Menopause and weight gain | Better Health Channel

Summary

Women at menopause often experience weight gain, particularly around the abdomen. This is often due to declining oestrogen levels, age-related loss of muscle tissue and lifestyle factors such as diet and lack of exercise. Contrary to common belief, weight gain is not linked to hormone replacement therapy (HRT).

Women at menopause often experience weight gain, particularly around the abdomen. This is often due to declining oestrogen levels, age-related loss of muscle tissue and lifestyle factors such as diet and lack of exercise.

Menopause occurs when a woman stops ovulating and her monthly period (menstruation) stops. Many menopausal women experience weight gain. Normal hormonal changes are thought to be partly responsible, although the exact process is not understood.

Body changes at menopause
As we age, our muscles decrease in bulk and the metabolism slows down. These changes can contribute to weight gain around the time of menopause. Other physical changes associated with menopause may include:

  • Skin changes, such as dryness and loss of elasticity
  • Vaginal dryness
  • Hair growth (or loss).
These changes may affect a woman’s body image and self-esteem. Taking steps to manage the symptoms of menopause can be a powerful antidote.

Oestrogen and fat distribution
It seems that oestrogen may influence body fat distribution. Oestrogen is the female sex hormone responsible for ovulation. Women of childbearing age tend to store fat in the lower body (‘pear-shaped’), while men and postmenopausal women store fat around the abdomen (‘apple-shaped’). Animal studies have shown that a lack of oestrogen leads to excessive weight gain, although the exact mechanisms are not yet understood.

Hormone therapy does not cause weight gain
Contrary to common belief, various studies prove that weight gain is not linked to hormone replacement therapy (HRT). If a woman is prone to weight gain during her middle years, she will put on weight regardless of whether or not she uses HRT. Some women may experience symptoms at the start of treatment, including bloating and breast fullness, and these may be misinterpreted as weight gain. These symptoms usually disappear once the therapy doses are modified to suit the individual.

The link to cardiovascular disease
As women get older there is an increased risk of cardiovascular (heart and blood vessel) disease. This may be partly due to the postmenopausal tendency to put on weight around the abdomen. Body fat that is stored within the abdominal wall and around the internal organs (visceral fat) is a risk factor for the development of cardiovascular disease.

HRT can reduce the risk of cardiovascular disease by preventing the shift in body fat distribution to the abdomen. In addition, oestrogen replacement boosts ‘good’ blood cholesterol (high density lipoproteins, or HDL) and lowers ‘bad’ blood cholesterol (low density lipoproteins, or LDL).

Other contributing factors
Apart from declining oestrogen levels, other factors that may contribute to weight gain after menopause include:
  • Loss of muscle tissue with age
  • Lowered metabolism
  • Reduced physical activity
  • Altered habits – for example, more freedom to eat out.
Managing menopause-related weight gain
To manage your weight after menopause, you should try to:
  • Eat a low fat, high fibre diet.
  • Have regular and sustained aerobic exercise. This will give your metabolism a boost. Aim for at least 30 minutes of moderate physical activity every day.
  • Build up and maintain your muscle mass with strength training such as weight training or weight-bearing exercise like walking. (See your doctor before starting a new exercise program.)
  • Accept the changes to your body.
Avoid crash diets
A crash diet is when you severely reduce the amount you eat over a short time. Your body responds to this reduced energy supply by using muscle tissue as fuel. Muscles use up a lot of kilojoules in your body. If you lose muscle tissue, it means you have further reduced your body’s ability to burn kilojoules. This means you are likely to put on more weight when you start eating normally again.

It seems that the ‘fat hormone’ leptin plays an important role in this process. Leptin contributes to appetite control and metabolic rate. Studies show that leptin levels drop after a crash diet, which increases the appetite and slows the metabolism.

Consult with your doctor
Your doctor can help you manage your menopause-related weight gain and other symptoms. If you have a pre-existing medical condition or haven’t been very physically active for some time, see your doctor before you start any new fitness program.

Where to get help Things to remember
  • At menopause, many women experience weight gain, particularly around the abdomen.
  • Contributing factors include declining oestrogen levels, age-related loss of muscle tissue and lifestyle factors such as diet and lack of exercise.
  • Treatment options include a healthy diet, regular exercise, strength training and hormone replacement therapy (HRT).
  • See your doctor for information and guidance if you haven’t exercised in some time.
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Jean Hailes Foundation

Last updated: June 2010

The information published here was accurate at the time of publication and is not intended to take the place of medical advice. Please seek advice from a qualified healthcare professional.

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