After the skin, your liver is your second largest organ. When my own symptoms were overwhelming me during menopause and I was putting on a lot of weight, I never gave my liver a thought. Nor it seems did any of the Health Professionals I visited at the time.
For decades , my beliefs were informed through the New Zealand fitness industry and the personal training industry that I founded for global fitness giant, Les Mills, that the key to weight loss was doing lots of exercise, including weight training to ‘burn calories’.
But when I became overweight in menopause, these beliefs were shattered. No amount of exercise was helping me lose weight. In fact, I had never felt more exhausted or unhealthy and sore.
That’s when undertaking my doctoral studies on women’s health and ageing changed the way I viewed both weight loss and menopause. An article about the high incidence of liver disease in menopause, by Duke University liver-health researcher, Dr Carla Brady, changed my life, and now, the lives of thousands of women who join me on the MyMT™ programmes.
It was this research that led me down the path of the liver and how it ages during and after menopause, especially, the liver mitochondria.
Your mitochondria are important in the liver. They are the primary site of energy metabolism and as you move through menopause, not only does the health of your liver alter the mitochondria, but so too, does the natural ageing of the liver. This occurs from the age of 45-50 years on.
I talk about the specific nutrients that your ageing liver needs, not only in my private coaching community, when women join any of my 12 week programmes, but also on the Certified Practitioner Course, where I focus on evidenced lifestyle science strategies.
Your liver health may be more important than you think as you navigate menopause, especially if your hot flushes are bothering you or your sleep is still challenging for you, or your weight is creeping up, whether you are on HRT or not.
New research in liver-ageing and longevity helps us to make sense of the nutrients we should be adding to our diet, something that I focus women on in the MyMT™ programmes.
The ageing of our organs offers a 'perfect-storm' when menopause arrives.
Biological ageing is also known as senescence. This term more accurately depicts the processes occurring when there is a loss of specific mechanisms that, throughout our lifetime, have regenerated and helped to maintain our health.
One of the positions that I’ve taken over the past decade since completing my health and ageing studies, is that menopause and symptoms, including weight gain, need to be seen in the context of biological ageing of women – afterall, menopause is the stepping stone into the next phase of our life, our years beyond menopause.
With this view, we can better understand that the liver, as one of the largest organs in the body, is also affected by menopause hormonal changes, or in other words, senescence. Your liver is ageing and changing.
As Dr Brady states,
“There is an interplay of hormonal issues and ageing that create a unique path for development of liver problems and liver disease in menopausal women, making chronic liver disease a significant burden on women’s health in their post-menopause years.” [Brady, 2015].
Through her work, I discovered how the liver and gall-bladder (if women have one) both change in structure and function as women move towards post-menopause.
Liver tissue is made up of lots of smaller units of liver cells called lobules. Many canals carrying blood and bile run between the liver cells. Blood coming from the digestive organs flows through the portal vein to the liver, carrying nutrients, medication and also toxic substances.
However, as we move through menopause, the size and function of both the liver and gallbladder are changing.
The liver shrinks in size and it’s blood flow slows. Enzymes which break down amino acids (proteins) and substances such as alcohol, are also declining.
The gall-bladder also produces less bile. Bile is the substance that helps to emulsify or break down fats. We have around 20% less bile being produced as we move through menopause. By the time women are 65 years old, this decreased production of bile may reach as high as 40%. (Brady, 2015).
Therefore, if your diet is high in fats (including animal fats), then your gallbladder cannot cope with the volume of fats that it has to emulsify.
Understanding that the liver is the hero in the story of your mid-life weight loss, energy and health as you age is important, especially for your energy levels and weight loss.
Liver Health and Quercetin
Our health chaos arrives slowly. And menopause is the ‘perfect storm’ for these changes.
Not sleeping, poor temperature regulation, changing weight, high total and LDL cholesterol, bloating and joint pain may send us into further health chaos as we move through menopause and into our post-menopause years. This is why I also developed the Beyond Menopause programme.
Whilst the focus is usually on cardiac health when we visit our Doctor with changing cholesterol and weight during menopause (which it should be), how many of us are being told that our liver health matters too? I will let you reflect on that.
