HRT Weight gain, actually cried this morning

[Gemzee]

I know the official line is HRT doesn’t cause weight gain, but I’m honestly in tears.

In 2023 I lost nearly 2 stone with diet and exercise, kept it off for 2 years (I was 40). I’ve had peri symptoms for 3 years, and in May finally started HRT. Progesterone tablets bloated me so I had the coil fitted instead – that helped the bloat, but since then my weight has crept up, boobs up a size too.

I’ve upped workouts (cardio + resistance 6 days a week, plus walking), no change to diet (healthy weekdays, wine/carbs at weekends like always). Despite this, I’m now over a stone heavier than last year – 3lbs in just the last 5 weeks (in which I've switched up my exercise routine!).

I feel like what’s the point? I’m doing more than ever but still gaining.

I could obviously completely cut out wine and not eat carbs at the weekend, so I guess if this is the choice I'd be miserable but I'm miserable now.

Should I come off HRT, will the weight even come off if I do? Thanks for reading.

(Ps: I have an underactive thyroid and take levothyroxine but dr says results normal in Feb so no test required till next year).

I put on a ton of weight during the menopause too, it's very common with or without HRT. I had to go on mounjaro to lose it all. All 5 stone of it.

I know your dr said your thyroid levels are normal.but are they on the low side? Do you know your actual levels?

I could honestly write your post, I was watching the scale creep up and being told it’s not HRT and yet I was eating less and less and exercising. I put on 10kg over 2 years.

Ive just had a gallstone issue 4 weeks of agony and surgery and as a result lost 7kg in one month, the difference was eating 200 calories maximum and I had no headspace for my HRT patches so that stopped.

im now recovered and still not eating much more than 800 calories a day my weight stabilised and about 2 weeks ago I thought right I’ll get HRT back on track.. within 2 weeks a 2kg gain.

it’s just ridiculous I can almost see the weight going on, I’m under 800 calories and gaining so I know it’s the HRT without any doubt.

but it helps me manage symptoms.. so I’m stuck between staying a healthy weight and having symptoms or going right back up?

I feel your pain but this gallbladder issue has shown me I can loose ( drastic) but HRT is the culprit.

My guess is that they use averages to tell us that HRT won't cause weight gain. Some women will lose weight because they finally have some energy again. Other women will be affected by the hormones differently and will gain weight. But if you average it out across a study group it will look like HRT doesn't cause weight gain.

Same as pp my weight kept creeping up no matter what I did. I was already overweight because of insulin resistance and pcos and menopause put me in the obese category. I am on mounjaro now as nothing else was working and I became borderline diabetic even after following advise from diabetes clinic. Thankfully lost 2 stones and blood sugar is in the normal range.

Yeah I feel stuck as well, it's really helped my brain fog, muscle aches and night sweats but I can't go on with the weight creeping (well not even creeping!) back on. I cried this morning because the thought of going back to my Jan 2023 weight is so so depressing! I've worked and am still working so hard for my health & fitness,for nothing.

Are you talking about the Mirena coil? I know it is sometimes prescribed as an alternative to HRT, but technically it shouldn't be considered a substitute. Can you get if out and move to patches or cream?
Weight gain is a well known side effect of the Mirena.

Hormones definitely affect some women in this way. I gained weight when younger when I first started taking the contraceptive pill. Was off it for quite some time when trying to conceive, lost weight.
I gained around 3st in both pregnancies, lost most of it afterwards.
Weight started creeping up as I got older, but I piled it on quickly when I started HRT.
Came off it as I didn’t find it helped my symptoms.
Had to take WLI to lose the 4st gained! It wasn’t budging otherwise.

I also piled on weight on my belly with HRT. Some of us do. I went off it for a bit, but have just gone back on because I can't endure the night sweats, hot flushes and depression. 😪

I am changing up my diet and increasing my exercise. I know you are already doing that! It's shit, honestly.

Solidarity. Having been slim and a stable weight for my entire life, including after three babies, I gained 5kg in 10 days when I started HRT (with Mirena for progesterone). I could literally see myself getting bigger every day - I wouldn't have believed it until it happened to me.

