What Causes Menopause Weight Gain & What to do About it

On average women gain around 10-15 pounds during the menopause transition. 

But, is there a way to prevent this weight gain?

If it's already happened is there anything you can do to lose the weight?

If you are struggling with weight gain after menopause then this is the article for you. 

We are going to explore all of the reasons why many women gain weight at menopause, what you can do about it, and how to prevent this weight gain from occurring

Let's jump in: 

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Menopause and its Impact on your Body

Every single woman will eventually go through menopause in her life. 

Despite the fact that so many women go through it, many women aren't prepared for the transition or what it means for their body!

So, with that in mind, let's dispel the uncertainty and talk about it in plain English. 

First of all, what is menopause?

Menopause is a state which occurs in the female body which marks a sudden and rapid decline in the sex hormones estradiol and progesterone. 

The sudden decline in these hormones is responsible for all of the symptoms associated with menopause, including weight gain. 

These sex hormones (estrogen and progesterone) are some of the most important hormones in biology because they help define the female phenotype. 

impact of estrogen deficiency at menopause on various tissues in the body

You can imagine why the sudden decline in these hormones cause many problems in the body (1). 

The decline in estrogen predisposes women to osteoporosis (2), weight gain, stroke (3), heart attack (4) and more. 

For our discussion, we are going to be focusing primarily on weight gain, but just realize that much of the information presented here may help with other issues as well. 

So is it an inevitability that you will gain weight during your menopause transition?

Not necessarily, and this is something that we will touch on later in this article.

But first, let's discuss what actually causes weight gain when you hit menopause: 

What Causes Weight Gain at Menopause?

Weight gain at menopause is primarily caused by 3 main categories. 

Understanding these categories is very important because if you understand what is causing weight gain in your body then you can target treatment to those specific issues. 

So, what is actually happening in your body to cause weight gain? 

#1. Genetics. 

The first reason has to do with your genetics (5). 

A good way to determine how you will handle menopause is to talk to your mom or sisters (or other women in your family who have gone through menopause). 

Their experience will probably be a good reflection of what your experience will be like. 

You can't always control your genetics (meaning your mom and dad), but you can actually control some of the expression of your genes through something known as epigenetics (6). 

So, even if it's in your cards to gain weight at menopause doesn't necessarily that you will. 

Certain factors, including behavior factors such as the foods that you eat and how much you exercise, can impact the expression of your genes. 

In this way, you may be able to prevent some of the negative side effects associated with menopause even if you are genetically pre-disposed to them because of your DNA. 

#2. Hormonal Changes. 

The next category, and probably most important, has to do with the changes associated with the menopause transition. 

You already know that your sex hormones are powerful, but what you probably didn't realize is that they impact very important processes in your body including how your body metabolizes and stores fat

And this makes perfect sense if you think about it:

When women gain weight they tend to gain weight in very specific areas on their body. 

They tend to gain weight in the breast area and in the gluteal region. 

This specific pattern of weight gain is promoted by the relative amount of estrogen and progesterone in their body. 

So, using that logic, it's not hard to see why a sudden decline in these important hormones may impact your body weight and how body fat is distributed on your body!

impact of estrogen on fat cells

Estrogen seems to play a very prominent role in the regulation of body fat on women (7), and the decline in estrogen during menopause may be largely responsible for weight gain that many women experience. 

A decrease in estrogen has been linked to the following changes:

  • Changes in metabolism
  • Changes in appetite
  • Adipose inflammation
  • Insulin resistance
  • Development of fatty liver
  • Inflammation and atherosclerosis

In addition to estrogen and progesterone, your testosterone also may take a hit and begin to decline as well. 

Testosterone is important for regulating body weight, muscle mass, and even your mood. 

The moral of the story here is that the decline in these hormones impacts your weight in a positive or negative way. 

#3. External Factors. 

Lastly, other factors can also influence your weight. 

These factors are all of the factors that you would normally consider if you are gaining weight and include how much you exercise, the type of foods that you eat, what medications you are taking, and if you have other medical conditions. 

When you hit menopause it seems that many of these factors can exacerbate the underlying hormone changes that occur and make your weight gain more dramatic. 

This helps to explain why many women gain weight at menopause despite not changing how much they exercise or the foods that they eat. 

