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  • Writer's pictureMonica Bell

Can Hormone Replacement Therapy Help with Weight Gain?

Updated: Dec 15, 2021

Are you in perimenopause or menopause? Are you gaining weight? You are in good but frustrated company since you may be mystified as to why this is happening. Everything was humming along, and then after menopause, the pounds start to creep up. It is estimated that the average weight gain for menopausal women is 10-15 pounds, but many women gain much more.

There are various reasons for weight gain, and many may be associated with declining hormones. Hormone replacement alone might not solve your weight gain issues, but you can whittle down those pounds with a prudent approach to overall health and feel better than ever.


What do Hormones Have to Do With Weight Gain?

Throughout life, women often gain weight around their hips and thighs. However, after menopause, weight gain occurs around the midsection and abdomen. This type of fat gain builds up in the stomach and around the organs, known as visceral fat. Visceral fat is, of course, unsightly, but beyond that, it has health consequences and is associated with risk factors:

  • Diabetes

  • Stroke

  • Some cancers

  • Heart disease

But, there is more to the story than just estrogen though estrogen is a big piece in the weight gain puzzle. Let’s look at how declining hormones are associated with other aspects of health that contribute to weight gain.

Aging and Muscle Mass

A natural consequence of aging is the loss of muscle mass. Muscles can’t grow if they aren’t stressed with weight-bearing exercises. Frankly, if you don’t have enough energy or the hormonal foundation to support muscle mass and bone density, you will continue to lose both.


In animal studies, estrogen helps to control body weight. Lab animals with lower levels of estrogen tend to eat more and be less physically active. Reduced estrogen also lowers metabolism, which is when the body converts stored energy into working energy.

You need adequate estrogen levels to maintain energy. Declining estrogen causes fatigue, and who feels like being active when you are tired? A vicious cycle ensues where you feel tired, so you don’t exercise, your metabolism decreases, and you eat more! This is all a recipe for continued weight gain.


Wait! Testosterone, you thought, was a male hormone. But, women produce testosterone, too, just not at the levels that men do. By the time women reach menopause, their testosterone levels are at half or lower than in their 20’s.

A drop in testosterone levels can reduce sex drive, increase body fat, decrease motivation, and contribute to insomnia problems. Low testosterone can add up to chronic low energy and mental and physical fatigue. And, testosterone helps build muscle, and the more muscle you have, the higher your metabolism.

If you are worried about getting too “bulky,” don’t. There are very few women who have enough testosterone to build enough muscle mass to look bulky. The idea is to return your testosterone to pre-menopausal levels.


Progesterone is a natural sleep aid. As progesterone levels drop during menopause, you may experience problems sleeping, which affects energy levels during the day.


Many women experience thyroid problems as they get older- specifically hypothyroidism which is an underactive thyroid. Sub-clinical hypothyroidism is a condition where your thyroid is not working fully, but blood tests are coming back within normal ranges. The symptoms of underactive thyroid are fatigue, brain fog, and weight gain.


How to Get to a Healthy Weight

First and foremost, schedule a consultation with us at Optimal Hormone Health so we can draw labs and individualize a plan to restore your hormones. Hormone replacement will be a giant first step to regaining your energy and motivation. By evaluating current hormone levels (including thyroid), we can optimize your hormone replacement. To harness that energy and motivation for weight loss, we recommend the following:


Almost any movement is better than none. With your renewed energy, exercise should be easier. Walk, run, hike, or whatever activity appeals to you. When you schedule your activity, you will be more likely to stay with it. Your job is essential, right? Well, this is your job. Please add some weight-bearing exercises to take full advantage of restored hormones to build muscle and bone density.


Junk food equals weight gain! Eliminate trans fats, high sugar, processed meats, and dairy (if you can). Keep your diet clean and close to the earth—fresh vegetables and fruit. Some people follow an intermittent fasting regime for 10-12 hours a day, encouraging weight loss. The easiest way to achieve this is to stop eating at 7 or 8 pm and not eat again until 7 or 8 am the following day.


Hormones and Weight Gain

Weight gain happens slowly, and weight loss requires patience and commitment to a healthier life. Start with bioidentical hormone replacement to improve your energy, concentration, and motivation. Then tackle exercise and diet for a prudent and beneficial weight loss plan to last a lifetime.

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