Too Many Women Gain Abdominal Weight During Menopause – Should You Be Concerned?

Generally, most women are afraid that oestrogen will cause weight gain. Most women link menopause to oestrogen to getting fat. However, how accurate is this?

Oestrogens are important participants in metabolic regulation and weight distribution. The loss of the main oestrogen, oestradiol, due to natural or surgical menopause has a wider impact on the body going far beyond the reproductive system. While most women are aware of the potential oestrogen sensitive cancer concerns, premenstrual symptoms or oestrogen dominant reproductive issues, most neglect to consider the potential benefits of oestrogen. Oestrogen has a strong protective benefit on bone production, heart and cardiovascular health, mental health, skin and aging benefits, and in this case, most importantly, metabolic protection (yes, protection from weight gain!).

Large clinical trials have revealed a robust protective role of oestradiol against metabolic syndrome and diabetes. Several studies have consistently shown that those women who are reintroduced to oestradiol after menopause have a reduced rate of insulin resistance and type 2 diabetes development, compared to those who remain oestradiol deficient (1, 2). Further studies have also proposed that hormone replacement therapy improves glucose control in menopausal women with pre-existing diabetes, suggesting that oestradiol can increase insulin sensitivity (3). This goes a long way towards understanding the common ‘middle aged spread’ that appears with menopause (and oestrogen deficiency).

A less relatable, but more direct study has shown that female mice who had their ovaries removed developed significant weight gain and reduced insulin response (insulin resistance). When these same mice were given oestradiol treatment, their insulin sensitivity improved, and their metabolic risk reduced (4). Whilst this is not a human study, it quite clearly and directly shows a powerful link between oestradiol and weight gain/insulin response. Clinical and animal studies have revealed that a loss of circulating oestrogen can induce a rapid change in whole body metabolism, fat distribution and insulin action. The exact way that oestrogen causes this response is still being determined.

Unfortunately, I am not saying that oestrogen is the answer to your weight gain concerns (it would be a nice, straight forward answer!), but I am saying that oestrogen should not be feared. It is our feminising hormone, it is a strong part of what makes us women, and it plays many large and wide positive roles within our bodies (bone health, heart health, mental health, skin health, metabolic health, etc.).

Oestrogen needs to be viewed in its entirety. There are potential negatives associated with oestrogen, and unfortunately these negatives take a lot of the spotlight and easily and understandably place a shadow over the oestrogen hormones as a group. Don’t forget to look at both sides of the picture.

Most people I speak to are concerned that oestrogen will cause sweet cravings and weight gain. This is absolutely one of the biggest concerns I hear when the discussion of starting oestrogen is considered. VERY interestingly, there are no studies on how oestrogen excess leads to sweets cravings and weight gain.

The best link I can find, is that our taste buds potentially change as per our hormone levels, leading to a change in food preference (5-8). And as our moods change with hormonal fluctuations (think classic PMS moods) our minds might take us to comfort eating.

Don’t forget that the individual picture, history and symptoms need to be taken into consideration when assessing hormonal balance. Speak with the team at the Australian Menopause Centre if you want to discuss your hormone picture, your hormone needs or your hormone concerns. Its not as simple as it was once believed.

1. Salpeter SR, Walsh JM, Ormiston TM, Greyber E, Buckley NS, Salpeter EE. Meta-analysis: effect of hormone-replacement therapy on components of the metabolic syndrome in postmenopausal women. Diabetes, obesity & metabolism. 2006;8(5):538-54.
2. Pentti K, Tuppurainen MT, Honkanen R, Sandini L, Kroger H, Alhava E, et al. Hormone therapy protects from diabetes: the Kuopio osteoporosis risk factor and prevention study. European journal of endocrinology. 2009;160(6):979-83.
3. Szmuilowicz ED, Stuenkel CA, Seely EW. Influence of menopause on diabetes and diabetes risk. Nature reviews Endocrinology. 2009;5(10):553-8.
4. Gupte AA, Pownall HJ, Hamilton DJ. Estrogen: an emerging regulator of insulin action and mitochondrial function. Journal of diabetes research. 2015;2015:916585.
5. Alberti-Fidanza A, Fruttini D, Servili M. Gustatory and food habit changes during the menstrual cycle. International journal for vitamin and nutrition research Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung Journal international de vitaminologie et de nutrition. 1998;68(2):149-53.
6. Elliott SA, Ng J, Leow MK, Henry CJ. The influence of the menstrual cycle on energy balance and taste preference in Asian Chinese women. European journal of nutrition. 2015;54(8):1323-32.
7. Bowen DJ, Grunberg NE. Variations in food preference and consumption across the menstrual cycle. Physiology & behavior. 1990;47(2):287-91.
8. Saluja P, Shetty V, Dave A, Arora M, Hans V, Madan A. Comparative Evaluation of the Effect of Menstruation, Pregnancy and Menopause on Salivary Flow Rate, pH and Gustatory Function. Journal of clinical and diagnostic research : JCDR. 2014;8(10):Zc81-5.