Preventing Weight Gain

Have you heard that an ounce of prevention is worth a pound of cure?

This concept holds true for many medical conditions and weight gain at menopause is no different. 

It turns out that the best way to treat weight gain at menopause is to completely stop it from occurring!

But how do you do that? And is it even possible?

The answer is yes. 

Several studies have shown that it's possible to mitigate (8) (or reduce) the weight gain associated with menopause by following a couple simple rules. 

#1. Try to be a normal weight during the menopause transition

Women who are overweight when they transition into menopause tend to gain the most weight compared to women who are a normal weight. 

It's kind of an unfair situation, especially if you are overweight, to begin with, but that's what the studies show. 

It's a lot easier to lose weight BEFORE menopause, so if you are reading this and you haven't hit the transition point yet then you want to focus on losing weight in a healthy way right now. 

If you're reading this and you're already past menopause then you'll want to follow the instructions below. 

#2. Eat healthy foods.  

Eating a healthy diet is another way to prevent weight gain at menopause. 

And by eating healthy I am not referring to a crash diet or fad diet, I am referring to eating a healthy and nutritious diet which is full of fruits and vegetables. 

This is the type of diet which is sustainable and one that you will want to stick to indefinitely. 

#3. Exercise regularly

Lastly, another tip you can utilize is to start up an exercise regimen prior to the menopause transition. 

Exercising can help keep your hormones in balance and prevent excess weight gain when your hormones start to go into flux. 

But what about the people who have already gained weight? 

Well, don't worry...

If you fit into the category where you've already gained your weight then you will want to follow the instructions below. 

Treating Weight Gain

Here is a bit of bad news for women who are post-menopausal:

It's more difficult to lose weight after menopause than before (9). 

Studies have shown that women who lose weight right before the menopause (10) transition have a high risk of gaining their weight back. 

I'm sorry to be the bearer of bad news but it's something you should be aware of because it will help you be successful. 

The hormonal changes that occur during the menopause transition make the fat that is on your body more "sticky"

"Sticky" in the sense that it will want to stick to your body despite your best efforts. 

Much of this has to do with the sudden decline in estrogen and how estrogen impacts fat metabolism. 

As women enter menopause they tend to lose fat in the places they want it (breast tissue and butt area) and gain it in places they don't want it (the belly) (11). 

This redistribution of fat is primarily from the changes of estrogen. 

But just because losing weight is difficult doesn't mean that it is impossible. 

If you find that you have gained a few extra pounds during menopause then you'll want to consider the following treatment options:

  • Consider balancing your hormones with HRT - HRT can help bring your hormones back to normal levels and can be perfectly safe for most people (12). HRT includes the use of estradiol, progesterone, and testosterone in safe physiological amounts. 
  • Exercising regularly with high-intensity interval training and weight training - You'll want to specifically focus on short bursts of high-intensity exercises as these tend to put more demand on your body and help reverse hormone resistance syndromes such as insulin resistance. Strength training also helps to promote muscle mass which can improve your metabolism. Studies have shown that a total of 2-2.5 hours of exercise per week is sufficient to get these benefits! (13)
  • Consume a healthy diet (not a fad diet) - Eating a healthy diet (high in fruits and vegetables) and low in refined and processed carbohydrates may help you normalize your weight. Foods such as bread, pasta, cereal, etc. can all negatively impact your hormones and lead to insulin resistance. You can learn more about which foods to eat and avoid in this post
  • Take certain supplements - Some supplements may be able to help alleviate your symptoms and promote weight loss. Supplements such as protein powder, berberine, and alpha lipoic acid may help many women in menopause. 

Balancing your Hormones with HRT

HRT, otherwise known as hormone replacement therapy, gets a bad name from many doctors and media outlets. 

But should the use of hormones be completely avoided during menopause?

The answer is no!

Using hormones can actually help accelerate the weight loss process by bringing your hormones back to youthful levels before you hit menopause. 

The entire goal when using hormones is to obtain a youthful level of hormones, not an excessively high level of hormones. 

This can be done using what is known as bio-identical hormones. 

Bio-identical hormones look structurally identical to the same hormones that your body produces naturally. 

impact of estrogen on hypothalamic function

And, if given in the right doses, do not carry any negative side effects. 

