Menopause and weight gain

Many women approaching the menopause will experience a number of symptoms, including vaginal dryness, hot flushes and a lack of sex drive. However another symptom that may arise as a result of the menopause is weight gain. Most commonly occurring around the hips and abdomen, this menopausal symptom for the majority of women is considered to be the least desirable.

Although the exact factors that contribute to weight gain are not entirely understood, it is known that a decline in oestrogen levels, a loss of muscle tissue and lifestyle factors are part of the cause. Though it can be argued that a slight increase in weight is a natural part of getting older, the truth is excess weight gain (particularly on your lower abdomen) can lead to a number of health complications. These include:

  • heart disease
  • high blood pressure
  • diabetes
  • high cholesterol
  • kidney disease
  • osteoarthritis
  • stroke
  • sleep disorder


As a woman enters the early stages of menopause she will experience hormonal fluctuation, resulting in the decline of oestrogen levels. The loss of oestrogen from the ovaries acts as a catalyst, triggering the body to find the hormone in other places. The natural production of oestrogen is in part produced by fat cells. To increase production of oestrogen therefore, it is believed the body converts calories into fat. The decline of oestrogen can also cause ‘insulin resistance’, causing the body to use starches and glucose less effectively, resulting in an increase of stored fat.

Loss of muscle mass

A woman’s muscle mass will decline at menopause. As a result her resting metabolism will decrease, making weight gain more likely. The rate your body can use up energy during physical activity (aerobic capacity) will also significantly decline. As a result the ability to use the same amount of energy and achieve weight loss similar to that of the post menopause period is highly unlikely.

HRT and weight gain

A common belief held by women is that hormone replacement therapy will result in weight gain. As a result many women resist taking HRT. Contrary to this popular opinion, there has been little scientific evidence to suggest that HRT is linked with weight gain. Rejecting hormone replacement therapy because of a fear of gaining weight gain is not advised. Slight fluid retention may be experienced at the start of therapy treatment and as a result may be misinterpreted as weight gain. However, this is usually temporary and should subside in a couple of weeks.

Managing menopause-related weight gain

To manage weight caused by the menopause, it is recommended that you:

  • Engage in frequent physical exercise day
  • Eat a healthy and low calorie diet
  • Strengthen and build your muscle mass using strength training
  • Take HRT, which has been clinically shown to improve energy levels

It is inevitable that during ‘the change’ you will experience some weight gain. However, implementing dietary changes, exercise and treatment will help you to manage this weight gain and other common symptoms associated with the menopause.

Dr Bram Brons is an independent GP and a member of the medical team at HealthExpress – – an online clinic that specialises in a range of health issues, including female sexual health.

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