Combating Menopause Belly With Hormone Therapy: Getting Back to Your Goal Weight

Woman exercising to combat menopause belly.

A woman’s physiology and metabolism are firmly connected to her hormones, especially estrogen and progesterone. It is no wonder then that menopause can bring unwanted changes that affect your health. Understanding the implications of this hormonal milestone can empower you to take a preventive stance. 

As you approach midlife, your body begins to transform. You may experience irregular periods, vaginal dryness, hot flashes, fatigue, or mood changes—or all of the above. With so many changes happening, you may not initially notice a bit of weight gain until it settles around your waist.

Abdominal weight is often an important sign of hormonal transition. And it isn’t just a matter of aesthetics; it is also a symptom of metabolic change. Knowing why “menopause belly” happens and how hormone therapy can open up options for looking and feeling your best.

The Signs and Symptoms of Hormonal Change

As menopause approaches, the production of the two main female sex hormones—progesterone and estrogen—slowly winds down. In the absence of these hormones, the ovaries will stop eventually releasing eggs, and your menstrual cycle will stop. This process takes 4-8 years on average and is referred to as perimenopause. Menopause is the point when a woman has not had a period for 12 months. 

Though each woman’s experience is unique, the time leading up to menopause is often characterized by emotional, physical, and cognitive symptoms that can range drastically in severity and duration. These may include:


Anxiety, depression, irritability, mood swings.


Hot flashes, vaginal dryness, headaches, fatigue, abdominal weight gain.


Brain fog, forgetfulness, lack of concentration, inability to focus.

For some women, shifting body composition, including unexpected weight gain, is the change that spurs them to consult their doctor. 

Being concerned about physical change isn’t an issue of vanity. Looking and feeling different than you are used to or than you want to can be emotionally difficult and deeply impact your confidence. Additionally, abdominal weight gain increases the risk of insulin resistance, type 2 diabetes, heart disease, metabolic syndrome, and high blood pressure.

How to Combat Menopause Belly

Preventing or correcting central obesity, sometimes known as menopause belly, is as much about preventing chronic disease as it is about looking your best. Smart lifestyle choices can help you counteract abdominal weight gain and support greater wellness in midlife. 

Eat a Balanced Diet

Perimenopausal hormone changes cause a loss of muscle mass and the deposition of fat around the abdomen. Eating a diet built on lean protein, healthy fats, whole grains, and plenty of fruits and vegetables and avoiding excess calories can help you maintain a healthy weight and minimize the accumulation of fat. It can also support bone mineral density and prevent osteoporosis. Talk to your doctor about your caloric and nutritional needs to ensure you are on the right track.

Exercise Regularly

Adding aerobic and weight-bearing exercise to your routine is a powerful way to burn calories, retain muscle, and combat menopause belly. However, many women find it difficult to get moving as they approach menopause. Some research suggests falling estrogen may be responsible for this lack of motivation, which means that without the benefit of estrogen, maintaining a healthy body composition could be an uphill battle.

Monitor Health Parameters

By being diligent about preventive care, you can minimize your risk of many of the chronic health problems that affect postmenopausal women. Routine monitoring of blood pressure, glucose, cholesterol, and other biomarkers can help your doctor catch anomalies as early as possible. 

Consider HRT

While lifestyle strategies can go a long way toward helping you look and feel your best, none compensate for the loss of estrogen and progesterone. That’s why many women rely on hormone replacement therapy (HRT). Restoring your hormones to optimal levels may alleviate menopause symptoms and protect against common health conditions that often arise in midlife. Compounded bioidentical hormone therapy allows your doctor to create a personalized treatment plan based on your body’s needs.

The Benefits of Preventive Care Are More Than Skin Deep

Though menopause belly may be the outward sign that motivates you to seek treatment, the implications are more than just skin deep. A 2020 study found that menopause was associated with a higher risk of impaired glucose tolerance, elevated blood pressure, and elevated triglycerides. As the authors note, this means that “perimenopause may be an important preventive care opportunity to assess metabolic risk factors and improve health and longevity.”

Making smart lifestyle adjustments and seeking expert care are the best ways to set yourself up for success as menopause approaches. A practitioner who specializes in hormonal health can give you the guidance and support you need to not only address your menopause belly, but take control of your wellbeing for years to come.

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