Can Menopause Hormone Therapy Prevent Menopause Weight Gain?
Or help with weight loss after menopause?
I can’t believe we’re at the tail end of March! We’re just back from a spring break trip that was filled with good people, amazing food, and lots of sunshine.
To entertain ourselves on the drive to/from Ohio, we listened to this audiobook with our 16 year old son. I had already listened to the book last summer, and it was just as engaging the second time around. But be warned: it’s the first in a series, ends with a MAJOR plot twist, and the next book isn’t coming out until November. 😩 That said, two thumbs up from the four people in my family who have either read or listened to it - it’s a good one!
Today’s newsletter is a popular one from the archives that I wanted to have a permanent landing place on Hot & Bothered. This version is lightly edited from the original email (sent in late 2023) to reflect updated information.
Without further ado …
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A few months ago I got a DM from someone on instagram wondering if menopause hormone therapy would help her lose the weight she gained during her menopause transition.
The answer to her question was an easy one: for a postmenopausal woman no longer bothered by menopause symptoms, going on hormone therapy isn’t going to be helpful for weight loss. Full stop.
But what about for a symptomatic woman in the thick of the menopause transition?
Hmmm … this answer paints a more complicated picture.
So let’s talk about it, shall we?
Does menopause hormone therapy help women avoid weight gain or lose weight during the menopause transition?
Based on the data we have, the short answer is no. There is minimal to no direct impact on weight gain or loss.
But hang in there with me …
Among many other things, the Women's Health Initiative looked at weight gain in women who took menopause hormone therapy vs. women who did not take menopause hormone therapy.
And while there wasn’t a statistically significant difference in weight gain between the two groups, the group who took hormone therapy did have slightly less belly fat accumulation than the group who did not take hormone therapy. So menopause hormone therapy did create a small impact on where the extra weight was stored.
Also worth noting, one of the big criticisms of the Women’s Health Initiative was that most of the women who were enrolled in the study were well past the average age of menopause (the biggest cohort was women ages 60-75). So does the data on hormone therapy and weight gain apply to younger women who are highly symptomatic and in the thick of their menopause transition? We won’t know until we study it.
Interestingly, hormone therapy can significantly reduce the diagnosis of type 2 diabetes, which is typically caused by obesity. So while the data we have suggests hormone therapy doesn’t impact menopause weight gain, it can help prevent metabolic disease caused by obesity. (Side note: menopause hormone therapy is not FDA approved for prevention of type 2 diabetes.)
Where I do think menopause hormone therapy has the potential to impact weight gain/weight loss is by reducing menopause symptoms that create conditions for weight gain or make losing weight extra challenging.
For example, chronically disrupted sleep can lead to weight gain due to elevated stress and hunger hormones as well as increased insulin resistance. Hormone therapy can reduce symptoms that keep a menopausal woman from sleeping well - like night sweats and anxiety.
Many women also rely on food and alcohol to manage menopause-related depression, anxiety, mood swings, etc. Might the management of these symptoms - through hormone therapy - lead to less emotional eating/drinking and therefore less weight gain? Perhaps.
And finally, we have a few small studies that suggest there is a benefit to combining estrogen therapy with exercise to prevent loss of muscle mass, strength and performance during the menopause transition. Assuming this finding holds true in larger studies (which we won’t know until those studies actually happen), could this translate to less fat accumulation overall? I can’t imagine it wouldn’t be helpful, but we just don’t have any data yet.
And that’s the biggest issue: not enough data!
The impacts of menopause hormone therapy are being studied, but there’s just so much we still don’t know.
Long story short: Menopause hormone therapy isn't a magic bullet when it comes to preventing weight gain or assisting with weight loss during the menopause transition.
Could it be helpful? If you're experiencing menopause symptoms that are contributing to weight gain, hormone therapy could potentially be helpful, but only indirectly. That said, until we have more research, we're left to feel our way through. As per usual. Sigh.
Your best strategy is to focus all those totally unsexy-yet-super-important foundational pillars of heath: regular exercise, stress management, eating a high fiber/high protein/low processed foods diet, and getting good sleep.
Like this post? Have a question? Need to vent about how much we still don’t know? Or maybe you want to give me a book recommendation? You’re welcome to hit that heart button or leave a comment and I’ll be sure to reply.
xo, Rebecca