Perimenopause & Weight Gain: Fact or Fiction?
Many women in their 40s and 50s report that the strategies that used to work for weight management no longer do. If you are experiencing weight gain without any changes to nutrition or lifestyle, perimenopausal hormone changes could explain the shift.
Perimenopause is the transition to menopause, the one-year mark without a period, and the phase in life when many women experience menopausal weight gain and other symptoms like hot flashes, mood changes, insomnia, and brain fog.
Perimenopause weight gain is common but not inevitable. Perimenopause is an invitation to shift nutrition and lifestyle habits to support you into this new phase of life.
What used to work to manage weight – like eating less and exercising more – no longer works because your body requires something different. Today’s article will cover perimenopause and weight gain and how to lose weight while perimenopausal.
If you have these questions, this article is for you.
- Does estrogen cause weight gain?
- Does menopause cause weight gain?
- Does low estrogen cause weight gain?
- Can perimenopause cause weight gain?
Let’s get into the details! Keep reading to learn more about:
- Factors in perimenopause sudden weight gain
- Estrogen and weight gain
- How to manage perimenopause weight gain
Factors Contributing to Perimenopause Weight Gain
Perimenopause is a significant transformation. Since puberty, your brain and body have been wired for reproduction, and now the body is recalibrating its resources away from reproduction. This transition can feel uncomfortable and is associated with symptoms.
Let’s look at the hormonal shifts contributing to sudden weight gain in women.
Hormonal Shifts
Consider perimenopause like reverse puberty. There is hormone instability and, ultimately, a decline in estrogen and progesterone. This change affects the whole body, and today, we are focusing on metabolic health and weight gain during perimenopause.
Estrogen supports metabolism and blood sugar balance. Low estrogen increases insulin resistance, where cells don’t respond appropriately to insulin. Insulin resistance contributes to metabolic syndrome, prediabetes, hypertension, heart disease, and other chronic diseases that increase after menopause.
Other estrogen decline symptoms include vasomotor symptoms, such as hot flashes and night sweats. Interestingly, these symptoms may precede weight gain in menopause.
Muscle Tone Replaced with Fatty Tissue Deposits
Insulin resistance also makes it easier to gain weight, especially around the midsection, which is why sudden belly weight gain occurs during perimenopause and into menopause as estrogen declines. This visceral fat deposition is a less healthy pattern compared to evenly distributed weight.
As fat increases in perimenopause, there is also a natural loss of lean body mass (muscle) with aging. Less muscle means less calorie-burning capacity and a slower metabolism.
Metabolism and Lifestyle
With age and perimenopause, lifestyle habits play a significant role in how you feel. If you’ve run on caffeine, adrenaline, perfectionism, and staying busy for decades, your body may not be able to handle the stress anymore.
While perimenopause is a natural transition that all women will experience, it may not match our current environment of high stress, poor nutrition, toxin exposures, and other stresses of modern times. Luckily, these factors are largely modifiable and making shifts in lifestyle will support you through perimenopause and beyond. Establishing foundational habits is also key in preventing or reversing perimenopausal weight gain.
The Role of Genetics
Is there a genetic component to perimenopause? Your mother’s perimenopausal experience and timing of menopause may help predict yours. If she experienced weight gain, you might too.
However, the genetic component is small, which is good news because we can’t change our genetics. We can change our genetic expression by shifting our habits and environment, the pieces within our control that provide the most significant benefits for countering female weight gain.
The Impact of Declining Estrogen
We’ve discussed how declining estrogen contributes to increased perimenopause belly fat and other symptoms. However, low estrogen (and progesterone) impacts much more than weight; it has body-wide effects and long-term consequences.
The loss of reproductive hormones affects all body systems, including the brain, heart, bones, metabolism, and more. The risk of heart disease, dementia, cancer, osteoporosis, frailty, and other chronic conditions increase dramatically post-menopause.
The window for prevention is before and during perimenopause – in your 30s and 40s – to set the stage for health after midlife. As we talk about lifestyle change for weight management, consider the benefits for the whole body and disease prevention.
Weight Management During Perimenopause
In perimenopause, your body changes in many ways. The loss of ovarian function and aging is inevitable. For women who’ve struggled with body image and dieting for much of their lives, it might be helpful to forge a new relationship with your body, one of kindness and self-compassion.
Here are some ways to nourish your body with food and healthy habits to set the foundation for perimenopause and the rest of your life. Remember, change is hard, and it takes time. Consistency is more important than perfection, Start with one thing at a time.
Balanced Diet
While there is no one perfect perimenopause diet for everyone, there are some principles that can help support metabolic health and offset the impact of declining estrogen. Start with balanced meals, with an emphasis on:
- Protein – Many women are not eating enough protein to support maintaining (and building) muscle. Choose quality plant proteins like tofu, tempeh, lentils, and beans, and supplement with animal proteins like eggs, organic dairy, wild fish, and lean meats.