I came straight back off the spray but have kept the Mirena because I need it to deal with very heavy periods and anemia. I dropped a bit of the extra weight but I'm still a dress size bigger than I was and my waist has disappeared. I can't see how I'll shift it without significantly reducing calories, which I'm loathe to do after having always enjoyed a really relaxed attitude to food. The thought of having to go watch what I eat in perpetuity now is pretty depressing.

I'm on Oestrogel and have a minera coil. Got the coil as the progesterone part of the hrt didn't suit me. I'm pretty sure the gel & the coil are commonly used together.

I am on Oestrogel only as I have had a hysterectomy. No progesterone.
I feel so much better with HRt but look much better without!

I'm sure it's frustrating. My first thought was you maybe didn't give micronised progesterone a decent trial- 3 months is the minimum, so you've swapped to 2 sorts (now the Mirena) within 4 months.

The reason for giving any type 3 months is there can be some bloating but it may well settle down.

Have you thought about reducing the amount of gel? Most women are told to start on 2 pumps but for many that's too much, too soon.

My consultant advised me to start on less than half a pump and work upwards. It took me over 3 months to get to 2 pumps. This gives your body time to adjust.

It's not always the progesterone part that's the cause.

The only other thing to do it to be ruthless with what you eat and especially carbs. Exercise won't do much for weight to be honest, it's the food that counts mostly. Your 2 days of 'having a bit more' at a weekend might be worth looking at.

Not wanting to sound like a party pooper!

@TreesWelliesKnees The research isn't based on averages. If it was, that would be in the stats.

@WhiteAndBlack The Mirena is recognised option as a progestogen with HRT.

You didn’t change your diet …..despite the fact that your calorie needs drop as you go through menopause.

If you continue to increase your weight, you should definitely look again at your thyroid meds, and maybe ask to be referred to a menopause consultant for advice, as starting peri at 39 is very young.

I have heard a few friends say they have gained weight since starting hrt too.

The Mirena coil caused massive weight gain for me; it was at least a pound a month. The GP didn’t want to remove it because she didn’t believe it really was causing weight gain and there wasn’t an alternative to treat flooding. When I finally got it removed, my appetite reduced to normal levels within a day. I take oral progesterone now and it doesn’t cause the same effect on appetite and weight gain.

I massively changed my diet in 2023 and lost weight, kept the weight off for 2 years but now since hrt it's coming back even though I've upped my cardio/resistance. So yes ok I've not changed my diet since starting hrt, are you saying I shouldn't ever have carbs or wine again now I'm a few years into perimenopause?

I guess the question is do I have to make my calories 1000-1200 every day rather than just Mon-Fri (my cals probably go up to 2000 on a Sat/Sun) - sounds a really miserable existence to be honest!

I'm only 42 and was a happy size 8-10 the last couple of years, I've gone up a size which would be completely fine as I realise size 10-12 is not big (I'm only 5ft 1 though so it's noticeable) but the boob size and the weight on my tummy and inner thighs looks awful.

My boobs have got so big that the tops I bought last year are straining 😔

I agree in my job I do 20,000 steps a day on average and I’m putting on about 2 pounds a week on HRT.
My brain knows that I need it, But it’s taking every ounce of me to continue with it because the visible signs of weight gain are so upsetting

My boobs have gone up 2 sizes too but I was only a B cup before. Now D. I have just bought some cheap tops in a size up as all my clothes were tight. Hope I don't have to buy a whole wardrobe. Gone up from a 10 to a 12 and now a 14 in some.

OP, 42 seems too early for such weight gain. I am 53 and post surgical menopause.

Please do check for fibroids or ovarian cancer as well. I had tons of fibroids.

The last doctor I saw said "HRT means weight gain" and if I wasn't happy with the weight gain I can stop HRT.

Not trying to be dramatic but peri at 39 is early. Yes, I know menopause is from 45-55 ish but starting peri at 39 is early. Periods stopping before 45 is early menopause and is classed as a medical condition as it has risks.

So, although you are just 42 , your body is behaving like someone 10 years older. Which is why you could be struggling with weight gain.

Do you think your calorie intake is as low as 1K a day? That's 3 meals of 330- 400cals. It's possible you are underestimating it. And your weekend 'splurge' might be more than you think so over the week your intake it more than you think.

I did mention your estrogen dose- how many pumps are you on?
It's worth experimenting with that because you may just need 1 pump to control your symptoms. It's not always the progesterone that's the culprit.