Guest Post by Dr Laura Villa; Image by José Manuel de Laá from Pixabay 

Did you know that the average woman gains 1 to 2 pounds a year through menopause?

Before we get into the why, let’s go through some definitions.

Menopause and Perimenopause

Perimenopausethe time before menopause, is where estrogen and progesterone levels begin to fluctuate widely. These fluctuations in hormones are thought to cause the menopausal symptoms experienced by many women in their 40s and 50s. Many women start to see changes in their bodies at this time, and these changes often continue after a woman passes menopause.

Menopause occurs when the ovaries stop producing estrogen and progesterone. It is diagnosed after you have gone 12 months without a period. In the United States, the average age of menopause is about 52. However, menopause generally occurs in women aged 45 to 55 or older.

Weight gain at menopause is prevalent. It is mostly due to a mix of factors like hormonal changes and aging. 

  • Fluctuations in sex hormones. Low levels of estrogen lead to increased fat storage, especially around the midsection. 
  • A decrease in metabolism. Sadly, as we age, metabolism decreases. 
  • Loss of muscle mass. Again, due to the aging process, hormonal changes, and decreased physical activity, muscle mass is lost. Because of the decline in muscle mass, fewer calories are burned. 
  • Inadequate sleep. Many women have trouble sleeping during menopause, and poor sleep is linked to weight gain. Sleep disturbance is common and is usually secondary to symptoms caused by low levels of estrogen and progesterone. 
  • Increased insulin resistance. Women often become insulin resistant as they age, making losing weight more difficult. Insulin drives glucose to be shifted and stored as fat, and it controls hunger and satiety. 
  • Increased cortisol levels. Due to the strain of menopause, you release too much of this stress hormone. High levels promote fat storage in the midsection.  

So what can you do to help prevent weight gain after menopause?

  • See your doctor for a complete physical and comprehensive lab work. This includes checking sex hormones, cortisol levels, and thyroid markers. It is important to note that endocrine organs are synergistic; therefore, it is necessary to support the entire system rather than focusing on a single hormone. 
  • Make sure you are getting adequate nutrition. A diet that is rich in whole and unprocessed foods is vital. Focus on vegetables, whole grains, beans, seeds, nuts, fruits, lean proteins, and healthful fats. 
  • Increase physical activity. The more active you are, the less likely are you to gain weight. Strength training and weight-bearing exercises help build muscle and stimulate metabolism. 
  • Limit alcohol consumption. Drinking comes with many risks if done in excess. However, even moderate consumption, which increases your calorie intake, can lead to weight in the midsection.  
  • Get restful, quality sleep.
  • Stress management. Increased stress levels increase cortisol levels, which, as I mentioned before, will lead to increased abdominal fat. Try doing meditation, yoga, breathing exercises, being out in nature, or getting regular exercise. 
  • Talk to your doctor about hormone replacement therapy. 


  • Woods NF, Mitchell ES, Smith-Dijulio K. Cortisol levels during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study. Menopause. 2009;16(4):708-718. doi:10.1097/game.0b013e318198d6b2
  • Proietto J. Obesity and weight management at menopause. Aust Fam Physician. 2017;46(6):368-370.
  • Kapoor E, Collazo-Clavell ML, Faubion SS. Weight Gain in Women at Midlife: A Concise Review of the Pathophysiology and Strategies for Management. Mayo Clin Proc. 2017;92(10):1552-1558. doi:10.1016/j.mayocp.2017.08.004