The Menopause Weight Gain Connection

Menopause, a natural and normal life change, occurs typically around a woman’s 40s or 50s. Defined by cessation of menstruation for 12 months, many physical symptoms develop due to a decline in estrogen levels. Hot flashes and night sweats, mood disturbances, and insomnia are some of the side effects that occur for months preceding the perimenopausal transition. Estrogen synthesis occurs mainly in the ovaries with conversion to 3 physiologic forms: estrone (E1), estradiol (E2), and estriol (E3). In postmenopausal women, E2 is the most bioactive and potent. Estrogens regulate many vital elements of metabolism, such as food intake, body weight, glucose homeostasis, body fat distribution, and lipolysis. 50% of perimenopausal women experience weight gain averaging 1.5lbs each year following menopause. Weight management during menopause is essential for overall health and wellness.

Weight loss through peptides

Glucagon-like peptide (GLP-1) agonists are compounds that simulate a naturally occurring hormone released by the endocrine cells of the small intestine. GLP-1 stimulates insulin secretion from the pancreas following an oral glucose load and blocks the secretion of glucagon, preventing stored glucose release. GLP-1 analogs assist in glycemic control, slowing digestion, reducing appetite, and activating satiety. Weight loss is achieved through these mechanisms, with an average range of 5-10% in total body weight when compared to the placebo. Some GLP-1s can achieve a 30% reduction in total body weight. Added benefits of GLP-1s include a decrease in cardiovascular and stroke risk.

Can hormones help?

Hormone replacement therapy (HRT) offers a myriad of benefits during the perimenopausal period. HRT can address the adverse effects of menopause, like hot flashes, night sweats, mood instability, and insomnia. Normalizing E2 hormone levels regulates bodily functions, mitigating weight gain observed following menopause, which affects 60% to 70% of women. HRT also impacts body composition by redistributing abdominal fat that often accompanies menopausal weight gain. A well-balanced diet combined with exercise and HRT can serve as valuable tools to combat weight gain associated with menopause. A healthcare provider can create a personalized wellness strategy to reach anticipated weight loss goals utilizing HRT.

Combination therapy is even better

A recent study investigated the effect of weight management treatment combining HRT and GLP-1 agonists. Postmenopausal study participants were evaluated at 3, 6, 9, and 12 months to compare endpoints of total body weight loss (TBWL%) and changes in cardiovascular markers, including glucose, blood pressure, and lipids. At 12 months, a more significant percentage of participants on combined therapy achieved 5%-10% TBWL. All study participants experienced improvement in cardiovascular risk factors.

Optimizing menopausal wellness with GLP-1 and HRT

Menopause, characterized by declining estrogen, leads to weight loss in the majority of women. GLP-1 agonists are a class of medications that stimulate a naturally occurring hormone that improves glycemic control and aids weight loss by reducing appetite and slowing digestion. HRT can alleviate menopausal symptoms and influence body weight composition. When combined, GLP-1 agonists and HRT offer enhanced weight loss and improved cardiovascular health. Individual treatment plans, including lifestyle modifications, are essential for achieving weight management goals and overall wellness following menopause.