Does HRT Help With Weight Loss? What To Expect From Hormone Therapy During Menopause
Doctors reveal how to keep your metabolism up whether you’re on HRT or not
Many women going through menopause turn to hormone replacement therapy (HRT) to help alleviate symptoms like hot flashes, vaginal dryness and insomnia. But does HRT help with weight loss, too? And what happens when you stop taking it? Keep reading to learn more about the role HRT plays in weight loss and weight gain, and to discover how discontinuing HRT may impact your body.
Does HRT help with weight loss?
Before we go into how stopping HRT can affect your weight, we first need to understand what happens when you’re on it. Hormone replacement therapy helps correct hormonal imbalances and reverses declining hormone levels (such as estrogen). This can help ease symptoms of menopause—yes, even weight gain—especially when paired with a balanced diet and regular exercise.
That said, HRT itself is not a weight loss drug, despite its ability to help decrease belly fat and mildly support your metabolism, explains Barbra Hanna, DO, FACOG, NCMP, board-certified ob-gyn and founder of MyMenopauseRx.
Woman's World Answers
So how exactly does it aid weight loss? According to Kathleen Jordan, MD, NCMP, Chief Medical Officer at Midi Health, studies show that HRT helps manage weight distribution, deflecting the tendency to gain belly fat during menopause.
In fact, one recent study found that up to 70 percent of women experience weight gain during the menopause transition. But the researchers noted that those who took HRT in addition to the weight loss drug semaglutide (Ozempic, Mounjaro, Wegovy) lost more weight than those who were on semaglutide alone.
Dr. Jordan adds that HRT has also been shown to help patients sleep, feel more energized and engage meaningfully in exercise and movement.
Does stopping HRT cause weight gain?
As weight loss isn’t guaranteed with being on HRT, weight gain also isn’t guaranteed if you go off of it. “The bodily changes that come with stopping HRT will depend on a few variables, including the type of HRT taken, whether the patient is in perimenopause or full menopause and their overall health,” says Dr. Jordan.
Some women may also notice shifts in their weight distribution after stopping HRT, such as gaining some of their “menobelly” back or losing muscle mass. “Without estrogen’s support, fat storage patterns often shift back toward the abdominal area, and you may notice undesirable changes in your lipids and blood sugar levels due to estrogen’s role in supporting metabolism and blood sugar activity,” says Dr. Jordan
Whether you’re going on or off HRT, it’s important to know that weight gain or loss depends on numerous factors such as diet, exercise, genetics and/or overall lifestyle habits, especially as you age says Brynna Connor, MD, Healthcare Ambassador at NorthWestPharmacy.com.
How stopping HRT affects your metabolism
If you decide to stop HRT, you can expect some shifts in your metabolism. Changing hormones can affect your gut microbiome, which affects metabolism and how you absorb nutrients, explains Bruce Dorr, MD, FPMRS, FACOG, a senior medical advisor for Biote. Testosterone helps maintain muscle mass, while estrogen “helps with free fatty acid metabolism, and its absence can lead to weight gain,” he says.
Dr. Connor adds that when you stop HRT, especially if you’ve been on it for a while, you may experience a decrease in your resting metabolic rate (RMR). “This potential decrease could cause your body to burn fewer calories at rest, possibly leading to weight gain and/or difficulty losing weight.”
Another possible change? “Estrogen has been shown to enhance metabolic function and prevent insulin resistance, so stopping HRT could negate any positive metabolic effects you experienced,” says Dr. Hanna.
How to lose weight after stopping HRT
Nutrition plays a big role in how the body adapts post-HRT. “Avoiding large amounts of simple carbohydrates, prioritizing protein and eating enough fiber-rich foods and healthy fats can help keep metabolism steady and prevent unnecessary weight gain,” says Dr. Jordan.
She adds that cutting back on refined carbs and sugar is especially important since, during menopause, 40 percent of women head into prediabetes. Don’t neglect hydration and gut health, either. “Foods rich in probiotics and prebiotics can help digestion and overall metabolic function,” says Dr. Jordan.
Exercise helps, too
Dr. Hanna notes that all women, whether on or off HRT, will lose muscle mass with age. “Since muscle naturally burns more calories than fat, one of the most effective strategies to maintain your weight is to add strength training to your self-care regimen at least two to three times per week,” she says.
Building the larger muscle groups of your legs and chest is the most effective way to do this. “Muscle helps with metabolism and, long-term, keeps your functions high and consistent,” says Dr. Dorr. Tip: While strength training is key, it’s easier to stay motivated if you’re doing exercises or workouts that you enjoy. (Check out three fun treadmill workouts to get started.)
Remember that weight changes in menopause aren’t just about calories in and out—sleep, stress and overall hormonal balance all play a role. Whether you’re navigating HRT or other treatment options, Dr. Jordan suggests taking a personalized approach to midlife because no two women experience menopause the same way.
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