Menopausal Weight Changes

3 minute read

By: Sharon D. Malone, MD|Last updated: October 21, 2022

You might be wondering, what the hell is going on with my weight? I haven’t changed my diet. I haven’t changed my exercise routine. And yet, I can’t button my pants! 

All I can say is, I feel you. As women enter their forties (and fifties), through no fault of their own (blame lower estrogen levels), they will start to put on weight at the rate of about one pound a year due to aging. What this means is that on average, during the menopausal transition, women will gain 5-10 pounds. Oh, wait. It gets worse. 

Because of lowered estrogen levels, more of that excess weight ends up in your midsection than it normally would. Why is that? Although lowered estrogen levels during perimenopause and beyond isn't entirely responsible for the weight gain, it is responsible for where that weight lands. Another downside of reduced estrogen levels is that you start to lose muscle and gain fat. And since fat is less metabolically active than muscle, it’s harder to lose. So you are not imagining it. That little roll of fat that found its way to your belly is incredibly difficult to dislodge.

What can you do about it? You already know that decreasing your calories and increasing your exercise helps, but you might not know that so does adding estrogen. While estrogen does not directly influence your metabolism, it does help you maintain your muscle mass (which helps when you’re trying to lose weight. It also helps by treating menopause symptoms like sleeplessness and hot flashes, which are associated with weight gain. So, give HRT a try. What have you got to lose? About 10 pounds. Sorry, I couldn't resist!

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