Will HRT help with menopause-related weight gain around my middle?

[Mimicking]

Firstly, thank goodness I found you!

There is probably a multitude of this question, but I cannot be bothered to troll through all the threads (far too tired for that!)

Weight. Will taking HRT help reduce my middle? I have been prescribed the gel stuff and some tablets - no idea of the names. I haven't started using it yet.

Over the last year I have been eating less, drinking less but also moving less due to a change in job. The weight seems to be staying regardless of the reduced eating and drinking. It wasn't a strategic move, my appetite just became smaller and I don't enjoy alcohol like I used to.

Will I see an improvement with the weight gain when I start HRT?

Reasons for the prescription: (Age 43) Severe anxiety, paranoia and heart palpitations. Cycle as regular as clockwork but has reduced to 21 days over the last couple of years. I was flooding every month but my last two periods have been surprisingly lighter. Sudden bouts of rage that came out of nowhere. Oh and brain fog! Seriously can't remember words or string a sentence together most of the time. The other day I was in the car and I couldn't for the life of me remember where a certain shop was located!

The only reason I haven't started taking the medication is because I was overwhelmed by the sheer amount of tablets I was taking. I was prescribed an antidepressant for the anxiety (which has helped no end) My iron levels were low - prescribed iron tablets. On top of that I take meds for an autoimmune disease.

It did for me. That sneaky 10 lbs that had crept on around my middle, that would NOT shift unless I took incredibly drastic measures? Melted away.
I am currently less active than I usually am due to injury and my diet isn’t what it normally is for a variety of boring reasons. But, my weight is holding steady, as it always did before I hit peri! I bloody love my HRT ( and not for the weight loss, but the lack of rage, crying at nothing, anxiety and insomnia is marvellous)
And yes, I also take testosterone…..

Is heart palpitations and peri menopause sign? I’ve been having them for the last few months along with wanting to cry randomly and haywire periods

I've been weight training for years. I hit peri around 2 years ago. My mental health severely declined, I lacked the energy to function at a basic level (let alone carry on training with any intensity), started drinking and eating too much, developed a lot of android fat, almost suffered a complete nervous breakdown whilst my marriage nearly ended. Bad times. Estrogel and progesterone certainly helped level me out, but for me testosterone was definitely the icing on the cake. I'm now back to training again and the weight has dropped off really quickly but I am fortunate in that I have years of experience (both with training and diet) and already had a lot of lean muscle tissue. My diet is 95% clean (high protein, high fibre and healthy fats) and I am making good gains again. I have completely cut out alcohol as I just can't sleep if I touch a drop. I take creatine which I find really helpful and would advise other women look into. As well as well documented performance benefits it also aids recovery, increases energy and aids cognitive function.

I put on weight with HRT

Do those of you taking testosterone get side effects like increased facial hair etc? I had enough of that when I was younger (I wonder now if it was PCOS but never diagnosed).

I'm interested in hrt because of heart and bone protection, and to get rid of hot flashes and itching, but I am fairly certain I have genetic risk of dementia, and the most recent studies are more worrying regarding combined HRT and increased risk, so I'm not hurrying to go on it yet. The more I might be able to treat with topical oestrogen (which I've just started for bladder symptoms) or perhaps adding things like testosterone, or even other supplements, the better. I'm OK with mood and energy and brain fog, so the weight issues haven't been so bad as I am exercising more than I used to. Not so much weights though as I have had shoulder injuries. Maybe I need to find other ways of protecting my heart and bones, and to hope that the hot flushes and itching go away with time.

@MonetswaterliliesI apply testosterone gel to the top of my thigh and I sometimes notice a couple of hairs there that I can quickly remove. I haven’t noticed any more hair anywhere else however I think women do get more dark hairs on their chin etc as they age whether they use testosterone or not.
Regarding HRT and dementia-I have only ever read positive reports that HRT can possibly protect the brain against dementia risk. I think more women than men are diagnosed with dementia and this appears to therefore be linked with falling oestrogen levels. Theoretically HRT can protect against this although I don’t think there’s any definitive evidence yet. I certainly feel a benefit with HRT and brain fog so very happy to continue.
Also prescribers will rarely prescribe testosterone without HRT.

Nothing helped for me except increased running, spinning, and some use of orlistat. (weight loss pills). As soon as I hit 40 I absolutely packed on the pounds, despite eating well and working out.

But @StephensLass1977 those exercises are cardio, which stress your body and trigger cortisol production, which lays down fat, particularly around the middle. Oestrogen keeps cortisol in check but through peri and post menopause there won't be enough to outweigh the cortisol, even on HRT.
So cardio is potentially going to put weight on, not take it off.
Which is why you need to be lifting weights.

