As they go through the transition into menopause, many women find themselves gaining weight. Women may find that it suddenly seems harder to maintain a healthy body weight, and they gain stubborn fat that’s very difficult to lose. Because estrogen levels are declining rapidly around the same time, many women wonder whether it’s the hormonal changes that might be causing them to have this issue.
What are the effects of estrogen on body weight? Is there evidence for changes in estrogen causing weight gain? Or is hormone replacement therapy actually to blame – for example, can Premarin cause weight gain?
Can low estrogen cause weight gain?
Around the time of menopause, levels estrogen in females drop dramatically. Women often experience a variety of symptoms, from hair loss to anxiety. During this time, it’s common for women to experience increases in the amount of fat tissue in the body. The distribution of fat also commonly changes. Women often have a tendency to gain weight around the hips and thighs before menopause, but after menopause, it shifts to around the midsection, especially on the abdomen.
Researchers believe that this is for a variety of reasons. One is the direct effect of certain types of estrogen, especially estradiol, on metabolism and on the distribution of fat tissue in the body. Estrogen may also impact the microbiome, or the balance of bacteria in your gut, which can have effects on body weight. The changes in estrogen during the menopausal transition also tend to interfere with sleep, and lack of sleep can lead to weight gain.
In addition, the aging process itself causes people to have a slower metabolism as they get older. They often lose muscle mass, and become less physically active than when they were younger. What and how much people eat often also changes as they get older. These factors can also contribute to weight gain around menopause.
If you’re not sure whether you’ve entered perimenopause (the period of time before you go through menopause, when hormone levels start to shift), then you can take a blood test to measure your levels of various hormones. You can go to your doctor and ask for this test, or you can get a home test kit for more convenience. If you prefer a home test kit, make sure you choose a service that uses accredited laboratories for testing, so you can trust your results.
Is there weight gain with hormone replacement therapy?
Hormone replacement therapy, or HRT, can be used to help manage the symptoms that occur during menopause. Some women worry that taking HRT will cause them to gain weight. The origin of this idea is likely that many women tend to gain weight around menopause. If they take HRT, they may attribute the weight gain to the HRT, when in fact it was menopause itself – and the aging process in general – that actually caused them to gain weight.
In fact, studies have shown that HRT actually helps to reduce the amount of weight gain during menopause, and may even help to promote weight loss. So for women who are wondering whether HRT will cause them to gain weight, the answer is that it’s very unlikely.
What are the best estrogen supplements for weight loss?
When women learn that HRT may help to reduce weight gain and even promote weight loss, many become very interested in taking estrogen for weight gain, to help them lose those stubborn extra pounds. There are many estrogen supplements out there that promise to help you achieve your weight loss goals.
However, there’s simply no evidence that most of these products work – despite the slick marketing videos that imply that there is. Not only is taking a supplement very likely to be a waste of money, but it can even be dangerous in some cases. If you do decide to try a weight loss supplement, make sure you bring it up with your doctor, in case it may interact with your prescription medications or exacerbate any health problems you may have.
In addition, although HRT may help with weight gain and other symptoms of menopause, it can also come with risks for many women, including an increased risk of stroke, heart attack, and breast cancer. It’s important to discuss the risks and benefits of hormone replacement therapy with your doctor in order to decide if it’s right for you, and to choose the right type and dose.
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Dietary Supplements for Weight Loss. National Institutes of Health. https://ods.od.nih.gov/factsheets/WeightLoss-HealthProfessional/#en11. Accessed 6 July 2022.
Greendale GA, Sternfeld B, et al. Changes in body composition and weight during the menopause transition. JCI Insight. 2019 Mar 7;4(5):e124865. doi: 10.1172/jci.insight.124865.
Hormone therapy: Is it right for you? Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/menopause/in-depth/hormone-therapy/art-20046372. Accessed 6 July 2022.
Menopause weight gain: Stop the middle-age spread. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menopause-weight-gain/art-20046058. Accessed 6 July 2022.
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