I have a fasted blood test (LOL!) OR.. I’ll eat at 3 for the last time if I have the ability. Then if I’m breaking fast at 5 or’s still 14 ish hours. My body begins to burn carbs (stress mode) after too long.. so this is way better for me.

    TEST …. I also am using a LUMEN to monitor what I’m burning. Easy feedback. And you’ll know .. what exercise moves you back into fat burning and what level of fasting or timing of a fasting window that moves you in or out of fat burning.
    Longevity benefits.. come from any level of fasting. 12 hours overnight and no snacks between meals is a benefit. So… you don’t have to do 18 hours- for some this would be DEVASTING!

  8. Debra Atkinson

    Alice, the bottom line is always… is it working, FOR YOU? And when did you start fasting last night? I shoot for a minimum of 12 hours. (see my response above: you have to test you. is what you’re doing working? are you where you want to be? if not, change and test something else) Cortisol breaks down muscle… so yes, if you eat by 10 or 11.. you should be okay, but exercise in a fasted state may breakdown muscle (harmful to metabolism) so that all you’re doing with it.. is trying to offset negatives of fasting.
    Keep in mind intermittent.. means Not same every day.. as well. You need and want metabolic flexibility. EAT ENOUGH during the window. Reducing eating window and reducing caloric intake… is just DIETING.

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