HRT and testosterone helped me a little with the dreaded middle age spread but the game changer has been intermittent fasting. I’m now back down to where I was way before the menopause, I’d put a stone on which when you’re only 5’3” really shows. My only regret is getting rid of my pre menopause clothes presuming I’d never get into them again 😩

ah I wondered if it would ever be prescribed separately. Sounds like not then.

The dementia research is more recent, showing some negative links with combined hrt in people who already have genetic predisposition to it, so a specific cohort. It also depended on the length of time and age it was taken. But it is still worrying, so I'm not sure about starting it.

I had laser treatment for ages to reduce the dark hairs in peri, and they did reduce but not totally go away, and they are still coming. I'm glad it doesn't sound like testosterone makes that even worse!

In my experience, no HRT doesn't help with that.

What does though, is reducing my intake of carbs.

The dementia risk was updated recently and no association has been found.
The biggest risks are genes and lifestyle.
The main causes of death in women are CVD and dementia. The vast majority of women with dementia have not used HRT and if they have it won't be the newest types.

One flaw in the research was that women with 'brain fog' and 'forgetfulness' were asking for HRT when it may have been early dementia that was the issue.

I did have high hopes it would because it reduces other symptoms and has for me such as poor sleep, energy, but sadly no, it hasn't made any difference to the meno tummy 😥

The most recent research on dementia is more nuanced, and relates to the genetic predisposition that women have; combined HRT had an association with increased risk in women with genetic risk, whereas oestrogen only HRT didn't (but obviously only suitable for some women); the age and length of time was also related. Some of this research was on the newest types. In women without some of the risk factors already, it was potentially protective, but it was hypothesized that the progesterone interacted in such a way to increase the risk in those with the genetic link. It is something I am particually worried about as I have such a big family association with dementia, and really hoped that HRT would be protective, but the more I read lately, the less I am sure of that.

I lost a little without any effort, my appetite reduced slightly and I have so much more energy to keep active.

HRT has helped me in so many ways but not to lose weight. I didn’t put any on either. Other than when I had long covid so that was the reason.

I need to remember to put my testosterone cream on! But my muscle mass has gone up by 1kg in about 4 month. Heavy weights are the game changer. Not intense cardio - too much stress on the system at this age. I walk lots. I do think sprint interval training is good rather than hours of cardio but I can’t do that right now.

Diet obviously important. I used to be able to eat what I want and stay a size 8. Now I have to be really careful and eat enough protein. It’s not easy.

I think this is key. Its the other symptoms that HRT helps with- in turn that should help with the loss. It hasn't really for me however I probably need to put more effort in.

Can you just take testosterone alone? I’m perimenopausal and really struggle with oestrogen, I get jittery and feel lightheaded and strange after a few days of taking it. I must need it though as I’m sleeping really badly and I’m so tired, I can tolerate progesterone really well and it helps loads with sleep but makes me so bloated and fat in the face. I just can’t win.

I believe you can but obviously check with your GP first.

I do know they like your oestrogen leves to be optimal as if they are low then testosterone can convert to oestrogen. So I had to do 3 months of oestrogen patches before starting but my levels were low.

I take testosterone only. Because of endo and because I've recently had the coil out, I've stopped the oestrogen for now but continued with the testosterone, primarily for low libido. My gynaecologist said its perfectly fine to take it on its own but he says its only licensed for low libido even though it may have other advantages.

The addition of testosterone has definitely helped me manage cortisol which is essentially what it boils down to. I'm back to training at a similar intensity and with a similar overall volume as I was doing in my twenties. I'm on a 12 week X6 day a week power building programme at the moment which I'll repeat after a deload period. Even weight training is associated with cortisol creep. I think it comes down to listening to our bodies and managing it properly.

I second the weight training. I'm 60, been on HRT for years. Had put on a stone and a bit as a slow creep weight gain. Was tipping into a large 12 small 14. Id tried cardio and increased walking but it did nothing to shift the weight. Discovered weights ( just heavy hand weights and dumbells). Worked out for 30 minutes every day. Also ate in a calorie deficit.Weight has gone. I'm back to a size 10 with a flat tummy. Now do a ten minute workout with weights that targets arms, legs and tum every morning. Very happy with my body.

From your OP I would say that you need to find ways to be more active. HRT may well give you more energy and get rid of any aches and pains (it did with me), plus we now have longer days and the evenings are becoming lighter, which makes it easier to go out after work for a walk/run/cycle/whatever. Mid-life weight can be hard to shift and I didn't find HRT really helped, but keeping active does help, I find.

Unlikely, sorry. You need to review what you are eating and drinking.

Would you mind sharing your routine? I’ve recently invested in some weights and really need to get started. I’m a bit broke at the moment so a monthly gym subscription is not really an option!