Estrogen promotes the storage of fat for healthy reproductive years. When estrogen is balanced, the right amount of fat helps carry out female reproductive functions. However, when there's too little or too much estrogen, weight gain often results.
Additionally, improving dietary choices, increasing physical activity, getting more sleep, managing stress levels effectively, quitting smoking, and limiting alcohol are all ways to decrease and avoid hormonal weight gain.
Estrogen causes a typical female fat distribution pattern in breasts, buttocks, and thighs, as well as its more feminizing effects. During the reproductive years, women get additional fat deposition in the pelvis, buttocks, thighs, and breasts to provide an energy source for eventual pregnancy and lactation.
And changes in these hormones can sometimes result in unexpected — and uncontrollable — weight gain. A few examples include: Estrogen shifts. During menopause, a decrease in estrogen is linked to lower muscle mass and increased fat stores for women, usually around the midsection.
“Women also become more estrogen-dominant as we move into perimenopause and beyond. Estrogen dominance promotes insulin resistance, which causes the belly fat build-up,” she says.
Eating a healthy diet rich in complex carbohydrates, healthy fats, and whole grains, exercising regularly, and managing stress levels are essential for reducing hormonal belly fat.
Low estrogen levels also change where fat is stored. It's normally stored in the thighs and hips, but when estrogen production takes a hit, fat storage shifts to visceral fat in your belly. Not only is visceral fat deeper, but it's tough to remove and increases your risk for disease.
Another reason why some women may appear to gain weight occurs when background anxiety, with reduced appetite, keeps weight a little lower than it would be naturally. This anxiety is often reversed by the positive impact of HRT, which in turn can increase appetite and weight over time.
Some evidence suggests that estrogen hormone therapy increases a woman's resting metabolic rate. This might help slow weight gain. Lack of estrogen may also cause the body to use starches and blood sugar less effectively, which would increase fat storage and make it harder to lose weight.
Bloating, or swelling due to a buildup of fluid in the tissues can cause weight gain. This may be due to menstruation, heart or kidney failure, preeclampsia, or medicines you take. A rapid weight gain may be a sign of dangerous fluid retention. If you quit smoking, you might gain weight.
Weight gain and HRT
There's little evidence that most types of HRT make you put on weight. You may gain some weight during the menopause and as you get older, but this often happens whether you take HRT or not. Exercising regularly and eating a balanced diet should help you to manage your weight.
The research shows that menopausal HRT doesn't cause weight gain. That being said, it's common to gain a small amount of weight during this time of life. Stopping HRT won't make much difference for your weight. But other factors can affect your weight, including your diet and exercise habits.
High estrogen and low progesterone levels can lead to water retention and bloating. Estrogen often acts as a fluid retaining hormone, while progesterone is a natural diuretic.
You may feel bloated and uncomfortable like having trapped wind. This can be due to the progesterone and usually settles with time.
All of the data that we have suggests that HRT does not cause weight gain and it is in fact menopause that causes weight gain. Of course weight gain is very multifactorial. Many women actually find that they lose weight by using HRT as it shifts the metabolism back into a pre-menopausal metabolic state.
Occasionally, patients gain weight at the beginning of HRT as their hormones get regulated. But this side effect generally subsides within weeks. And while some patients report losing weight with HRT, that's because the work they were already doing to eat a healthy diet and get exercise can finally pay off.
Symptoms of a high HRT dose: Nausea and vomiting. Breast tenderness and enlargement. Spotting or heavy bleeding.
Your body needs estrogen for your reproductive, cardiovascular and bone health. Too much estrogen, though, can cause irregular periods and may worsen conditions that affect your reproductive health. Your provider can help diagnose what's causing your high estrogen levels and recommend treatments that can help.
Estrogen helps protect the heart from disease, potentially by maintaining higher levels of good cholesterol, called high-density lipoprotein (HDL), in your blood. Lower estrogen levels, especially during menopause, can increase your risk of developing heart disease.
Many women notice an increase in belly fat as they get older even if they don't gain weight. This is likely due to a lower level of estrogen because estrogen seems to have an effect on where fat is located in the body. Genes can contribute to an individual's chances of being overweight or obese too.
Recent studies show that menopausal women on hormone therapy tend to have less body fat, especially visceral belly fat. Because estrogen affects how your body distributes fat, low estrogen levels can contribute to gaining fat in your belly area.