Weight gain at menopause is very common.
There are many factors at play, including hormones, aging, lifestyle and genetics.
However, the menopausal experience is highly individual, and varies from woman to woman.
This article explores why some women gain weight during and after menopause.
There are four periods of hormonal change that occur during a woman's life.
These include premenopause, perimenopause, menopause and postmenopause.
Premenopause is the term for a woman's reproductive life, while she is fertile. It begins at puberty - starting with the first menstrual period, and ending with the last.
This phase lasts for approximately 30-40 years.
Perimenopause literally means "around menopause." During this time, estrogen levels become erratic and progesterone levels decline.
A woman may start perimenopause anytime between her mid-30s and early 50s, but this transition typically occurs in her 40s and lasts 4–11 years ().
Symptoms of perimenopause include:
- Hot flashes and heat intolerance.
- Sleep disturbances.
- Menstrual cycle changes.
- Mood changes, including depression, anxiety and irritability.
- Weight gain.
Menopause officially occurs once a woman hasn't had a menstrual period for 12 months. The average age of menopause is 51 years ().
Up until then, she is considered perimenopausal.
Many women experience their worst symptoms during perimenopause, but others find that their symptoms intensify in the first year or two after menopause.
Postmenopause begins immediately after a woman has gone 12 months without a period. The terms menopause and postmenopause are often used interchangeably.
However, there are some hormonal and physical changes that may continue to occur after menopause.
Bottom Line: A woman goes through hormonal changes throughout her lifetime that may produce symptoms, including changes in body weight.
During perimenopause, progesterone levels decline slowly and steadily, while estrogen levels fluctuate greatly from day to day and even within the same day.
In the early part of perimenopause, the ovaries often produce extremely high amounts of estrogen. This is due to impaired feedback signals between the ovaries, hypothalamus and pituitary gland ().
Later in perimenopause, when menstrual cycles become more irregular, the ovaries produce very little estrogen. They produce even less during menopause.
Instead, estrogen is made from androgens, like testosterone. This happens in other tissues, such as breast and brain tissues. However, the amount of estrogen circulating in the blood is very low (4).
Some studies suggest that high estrogen levels may promote fat gain. This is because high estrogen levels are associated with weight gain and higher body fat during the reproductive years (, 6).
From puberty until perimenopause, women tend to store fat in their hips and thighs as subcutaneous fat. Although it can be hard to lose, this type of fat doesn't increase disease risk very much.
However, during menopause, low estrogen levels promote fat storage in the belly area as visceral fat, which is linked to insulin resistance, type 2 diabetes, heart disease and other health problems ().
Bottom Line: Changes in hormone levels during the menopausal transition may lead to fat gain and an increased risk of several diseases.
It's estimated that women gain 2–5 lbs (1–2 kgs), on average, during the perimenopausal transition ().
However, some gain far more weight. Unfortunately, this appears to be particularly true for women who are already overweight or obese.
Weight gain may also occur as part of aging, regardless of hormone changes.
When researchers looked at weight and hormone changes in women aged 42–50 years over a 3-year period, there was no difference in average weight gain between those who continued to have normal cycles and those who entered menopause ().
The Study of Women's Health Across the Nation (SWAN) is a large observational study that has followed middle-aged women throughout perimenopause. During the study, women gained belly fat and lost muscle mass ().
Another factor contributing to weight gain in perimenopause may be the increased appetite and calorie intake that occurs in response to hormonal changes.
In one study, levels of the "hunger hormone" ghrelin were found to be significantly higher among perimenopausal women, compared to premenopausal and postmenopausal women ().
The low estrogen levels in the late stages of menopause may also impair the function of leptin and neuropeptide Y, hormones that control fullness and appetite (, ).
Therefore, women in the late stages of perimenopause who have low estrogen levels may be driven to eat more calories and store fat.
Progesterone's effects on weight during the menopausal transition haven't been studied as much. However, some researchers believe the combination of low estrogen and progesterone could further increase the risk of obesity ().
Bottom Line: Fluctuations in estrogen, progesterone and other hormones can lead to increased appetite and fat gain during perimenopause.
Hormonal changes and weight gain may continue to occur as women leave perimenopause and enter menopause.
One predictor of weight gain may be the age at which menopause occurs.
A study of over 1,900 women found that those who entered menopause earlier than the average age of 51 had less body fat ().
Additionally, there are several other factors that may contribute to weight gain after menopause.
Postmenopausal women are generally less active than when they were younger, which reduces energy expenditure and leads to a loss of muscle mass (, ).
Menopausal women also frequently have higher fasting insulin levels and insulin resistance, which drive weight gain and increase heart disease risk (, ).
Keep in mind that the averages found in studies do not apply to all women. This varies between individuals.
Bottom Line: Fat gain tends to occur during menopause as well. However, it's unclear if this is caused by an estrogen deficit or the aging process.
Here are a few things you can do to prevent weight gain around menopause:
- Reduce carbs: Cut back on carbs in order to reduce the increase in belly fat, which drives metabolic problems (, ).
- Add fiber: Eat a high-fiber diet that includes flaxseeds, which may improve insulin sensitivity ().
- Work out: Engage in strength training to improve body composition, increase strength and build and maintain lean muscle (, ).
- Rest and relax: Try to relax before bed and get enough sleep, in order to keep your hormones and appetite under control ().
If you follow these steps, it may even be possible to lose weight during this time.
Bottom Line: Although weight gain is very common during menopause, there are steps you can take to prevent or reverse it.
Menopause can be challenging, both physically and emotionally.
However, eating a nutritious diet and getting enough exercise and rest can help prevent weight gain and reduce disease risk.
Although it can be difficult, do your best to accept the changes in your body that will inevitably happen with age.