40s woman doing plank in living room

The Truth About Menopause, Weight Gain and "The Pooch"

By Colleen McCleery, MD, OB/GYN—Exuberan® by Virtua

Menopause is a mixed bag of little surprises. While most women look forward to saying goodbye to tampons and pads, far fewer are excited to now experience hot flashes and night sweats. And it's probably fair to say that weight gain is the least popular and often least expected "side effect" of this hormonal shift. 

Considering many women struggle with their weight on a good day, it's not surprising that this is the number one complaint from patients going through this transition.

The biology of menopause

During the late 40s to mid-50s, a hormone called FSH (follicle-stimulating hormone) increases and no longer performs its job to regulate the ovaries. During this increase in FSH, other hormones like estrogen, progesterone, and testosterone decrease.

decrease in testosterone can lead to weight gain and decreased energy. And, not surprisingly, estrogen loss has far-reaching effects beyond hot flashes.

  • It contributes to reduced tissue elasticity and moisture loss, which can cause pain with sex.
  • It affects desire and interest in sex.
  • It contributes to memory loss or other mood changes such as irritability and depression.
  • It affects calcium balance, causing it to leech from the bones.

But why weight gain?

You may be frustrated if you have healthy habits, but your body doesn't change the way you'd expect. That's because estrogen is a crucial player in maintaining weight balance. Estrogen loss can change how your weight is distributed—directing an accumulation right to your abdominal area (what women often refer to as "the pooch"). It also lowers your metabolic rate and can affect your sleep habits. All of these issues combined create the perfect scenario for weight gain.

When you aren't sleeping well, you tend to feel hungrier during the day and compensate for your fatigue by increasing carbohydrate intake. Excess carbohydrates are converted to—and stored—as fat. Your body finds this especially handy since fat releases more of the extra estrogen that it's missing.  

You're never too young to prepare

As you enter your late 40s, it's important to make sure regular exercise becomes part of your routine. Ideally, 30 minutes, 4-5 times a week, can help you stay healthy.

Find exercises that interest you, so you stay committed, and be sure to include aerobics (great for cardio and fat burning) and weight training (great for preventing bone loss and reinforcing aging joints). Then, as your hormones shift, you already have a head start. And don't forget to reinforce all of your hard work by eating lean proteins, vegetables, fruit, whole grains, and low-fat dairy (or non-dairy substitutes) to support good health. 

You also can talk to your OB/GYN about managing your menopause challenges with hormone replacement therapy, including bioidentical hormone replacement.

To make an appointment, call 844-896-6367.

Updated May 17, 2021

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