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Menopause, HRT and weight: What’s going on?

Menopause, HRT and weight: What’s going on?

One concern some women may have during menopause is about weight gain and many assume that HRT contributes to this. In fact, it’s quite normal for women to put on weight as they go through menopause, but many factors can play a part. Hormonal changes can affect mood, appetite, and metabolism. Age also influences your weight during menopause, as we tend to exercise less and burn less energy.

Menopause is a natural process that women go through as they get older. HRT can help relieve the sometimes distressing and uncomfortable symptoms of menopause. Here we’ll find out how the menopause is linked to weight gain and what part (if any) HRT plays.

Daniel Atkinson
Medically reviewed by
Daniel Atkinson, Clinical Reviewer
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Medically reviewed by
Dr Daniel Atkinson
Clinical Reviewer
on Jul 07, 2025.
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Last updated on Jul 07, 2025.

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Does menopause cause weight gain?

Many people wonder ‘can menopause cause weight gain?’ The simple answer is yes, but there are reasons why this occurs. According to one study, sex hormones play an essential role in our energy metabolism, eating behaviors and regulation of appetite. Estrogen is said to inhibit food intake, whereas progesterone and testosterone stimulate your appetite.

During menopause, estrogen levels drop. This can lead to all the common symptoms of menopause, such as mood changes, hot flashes, breast tenderness and changes in periods. It can also lead to an increase in body fat around the belly, hips, and thighs. Estrogen helps to regulate body weight and metabolism, so once it drops, weight changes can happen. Therefore, it’s fair to say that menopause and weight gain can be linked.

Changes in hormonal balance and the fact that menopause normally occurs at middle age means that women tend to have a slower metabolism due to less exercise and less lean muscle. If you don’t adjust your diet or exercise regime accordingly, it’s likely that you’ll more easily gain weight during menopause.

‘Menopause belly’ – what is it?

During menopause, many women will naturally experience weight changes around their midsection. Often labeled as ‘belly fat’, it’s a common and natural occurrence. There can be a number of things that influence how much weight you gain during menopause, however, the hormonal changes your body experiences is the main cause of the ‘menopause belly.’

When women go through menopause, estrogen decreases which increases the percentage of testosterone within your hormonal balance. As women age, their weight generally tends to accumulate around the hip area, whereas for men it tends to be around the stomach. When the concentration of estrogen in women is lower than it was previously, fat storage can be redirected around the stomach. So, while the menopause is not directly linked to weight gain, changes in fat distribution and body composition can be.

How long does menopause weight gain last?

The amount of time menopause-related weight gain lasts for will vary person to person. Some women will experience weight loss once they have gone through menopause and their hormones rebalance. Whereas others may not return to the same weight that they had before menopause, even once it has passed.

Because your metabolic rate decreases with age, it becomes easier to gain weight while eating the same amount and types of food you’re used to. Adjusting your diet and living an active lifestyle can help keep weight gain to a minimum, but it can be more difficult compared to losing weight at a younger age.

Does HRT cause weight gain?

One of the main concerns for many women when it comes to starting hormone replacement therapy (HRT) is ‘can HRT cause weight gain?’ While weight gain is common during menopause, studies show that weight gain is not a direct side effect of starting HRT.

HRT does come with potential side effects. The hormones estrogen and progesterone can cause bloating, swelling and tummy ache. Your appetite may even change too. This means that while you take these hormones, you may see temporary changes and fluctuations in your weight. These side effects, combined with changes in weight distribution, can contribute to why HRT and weight gain are often associated with each other.

It’s important to remember that whether you choose to use HRT or not, weight gain during menopause is extremely common. HRT is unlikely to cause weight gain as a side effect as the hormones should help to balance weight management.

Does the type of HRT matter?

HRT exists in many forms including tablets, patches, pessaries, and gels. It’s easy to feel overwhelmed by the choices available, but finding a suitable dose and delivery method of HRT can help you deal with your menopausal symptoms effectively and comfortably. Discussing the pros and cons of the different types of HRT available with your doctor is a good step.

