Does hormone replacement therapy during menopause make women gain weight?

November 19, 2010 at 12:00 am in Healthy Living by Holly Thacker, M.D.

It’s a fact: Our metabolism changes as we age. By mid-life, few of us can get away with drive-through dinners or late-night eating without tipping the scale. As we celebrate more birthdays, metabolism naturally slows. Simultaneously, we lose muscle mass, and since muscle helps burn calories, our bodies must work harder for us to afford any extra portions or desserts.

Hormones and weight

Whether you’re naturally menopausal or your ovaries were removed through a hysterectomy, you are likely to notice an accelerated loss of muscle mass. The way to combat this is with weight-bearing exercise such as strength training, which will help build muscle mass. You can do this. I know many women in mid-life and beyond who are stronger and in better shape than some 20- or 30-year-olds.

Is it true that hormone therapy will make me gain weight?

This is a common myth. In fact, women who take hormones are less likely to gain weight than those who are not on HT because they better maintain lean muscle mass. Some women on hormones even lose weight (usually only a pound or two – this is no reason to begin HT).

Women who gain weight on hormones are neglecting proper nutrition and exercise, unless they are reporting water weight gain. Higher doses of estrogen can promote salt and water retention in some women, which can be easily managed by restricting salt intake, reducing the estrogen dose, or occasionally using diuretics.


Dr. Holly Thacker is a menopause health specialist and the author of the Vibrant Nation Health Guide, Recognizing and Treating Menopause Symptoms: A 50+ woman’s guide to managing hot flashes, weight gain, mood swings, depression, vaginal dryness, night sweats and other menopause symptoms.

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