Summary

  • At menopause, many women experience weight gain, particularly around the abdomen.
  • Contributors to weight gain at menopause 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 HRT.
  • See your doctor for information and guidance if you haven’t exercised in some time.
Menopause occurs when a woman stops ovulating and her monthly period (menstruation) stops. Menopausal women 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. However, the exact process leading to weight gain and the relative contribution of the different factors are not understood.

Body changes at menopause


As we age, our muscles decrease in bulk and our 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 help.

Oestrogen and fat distribution


Oestrogen levels may influence body fat distribution. Many women in the early menopausal years gain fat mass as their oestrogen levels drop.. 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.

Other contributors to weight gain at menopause


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.

Hormone replacement therapy (HRT)


Contrary to common belief, weight gain is not linked to HRT. Some studies suggest that use of HRT is associated with less fat gain and potential beneficial effects on muscle mass.

If a woman is prone to weight gain during her middle years, she will put on weight regardless of whether 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.

Menopause and cardiovascular disease


As women get older, their risk of cardiovascular (heart and blood vessel) disease increases. This may be partly due to the postmenopausal tendency to put on weight around the abdomen. Body fat 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 accumulation of abdominal body fat. In addition, oestrogen replacement boosts ‘good’ blood cholesterol (high density lipoproteins, or HDL) and lowers ‘bad’ blood cholesterol (low density lipoproteins, or LDL).

Managing menopause-related weight gain


To manage weight after menopause, try to:
  • Eat a low-fat, high-fibre diet
  • Engage in 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 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 involves severely reducing 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, so if you lose muscle tissue, 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.

Leptin (the ‘fat hormone’) plays an important role in body weight management, as it contributes to appetite control and metabolic rate. Studies show that leptin levels drop after a crash diet, which increases the appetite and slows metabolism.

Consult 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 a new fitness program.

Where to get help

  • Your doctor
  • Jean Hailes for Women’s Health Tel. 1800 JEAN HAILES (532 642)

Things to remember

  • At menopause, many women experience weight gain, particularly around the abdomen.
  • Contributors to weight gain at menopause 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 HRT.
  • See your doctor for information and guidance if you haven’t exercised in some time.
References
  • Jean Hailes for Women's Health - Menopause management. More information here.
  • Healthy ageing and lifestyle, Australian Menopause Society. More information here.
  • Santen RJ, Allred DC, Ardoin SP et al, 2010, ‘Postmenopausal Hormone Therapy: An Endocrine Society Scientific Statement’, The Journal of Clinical Endocrinology and Metabolism, vol. 95(Suppl 1): S7-S66 (pages S36-S37). More information here.

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This page has been produced in consultation with and approved by: Jean Hailes for Women's Health

Last updated: November 2014

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