Weight gain on HRT - does it come off if you stop HRT?

[GoldenRetrieverBert]

Fully aware that weight gain may be caused by menopause itself; HRT and/or cravings from tiredness/hormones etc (I also seem to shovel crap in my mouth mindlessly like I'm detached from my body, WFH is not helping this either.

But my weight is creeping up and up - put on 2 stone since starting HRT 3 years ago.

Feeling so down and flat (and fat!). Hate myself and worried about my health too.

Wondering jf coming off HRT would help, or if I'll just have the same issues anyway then along with the lack of benefits from HRT. It's so confusing.

Any advice?

I’ve gone on and off HRT 3 times now for medical reasons (one of the specific tests I had to have was affected by oestrogen) and each time I’ve put on a stone and lost a stone so it definitely goes on and off for me. I’ve been off it for months now and my weight is much more controllable without it, I’m steadily losing weight now whereas I was just slowly piling it on before.

The only way to find out is to sort out your food intake first.
Not 'having a go' but you do say you're over eating.
I've been on HRT for over 15 years. I've not put weight on BUT I could.
I have to be very careful all of the time because the weight goes on very easily.
What changes can you make to what you're eating?
Seems a shame to give up the benefits of HRT if it's not the cause.

If you have the time, watch this, I think it helps to understand more of what is going on.

At the start of menopause my weight came on thick and fast, hubby was commenting I’d put on a bit of timber around the midriff🧐 I’ve found that being on HRT along with intermittent fasting has sorted all of this. I’d sooner be on HRT for the benefits it gives me, protecting my bones, heart etc. My sister in law is 59, her periods stopped at 50, she decided to take natural remedies, she now has osteoporosis and is breaking bones very easily, and is as my husband says “carrying a bit of timber” around her midriff. Hubby is now 60 and “carrying said timber around his midriff” I’m having great joy teasing him, no HRT for him😜

I also take testosterone which is really beneficial for my energy and libido, which has also helped my muscle mass and it strengthens your bones. I once read that the areas where your estrogen disappears is taken over by fat cells, they just move in like little squatters, so unfair. I will need estrogen for life as I have really bad vaginal atrophy, it was so bloody painful and debilitating, it was painful to sit down, have a wee and sex was definitely off the table. Estrogen vaginal tablets were never sufficient so I have a patch with progesterone tablets to protect my uterus 🤗

I think if my dh made comments about my weight it would take more than testosterone to bring back any sense of libido whatsoever. It’s so bloody rude!

What is the mechanism that leads to weight game with HRT? I’ve seen this observation a lot on MN so it’s clearly not uncommon.

HRT raises cortisol levels - it’s essentially a steroid. I know this because I have Addisons disease and one of the stipulations for having the tests we need to diagnose it (ie tests for cortisol levels) you need to completely stop any oestrogen (ie HRT and / or the combined pill, mini pill is fine) for 6 weeks prior to any tests as it falsely elevated cortisol levels - ie you’ll get a much higher cortisol level whilst on it. Cortisol is a steroid the body naturally makes but if you have too much of it it can lead to weight gain and all sorts of other issues. It’s a lot more complex than that - I actually train medical students about Addisons disease (which is a severe lack of cortisol) and cortisol itself so I could waffle on about it all day but that’s essentially the jist of it.

I’ve never heard it explained from this POV, it’s really interesting to know, thank you.

@Pigeonqueen thats really interesting, thanks.

Do you know of a way to lower cortisol levels healthily?

Interesting isn’t it. Link here if you’re interested explained under patient preparation- (this is only one of many tests done to ascertain adrenal function and cortisol production but the advice is the same for all of them)

www.gloshospitals.nhs.uk/our-services/services-we-offer/pathology/tests-and-investigations/short-synacthen-test-sst/

Thank you @Pigeonqueen

No, cortisol is regulated by the adrenal glands and / or the pituitary. There’s a huge misconception in the media about it at the moment whereby people are talking about “adrenal fatigue” (which doesn’t exist, you either have adrenal insufficiency or you don’t, which is a life threatening serious condition) or you can have cushings which is even more rare where you produce too much cortisol. You can work to reduce your stress levels as this can cause your cortisol levels to change throughout the day but not to the extent of being problematic unless you have either of these conditions as your body should work to regulate your levels effectively.

