Weight gain before, during, and after menopause seems impossible to avoid and can be very frustrating!
Of course, you can blame the dramatic changes in hormone levels for the weight gain -at least partially. Thus, understanding how the hormones work and what you can do to minimize the impact of the changes can help you reach your weight goals.
This blog post focuses on the role of hormone imbalances on menopause weight gain, specifically, it explores the question: does progesterone cause weight gain?
What is progesterone?
Progesterone is a sex hormone produced in the ovaries following ovulation, and it helps prepare the body for the possibility of pregnancy. If the woman gets pregnant, this hormone will help maintain a healthy pregnancy.
But progesterone does more than that! This hormone impacts our brains, bones, metabolism, mood, libido, and thyroid hormone levels (1).
Being a sex hormone produced after ovulation, it is expected for progesterone to decrease as women enter menopause.
Does progesterone cause weight gain?
It can play a role in weight gain because of the interaction with other hormones. Now, later we will discuss how progesterone therapy can lead to both weight loss and weight gain.
Progesterone and estrogen balance
When hormone levels are well balanced, estrogen and progesterone work together to regulate each other’s effects, including those involved in weight management.
For example, estrogen promotes fat storage, while progesterone allows the body to use fat for energy.
It is easy to see that having too much estrogen compared to progesterone can result in more fat being stored while the ability for the body to use fat decreases, resulting in a perfect scenario for weight gain.
Wait, what? Don’t both hormones decrease in menopause? Yes, but progesterone might drop faster than estrogen leading to estrogen dominance (having too much estrogen compared to progesterone).
Another interaction between progesterone and estrogen is fluid balance. Estrogen retains water, while progesterone acts as a natural diuretic releasing water. As a result, when there is too much estrogen and little progesterone, the body retains fluids.
Fluid retention can increase body weight, and while this is not permanent, women feel bloated, see a larger number on the scale, and become frustrated.
So, it is important to remember that weight fluctuations are common; if you see a weight difference of 4 pounds in a day, it is likely due to water retention.
In addition, estrogen dominance can also increase insulin resistance, which can cause food cravings making weight management more difficult.
As you can see, low progesterone is not a direct cause of extra body weight but can play a role.
Progesterone and the thyroid hormone
Low levels of progesterone can cause the overproduction of a protein called thyroid-binding globulin (TBG). This protein can bind to the thyroid hormones and stop letting those hormones get into the cells to do their work.
As a result, it is possible to develop symptoms of hypothyroidism, including weight gain. Unfortunately, this decrease in thyroid function might not be detected by normal blood tests.
Progesterone and sleep
The hormonal imbalance that is common in the years leading up to menopause can cause night sweats and hot flashes, making it very difficult to get a good night’s sleep.
Furthermore, progesterone can promote sleep by helping the woman to relax. Higher levels can make you feel sleepy. In contrast, low progesterone levels can bring anxiety, restlessness, and trouble falling and staying asleep (2).
That being said let’s dive into how lack of sleep impacts weight (3). Ready?
Lack of sleep can change how the reward system in your brain works in response to the sight of junk food. Research suggests that people who don’t sleep enough tend to eat more processed carbohydrates and foods containing large amounts of sugar (4)
In addition, lack of sleep changes the normal function of the hormones that regulate your appetite and satiety (5), potentially making you hungrier than usual, and less satisfied after you eat.
Finally, lack of sleep can increase cortisol levels leading to weight gain, particularly around your abdominal area -often called stress belly.
Other causes of menopause weight gain
You know well that weight gain has multiple causes and hormonal changes might be just one part of the problem.
One common cause of weight changes in menopause is the decrease in metabolic rate due to changes in muscle mass. Because muscle burns calories throughout the day, the less muscle you have, the fewer calories you burn.
As body composition changes and the woman increases her body fat and decreases her lean body mass, the more difficult it becomes to achieve and maintain healthy body weight.
Additionally, there are also changes in physical activity levels. Many women become more sedentary, burning fewer calories and gaining weight as a result. Remember that physical activity is one of the components of weight management that is under your control.
Also, small changes in eating and drinking habits can easily add up pounds over the years. Adding a few calories a day is almost unnoticeable but can add hundreds of calories a week and several pounds a year.
Last, changes in stress levels due to hormonal imbalances and life stressors can also play a role in body weight.
Can progesterone therapy result in weight loss?
There are many factors affecting hormones during menopause, so it is essential to work with your healthcare provider to identify the best treatment to help you reach your goals.
If your progesterone levels are not low, then progesterone therapy will not work on weight loss. Progesterone levels can be easily tested in urine or blood, using simple tests that your physician can order.
Now, if your physician determines that progesterone levels are a problem, you might get the option of using a bioidentical hormone replacement therapy (BHRT) such as progesterone cream.
Bioidentical hormone therapy can potentially result in weight loss by helping balance your hormones.
However, it is essential to keep in mind that synthetic options of progesterone, like progestin, can cause a hormone imbalance, resulting in weight gain (6).
The most common side effect of progesterone is sedation, so it is recommended to take it at night. In addition, some women notice depression and lower energy levels.
Women with a history of breast cancer should be particularly careful about using progesterone. Again, this is something to discuss with your doctor.
Can progesterone therapy cause weight gain?
Wait, this is confusing! Didn’t I just read that progesterone therapy can result in weight loss if progesterone levels were low?
Yes, you did. However, weight gain can also be a side effect of BHRT progesterone therapy. Research looking at the side effects of progesterone therapy often studied the synthetic form: progestin, the one often found in birth control pills.
Progestin can cause water retention and bloat, unlike natural progesterone, and as mentioned before, it can lead to a decrease in the body’s production of progesterone, leading to a disruption of the hormone balance in the body, including estrogen dominance (7).
Natural ways to balance hormones
It is inevitable the change hormone levels and balance during menopause, but you can minimize the impact on your body by creating healthy habits that will also help with weight management.
- Eating enough protein, healthy fats, and enough vegetables and fruits
- Limiting caffeine and alcohol
- Eating less sugar
- Managing your weight
- Working out and moving more
- Drinking enough water
- Getting enough vitamin D
- Managing your stress
- Sleeping better
So, in conclusion, does progesterone cause weight gain in menopause?
The answer is not a straight one, it could impact weight gain but it is not a direct cause.
Unfortunately, there is little you can do about declining amounts of this hormone in your body. However, there are many things you can do to balance your hormones as much as possible and definitely lots you can do to manage your weight.
It all starts with stressing less, sleeping more, exercising the right way (sorry, walking might not be enough), eating healthy, and enjoying life in a different way.
Dr. Su-Nui Escobar is a Registered Dietitian/Nutritionist in Miami, FL. She is passionate about helping women over 40 live their best lives through healthy eating and a healthy lifestyle. Su-Nui is a doctor in clinical nutrition, able to translate complicated evidence-based science into practical advice. Su-Nui’s charisma and warmth have made her a frequent guest on Hispanic popular morning television shows.