HRT and Weight Gain — Is There a Link?

While menopause is a natural part of the female aging process, you do not need to settle for suffering.

Menopause symptoms can act as a painful barrier to maintaining day-to-day routines for many women worldwide. Looking for ways to manage their symptoms, many women turn to their primary care providers to learn more about their treatment options.

One treatment option is hormone replacement therapy (HRT).

The goal of HRT is to minimize the severity of menopausal symptoms through the use of low-dose hormones.

Depending on where you live, HRT may or may not be a popular option; and it is necessary to separate facts from opinions.

HRT is not without side effects, and conflicting opinions from medical professionals, friends, and family can make this a complex subject to discuss.

One of the questions asked about HRT is, “does HRT cause weight gain, and what can I do to prevent it?”

This article explores the connection between hormone therapy and weight loss or weight gain.

While the experience of menopause is different for every woman, understanding risks and hearing about the most common experiences of others can help determine if this treatment is a good fit for your needs.

Understanding hormone replacement therapy for menopause

Menopause, defined as the timeline after a woman’s last menstrual period, is heavily associated with the reduction of the hormone estrogen throughout the body.

When this occurs, painful and sometimes debilitating menopausal symptoms like vaginal dryness, hot flashes, and sleep disturbances can arise, significantly impacting a woman’s quality of life.

Treatments like HRT were researched and created to combat the severity of menopausal symptoms.

The treatments were designed to provide a daily low dose of the needed female sex hormones to supply the body with just enough estrogen (or progesterone) to make the symptoms less severe.

Does HRT cause weight gain?

Many women’s primary concerns about HRT are focused on alleviating menopausal symptoms, but if you have some questions about how this treatment could lead to fluctuations in your current weight, you are not alone.

Research has indicated that there is no conclusive connection between HRT treatments and weight gain.

This being said, changes in your weight are a common component of menopause and may be why many women voice their concerns about this possible side effect when starting menopause therapies.

If you are concerned about the possibility of weight gain as a result of starting HRT, there are some steps you can take to reduce your risk, such as:

  • Maintaining a daily exercise routine
  • Eating a balanced and nutritious diet
  • Practicing healthy sleep hygiene habits
  • Speaking to your primary care provider to see if HRT is suitable for you

Ten questions to ask your primary care provider before starting HRT

If you are considering HRT for your menopause symptoms, here is a list of questions that you may find beneficial to bring to your consultation appointment with your provider:

  1. What types of hormones will I be taking during HRT?

There are two primary types of hormone therapy available for women experiencing menopausal symptoms: estrogen-only therapy and estrogen & progesterone therapy. We recommend speaking with your provider about which option best suits your needs to target your specific symptoms.

  1. How will I take my daily HRT medications?

Depending on the type of HRT recommended, there are various options for taking the needed hormones. From oral tablets to vaginal creams, you can ask your provider about your options to ensure that you get the solution you are most comfortable with.

  1. What are the benefits and risks of HRT?

Like any other medication, HRT offers both benefits and risks for the person choosing to start treatment. As every person’s body and health status is different, asking this question is essential to determine if HRT is suitable for you.

  1. What dose of hormones will I be starting with?

Your provider should start you on the lowest hormone dose possible to achieve the target results as a general rule of thumb. You may need to adjust your dose throughout your treatment, depending on how you feel.

  1. What side effects of HRT should I look out for?

HRT is not without side effects. We recommend asking your provider for a list of the most common side effects of your therapy so you can more easily identify if something is not working for you.

  1. How would I stop taking the hormone if I decide to discontinue treatment?

Should you decide to stop your HRT treatment, it is important to educate yourself about the safest option for your body. Your provider should provide you with detailed instructions about how you can wean yourself off the hormones during your therapy.

  1. Is HRT safe for me?

Depending on pre-existing conditions and the severity of your menopause symptoms, HRT may not necessarily be the safest treatment option for your needs. Your care provider should be able to shed some additional light on the safety and efficacy of HRT before you begin treatment.

  1. Will HRT interfere with my other medications?

With many women taking other medications for pre-existing medical conditions aside from menopause, it is essential to ask your provider if your HRT will cause any potentially harmful interactions with your current prescriptions.

  1. Are other patients happy with the results of HRT?

While it may seem like a funny question to ask, learning more about other patients’ experiences with HRT so you can better understand the entire experience and process.

  1. Is HRT suitable for me?

At the end of the day, you will be the patient who is taking the HRT medications. We recommend asking your provider to assess if this option is best suited for treating your symptoms or if they recommend other options that may also be successful.

Learn more about your treatment options for Menopause

There is no one-size-fits-all solution to menopause symptoms.

From at-home options like exercise routines and dietary adjustments to more involved options like hormone replacement therapy, there is no wrong answer for treating your menopause, so long as you feel well and are up to date on all of the possible risks and benefits of each treatment option. Using this article as a reference, we hope to inspire women to explore their options, find out the facts, and do what feels best and suitable for their unique bodies.

At Fit4100, our team is committed to helping provide helpful and medically accurate information about menopause and aging to women worldwide.

While fluctuations in your weight are a common component of the hormonal changes associated with menopause, we understand that these changes can be limiting factors for women wanting to seek treatment for their symptoms. With this in mind, we hope that this article will act as a helpful guide for those looking to learn more about the potential benefits, risks, and association with weight gain of starting HRT.

To learn more about menopause, aging, and everything in between, please check out our other articles on our website blog today.

Is Weight Gain a Natural Part of Menopause?

Weight Gain and Menopause

Maintaining body weight within typical values for your body can be an increasingly difficult task with increasing age.

This can become increasingly problematic for women in the perimenopausal phase. 

