Menopause and Weight Gain

June 25, 2024


Menopause is a significant & transitional phase in a woman's life, but there’s often confusion surrounding it. Menopause occurs when a woman goes a year or more without periods in her 40s or early 50s. During this time, estrogen and progesterone levels drop, often leading to symptoms like hot flashes, night sweats, mood swings, and changes in libido.

It’s also important to understand that menopausal symptoms can start years before a woman's last period, which may last a few months to even 10 years (the perimenopause stage).


According to the Healthy Women Study, average weight gain during this time is around 5 lbs or around 1 lb a year. However, 1 in 5 (and possibly more!) may experience weight gain of 10 lbs or more.

Three key players in weight fluctuations are sleep disruption, loss of muscle mass, and insulin resistance!


When it comes to sleep disruptions, it’s important to identify the root cause. This may be hot flashes, sleep apnea, or even restless legs. Poor sleep can lead to increased appetite, decreased metabolism, and abnormal levels of cortisol (our stress hormone). Overtime, this can contribute to inflammation throughout the body and difficulty losing weight. Improving sleep quality allows the body to heal, balances other hormones and improves our day-to-night circadian rhythm.


It takes more energy (calories) to build and maintain muscle than fat. A decrease of estrogen can cause lead to loss of lean muscle. This causes a cascade of events that contribute to a slowed metabolism, fatigue, and difficulty losing weight. Unfortunately, poor sleep can also contribute to more muscle loss and longer recovery.

Research shows we need full body movement (particularly weights or resistance exercises) and plenty of protein throughout the day to combat this. Most experts recommend 1 – 1.5 gram of protein per kilogram of body weight, ideally close to 100g of protein every day.


Insulin resistance occurs when the body (particularly the cells in your muscles, fat, and liver) stops responding to the hormone insulin and cannot properly fuel itself. This can make it harder to lose or maintain a healthy weight.

Estrogen until this time can protect us against developing insulin resistance by making our cells more sensitive to insulin (meaning it helps the body work as it should!).

To address insulin resistance:

  • Focus on a well-balanced diet with enough protein & fiber at meals. The goal should be eating at regular intervals instead of grazing
  • Prioritize movement throughout the day – even a walk, swim, or stretch helps!
  • Trouble sleeping may also contribute to worsening insulin resistance – quite a vicious cycle! So focus on healthy sleep habits, avoid screen time just prior to bed, and talk to your primary care if medication may be appropriate
  • It may be worthwhile to consider medications like Wegovy/ Ozempic, Zepbound/ Mounjaro, or metformin in certain cases of insulin resistance
  • Consider hormone replacement therapy!


Menopause isn't just a physical shift – it can have an impact on mental well-being too. This can stir up emotions like depression, anxiety, and even make ADHD symptoms more noticeable. It’s important to tackle these mental health aspects alongside other menopause changes, creating a holistic care approach that fully supports you or your loved one during this transformative time.


Remember, supplements are there to supplement a healthy lifestyle. Some data suggests that using an over-the-counter vitamin d, probiotics, and/or collagen can combat some of the risks or side effects associated with hormone changes. Talk with your clinician if these may be appropriate additions for you!


There may be an ideal "window of opportunity" where HRT can be the most beneficial, but many women find it can offer significant relief even years after their last period. There is a lot of fantastic data showing the benefit of hormone therapy in improving risk of heart disease, osteoporosis, stroke, dementia, mood changes, diabetes, and even quantity (really!) of life.

We are lucky enough to have multiple physicians at our clinic who specialize in both menopause and weight loss!

Disclaimer: This blog provides general information and discussions about health and related subjects. The information and other content provided in this blog, or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this blog or in any linked materials. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting new diet, supplement, medication, exercise, or other health plan. If you think you may have a medical emergency, call your physician or emergency services immediately. The opinions and views expressed on this blog and website belong that only of the author of that blog article and not any organizations they may represent.
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