Generally speaking, though, no one type of HRT will be more or less likely to cause weight gain. If you are concerned about systemic side effects from your HRT, localized options, like vaginal gels or pessaries, could be the right option for you. Because these only work to counter vaginal symptoms of menopause, there’s a far lower risk of them causing changes elsewhere in your body.

Will I lose weight if I stop HRT?

You’re unlikely to lose weight if you stop hormone replacement therapy. If anything, you’re actually more likely to gain weight, because your levels of estrogen and progesterone will drop. Menopausal women who undergo HRT tend to have less body fat, especially visceral fat (fat that surrounds the internal organs) compared to women who aren’t on a HRT plan. However, studies show that this effect disappears once therapy is discontinued.[popoover id=ref6] If you’re thinking about discontinuing your HRT plan, then you should contact a physician who can advise you on the best way forward.

Can HRT help with weight loss?

Studies show that people who use HRT are less likely to put on weight than those who don’t, but it shouldn’t be used as a weight loss solution.

HRT works by trying to keep your hormones at a pre-menopausal level. As a result, you might not gain as much weight as someone who isn’t on a HRT plan because you will have the hormones that support your usual metabolism in your system. The only way to aid weight loss on HRT is to adjust your diet and exercise regime. Eating the right balance of food and exercising regularly can benefit you in many other ways too.

HRT and weight loss – choosing what’s best for you

If you’re noticing menopausal symptoms or weight gain, then HRT might be able to help with these symptoms. Unless you suffer from a preexisting health condition, choosing how to take HRT is normally a matter of personal choice. But if weight gain is your main concern then, as mentioned previously, there is no best HRT for weight loss. 

HRT is available in many forms:

  • Tablets
  • Skin patches
  • Gels
  • Pessaries  

Some brands are more popular than others. Vivelle-Dot or Climara patches tend to be a popular choice for those who suffer from certain health conditions or forget to take medication daily. Patches are easy to use and deliver a constant and low level of hormones. And evidence shows that women without a history of cardiovascular problems are at no increased risk of blood clots, stroke or heart problems when using patches and gels. Women who have experienced cardiovascular health problems in the past are safer to use patches and gels also.

Estrogel is another popular form of HRT that is absorbed through the skin, however, you must apply the gel yourself. Again, Estrogel and weight loss are not linked.

Tips to help with menopause weight – advice from our physicians

Maintaining a healthy weight can become harder as you get older and this can become even more difficult during menopause. However, weight gain doesn’t have to be inevitable during the menopause. Menopause weight gain can cause health complications, especially excess fat around your midsection. This includes but is not limited to:

  • Breathing problems
  • Type 2 diabetes
  • Heart disease
  • Blood vessel disease

As mentioned previously, no treatment alone will combat menopausal weight. As you get older, it’s important to look after yourself and to keep fit. Here are some tips to help with menopause weight.

Healthy eating

Focusing on healthy eating will benefit your mind and body and includes choosing nutritious food and controlling your portion sizes. Knowing your calorie intake and keeping it around the same level or below can be an easy and effective way to maintain or lose weight.

Regular exercise

Regular exercise is a good way of keeping active and healthy. The changes in hormones can affect your metabolic rate during and post-menopause, so you may need to participate in more intense exercise than before if your aim is to lose weight.

Prioritise sleep

Getting a good night’s sleep can be difficult when you are going through the menopause, but research has shown that a poor night’s sleep can impact your metabolism. Think about your sleep routine and how you can make it as effective as possible.

Have a support network

Getting help from your friends and family can be really beneficial. You could find a ‘workout buddy’ for support in keeping up with your new exercise routine.

Make sustainable changes

Losing weight safely and gradually is always better than quick fixes and fad diets. Make your weight loss plan easy to maintain long-term and stick to it. Eating too few calories can actually slow down your metabolism, which will make it harder to lose weight in the future.

HRT:

Get expert advice online

The symptoms that come with menopause can be tough to deal with, and weight gain can be common. As we’ve already mentioned, the right HRT and dosage can reduce the risk of weight gain during treatment. If you're interested in trying HRT to help you with not only your weight, but any other menopause symptoms, talk to your doctor. Based on your health, symptoms, and preferences, they'll be able to recommend a treatment that could work for you.

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When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

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