The perimenopausal phase is a transition period during which your body goes through hormonal changes that begin with menstrual irregularities and gradually lead to a complete cessation of menstrual cycles. 

Aside from the uncomfortable symptoms such as hot flashes and mood swings, the hormonal changes associated with menopause are seen as responsible for an increase in weight gain, especially around the abdomen.

But is weight gain a natural part of menopause or is it something that can be prevented?

Why Does Weight Gain Occur During Perimenopause?

Estrogen is not just a hormone necessary for reproductive functions, but it also plays an essential role in our body’s metabolism.

Estrogen can also influence how our body utilizes starch and blood sugar and lower estrogen levels have been associated with increased insulin resistance.

The decline in estrogen levels can lower the metabolism rate, which is the rate by which our body utilizes stored energy. 

Researchers have demonstrated in numerous studies that a women’s body composition can undergo considerable changes (such as abdominal fat deposition and increased body fat percentages) during menopause.

Such studies have also attempted to understand whether weight gain during menopause is a stand-alone phenomenon associated with increasing age or if hormonal changes are the primary culprit for the weight gain.

Researchers have concluded that weight gain is not solely a consequence of hormonal changes but is a combination of many changes that occur as a natural part of aging, such as lower activity level, family history of obesity, lifestyle choices, AND hormonal changes.

The studies found that the fall in estrogen levels during menopause was associated with an increased tendency for fat deposition in the abdominal area. This finding is further supported by the fact that patients suffering from Turner syndrome suffer from central obesity. It is well known that most women with Turner syndrome eventually develop premature ovarian failure that causes a drastic decline in estrogen levels, simulating menopausal hormonal changes earlier in life.

Several studies have provided substantial evidence that menopause is directly correlated with a rapid rise in body fat mass and abdominal circumference. 

How Does Weight Gain Impact Perimenopausal Women?

While menopause is inevitable, the symptoms associated with menopause can be managed via hormone replacement therapies and traditional herbal medicines. But, with this in mind, obesity and weight gain can worsen the symptoms associated with menopause, increase the risk of cardiovascular disorders, and negatively impact a person’s overall psychosocial wellbeing.

Reductions in body weight can improve some symptoms of menopause, such as hot flashes, and has a positive influence on mental health.   

How Can Menopausal Weight Gain Be Managed?

Many practical and easy management strategies are available to control weight gain associated with increasing age and menopause. Some common examples include:

Yoga for Menopause

Physical Activity

As exercise is inversely related to waist circumference and body weight, physically active women are less likely to be affected by the weight gain associated with menopause. Participating actively in physical activities can lower abdominal fat deposition, body fat percentage, and higher lean body mass even in women nearing menopause. Sixty minutes of moderate-intensity exercise, including daily resistance exercises, is mainly sufficient to maintain average body weight. 

Bringing awareness to our everyday activities is as equally important as exercise. Like weight gain, inactivity can creep up on us in our daily life, and we become unaware of how little activity we do during the day.

While we might do our morning walk, if we sit for the rest of the day, this can affect our metabolic rate and lead to “sitting disease.” The sitting disease is a term coined by the scientific community and is commonly used when referring to metabolic syndrome and the ill-effects of an overly sedentary lifestyle.

Increasing research supports the “sitting disease” and includes important reminders of why movement is so important during our entire life span.

Calorie Restriction

In combination with exercise, restricting calorie intake is best to control body weight and abdominal fat deposition.

A 5% decrease in body weight achieved with diet modification and exercise can prevent not only obesity but also decreases your likelihood of developing high blood pressure, high cholesterol, and diabetes. These minor changes can significantly reduce your risks of developing more severe health complications like stroke and heart attacks. However, make sure that you choose a healthy way to diet with sufficient protein and essential nutrient intake.

Natural remedies 

Traditional treatment strategies for menopause, including various herbs and even yoga, have been around for centuries. Several studies have also found them to be an effective and safe alternative to assisting with the management of menopause and perimenopause symptoms. 

Low impact meditative exercises like yoga and Tai Chi are great options for anyone looking to increase their daily exercise while reducing stress.


Acupuncture, a popular traditional Chinese medicine therapy, may also induce weight loss by regulating endocrine functions. A study on laser acupuncture found beneficial effects of this therapy on BMI with similar efficacy as anti-obesity pharmacotherapy. 

It is important to note that acupuncture is an adjunct therapy, meaning that it is intended to be practiced in addition to other healthy lifestyle choices like eating a nutritious diet and exercising regularly.


A natural alternative to estrogen is phytoestrogens, which are non-steroidal compounds derived from certain plants, including hops (Humulus lupulus), flaxseed, soy, and red clover. Hops, red clover, and soy contain other compounds with estrogen-like effects, such as daidzein, 8-PN, and isoflavones. Including these foods into your diet is a great way to support your overall health naturally.

Black cohosh (Cimicifuga racemosa)

Black Cohosh, a flowering plant found in North America, may be beneficial in managing menopausal symptoms such as hot flashes and profuse sweating. Recent studies on the impact of Black Cohosh on menopausal symptoms have demonstrated positive effects on weight gain and metabolic disorders.

Evening primrose oil (Oenothera biennis) 

Evening primrose oil possesses anti-inflammatory properties and is rich in omega-six fatty acids. As per a small study on the treatment of 56 menopausal women suffering from hot flashes and sweating with primrose oil capsules for six months, primrose oil can provide significant relief from nighttime hot flashes, which can improve sleep, decrease stress, and improve the overall health.

The Bottom Line

Weight gain is frequently associated with menopause, but it is manageable with some safe strategic approaches. You can use these strategies alone or in combination to attain your desired body weight and BMI to better reduce your risk of developing additional health complications as you transition into menopause.


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