Hormonal Changes Affect Your Weight During Perimenopause and Menopause

At some point during your menopausal journey, you are bound to experience the side effects of shifting hormonal levels.  I reached out to Dr. Apovian who is the Director of the Nutrition and Weight Management Center at Boston Medical Center, a Professor of Medicine at Boston University School of Medicine, and Vice President of The Obesity Society to help us understand why hormonal changes affect our weight.

She explained that the ovaries begin to produce less estrogen around age 30 for most women, marking the start of perimenopause.  Around the same time, our natural levels of melatonin drop, in turn impacting our hunger and stress hormones.  All of these hormones play important roles in the metabolism and maintaining a healthy weight.

It seems that estrogen, melatonin, cortisol, ghrelin and leptin are some of the main culprits! Dr. Apovain’s breaks it all down for us in a very “layperson friendly” manner and then discusses ways to reverse that weight gain that usually accompanies middle age:


Your ovaries begin to produce estrogen during puberty. Many women are not aware that fat cells also produce estrogen. During menopause, the amount of this important hormone produced by your ovaries decreases. Your fat cells try to compensate for the hormonal imbalance by swelling and becoming larger. These fat cells typically congregate around your waist, as the fat cells in your abdomen are capable of producing more estrogen than fat cells on either the thighs or hips.

Aside from an unpleasant shift in your body shape, extra visceral fat, particularly stored in the belly, raises risks for type 2 diabetes, metabolic syndrome, and cardiovascular disease.

Dr. Apovian’s Recommendations:

Adjust your diet to reduce or eliminate the foods that exacerbate hormonal imbalance, such as added sugars, processed foods, caffeine in excess, alcohol, and foods high in saturated fat, such as fried foods and full-fat dairy items.  Eat a diet rich in lean protein sources, which both help you to maintain lean tissue and lose weight in mid-life.  Add some foods that imitate estrogen in the body, such as soy proteins and flaxseed meal to help alleviate the side effects of your shifting hormonal levels.  And of course, more physical activity is always beneficial for managing your weight and alleviating the side effects of menopause.


Did you know that your melatonin levels begin to decrease around age 30?  If you ever wondered why you were able to sleep so soundly and deeply as a young adult, yet struggle to do so now, blame your lowered levels of melatonin.  For women, increased incidence of hot flashes, restless leg syndrome, sleep apnea, and a more frequent urge to urinate during the night makes getting enough sleep even more challenging. 

How does this relate to weight?  Our muscles, the primary drivers of our metabolism, are repaired while we sleep.  Getting less than 7-9 hours per night consistently slows the metabolism, in addition to ramping up hunger and stress hormones the following day.

Dr. Apovian’s Recommendations:

Many of us balancing the demands of work and family life consider sleep a luxury.  This mindset needs to change!  Make it a priority to guard your health, your longevity, and your ability to be a support to your family and your office by consistently aiming for 7-9 hours of sleep per night.  Go to bed and rise at the same time every day, power down devices a couple of hours before bed, stop drinking caffeine at noon, and add physical activity into your daily routine to help your body to prepare for sleep.  If you continue to have trouble, try adding some tart cherry juice concentrate into your diet, which is one of the richest natural sources of melatonin available.  Enjoy a couple of tablespoons in a smoothie or diluted in water a few hours before bedtime.


Stress signals our bodies to prepare for fight or flight by releasing the hormone cortisol.  When our bodies experience chronic stress, they believe that energy has been expended in fighting off the stressor, whether we actually engaged in physical exertion or not.  As a result, cortisol causes an increase in appetite, particularly cravings for sugar. In turn, high sugar and insulin levels signal the body to store fat, especially around our midsections. Heightened levels of cortisol also interfere with our ability to sleep soundly. Sleep deprivation is a stressor in and of itself, in addition to a strong factor in weight gain and metabolic aging, triggering a cycle of stress, weight gain, and more trouble sleeping.

While heightened cortisol levels are not unique to mid-life, the pressures many of us balance, in addition to adapting to our changing bodies during menopause, can be challenging, to say the least. 

Dr. Apovian’s  Recommendations:

If you have chronic stressors in your life (and who doesn’t?), prioritize consistent, sufficient sleep and find alternative ways to relieve stress, apart from eating.  Regular exercise is a wonderful way to improve mood and lower cortisol levels, and seeking out social support is another healthy way to manage stress and stick to your goals.  I find that jotting down my stressors before going to bed helps me to process them and fall asleep faster.  Consulting a professional, such as a cognitive-behavioral specialist, has also proved particularly effective for people to lose weight, manage stress, and sleep more soundly. 

Ghrelin and Leptin

These are the hormones that signal hunger and satiety, or fullness. When they are working together in a healthy balance, ghrelin notifies our brains when we need to eat, and leptin signals that we have had enough for our energy needs.   Insufficient sleep, caused by lowered levels of melatonin and estrogen, chronic stress, and added sugars in the diet all cause these hormones to become unbalanced.  A chronic lack of sleep increases ghrelin and suppresses leptin, which explains why we feel ravenous after a sleepless night, no matter what we eat.  Insufficient sleep also ramps up our cortisol levels, leading to feelings of anxiety and a tendency to overeat.  A diet high in added sugars triggers our bodies to develop a resistance to leptin, interfering with our ability to feel full and satisfied. 

In addition, our bodies require fewer calories as we approach middle age.  However, since many of our eating patterns are dictated by habit, most of us continue eating the same amount in our 40s as we did in our 20s.  Regularly overeating contributes to heightened ghrelin levels.

Dr. Apovian’s Recommendations:

Consistently getting enough sleep and managing your stressors will go a long way in balancing out these important hormones.  In addition, eat a diet rich in lean protein sources.  Protein is the most satiating of the macronutrients and keeps you feeling full and satisfied longer between meals, for fewer calories.  Try my high protein smoothies, specifically designed to battle the weight gain that accompanies middle age.

Armed with the correct information and guidance, we can combat that menopausal weight gain. Now, I am off to have a serious talk with my fat cells!

My Motto:  Suffering in silence is OUT!  Reaching out is IN!

For more great tips on how to deal with menopause download my free ebook: MENOPAUSE MONDAYS  the Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.   

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Ellen Dolgen, spurred by her own experience struggling with the symptoms of menopause, is devoted to helping women everywhere. Through and her FREE eBook, MENOPAUSE MONDAYS The Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause, she shares the expertise of numerous specialists to replace confusion and embarrassment with medically sound solutions, presented in an entertaining and informative way. From hot flashes, insomnia, mood swings, mental fogginess, loss of libido, heart health, and lots more in between, provides empowerment for women to become their own best health advocates. Her motto is: Suffering in silence is OUT! Reaching out is IN!