HRT & weight gain

[Hueandcry]

I'm post-menopausal at 48 & was prescribed HRT by my gp about 6 months ago. I also suffer from long-term depression & take Sertraline. Since starting the HRT I've gained a lot of weight. I'm 5ft3 & have gained about 1 1/2 stone. My eating habits haven't really changed & I exercise regularly. It's really getting me down. Nothing fits but I have no money for a new wardrobe. Despite my depression having previously been under control it's now much worse & feeling fat & frumpy is not helping. Does anyone have experience of hrt & weight gain. The only option seems to be to come off it but it has improved the hot flushes/night sweats so I don't want to do that either. Help!!

The answer is here :)

My eating habits haven't really changed & I exercise regularly.

HRT does not cause weight gain. Change in metabolism in middle age does. The 2 things often coincide.

I have been on HRT for 9 years and my weight hasn't changed, in fact I'm 4lbs lighter than I was a couple of years ago. Same height as you.

I eat about half or 2/3rds what I could before age 50. I rarely eat carbs - a small portion once a day usually- and fill up on veg, fruit, nuts, full fat plain yoghurt, lean protein.

You simply cannot carry on eating at 53 what you did before. Sorry!

I'm 48 not 53

sorry Hue-putting years on you!

I'm just quoting the research- shows no weight gain.
Some women find their breasts get bigger but that would not amount to much weight. Others find the progestogen stage each month causes bloating. But this again is only a couple of pounds or so.

Sorry but it IS food. If you work out your BMR then weight loss will happen if you eat less than you need.

Sorry what is BMR?

Base Metabolic Rate

www.active.com/fitness/calculators/bmr

Lots of people swear by using My Fitness Pal. You enter in everything you eat every day and it works out your cals and what you need to lose weight.

This is worth reading- qualified dietician- and most of the links in the feature to recent research are up to date.

www.healthspan.co.uk/menopause-advice/hrt/myths-busted-the-real-side-effects-of-hrt

Try coming off the HRT & see if the weight falls off you? Only way to test it.

I thought middle aged slow-down in metabolism happened to me suddenly when I was 38. That was the summer when I was trapped at home with small children; I stopped having an appetite, stopped eating, and didn't lose any weight. That decline in appetite has just continued on in the same slow way for 11 yrs now, unless I exercise a lot. imho, 40-41 not too young. Supposed to be gradual & constant. (All nothing to do with HRT or menop, obvs).

Well, my doctor told me herself that HRT causes weight gain. She is on it and has put on weight. She says she has to eat a lot less to counteract it. It's hard as weight gain is often a result of menopause regardless, but HRT definitely doesn't help.

So if HRT causes weight gain, how come that not all women on HRT gain weight? Explain ?
I'm sorry but one doctor's anecdotal experience proves nothing. Over 60% of women are overweight or obese. Only 10% of women use HRT.
Your dr has to eat less due to changing metabolism.

I don't eat cakes, biscuits, puddings, crisps, chocolates or sweets, sugary drinks, rice, pasta, pizza, potatoes (except a small amount now and then), cereals. I eat very well and yes, I'll have a pudding maybe once a week, but overall I don't eat a lot of stuff that most people eat every day. I can't. If I do, at 5 3' and in my 60s, the weight piles on. Nothing to do with HRT.

Thanks Polly. Everyone is different though?
I had to have the mirena coil removed years ago due to horrendous side effects but some people love it. It actually says in the blurb that comes with my tablets, Kliovance, that weight gain is a side effect. I guess the only way to prove it for me is to stop taking them? I've read that the patches don't have the same side effects - does anyone have any experience of this.

Kliovance is conti HRT. It's usually the progestogen that causes women to feel bloated due to water retention. IF HRT were to cause a change in metabolism, it's more likely to come by using a conti form where you take 2 hormones daily, rather than sequi.

Unless you have a really strong reason to use conti rather than sequi, you might find a difference by changing to a sequi form.

Logically, HRT should make it easier to lose or maintain weight. This is because it's 'tricking' our bodies into the pre-meno stage we were in when we were fertile. It's overriding the change (partly but not wholly) that comes with middle age and a slower metabolism.

I don't see how patches would be any different, in fact the reverse ought to be true. With pill form HRT a lot of the active ingredients are lost during digestion - that's why pills are a higher dose often to allow for loss during digestion. With patches, the hormones get straight into your system with going through first bypassing the liver.

I'd be tempted to say try cutting out all carbs except for 30mgs of wholefood carbs a day, eating only fruit, veg, lean meat and fish, small amount of dairy, no sugar, no puddings, or refined cereals. no booze, and see how your weight is in a month.

Hi Hue

Sorry that you are feeling low, similar has happened to me. I have a sensitivity to any medication and am also on anti depressants for many years. With some I have ballooned up and others not.
I think it's a similar explanation with HRT as it says on the pamphlet that it can cause different side effects, weight gain is one.

With the anti depressant that you take, did you find that you gained weight with that? As some do and some don't and affect people differently. I gained weight with the Mirena and lost the weight when it was taken out. Over the summer I was put on progesterone, I gained, I stopped taking it and lost. So it's a hit and miss exercise.

Try Black Cohosh for night sweats and Magnesium. You have nothing to lose short term.

I have nothing more to offer, other than to let you know that there are others fighting the same problem.

