Menopause Hormone Therapy and Weight Gain

weight gain

One of the most pervasive concerns associated with menopause is menopause hormone therapy and weight gain, often attributed to hormonal changes, particularly the decline in oestrogen levels. This concern has fuelled the myth that Menopause Hormone Therapy (MHT) exacerbates weight gain. However, delving into the science behind menopause and its effects on the body reveals a more nuanced understanding.

Understanding Oestrogen and its Role:

Oestrogen, primarily produced in the ovaries, plays a crucial role in regulating metabolism and body composition. As women approach menopause, ovarian function declines, leading to a significant reduction in oestrogen levels. This decline in oestrogen has various physiological implications, including changes in fat distribution.


While it’s true that oestrogen levels decrease during menopause, it’s essential to recognize that oestrogen is not solely produced in the ovaries. Adipose tissue, or fat cells, also contribute to oestrogen production through a process called aromatization. As oestrogen levels decline, the body may attempt to compensate by increasing fat storage, particularly around the abdominal area, leading to the characteristic “middle-aged spread.”


The Role of Menopause Hormone Therapy:

Menopause Hormone Therapy (MHT), also known as hormone replacement therapy (HRT), involves the administration of oestrogen and, in some cases, progestin to alleviate menopausal symptoms. Contrary to popular belief, MHT does not inherently cause weight gain. In fact, studies have shown that MHT can help mitigate some of the changes associated with menopause, including weight gain and redistribution of body fat.

Oestrogen replacement therapy can help regulate metabolism, maintain lean body mass, and prevent the accumulation of abdominal fat. By replenishing oestrogen levels, MHT may counteract the body’s tendency to store fat, thereby supporting weight management efforts during menopause.


The Role of Diet and Exercise:

While MHT can be beneficial, it’s important to complement hormone therapy with a healthy lifestyle, including a balanced diet and regular exercise. Specifically, certain dietary strategies can help mitigate menopausal weight gain. Focus on consuming nutrient-dense foods, including fruits, vegetables, lean proteins, and whole grains, while limiting processed foods and sugary beverages.

In addition to dietary modifications, incorporating specific types of exercise is crucial for managing weight during menopause. While cardio exercise is often touted as the go-to for weight loss, it may not be the most effective approach for menopausal women. Instead, prioritising strength training and resistance exercises can help preserve lean muscle mass, boost metabolism, and combat age-related changes in body composition.

Strength training exercises, such as weightlifting or bodyweight exercises, stimulate muscle growth and increase metabolic rate, contributing to more efficient fat burning. Moreover, resistance training can improve bone density, reducing the risk of osteoporosis, another common concern during menopause.

In summary, the myth that Menopause Hormone Therapy (MHT) causes weight gain overlooks the complex interplay between hormonal changes and lifestyle factors during menopause. While oestrogen depletion may contribute to weight gain and redistribution of body fat, MHT can help alleviate these effects by replenishing oestrogen levels. Moreover, adopting a healthy diet and engaging in specific types of exercise, such as strength training, are essential components of a comprehensive approach to weight management during menopause. By dispelling misconceptions about menopause hormone therapy and weight gain and embracing evidence-based strategies, women can navigate menopause with confidence and optimise their overall health and well-being.



  1. Menopause: Nutrtion & Weight Gain by Nigel Denby, Registered Dietitan.

  1. Why Some Women gain Weight in the Menopause: Medically reviewed by Atli Arnarson BSc, PhD — By Franziska Spritzler — Updated on April 3, 2020

  1. 3)   Diet may counteract menopause metabolism change, ZOE study shows by 

 Yella Hewings-Martin, PhD & reviewed by Francesca Giordano, PhD