In both of the foundation MyMT™ programmes, I have an entire 1 hour podcast/webinar devoted to the scientific evidence about how to turn around your liver health in a way that helps to rejuvenate your ageing liver.
The liver is the only organ that is ‘adaptogenic’ which means that it heals and repairs, but we need to achieve this in a systematic way over at least 6 weeks.
For example, food based nutrients continue to be investigated for their role in changing metabolic pathways involved in the detoxification process not only in the liver, but throughout our body (Hodges & Minich, 2015).
One of these nutrients is Quercetin. (Sotiropoulou, et al., 2021)
Quercetin is a bioflavonoid existing in green vegetables, onions, the skin of red apples, green tea, citrus fruits and red grapes (including wine). Most importantly, quercetin is present in purple berries, especially blueberries.
This powerful nutrient helps to protect the liver by reducing inflammation and improving mitochondrial function through multiple mechanisms.
With a lens on mitochondrial function, where your energy is produced, quercetin promotes mitophagy (the removal of damaged mitochondria) and enhances mitochondrial biogenesis (the creation of new mitochondria).
For those of you who are struggling to lose weight, your liver mitochondria and energy production in the liver, matters in menopause and post-menopause, especially if you are doing a lot of exercise which requires your liver to turn over more glucose than normal to fuel your muscle demands for exercise. If your liver is unhealthy, then this metabolic pathway may become dysfunctional and you end up putting on more and more weight.
Once we understand the metabolic pathways that help to rejuvenate our liver, we have the ability to turn around our energy, weight, cholesterol and bloating at this time of life. As I discovered myself, if we are going to change our health and manage our weight as we age, then the liver is the organ to focus on first.
This means that we have to learn how to make some lifestyle adjustments to accommodate these changes. Otherwise our weight gain creeps on and on as the years advance.
With increased weight gain, both cardiac and metabolic health may change as we move into post-menopause. For too many women, what ensues is frustration and confusion about their blood work, as, instead of feeling healthy and vibrant, they may feel exhausted.
Health and medical researchers already know from research on our mother’s generation, that weight gain around the trunk at this time of life sends women into post-menopause heart disease, obesity and Type 2 diabetes.
For many women putting on a lot of belly fat, or if you have the ‘hard-fat’ sitting around your abdomen, then please try to come on board into my ‘Menopause Weight Loss Program .
Why is it 3 months? Because that’s how long it takes for you to turn around your liver, reset your hormones for your ageing and discover how to change your nutrition, sleep and exercise habits so that you thrive at this stage of life. I hope you can explore how the MyMT™ programmes and support can help you.
References:
, , , , , , , and (2020) Nonalcoholic fatty liver disease burden: Australia, 2019–2030. Journal of Gastroenterology and Hepatology, 35: 1628– 1635. https://doi.org/10.1111/jgh.15009.
Armeni E. et al. OR25-02. Presented at: ENDO annual meeting; June 1-4, 2024. Hot Flash Severity Predicts Metabolic-Associated Liver Disease.
Bansal R, Aggarwal N. Menopausal Hot Flashes: A Concise Review. J Midlife Health. 2019 Jan-Mar;10(1):6-13. doi: 10.4103/jmh.JMH_7_19. PMID: 31001050;
Brady CW. Liver disease in menopause. World J Gastroenterol. 2015 Jul 7;21(25):7613-20. doi: 10.3748/wjg.v21.i25.7613. PMID: 26167064.
Le Couteur, D.G., Ngu, M.C., Hunt, N.J. et al. Liver, ageing and disease. Nat Rev Gastroenterol Hepatol 22, 680–695 (2025). https://doi.org/10.1038/s41575-025-01099-z
Preedy, V. & Patel, V. Eds. (2020). Aging – Oxidative Stress and Dietary Antioxidants. 2nd Ed. Academic Press: London, UK
Sotiropoulou M, Katsaros I, Vailas M, Lidoriki I, Papatheodoridis GV, Kostomitsopoulos NG, Valsami G, Tsaroucha A, Schizas D. Nonalcoholic fatty liver disease: The role of quercetin and its therapeutic implications. Saudi J Gastroenterol. 2021 Nov-Dec;27(6):319-330. doi: 10.4103/sjg.sjg_249_21.