Agree

Thank you.

Thanks, that’s very interesting.

I suspect it's like the contraceptive pill and pregnancy. Some women find that oestrogen makes them gain weight. Others don't

I gained weight when I entered peri. HRT enabled me to lose weight.

It's very difficult though to prove this one way or the other. All the research that has been done shows it doesn't cause weight gain.

One thing that does change is weight distribution. Women put weight on around their middle due to falling estrogen. (And this is one reason why they end up having the same risks of heart disease as men- lots of abdominal visceral fat.)

So it doesn't stack up completely that using HRT makes us gain weight. If it did, all women on HRT would gain weight. And they don't.

At least when using patches or gel, you can alter the dose quite easily compared with tablets that are a very blunt form of HRT- you get 1mg or 2mgs of estrogen and that's it (nothing in between.)

So it's worth experimenting with the dose to get enough to control symptoms but not to feel bloated.

Also, many of the posts here about weight gain end up with posters 'admitting' they're eating too much - even if it's just 200 cals extra a day which adds up to a stone every year.

There's perhaps a misunderstanding over what we can all eat in our 50s and 60s when we're not as active as we were in our 20s and 30s.

I had to come off HRT as the breast clinic were having trouble taking scans and asked me to stop. I’m mid 50s. I was also 3 stone overweight.

hRT really managed my symptoms but I’d been on it for about 10 years and tbh most of the symptoms have gone now.

a year later I’ve lost a stone and a half and am still losing weight. But I’ve also upped the exercise I’m doing and have seriously increased the amount of veg, fibre, protein and reduced white bread type carbs.

So I’m not sure whether coming off hrt or just eating more mindfully has done it. I’m also a lot stronger due to the exercise. I’ve got very high blood pressure which medication isn’t reducing very effectively so trying exercise and diet too.

now need to work on the next one and a half stone….

Also, many of the posts here about weight gain end up with posters 'admitting' they're eating too much - even if it's just 200 cals extra a day which adds up to a stone every year.

There's perhaps a misunderstanding over what we can all eat in our 50s and 60s when we're not as active as we were in our 20s and 30s.

It may be a coincidence but I have put on around two stone since starting HRT.

I’m probably more active now than when I was in my 20s and 30s. I spend on average five hours a day teaching (actively) or taking classes at a gym.

However, my appetite has increased enormously. HRT? Testosterone?

I may have misunderstood so apologies in advance, but are you saying that you are eating a lot more, but you think you're expending it all with the work you do?

Have you tracked your calories in/ out?

Hi - interesting discussion! I literally posted earlier this evening under menopause topic as I’m at my wits’ end with this issue. Can I ask, please, what a typical day’s food looks like for ladies in their mid 50s - mid 60s and are keeping weight down? I feel I’m eating so carefully but still the dreaded mid-section fat! Are you ladies finding you have to eat very little post-menopause? Struggling as trying harder than ever with little success!

Honestly? I barely eat.
1 egg and a couple slivers of avocado for brunch. A tiny nibble of not much mid afternoon like half a piece of fruit. Dinner may be a small platter of crudités and a lamb chop

I just decided to put food on a back burner. I hate carrying extra fat more than I miss food

I was really wondering what had triggered my increased appetite. I have always been very active but didn’t eat like a horse.

You might all be interested in this podcast which is a seriously in-depth look at how our fat changes after menopause and takes on different hormonal roles in our body. It was fascinating. It covers the impact of hrt as well.

podcasts.apple.com/gb/podcast/zoe-science-nutrition/id1611216298?i=1000637038881

Have you thought about insulin insensitivity? It's possible to have metabolic syndrome where you're craving food (carbs) to keep your glucose levels high. Not likely if you are fit and active, but one thing HRT does it help prevent diabetes by regulating blood glucose.
I know I've read/ listened to the Zoe link above ages ago- not sure if it mentions this.

This is another link to an 'easy read' from Zoe on menopause and weight.

https://zoe.com/learn/menopause-weight-gain