In fact, studies from the Endocrine Society have shown that in many women the benefits outweigh the risks (14) (especially if used in the first 10 years after you hit menopause). 

So why are people so afraid of HRT?

Much of the confusion surrounding HRT has to do with identifying the difference between synthetic and bio-identical hormones. 

Most hormones are lumped into the category of HRT even though they are all slightly different. 

The synthetic hormones, those created by pharmaceutical companies, often carry with them increased risk. 

Bio-identical hormones, on the other hand, can be safely used provided they are dosed correctly. 

Using HRT, especially if you are symptomatic and struggling with weight gain, can help put your body back into a weight loss sensitive state. 

This means it will be easier to lose weight and get back on track. 

The use of HRT usually does not lead to significant weight loss by itself, but it can make the weight loss process easier. 

Generally, HRT is done with the use of bio-identical hormones such as progesterone, Bi-est, and Testosterone

Conclusion

Gaining weight after menopause can be incredibly frustrating, especially if it comes without you making any changes to your diet or lifestyle. 

But don't let it bring you down.

There are several steps you can take to help lose the weight you gained and get back to a normal body weight in the process. 

Strategies such as the use of HRT, exercising against resistance, consuming healthy foods, and reducing your stress can all positively impact your weight. 

Remember as well:

HRT is not necessarily dangerous and can be used to help your body become more sensitive to weight loss. 

Consider using HRT if you suffer from weight gain at menopause and if you have menopausal symptoms. 

Now I want to hear from you:

Are you struggling to lose weight?

Are you suffering from the symptoms associated with menopause?

What therapies have you tried?

What has worked for you? What hasn't?

Leave your comments and questions below! 

References (Click to Expand)

This post was most recently updated on August 23rd, 2019

Dr. Westin Childs

Dr. Westin Childs is a Doctor of Osteopathic Medicine. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders.He is trained in Internal Medicine, Functional Medicine, and Integrative Medicine. His focus is on managing thyroid disorders, weight loss resistance, and other sex hormone imbalances.You can read more about his own personal journey here.

21 thoughts on “What Causes Menopause Weight Gain & What to do About it”

  1. I’m 49 & have experienced several symptoms of menopause with gain & insomnia being the absolute worst. I have depleted testosterone & an estrogen level that indicates I’m in menopause. With great reservations, I started BHRT yesterday with a pellet. I’m sure it just a placebo effect, but last night I felt drowsy doing dishes, & slept 6 hours straight through the night with no waking. I feel very hopeful about BHRT.

  2. Hi Dr. Childs,
    Ugh yes struggling with redistribution of fat in abdomen, thighs, hips and butt and horrible sagging arms. Am working with functional md now. I am estrogen dominant with very low progesterone. 140 to 0.2. My free T3 and Free T4 are too low and Tsh is between 4 and 4.7. Just got on Armour. We tested nutrients – vitamins, minerals, fatty acids, antioxidants, toxins, adrenals…so far I am working on thyroid, correcting deficiencies; and some ways to detox liver.

    My weight went up only 8 lbs as I transition but it’s all fat and the skin on my arms hangs like it’s three sizes too big for my body. And it is stretched out and wrinkled…what! I wasn’t heavy to begin with.

    Hair loss and thinning four almost four years now was my first symptom. Anyway next intervention will be progesterone and my holistic dr doesn’t like cream versions. She even brought up prometrium … is this a poor choice? I believe I could be helped with the lost skin elasticity and fat issue by balancing out estrogen and also trying to dump as much as possible; do you think I should go the progesterone pill route based on my issues? Btw I am 54 and in good health otherwise and this transition is killing me! Lifting weighs and treadmill for a year and a half aren’t doing a lot as far as visible results. Thanks for this blog!

  3. Hey there! I am sad so sad to realize I am in menapause! I am only 44. I told my doctor two years ago that I was starting to feel different.I stopped having periods six months ago. The irritability and overall yuck I have felt gas been overwhelming to me. I went into a new doctor and she tested my hormones. My levels are all ridiculous. I am in full on menapause. My progedterone was .025 My estrogen was 57 and my testosterone didn’t even register. So tonight I just placed my new HRT cream compounded just got me on my legs. I’m sitting up reading articles about this phase of life. It is crazy I do not recall much talk of this. I do know my mother in law would always say don’t use hormones try to push through. My doc told nr that there are new studies indicating the estrogen levels being low fie so ling can cause dimentia. This broke my heart! I watched my mother in law slowly slip away from Lewy Body dementia two years ago. I am so incredibly sad about this menapause business! I am so young(well for menapause) and can not even believe I am such a mess hormonally. Hoping the HRT helps. I am so very tired, so grumpy, and just want to be alone and watch Netflix. (With a fan of course, cause holy HOT FLASHES!)

