Does HRT Cause Weight Gain? A Comprehensive Analysis

Last updated 04.16.2024 | by Sabrina Johnson | 7 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.

HRT is one of the most preferred options by many women to manage several menopausal symptoms like hot flashes, sleep problems, night sweats, moodiness, etc. Menopause means a dip in estrogen levels. HRT helps to make up for the low estrogen levels by substituting for the same. A finding showed that of the women opting for HRT, around 74% of females had both their ovaries removed surgically. About 50% of them underwent hysterectomy, and 29% of them had natural menopause.

Now, let’s get to the topic in question. Can HRT result in weight gain? It isn’t unusual for women to put on additional pounds during menopause. However, many women have reported weight gain when opting for hormone replacement therapy. Is there any truth to this notion? That’s what we will discuss here. I will discuss aspects like why women gain weight in menopause, if HRT causes weight gain, and tips to manage weight in menopause. Here we go.

Do Women Gain Weight In Menopause?

Menopausal weight gain is quite common in most women. In their 50s, women gain 1.5 pounds yearly. When transitioning into menopause, women gain around a pound each year. The average weight gain in perimenopause varies from one woman to the other.

Around 20% of females may gain about 10% while transitioning into menopause. One of the main reasons is hormonal fluctuations, which cause women to put on extra pounds around their abdomen instead of thighs and hips. This isn’t the only reason for weight gain in menopause. When a woman ages, her fat deposits increase while muscle mass decreases.

Low muscle mass decreases metabolism. This means that fewer calories are burned, and there is an increased accumulation of fat in the body, which triggers weight gain. That’s why when you are in your 40s and 50s, you shouldn’t eat recklessly and must pay attention to exercise, lest you may gain weight fast.

Obesity runs in families as well. If anyone in your family is heavier, you may also follow suit.

Does Hormone Replacement Therapy Cause Weight Gain?

Now, let’s get to one of the most significant questions: Is weight gain a side effect of hormone therapy? Hormone therapy has many benefits, as I mentioned above. It is essential in controlling a majority of menopausal symptoms. However, where there is a boon, there is a bane. HRT also comes with its set of side effects.

A lady once said that she had considered the option of HRT to lessen hot flashes, which was getting troublesome eventually. However, the scary stories she heard from her mom-in-law and mom regarding putting on the extra pound compelled her to stay away. To answer this, I would say HRT has side effects, which vary from one woman to the other. However, they aren’t as scary as people perceive them to be.

Regarding weight gain, there is little evidence about the direct impact of HRT on increasing your weight. Studies have also shown that some variants of estrogen help to prevent an increase in your body mass, which is quite common in menopause. Some women often experience bloating, swelling, breast tenderness, and water retention as an after-effect of hormone therapy. This may appear closely similar to the effects of weight gain.

Stress is a common factor experienced by almost half the perimenopausal and menopausal women. In stressful moments, sometimes your appetite may also take a toll. However, when on hormone therapy, your fluctuating hormones get balanced, and it helps to lessen stress effectively. When you are less stressed, your appetite may return to normal, and you could gain weight, especially if you binge eat a lot. This isn’t applicable for all, but it is just an assumption of one of the few reasons why HRT could trigger weight gain.

Some of the side effects of HRT include nausea, headache, vomiting, vaginal cramps, allergic reactions, an increase in blood pressure, etc. If you are experiencing these side effects after taking HRT, it is always important to consult your doctor at the earliest.

Tips for Weight Management in Menopause

You can control the menopausal weight gain by making some lifestyle changes. Here are some tips to follow:

  • Eating healthy is paramount for managing weight gain and controlling other menopausal symptoms. Eat a lot of vegetables and fruits. Include nuts, pulses, beans, and fish once or twice weekly. You must also consider making legumes, unsalted nuts, and seeds (four or five portions) a part of your diet each week.

    I would like to be more specific about fish. Make sure you are having oily ones high in omega-3 fatty acids. The fish to choose from include trout, mackerel, herring, salmon, and sardine. Lessen your intake of fatty, sugary, and salty foods, as they may trigger weight gain and make you more susceptible to several health issues.
  • Physical fitness is another mandate for managing most menopausal symptoms. Exercise improves muscle mass, enhances balance and coordination, and contributes to a healthy weight. Stress upon moderate physical activities like swimming, brisk walking, and mowing for 2.5-5 hours weekly. Another recommended exercise regime is 1.25-2.5 hours of intense physical activity like fast cycling, jogging, aerobics, and even indulging in team sports. You should begin slowly and then increase your workout level. If you have any heart issues and other pre-existing conditions, consult your doctor before indulging in any intense workout.
  • Sleep deprivation is common in menopause due to hormonal imbalances and several physical changes that you may experience. When you sleep less for a long span, your weight spikes. Insufficient sleep increases ghrelin levels, the hormone responsible for an increased appetite. It even lessens your leptin levels, which promotes a feeling of fullness.

    When you eat a lot, your weight will increase. That’s why maintaining a proper sleep schedule is essential. You may even opt for yoga, breathing, and relaxation techniques for better sleep.
  • Around 50% of menopausal and postmenopausal women experience stress. Did you know? Chronic stress puts you at risk of weight gain, which has even been established through studies. That’s why keeping your anxiety levels under control is needed. Besides opting for relaxation methods, you could even seek a counselor’s consultation if controlling your stress in menopause gets difficult.


When should you consult a doctor regarding weight gain from menopause?

If you are gaining weight quickly during menopause and it is affecting your daily life, you must seek a doctor’s consultation as soon as possible. Rapid weight gain may put you at risk of bone-related issues, cardiac problems, and other complications. That is why seeking a doctor’s consultation is vital.

Does hormone therapy help with weight loss in menopause?

Hormone therapy, as mentioned above, helps with several menopausal symptoms. The direct impact of HRT on weight gain or loss hasn’t yet been confirmed. In menopause, women are at risk of abdominal weight. Hormone replacement therapy is known to redistribute fat to all parts of the body and prevent it from accumulating only in the middle section. So, HRT may be effective in that way. Yet, you must consult your doctor and discuss the impact of HRT on weight reduction before you opt for the same.


Hormone replacement therapy may help manage weight, but that’s not the only thing you can rely on when dealing with increased weight gain in menopause. Managing your lifestyle, watching your diet, and prioritizing exercise are also crucial.


  • Sabrina Johnson

    Meet Sabrina Johnson, a compassionate author and a seasoned expert in Obstetrics and Gynecology. She is a driving force behind Simply Menopause, where her extensive medical knowledge and empathetic nature come together to empower women in their menopausal journey. Sabrina offers culturally sensitive guidance and support through her approachable writing, making her a trusted friend on the path to menopause wellness.