Menopause occurs when your ovaries stop making estrogen, a hormone that helps control your menstrual cycle, and marks the end of your reproductive years. That said, you aren't officially diagnosed until gone 12 months without a period, according to the American College of Obstetricians and Gynecologists (ACOG).
However, there are lots of changes that occur during perimenopause (the years that your body transitions toward menopause), like hot flashes, emotional changes, sleep disturbance, vaginal dryness, lower energy, slowed metabolism, the Mayo Clinic says. “Your body will likely change when you go through menopause, and that’s OK,” says Lauren Streicher, MD, a professor of clinical obstetrics and gynecology at Northwestern University's Feinberg School of Medicine and author of Hot Flash Hell.
- Jennifer Wider, MD, nationally-renowned women’s health expert, author, and radio host
“Although some experts do not think menopause is associated with weight gain, most folks do,” says Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School. “The typical weight gain—without eating more or exercising less—is about five to eight pounds from the beginning of perimenopause to one year without a period, the full menopause mark.” While that doesn’t mean that menopausal weight gain is inevitable, it is something that can and does and happen, she says. In short: It's perfectly normal.
Below, you'll find what you need to know about menopausal weight gain, and why it’s totally normal if this happens to you.
Why can weight gain happen during menopause?
There’s not one exact reason, but there are a few factors at play. “Weight gain is likely tied to the drop in estrogen that women experience during menopause,” says Women’s health expert Jennifer Wider, MD. “As a result, body metabolism can slow down and changes may occur in how the body stores and distributes fat. This can lead to weight gain in some women.”
At the same time, testosterone levels in your body drop, says Christine Greves, MD, a board-certified ob/gyn at the Winnie Palmer Hospital for Women and Babies. “Testosterone is responsible for muscle growth, and muscle burns more calories than fat,” she explains. “If you have less muscle, you’re not burning as many calories as before.”
The symptoms of menopause can also indirectly lead to weight gain, Dr. Streicher says. “There is a very high correlation between hot flashes and weight gain,” she says. When a woman has a hot flash, she has an increase in the stress hormone cortisol, which causes a change in her metabolism.
“Hot flashes can also interfere with sleep,” Dr. Streicher says. “And when you have less than seven hours of sleep, it stimulates the hunger hormones and you make bad nutrition choices, like choosing high-carb foods instead of broccoli.”
Finally, menopause is part of getting older, which has also been linked to weight gain.
Ultimately, gaining weight during menopause is completely normal. And, if there are no concerns about how it will impact your health, there’s no reason to stress over it. Still, experts say there are small lifestyle factors you can examine:
- Focus on your sleep. “If someone comes into our clinic and their biggest issue is gaining weight during menopause, our first question is, ‘How are you sleeping?’” Dr. Streicher says. Trying to make sleep a priority and aiming to get at least seven hours a night can help, she says.
- Increase your protein intake. Dr. Wider specifically recommends increasing your protein intake. Loading up on fruits, vegetables, and whole grains can also help keep you healthy while your body changes.
- Exercise regularly. The Physical Activity Guidelines for Americans recommend aiming to get 150 minutes of moderate-intensity exercise a week, along with two days a week of muscle-strengthening activity. Making a point to exercise regularly “can help lessen a natural decline in muscle mass,” Wider says. “It’s also good to prevent heart disease and osteoporosis, the two leading problems women can develop at menopause,” Dr. Minkin says.
- Limit alcohol. Sticking to the recommended one drink or less per day can help minimize extra weight gain. “Alcoholic beverages add excess calories to your diet and increase the risk of gaining weight,” Dr. Wider points out.
- Talk to your doctor about your concerns. It’s not for everyone and there are some potential risks involved, but hormone therapy can relieve hot flashes, night sweats, and even help prevent bone loss that can happen in early menopause, ACOG says.
Just to reiterate, it’s perfectly normal to gain a little weight when you go through menopause and for your body to change. “Even if someone doesn’t gain a pound, there’s usually a redistribution,” Dr. Streicher says. “It’s all normal.”
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