  4. Hello,

    I have hashimoto and at 49 i am in menopause. I get terrible hot flashes as well as weight gain from both I guess from the thyroid and menopause. I take synthroid and I just started your t3 conversion. I am either freezing or sweating. I have always been pleasantly plum – but now I am fat. i need to lose about 60 lbs and I only 5 ft tall. I am on weight watchers and as long as i stick to it completely I can loose but it is very hard and very slow!!! I was on estrogen but it made me nervous – both of my sisters had pre-cancer cells with their breasts so I went off of it now i am on bee honey made in Sweden – i don’t think it does anything.

    If you have any helpful advise that would be great!!

  5. Dr. Child’s,
    I am 11 years post-menopause, have a thyroid nodule and Hasimoto’s. I have been on Synthroid for years with little change in dosage. I stumbled upon your site this morning and it is revelatory! I now have a hundred questions for my doctor(s).
    Two questions for you:
    1)I had never heard of a functional medicine doctor and now that my endocrinologist has moved, I need to find a new practice. What should I be looking for? My well- loved GP retired a couple of years ago and my new GP has never really been involved in any of this beyond the basic thyroid function test. For instance, the GYN. prescribed a vaginal e-ring (no HRT for me because of genetic cancer history). Is there a specialty of medical practice that combines all these factors? By the way,my daughter has Down Syndrome and is on my same Synthroid dosage.—we’re looking for a new doctor together!
    2) I do not struggle with+10/15 lbs., but rather +30/35. I try to keep active, lift heavy weights 3 to 4 times a week, and eat healthily. If I keep the calories up (1400-1600) with lots of protein (over 100g), my muscles “grow” and I look better, but I don’t lose the pounds. If I restrict the calories on Weight Watchers and eat that balanced diet, I lose the weight. You don’t appear to recommend calorie restriction.
    Thanks in advance for your time.

    • Hi Anne,

      You can use this resource to try and help you find the right type of doctor: https://www.restartmed.com/thyroid-doctor/

      I don’t recommend calorie restriction because it just doesn’t work. You have about a 1 in 216 chance that you will lose weight and keep it off using that method based on decades of studies and the general trend towards obesity in our culture. You may lose weight the first several times you do it, but you will find that eventually calorie restriction stops working at all and you will continue to gain weight and have trouble losing weight from that point forward.

  6. I stumbled across this video after researching menopause and weight gain. I am 52 and had my kids late at 39 and 41. Thought menopause was something that would happen in my late 50’s but NO…I went thru menopause at the normal age of 51 but I had no idea about the weight gain! Liked how you talked about the weight gain and how it happens from doing nothing different. I’ve gained 17 pounds 🙁
    I just want it off. I started the estradiol and progesterone and it helps with sleep but I have not lost any weight yet. Do you think I need to take thyroid medication and/or testosterone as well?

  7. Hey Dr. Childs, I’ve followed some of your advice on how to lose weight in meno. Those pounds appeared out of nowhere 2 yrs ago or so, concentrated around my stomach, hips, thighs, rear, you name it. I don’t get how I could possibly have ED (very high estrogen to progesterone ratio) and also suffer symptoms of low estrogen (thin skin, sagging, etc. etc)

    Weight stays the same but fat distribution is completely different to me. Hair loss and thinning began as a 1st symptoms about 2 yrs before weight issue. My FM tried thyroid meds, natural and synthetic, and progesterone. I wiped out toxins and followed a junk-free healthful diet for years, resolved all identified nutritional deficiences, walk 12,500 steps a day and weight is not budging and hair is so thin and missing in strips, nothing like its former thick full self.

    Will any of it resolve after meonopause? Am turning 55 and still get a period every 7 mos just when I think I’m done. I give up. Progesterone and thryoid meds caused skin reactions regardless of type or dose so I stoppe them. Am I doomed? My FM is getting a little frustrated and I’m incredibly miserable.

