Can HRT help with menopausal weight gain?

It’s common to put weight on during perimenopause and menopause – can hormone replacement therapy help?

Many women find that they gain weight during perimenopause or menopause. Sometimes there can be no obvious cause – no change in diet, exercise or routine – but other times menopausal symptoms can play their part, for example by affecting motivation or ability to exercise. If you’ve put on the pounds you’ll want to explore possible solutions but first it can help to understand some reasons behind weight gain.

Why does menopause cause weight gain?

During perimenopause, fluctuating oestrogen levels can lead to an increase in body fat, particularly around your tummy. You may also develop cravings for sugary or fatty foods. Symptoms such as muscle and joint pain or vaginal dryness may contribute to you reducing your activity levels, while hot flushes and night sweats can disturb your sleep. Sleep can help to regulate two hormones (leptin and ghrelin) that influence your appetite.

The hormones oestradiol, progesterone and testosterone all help to regulate how your body uses insulin, and low hormone levels can make your body less sensitive to insulin, causing insulin resistance. Insulin resistance is often accompanied by weight gain. Metabolic changes also occur during menopause – lean muscle mass reduces and affects metabolism, for example.

You can book an appointment to speak to a Newson Clinic healthcare professional about your perimenopause or menopause symptoms here.

Can HRT help me lose weight?

If you are experiencing perimenopausal or menopausal symptoms, HRT is usually the first-line treatment to improve both symptoms and improve future health. There is evidence that women who take HRT lose weight as well as improve their metabolism and reduce their future risk of developing type 2 diabetes [1].

A study found that women taking HRT had less visceral fat, lower glucose and insulin levels [2]. Testosterone and weight loss has not been studied in women but it is known that testosterone in men can improve metabolism and reduce weight [3]. In our clinic, many women find that with the right dose and type of HRT, their weight improves and their body shape changes so they lose fat and gain muscle more easily.

Also, many women who take HRT, sometimes including testosterone, find that as their menopause symptoms become more manageable, they feel better and have more energy to look after themselves, exercise and have a healthy diet, which helps with their weight.

References

1. Lovre D., Lindsey S.H., Mauvais-Jarvis F. (2016), ‘Effect of menopausal hormone therapy on components of the metabolic syndrome’, Ther Adv Cardiovasc Dis, 27;11(1):33–43. doi: 10.1177/1753944716649358
2. Bermingham, K. M., Linenberg, I., Hall, W. L., Kadé, K., Franks, P. W., Davies, R., Wolf, J., Hadjigeorgiou, G., Asnicar, F., Segata, N., Manson, J.E., Newson, L. R., Delahanty, L. M., Ordovas, J. M., Chan, A. T., Spector, T. D., Valdes, A. M., Berry, S. E. (2022), ‘Menopause is associated with postprandial metabolism, metabolic health and lifestyle: The ZOE PREDICT study’, EBioMedicine, 85:104303. doi:10.1016/j.ebiom.2022.104303
3. Tchernof A., Després J.P. (2013),’Pathophysiology of human visceral obesity: an update’, Physiol Rev. 93(1):359-404. doi: 10.1152/physrev.00033.2011