I'm on hrt the last 6 months and I don't have any change to my weight. I only find a decrease to my muscle mass due to menopause and I have to try harder at the gym! I did not change my diet or my daily exercise programm. I m just more careful with alcohol, I drink only a glass of wine per week.

I’ve was on prem-pac (stopped making) then Estelle - both (oestrogen followed by days of progesterone) - no weight gain! Then gp said I had to change to kliovance combined pills - hate hate hate! It does cause weight gain and I follow very struck healthy eating with no cakes, biscs, crisps, drinks, alcohol, low carbs, low quantity. So I’m going to ask to change it. Have to stay on HRT at mo otherwise there will be a mad crazy woman running around the office.

I think that if you suits you a type of hrt you can stay on it...why do you change? Maybe we have just to reduce our dose according to our age.

HRT does not cause weight gain
So they say... I don't agree at all. I've been perimenopausal for about 5 years and during all this time, managed to keep my weight down, actually being lower than it was in my 30s. Then I tried the HRT, and in less than a month, I had put on 1/2 a stone. Nothing changed at all, I ate and exercised just the same. This was one of the reasons I decided to ditch it.

It's been 2 months now and finally managed to lose it all without going on a crash diet and certainly not reducing the amount I eat.

They can show all the evidence they wish, I've seen many women of a healthy age putting on massive amount of weight quickly, not when they became menopausal but when they started on the hrt to think that at least for some women, there is a direct link.

Some of the synthetic progesterones cause bloating and water retention which is worse if you take it all the time. Oestrogen will make your floppy menopausal breasts become denser again and maybe a cup size larger (did for me). It will to some extent correct the pattern of fat distribution from the fat round the middle ( post-menopause - due to decrease in oestrogen and relative dominance of testosterone), to fat round the hips and thighs, but shouldn't necessarily of itself, alter the actual amount of fat. There is some summary info on menopause weight gain and HRT here.

Really useful discussion! The reason I had to change to combined HRT is because I am getting older - the previous were sequential HRTs I.e. progesterone tables for a number of days after a period of days on estrogen tablets. The combined in one tablet for older women that I’m on now (Kliovance) is causing the problems. There is small weight gain (half stone) but I realise I didn’t explain that my belly is very bloated ... to the extreme ...on Kliovance. So after researching many medical sites this evening (menopause matters doesn’t tell the whole story) I’ve discovered that HRT by mouth alters the production on bile in digestion processed by the liver/gall bladder. Therefore for me I will ask my GP if HRT patches which reach the blood stream without going via the liver are better for me. Sorry for long post! Hope this is useful for some people reading.

I’ve discovered that HRT by mouth alters the production on bile in digestion processed by the liver/gall bladder.

Without seeing whatever you found, I don't understand how some difference in bile/ digestion during the metabolism of oral HRT causes weight gain. Hormones taken transdermally do have to go through the liver eventually (as they are in the blood stream, my dr told me) but oral HRT is first broken down ('first bypass' it's called) via the liver.

If HRT did cause weight gain it would affect all women the same way and it doesn't. Like Bellaciao I've not had any in 11 years. I did gain 5 lbs a few years ago but that was by snacking and less exercise and I've lost it now. I do have to be very careful with what I eat and the way I control my weight is to have a 2-3lb 'tolerance level' so if I go above that, I cut back for a few weeks to lose it.

I was on the patch when I put on the weight so quickly and my fat content did increase at a similar ratio (went from 29% to almost 32%) so not redistribution.

No one human body is the same therefore it is not feasible to expect a drug to have the same effect on millions of different bodies!
For me Elleste Duet causes weight gain.
I’m extremely active and do a lot of exercise. I eat healthily. I’ve gained nearly a stone for the second time whilst on it. I took it two years ago for a few months and I didn’t like it so came off it and lost the weight immediately without any effort or change to diet. I’ve been on it for two months now and have gained nearly a stone. My breasts are bigger and i’ve padded out around my hips, thighs and backside. Logically I would say this makes sense as it tricks your body back into a false fertile state and surely women who are fertile need more fat for reproduction purposes. Just a thought!
Anyway....I have more padding due to Elleste and i’m 100% positive that Elleste causes weight gain for me.

I am 5'3" and until recently, weighed 7st 6lb. I recently went on continuous HRT (oestrogen patches and progesterone tablets) and in no time at all have gone up to over 8 st. I have not been as heavy as that in decades, and remained around the 7 st 5lb/7 st 6 lb mark throughout my mid- to late 40s and all the way through my 50s - even after I went into menopause at 53. All of a sudden, though, my thighs are just about squirting out of the seams of my jeans and my bum is bigger than I can ever remember it being. I don't mind the extra padding on my bum and thighs these days (in fact, it's welcome as the alternative to no fat, at my age, is loose skin and SAGGING), but it sure is inconvenient to have to buy new clothes. :( My eating and exercising hasn't really changed, either. So I don't honestly believe that HRT never affects weight in women; in some cases it does (otherwise, why didn't I get this plump years ago, when I first went into menopause???) But I shall continue with mine ANYWAY, as my mood and sex drive have improved NO END, with the mood change happening within HOURS of my starting treatment. I would never want to go back to feeling like I did before, so a bit of extra fat is a small price to pay. HRT is a life-saver, for me.

Oh, forgot to add... I'm 57, btw.