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.