Speakers: Dr Davorka Herman and Asst Prof Ivan Bolanča
“Weight gain after 45 is not inevitable. It’s modifiable. Changing diet and exercise habits is key to maintaining muscle mass, which is central to prevention.”
Menopause is a natural life stage that brings hormonal shifts that can influence weight, body composition, and overall metabolic health. Many individuals notice changes in how their body responds to diet, activity, and stress during this transition. This article provides an evidence-based overview to help clinicians and individuals understand what drives these changes and how to manage them with confidence.
Key topics covered:
- Hormonal changes in menopause
- The role of menopausal hormone therapy (MHT)
- Lifestyle strategies for weight management
- Practical guidance for clinicians
Hormonal Changes in Menopause
A decline in estrogen affects several metabolic pathways. Lower estrogen levels can contribute to increased visceral fat. This type of fat is metabolically active and associated with higher cardiovascular and metabolic risk. These changes are driven by physiology rather than personal choices. Understanding this helps clinicians frame weight changes in a supportive, stigma-free way.
Impact of Menopausal Hormone Therapy
MHT is not a weight loss treatment. It can, however, support healthier body composition when used appropriately. Research shows that MHT may help limit the accumulation of adipose tissue and support lean mass preservation. This effect is most pronounced when MHT is started around the time of menopause. MHT decisions should always be individualised and guided by clinical indications.
Lifestyle Interventions for Weight Management
Lifestyle interventions remain the foundation of metabolic health during menopause. Evidence supports:
- Regular physical activity
- Resistance training to maintain muscle mass
- Adequate protein intake
- Consistent sleep routines
- Stress reduction practices that support metabolic balance
Small, sustainable habits can make a meaningful difference. Clinicians play a key role in guiding patients toward realistic and supportive strategies.
Practical Strategies for Clinicians
A multidisciplinary approach is often the most effective. Clinicians may consider:
- Encouraging structured exercise programmes that include strength training
- Guiding patients toward dietary patterns that prioritise protein and balanced nutrition
- Including MHT as part of a comprehensive plan for symptomatic individuals, when clinically appropriate
Supporting patients with clear explanations and empathetic communication can reduce frustration and improve adherence.
Conclusion
Weight changes after midlife are common but not inevitable. With evidence-based guidance, tailored interventions, and supportive clinical care, individuals can maintain metabolic health and quality of life during menopause. Understanding how hormonal shifts interact with lifestyle factors empowers both clinicians and patients to make informed decisions during this
powered by Borlabs Cookie