Perimenopause Weight Gain

perimenopause weight gain

Can you overcome perimenopause weight gain? We look at how diet and exercise play essential roles in maintaining weight and health during and after menopause

  • As you transition through perimenopause and menopause, it is normal to gain weight, particularly abdominal weight or belly fat.
  • This is caused by a change in hormone levels.
  • Excess weight around a woman’s middle is linked with an increased risk of cardiovascular disease.
  • You can reduce risks by making healthy lifestyle choices.

Menopausal transition or perimenopause (means ‘around menopause’) lasts 2 to 8 years, the average being 4 years. As a woman nears menopause her ovaries gradually stop making the hormones estrogen and progesterone, and testosterone levels drop. With estrogen fluctuating menstrual cycles change in length, can become irregular, or might skip a cycle. Some more common symptoms of menopause are hot flushes, vaginal dryness, hair loss (and gain), mood swings, night sweats, sleep problems, and weight gain. 

Why do women gain stomach fat during perimenopause? 

While each woman’s experience with perimenopause and menopause is different, the change in hormone levels, mainly estrogen, often influences body fat distribution. Many women find they gain fat mass, particularly around the abdomen, during perimenopause and the early post-menopause years. 

Excess weight around a woman’s middle is linked with an increased risk of cardiovascular disease. An Australian government health website cites animal studies showing that a lack of estrogen leads to unwanted abdominal fat, saying the exact mechanisms are not yet understood

Estrogen maintains a woman’s cholesterol levels in the blood, so a drop in estrogen levels can mean an increase in LDL (bad) cholesterol and a decrease in HDL (good) cholesterol. This spike in bad cholesterol increases the risk of heart disease, stroke, and type 2 diabetes. 

And during this period a drop in testosterone levels is linked with slowing normal metabolic functions and a decrease in muscle and bone strength, also contributing to weight gain. 

Targeting that unwanted belly fat. What’s the advice for perimenopausal women experiencing weight gain?

Move more, eat less. As you age you need fewer calories. Women require 200 fewer calories per day in their 50s than in their 20s. Up to the age of 50 moderately active women generally need around 2,000 calories a day, after 50 years daily calorie intake should decrease to around 1,800. 

Weight gain and increased stomach fat happen as a result of aging, regardless of hormones. Lifestyle factors (diet and exercise) and genetics can play a role. And overweight women, or women with obesity, are more likely to experience higher weight gain due to changes in hormones.

Eat a healthy, balanced diet. Avoid restrictive or rapid weight-loss diets and try to eat fewer processed foods and refined sugars.

Exercise regularly, daily if possible. The Mayo Clinic recommends at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity every week. Doing strength training and weight-bearing exercise at least twice a week will help build and maintain muscle mass to prevent osteoporosis

Accept that age and hormone-related changes in your body are totally natural and try to reduce risks by making healthy lifestyle choices. Unwanted physical and mental changes during menopause can cause confusion and distress so don’t be afraid to seek medical advice. Your doctor can advise on appropriate treatment including hormone replacement therapy (HRT) and alternative therapies. 

Perimenopause is the first stage at the end of a woman’s reproductive years. Menopause is when you have gone for 12 months or more without having your period. During post-menopause many of your menopausal symptoms will ease, but the risks for heart disease and osteoporosis will increase. It’s important to talk to your doctor or an experienced medical practitioner who can offer support and advice during each stage.

Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and menopause. You can track your symptoms and get personalised support by using the Nabta app.

Get in touch if you have any questions about this article or any aspect of women’s health. We’re here for you. 


The Mayo Clinic, Healthy Lifestyle

Better Health Channel, Menopause and weight gain, http://Better Health Channel, Menopause and weight gain,

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