The Heavy Truth About Weight Gain in Perimenopause

January 17, 2020.

Okay, you may have noticed that pants may be fitting a little tighter in the thighs and waist and perhaps shirts are fitting more snug on your arms. Maybe you have stood naked in front of a full-length mirror and determined that your body isn’t looking quite like it used to in your 20’s and 30’s. Here’s the thing – it shouldn’t look like a 20-year-old’s body! You have done a lot of living in your skin if you have reached perimenopause and your body has done some amazing things. Nonetheless, you are not alone if you feel discouraged by the number on the scale or are carrying excess weight. Furthermore, it is not just by coincidence that many women gain weight at the onset of perimenopause.

Does perimenopause cause weight gain?

Yes, perimenopause can cause weight gain. Indeed, weight gain is one of the 34 symptoms of perimenopause. You may be wondering why perimenopause causes weight gain. However, you likely already know the answer: changes in hormones. You are probably tired of hearing that hormones are the culprit behind many of your annoying perimenopause symptoms, including weight gain. Read on for information about what is going on with the hormones that may be causing you to gain weight.

During perimenopause, estrogen levels fluctuate greatly daily, and may even change throughout the day. At the same time, progesterone levels experience a slower decline. At the onset of perimenopause, the ovaries often produce high amounts of estrogen due to miscommunication between the ovaries and two parts of your brain: the hypothalamus and the pituitary gland. As perimenopause progresses, you produce less estrogen as your menstrual cycle becomes more irregular. It is during the phase of high estrogen circulating in your bloodstream that women typically begin to gain weight.

Some studies have linked high levels of estrogen to an increase in fat. Biologically, this increase in fat related to high estrogen levels is to promote fertility and fetal development during the reproductive years. This is great when you are reproducing, but not so great when you are saying goodbye to your reproductive years like in perimenopause.

Changes of Fat Distribution in Perimenopause

The areas of our body where we store fat also changes when we reach perimenopause. Between puberty and perimenopause, we typically store fat in our hips and thighs whereas during perimenopause and menopause fat storage moves to the abdomen. When fat is stored in the abdomen, it is qualified as visceral fat and is linked to health problems including:

  • Insulin resistance
  • Type Two Diabetes
  • Metabolic Syndrome
  • Heart Disease
  • Obesity
  • Osteoarthritis

On average, women in perimenopause typically gain 2-5lbs during perimenopause. However, many women gain significantly more weight than the average and, if you are already overweight or obese, you are more likely to gain even more weight. Some women experience an increase in appetite during perimenopause. One study found that ghrelin (the hunger hormone) was significantly higher in perimenopausal and postmenopausal women. Low estrogen levels can impair the function of leptin and neuropeptide Y, which are hormones that control fullness and satiety

What Causes Menopause Weight Gain Besides Hormones?

There are many other factors that can lead to weight gain unrelated to perimenopause and menopause. In fact, some studies have demonstrated that women between ages 42-50 demonstrate weight gain whether they continue to have normal cycles or have entered menopause. Therefore, weight gain may be part of the aging process regardless of hormones. Similarly, part of the aging process can include a loss of muscle mass with an increase in fat mass. Muscle loss slows your rate of metabolism because your body is not requiring as many nutrients for muscle support. Other non-hormonal factors that may contribute to weight gain during perimenopause include:

  • Genetics
  • Lack of physical activity
  • Unhealthy eating
  • Stress
  • Fatigue
  • Poor sleep

Perimenopause weight gain is not inevitable and is reversible, and even preventable, with certain lifestyle modifications.

Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.

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Julia Walker
perry expert Julia (RN, BSN, BA) is a registered nurse based in Colorado. Julia's nursing background in women’s health has ranged from neonatal and postpartum care to labor and delivery, to outpatient gynecological medicine for both adolescent and adult populations. She specializes in helping women optimize their health during perimenopause and beyond.

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