    Any ideas what to try now, I’d love to hear from you.

  8. I am 52 and have been on HRT for 3 1/2 years. I have gained 33 lbs since starting HRT. I feel like I eat better now than I ever have. I am on Estradiol patch, tester one drops, and progesterone pills. I have Hashimotos which my doctor doesn’t believe in treating because thyroid lab results appear “normal”. My question is: What are the recommended estrogen:progesterone ratios? I’ve heard 1:600 is that true?

  9. I listened to your webcam and I’ve been through the menopause as I’m now 61. I have an under active thyroid which I take NDT 2 grain a day. I have been on this for almost 3 years. I also have high blood pressure and on meds for this too. I can’t lose weight no matter what I do and need to lose at least 2 stones, which started to increase from the age of 40 when my thyroid stopped working. Coupled with the menopause which I never took anything for I’m at my wit’s end please help.

  10. At age 46 I went from 110lbs to 160 over a 6 month period. I had no exercise or diet changes. My routine included 6 mile run 5 times week, weight training 3 times a week, dance class once a week. My diet has always been healthy one… lots of veggies, lean protein, and little to no carbs or fats. No sugar, no wheat, no dairy. I experienced a range of symptoms (joint pain, fatigue, nausea, mood swings.) It didn’t matter if I ate 200 calories a day or 1200 a day, I gained weight. I never ate more than 1200 calories a day. The endocrinologist said all the tests looked normal. This left me angry and frustrated because no one could explain why I gained 50% of my body weight in a 6 month period, let alone tell me how I could fix it.

    I had to stop running due to the joint pain and added weight, however I replaced it with 5 mile walks and swimming. Though I saw NO results regardless of my exercise and diet efforts.

    I’m now 49, I’ve since dropped 15 pounds through no special effort. I continue to eat healthy simply because that’s always been my lifestyle. PLEASE HELP I want to shed the remaining weight, or at least drop another 25-30. Currently, I seem to fluctuate between 140-150, without explanation. There are multiple days in a week when I eat very little (under 700 calories) because I am very busy and it seems that’s when I gain weight. There is no rhyme or reason as to why my body is doing what it is doing.

    Earlier this year I did the hormone reset diet (from the book with the same title.) I was already doing nearly everything that was in the book. I added some supplements. I saw zero results over a 3 month period.

    PLEASE point me in the right direction. Thank you.

  11. I am 53 years old and have been on Birth Control for 20 years. After taking blood tests for the past 3 years, my doctor has advised me to come off the birth control pills. I have done that. In the past 60 days, I have had no period, no spotting, nothing. I have also gained at least 10 pounds! I don’t exercise regularly but haven’t changed what I was doing before being off birth control. My diet is hit and miss, but I don’t eat sugary stuff, I don’t binge, and I have tried to eat smaller portions.

    I typically gain weight in my midsection, and this is where I have also gained the extra pounds. I am tired of all the fads, supplements, latest workout schemes aimed at taking my money!

    Do you have any thoughts on how to reverse the sudden weight gain? Also, is it typical to just go from having a normal period (on the pill) to nothing at all (after stopping the pill)?

  12. Last week my progesterone cream was late, so I have to wait for another week. My weight loss that week was four pounds. I am on progesterone cream for 6 years. I gained 30lbs in the 6 years only using progesterone cream. I think the weight is from the progesterone so now I will take half a dose to look if that’s working. Just started with testosterone and estradiol, all were low in blood tests, In the salvia test the progesterone was sky-high. After cervix cancer 6 years ago I got in menopause and get fenestron, and lots of other hormones to try pills, joint pain, and high blood pressure, migraine from it. I found the Progesterone bioidentical on my one and it worked wonders for joint pain. I think in the beginning, perimenopause the gap is because progesterone is dropping. then weight gain will start. After a few years, we think we need lots of progesterone, but we forget the estradiol is then also dropping so the gap will be bigger again. High progesterone and very low estradiol so again weight gain. So maybe it’s only a little bit we need and use too much al the time. I think the balance between the two is important.
    Every time my progesterone went up, my weight also did and I only had progesterone in 6 years. Estradiol was low all the time so no dominance. This is the best site I seen in those years!! And if you read it all you can put two and two together.

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