Weight Gain in Menopause

What is happening during the menopausal transition? As menstrual cycles cease to occur, estrogen and progesterone levels decline. Women may experience symptoms like:

  • Hot flashes

  • Insomnia

  • Impaired cognition

  • Mood changes

  • Vaginal dryness

  • Weight gain

One of the more distressing symptoms for women during this time is weight gain. What actually may be more bothersome during this time is a change in body composition. You may be experiencing a decrease in muscle tone, and an increase in fat around the midsection or abdomen.

When working with menopausal women on their weight, we need to look at three aspects:

  1. Energy intake

  2. Resting metabolic rate and

  3. Resting and active energy expenditure

Energy Intake

First of all, it is important to realize that calories matter when it comes to weight loss. If you consume more calories than you expend, you will gain weight. If you expend more calories than you consume, you will lose weight. Bottom line.

Energy intake boils down to how many calories you are consuming every day. A calorie increase as low as 240 calories/day can manifest as weight gain. 240 calories isn’t much. It is the equivalent of two glasses of wine, or a medium avocado. Even increasing your consumption of “healthy foods”, like avocado or chia seeds, while not DECREASING your consumption of other food, can lead to weight gain.

For example, I have seen women consume smoothies that can reach 700 calories. The smoothie is probably much healthier than the bowl of sugary cereal. But if that sugary cereal was only 300 calories, and you’re now consuming 700 calories, you’re bound to gain weight.

During the menopause transition, estrogen levels decline. Low estrogen causes an increase in food intake. Estrogens inhibit emotional and binge eating tendencies.

Therefore, adding bio-identical estrogen back to the system can help with weight management by decreasing overeating

Resting Metabolic Rate

This is a measure of how many calories you burn at complete rest. This decreases with age, specifically when lean tissue (or muscle) declines. If you have age related loss of muscle mass, you will have a lower metabolic rate. I’m no stranger to hearing “I’m eating the way I’ve always eaten, and now I’ve gained 5 lbs”. What may be happening is that the woman’s resting metabolic rate has declined, and she doesn’t need as much food to fuel her system anymore. How do you go about increasing muscle mass, and thereby increasing resting metabolic rate?

- Consume enough dietary protein

- Resistance exercise

- Vitamin D3 blood testing and supplementation

-Bio-identical estrogen therapy

Estrogen therapy prevents negative body composition changes in postmenopausal women by increasing lean body mass, and decreasing abdominal fat mass

Resting and Active Energy Expenditure

Resting energy expenditure is the number of calories you are expending (or “burning”) while not actively exercising. This is the number of calories you burn walking around. Active energy expenditure is the calories your burn while exercising.

When menopausal women have hot flashes and insomnia, their ability to move and exercise decreases. Therefore, addressing those obstacles is paramount.

Postmenopausal women walk approximately 2000 steps less per day than their premenopausal selves. Even though you’re carving out the time to go to the gym 3 times per week, what does the rest of your week look like? Slightly more walking during the day may make a large difference in how many calories you expend.

A reasonable strategy would be to increase calorie output by 200 calories per day. That tends to be anywhere from a 30-75 minute daily walk.

Naturopathic medicine has a lot to offer menopausal women who are looking to manage their weight and body composition changes. From running lab work like insulin and vitamin D3, to supplementation protocols involving fish oils and vitamin D3, to prescribing bio-identical estrogen and progesterone, to dietary interventions that include soy isoflavones and optimizing protein consumption.

Next Steps

Bio-identical hormone replacement therapy (BHRT) uses identical hormones to your natural hormones, and doesn’t cause an increase in cancer-causing estrogens and blood clots as seen with conventional hormone replacement therapy. Dr. Erin treats many perimenopausal and menopausal concerns and sympt

oms with BHRT. If you have any questions about BHRT, and weight management strategies during the menopause transition, please book a 15-minute free consult.

In Health,

Dr. Erin


Anagnostis, P., Dimopoulou, C., Karras, S., Lambrinoudaki, I., & Goulis, D. G. (2015). Sarcopenia in post-menopausal women: Is there any role for vitamin D?. Maturitas, 82(1), 56-64.

Kapoor, E., Collazo-Clavell, M. L., & Faubion, S. S. (2017). Weight Gain in Women at Midlife: A Concise Review of the Pathophysiology and Strategies for Management. Mayo Clinic Proceedings, 92(10), 1552–1558.

Karvonen-Gutierrez, C., & Kim, C. (2016). Association of Mid-Life Changes in Body Size, Body Composition and Obesity Status with the Menopausal Transition. Healthcare, 4(3), 42.

Petroni, M. L., Caletti, M. T., Dalle Grave, R., Bazzocchi, A., Gómez, M. P. A., & Marchesini, G. (2019). Prevention and Treatment of Sarcopenic Obesity in Women. Nutrients, 11(6), 1302.

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Stoney Creek, ON  L8G1J8

Tel: 1-905-662-0045
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Disclaimer: All material provided online is for information purposes only, and is not intended for use as individual medical advice. 

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