- Fiber – Along with protein, many women are not getting enough fiber. The best way to increase fiber is to swap processed carbs for whole food options such as beans, whole grains, starchy vegetables, and fruit. Some fiber superstars include berries, apples, lentils, avocados, chia seeds, flax seeds, and artichokes.
- Phytoestrogens – Natural estrogen compounds found in plants bind to estrogen receptors in the body, producing benefits. Increasing these foods in the diet can help support perimenopause and menopause. Some foods to consider include:
- Tofu, tempeh, edamame (choose organic)
- Flax seeds (ground)
- Red grapes
- Pomegranates
- Legumes
- Sesame seeds and tahini
- Garlic
Regular Exercise
Exercise benefits women in perimenopause by supporting cardiometabolic, physical, and mental health. However, perimenopause may be a time to reevaluate your exercise routine and make some changes.
The most beneficial thing you can do is begin strength training. Lifting weights and other resistance exercise can counteract the decline in muscle mass and weight gain during perimenopause. It’s also great for your bones.
It’s okay if adding strength training to your routine displaces some endurance activity. You may get more benefit from walking and moderate-intensity exercise because they are less stressful on the body. Break up long stretches of sedentary time with more movement and stay active throughout the day.
Stress Relief Techniques
Stress can be the hardest part to address but may be the most beneficial. Elevated stress hormones signal the body to store fat, especially around the midsection. During perimenopause, you may also be less resilient to stress as your brain recalibrates to a new hormonal landscape.
All this makes stress management and self-care essential. Figure out what works for you and make it non-negotiable. Some ideas include:
- Establishing a meditation or yoga practice
- Regularly walking in nature
- Maintaining close friendships and community
- Engaging in a hobby
- Setting boundaries and saying no
- Putting unscheduled time on your calendar
- Setting a reasonable bedtime and sticking to it
- Working with a therapist
Notice that most of these suggestions are low-cost or free. Many wellness tools and gadgets can aid in relaxation and self-care, but don’t neglect the basics of eating well, moving, sleeping, and connecting with others.
Hormone Therapy
Menopausal hormone therapy (MHT), also called hormone replacement therapy (HRT), is another tool in the perimenopausal toolkit. There is a history of fear and confusion around hormone therapy, and some women reman scared that using estrogen contributes to weight gain. But, new research reveals that MHT is much safer and more beneficial than previously thought.
MHT may help counter weight gain during perimenopause. A study from over 20 years ago suggests MHT “may actually help to prevent an increase in body fat mass and fat redistribution.” Newer research suggests: “There is strong evidence that estrogen therapy may partly prevent this menopause-related change in body composition and the associated metabolic sequelae.”
MHT can decrease perimenopausal symptoms, reduce chronic disease risks, and improve quality of life. It’s at least worth a conversation with a menopause-literate healthcare provider to learn about all the options and what’s the best fit for you.
Menopause and weight gain often go together, but they don’t have to. Midlife is an incredible opportunity to reevaluate what’s important and improve health habits to set the stage for longevity and vitality. In addition to the ideas outlined here, there is much room for personalized nutrition. Lizzy Swick Nutrition can help you dial it in and easily navigate perimenopause. Reach out today!
References
- De Paoli, M., Zakharia, A., & Werstuck, G. H. (2021). The Role of Estrogen in Insulin Resistance: A Review of Clinical and Preclinical Data. The American journal of pathology, 191(9), 1490–1498.
- Davis, S. R., Castelo-Branco, C., Chedraui, P., Lumsden, M. A., Nappi, R. E., Shah, D., Villaseca, P., & Writing Group of the International Menopause Society for World Menopause Day 2012 (2012). Understanding weight gain at menopause. Climacteric : the journal of the International Menopause Society, 15(5), 419–429.
- Gibson, C. J., Shiozawa, A., Epstein, A. J., Han, W., & Mancuso, S. (2023). Association between vasomotor symptom frequency and weight gain in the Study of Women’s Health Across the Nation. Menopause (New York, N.Y.), 30(7), 709–716.
- Hulteen, R. M., Marlatt, K. L., Allerton, T. D., & Lovre, D. (2023). Detrimental Changes in Health during Menopause: The Role of Physical Activity. International journal of sports medicine, 44(6), 389–396.
- van Seumeren I. (2000). Weight gain and hormone replacement therapy: are women’s fears justified? Maturitas,34 Suppl 1, S3–S8.
- Davis, S. R., Castelo-Branco, C., Chedraui, P., Lumsden, M. A., Nappi, R. E., Shah, D., Villaseca, P., & Writing Group of the International Menopause Society for World Menopause Day 2012 (2012). Understanding weight gain at menopause. Climacteric : the journal of the International Menopause Society, 15(5), 419–429.
