--- title: "Understanding Weight Gain during Menopause" entity: "blog" canonical_url: "https://www.dramytung.com/blog/weight-gain-menopause-and-hrt-what-you-need-to-know" markdown_url: "https://www.dramytung.com/llms/blog/weight-gain-menopause-and-hrt-what-you-need-to-know" lastmod: "2025-05-05T10:00:00.000Z" --- Understanding Weight Gain during Menopause Let’s talk about something that affects nearly every woman during midlife: weight gain during menopause often coined " meno-belly ". If you've noticed the scale creeping up and you're wondering if it's just "part of getting older," you're not alone. The truth is, while weight gain during menopause is common, but it is not inevitable. There are things we can do to Women in the [menopausal transition](/blog/understanding-menopause-symptoms-stages-and-what-to-expect) experience weight gain as a common part of this time in midlife. Weight fluctuations stem from a confluence of hormonal, metabolic, and lifestyle factors rather than from one single cause. Declining estrogen levels change fat distribution, decrease insulin sensitivity, and metabolic rate, while concurrent life stressors may influence behavioural patterns related to nutrition and physical activity. Hormone therapy may influence weight regulation during this transitional period in some women. By understanding the physiological mechanisms underlying menopausal weight changes, women can develop informed approaches to maintaining metabolic health throughout midlife and beyond. ## Why Weight Gain Happens During Menopause First, let’s clear up a myth. Menopause itself doesn’t directly cause weight gain. According to the Menopause Society, formerly known as North American Menopause Society (NAMS), what actually happens is a shift in where your body stores fat—especially around your abdomen. This is due to the decline in estrogen, not because your metabolism has suddenly shut down. You can read the entire [MenoNote on Weight gain during midlife from the Menopause Society here](https://files.hivecdn.com/11fa60d5-9e15-4928-a2ba-caf050a12a1d/MenoNote-Weight-Gain.pdf). The factors that impact weight gain the most include the following: Hormonal changes: Estrogen plays a role in how and where fat is stored. When [estrogen declines](/blog/managing-menopause-symptoms-what-are-the-top-ways-to-manage-symptoms-to-give-you-the-best-wellness-options), your body may start holding onto fat—especially around your middle section. It's also important to rule out thyroid conditions such as hypothryoidism or Hashimoto's thyroiditis which are imbalances in the thyroid that can lead to weight gain. Loss of muscle mass: Muscle burns more calories than fat. As we age, we naturally lose muscle, which slows down metabolism. Lifestyle factors: Stress, poor sleep, less movement, and dietary habits can all add up, especially during this transitional time. Genetics and aging: Our bodies change as we age, and for many women, that includes weight gain regardless of menopausal status. ## How HRT (Hormone Replacement Therapy) Fits In [Hormone replacement therapy (HRT)](/blog/menopause-and-hrt) particularly the use of topical estradiol (gel, cream or patch) with a progesterone ( Mirena IUD which contains a progestin , or oral micronized progesterone taken orally at bedtime) isn’t a weight loss solution, but it can help manage some of the symptoms that lead to weight gain, like poor sleep, low energy, and mood swings. The latest insights from the 2022 NAMS Annual Meeting emphasize: "While HRT doesn’t directly prevent or reverse weight gain, it may reduce the accumulation of abdominal fat and help improve body composition when paired with a healthy lifestyle." Also important to note, HRT is most effective when started near the onset of menopause, typically between ages 50–59 or within 10 years of your final menstrual period. If you're considering it, talk to your primary care provider to see if you're a good candidate. "After the menopause transition, women gain weight, increasing abdominal fat and decreasing lean body mass, with a significant reduction in energy expenditure. Increased insulin resistance and hyperinsulinism characterize this period, aggravated by an increase in plasma proinflammatory cytokines and free fatty acids, and a state of relative hyperandrogenism." (Perez, 2023) # What You Can Do About Midlife Weight Gain While you can’t stop aging or control your hormones entirely, there are practical ways to support your body through this transition. 1. Build muscle: [Strength training](/blog/more-women-are-lifting-weights-in-the-gym-here-is-why-you-should-also.)at least 2–3 times a week can help preserve lean mass and boost your metabolism. We need to challenge our muscles in order to help stimulate the growth of muscle tissue repair and prevent it's loss (sarcopenia). 2. Prioritize protein intake: Getting enough protein helps with muscle maintenance and can keep you feeling full. A general rule I tell my patients to follow is to aim for your body weight in lbs x 0.7 to give you the total amount of protein per day they should have as a goal. You can download my [free protein ebook here to read more about protein.](/protein-handout/hormone-health) 3. Watch portion sizes: You may need fewer calories than you did in your 30s, so pay attention to hunger cues and energy needs. 4. Get good sleep: Poor sleep is linked to weight gain, and menopause can really disrupt your rest. Explore sleep hygiene tips or talk to your primary care provider if [night sweats and insomnia](/blog/menopauseandbeyond) are interfering with your ability to get a good nights rest. 5. Move your body daily: Walking, biking, dancing—anything that gets you moving can help counteract weight gain and support heart health. Weekly exercise recommendations is a minimum of 150 minutes a week for weight maintenance, or 300 minutes a week for weight reduction. ## You’re Not Doing Anything Wrong It’s important to remember that gaining a few pounds during midlife is not a failure. Your body is going through real biological changes. Be kind to yourself, seek out professional guidance when needed, and focus on long-term habits over quick fixes. If you're curious about whether HRT might be right for you, or how to adjust your fitness and nutrition in your 30's, 40's, 50's, and beyond, bring it up with your primary healthcare provider. You deserve to feel informed and supported. I also offer free alignment calls with new patients who reside in Ontario. You can book [here](https://dramytung.janeapp.com/#/free-discovery-call). To your best Health, Dr. Amy Tung, ND, MSCP Naturopathic Doctor Menopause Society Certified Practitioner # References: [https://menopause.org/wp-content/uploads/for-women/MenoNote-Weight-Gain.pdf](https://files.hivecdn.com/11fa60d5-9e15-4928-a2ba-caf050a12a1d/MenoNote-Weight-Gain.pdf) https://www.everydayhealth.com/menopause/midlife-weight-gain-the-latest-thinking-from-nams-2022/ Davis, S., Castelo-Branco, C., Chedraui, P., Lumsden, M., Nappi, R., Shah, D., & Villaseca, P. (2012). Understanding weight gain at menopause. Climacteric, 15, 419 - 429. https://doi.org/10.3109/13697137.2012.707385. Greendale, G., Sternfeld, B., Huang, M., Han, W., Karvonen-Gutierrez, C., Ruppert, K., Cauley, J., Finkelstein, J., Jiang, S., & Karlamangla, A. (2019). Changes in body composition and weight during the menopause transition.. JCI insight, 4 5. https://doi.org/10.1172/jci.insight.124865. Pérez, C. (2023). Menopause and diabetes. Climacteric, 26, 216 - 221. https://doi.org/10.1080/13697137.2023.2184252. # Disclaimer: The information in this blog is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your doctor or other qualified health professional with any questions regarding a medical condition or treatment. Never disregard professional medical advice or delay seeking treatment because of something you have read in this blog. Individual results may vary, and the strategies discussed here are not guaranteed to work for everyone. This content does not create a patient-client relationship and should not be used as a replacement for personalized medical care.