How Menopause Affects Your Weight

How Menopause Affects Your Weight
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During menopause, your body goes through a lot of changes. They include your weight, body shape, and hormone levels. But the good news is there are ways to feel your best during this time.

In the WebMD webinar “How Menopause Affects Your Weight,” Beverly Tchang, MD, talked about these changes, including what causes them and what tools can help you feel better. She’s an endocrinologist at Weill Cornell Medicine in New York City, where she’s also program director of the obesity medicine fellowship. She’s co-founder of the nonprofit Tri-state Obesity Society.

“Menopause truly affects a lot of people’s quality of life. I urge you to ask your doctor for help with the symptoms and weight management,” she says. 

“Menopause is natural, but it doesn’t need to be uncomfortable. You don’t need to suffer through it.”

Poll Questions

Over 1,800 webinar viewers were asked about their menopause symptoms.

Belly fat was the main symptom for 73% of poll respondents. 

Over 40% said eating healthy helps their menopause symptoms.

Why Does Menopause Affect Your Weight?

Your estrogen, progesterone, and testosterone levels fall during menopause. This can affect your body shape.

“The truth is menopause itself doesn’t cause weight gain, but we do see a lot of body composition changes,” says Tchang. “That refers to the way fat, muscle, water, and bone make up your body.”

Aging may actually be what causes weight gain during menopause, while menopause changes how our body is made up. Your amount of fat may go up during aging and menopause, and at the same time, you may lose muscle mass. For this reason, your weight could stay the same, but your shape may change. 

How Can You Overcome Menopause-Related Weight Changes?

You can combat the discomfort during menopause through diet and exercise. If those aren’t enough, talk to your doctor about weight loss medications

Viewer Questions

How do you know you’re in menopause?

Is menopause the same for younger women surgically put into menopause by ovary removal?

How long after menopause can symptoms like hot flashes continue? When is it a good idea to report these to your doctor?

What’s the best doctor for overseeing both menopause and weight management?

We determine whether you’re in menopause through a discussion between you and your doctor. You’ll chat about what symptoms you have, you’ll make sure it’s not anything else (like a thyroid condition), and you may do blood work to check if your estrogen levels are low, or if other related hormones are too high.

But even if those hormone levels come back normal, you can still have some symptoms of menopause. It can be hard to tell, which is one reason it’s important to have an in-depth conversation with your doctor.

This webinar mostly covers what we call natural menopause, which is part of your natural aging process. Some people have surgical removal of their ovaries and go through early menopause in their 30s or early 40s. This is a different medical condition that has a different set of risks and potential benefits from medications like hormone replacement therapy. It’s different from natural menopause.

Report any symptoms as soon as you suspect they’re related to menopause. Some think menopause starts with irregularly timed periods. That’s not necessarily true. 

In fact, a change in the quality of your periods is a signal menopause might be starting. That could mean changes in the length of your periods, or the heaviness of them. Any change can be a signal. So if you see that, in addition to other symptoms (hot flashes, fatigue, weight, changes, etc.) talk to your doctor as soon as possible.

Doctors who manage menopause are endocrinologists or obstetricians and gynecologists (OB/GYNs). You also might also want to speak with a nutritionist and a personal trainer. You can find these experts on menopause.org or ABOM.org.

Please discuss “apron belly,” the belly fat linked to menopause. Are there exercises or diets that target this? Are recommendations different for women over 70?

How does alcohol affect menopause symptoms?

Are there any free, online, muscle-building programs you recommend?

“Apron belly” is very common. How we carry weight is based on biology. Some hormones, like insulin, can cause you to gain weight around the middle. So, if you have health conditions (like diabetes) that cause you to have more insulin hormone, these can cause you to have more belly fat.

As far as exercise, there’s nothing that targets a specific area of fat. It’s a matter of overall healthiness, physical activity, and cardiovascular activity, along with having a good diet and increasing your muscle mass to boost your metabolism. But a lot of this is driven by your biology, hormones, and genetics. That’s why some diets work for one person, but not another. It’s important to talk to your doctor to see if there are other medical therapies that might be more effective.

For people over 70, there’s a tendency to lose more muscle mass. But you need that muscle mass to protect you from cardiovascular disease and osteoporosis (weak bones) and from falls. So, we actually don’t want older people to lose too much weight. That’s because when you lose weight, you lose a combination of fat and muscle. The only way to manage that is to make sure you’re strength training. It’s the key to preserving muscle mass and allowing fat loss to happen, more than just overall weight loss. This is true for any age.

In terms of alcohol, drinking it increases our blood flow. When you have hot flashes, that also increases your blood flow. That’s why you may feel flushed and start sweating. When you consume alcohol (if you already have hot flashes), you can make it worse. As for lifestyle changes, we might recommend lowering how much alcohol you drink. It’s not that you can’t drink any red wine again during menopause, but it’s something to be aware of. Everyone is affected differently.

There are several muscle-building materials online. You can go onto YouTube or other health websites to find resources for strength-building exercises. If you’re not sure where to start, speak with your doctor. Or go to your local gym and ask to meet with a personal trainer. This may be a safer option. They can teach you proper form to ensure you don’t get hurt.

Discuss the link between hormone replacement therapy and dementia or heart attack.

For women on breast cancer medications, like anastrozole or tamoxifen, where hormone replacement is discouraged, are there alternatives?

For over-the-counter meds for menopause or weight loss, how do you know if they’re effective and safe?

The Women’s Health Initiative study surveyed thousands of women in the U.S. It looked exactly at this question: What are the benefits and risks of hormone replacement therapy?

They gave estrogen or progesterone, or the combination of them, to women when they were 60 years old – about 10 years after menopause. What we discovered, looking at that, was that we kind of missed the boat. It’s been 10 years since your body had any estrogen and progesterone. We think that that’s part of the reason we saw increased risk in dementia and heart attack. Keep in mind that, while their risk went up, it was still quite low.

You should totally avoid hormone replacement therapy if you have breast cancer. Especially breast cancer that’s being actively treated with those medications. Alternatives include non-hormonal options. They may help with hot flashes from menopause. There aren’t a ton of non-hormonal options. But there’s research looking into more non-hormonal treatments that don’t cause weight gain. Chat with your doctor about the best options for you.

Be careful with supplements and over-the-counter therapies. The supplement industry in the U.S. is not regulated. They don’t have 10 years of testing like other medications do. They might contain things not on the ingredient label, or contaminants. It could be a sugar pill, or it could contain nothing at all.

There are non-hormonal menopause treatment options that’ve been well-studied as supplements. They’ve been shown to reduce hot flashes. Ask your doctor about these.

Watch a replay of the WebMD webinar  “How Menopause Affects Your Weight.”

Watch other free WebMD webinars by leading experts on a variety of topics. 

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