1 year on HRT and the symptoms are as bad as before (weight gain mainly)

[HRHHRT]

Hi, please can someone help?
I went on HRT a year ago, I finally agreed to for my bones but mainly because my weight was ballooning with no correlation to calorie intake/deficit, and I have restricted my calories to the lowest point I reasonably can.

I was promised by the consultant that on HRT my metabolism would kick back in, and I'd shift the weight, and over the past year it didn't increase, at least... but this past fortnight my symptoms are as bad as they were before I went on HRT- I wake up every morning sopping wet from night sweats, I'm headachy, and most of all, my weight has just rocketed 2kgs without explanation.

I monitor my calories really closely and it's not because I'm eating more.

Have any of you experienced anything similar, and do you know how to help?
The consultant (private) very much refused to answer any questions and my poor GP is too busy for this sort of thing.

Hoping you can help me, I'm freaking out...

Thank you x

What dose are you on? Has that been reviewed?

Yeah my weight ballooned on HRT so I had to come off it.

If I exceed 1350 calories I gain, so I started Mounjaro and have lost over 40% of my body weight. Now BMI 20 and feel great.

Thank you- I'm Estradiol 100 and Progesterone pill 14/28 if that helps? It hasn't been reviewed, I have been on the waiting list for a gynae appointment on the NHS since November 2024, hence going privately 😬

I've probably put on about 10kg since starting HRT but I've gained my sanity. Now I'm feeling better mentally I will probably start thinking about my weight but I was losing my mind before HRT.

HRT solved all my symptoms except weight gain.

Excess cortisol is the culprit. I realised that to lose just one pound a week I had to only eat 1000 calories a day which I couldn't sustain. So I went on Mounjaro and lost 3 stone.

Our bodies are desperate to hold on to fat because it contains oestrogen which is what our bodies are craving. So our bodies make it really hard to lose weight. HRT only replaces a small amount of the oestrogen we had naturally.

It could also be that you are not absorbing it properly. If you had a blood test and oestrogen was very low that would indicate you aren't absorbing.

Thank you- I will ask about blood test. :) That's really helpful.

How many calories are you on now, may I ask?

I can understand how it's very frustrating and not the outcome you wanted. You must feel disappointed.

The science, according to the International Menopause Society, is that HRT does not cause weight gain, but that menopause can cause weight gain and re-distribution of fat - to abdominal fat.

You may be eating more than you need, or the 'wrong' type of foods.
Obviously no one here knows what you eat, but sometimes it's portion size not just type of food.

Are you doing any exercise? Do you walk every day for 45 minutes, briskly? Lift weights twice a week?
Exercise has been shown to improve vasomotor symptoms ( flushes and sweats.)

I have 3 meals a day, limited carbs, and lots of protein, fruit, veg and dairy.
I've been on hrt for around 18 years and no weight gain.
I do put weight on easily and always have.
I'm on 2 pumps of gel and 12 days Utrogestan.

I limit carbs to 50gms a day, roughly.

I think it might help if you listed a typical day's food/ activity.
Happy to share mine if it helps!

I was on HRT, 1 pump gel and 14/28 progesterone tablets. I came off it after 20 months because of weight gain and also it gradually started to make me feel worse. Been off it for about 6 months now and I feel absolutely great. I did put on lots of weight about a stone, and that hasn't come off yet so that is something I need to sort out.

Have you had your thyroid checked?

I’ve been on HRT 4 or 5 years and haven’t put on any weight. I did put on weight on the Pill though, so it’s not like hormones don’t affect me. I also felt crap when, for gynae reasons, I had to take a double dose of the Pill for a short time.

I’m on Evorel 25 plus Utrogestan. I understand this is a low dose. Just an idea, but maybe you’d feel better on a slightly lower dose? There must be a sweet spot for everyone.

'The consultant (private) very much refused to answer any questions and my poor GP is too busy for this sort of thing.'

Your consultant, who charged you a fortune no doubt, refused to answer any questions? Are you supposed to just do what you're told, like a child? FFS, it's disgusting what women have to put up with

This is absolutely core basic healthcare, so please do not think you are wasting your GP's time. My only worry would be that some GPs are utterly shit with women's health. I highly recommend Newson Health if you're interested in a different private route - they know their stuff and would welcome any questions you have

It sounds to me like you need your HRT dose reviewed and adjusted

sorry- missed this - but what did your consultant refuse to discuss?
At the very least they should test your thyroid. And perhaps cholesterol and BP.

Are you open to describing a day's food? (Not so we can be critical but to help.)

About 1200 a day maintaining my new much lower weight (8 stone 3)

I take a maintenance dose of Mounjaro in order to prevent weight gain back to previous obesity levels.

What calories are you on with Mounjaro? Congrats on the weight loss!!!

Thank you so much. I am so grateful to everyone for the support and quick replies, it's so scary having no sense of how to support my body :(
The consultant effectively said she wouldn't answer any questions, it was my GP's problem. She was a fancy one with a showbiz website so I was pretty unimpressed :"D

Foodwise, before I went on HRT I cut to 1240 kcals a day because my weight was rocketing uncontrollably. I have maintained that and it has started going up again :( I am active and do weightbearing exercise every day (pilates daily and 1hr cycling give or take), and I eat really healthily (no refined sugar, etc).

Congratulations, but I am sad to hear it's still 1200- I want to be able to eat a full day's calories again :((((((((

Seven times :D

Yes but I am absolutely full on that intake. No feeling hungry or deprived.

Counterintuitive as it sounds, you may be overdoing the exercise. The cycling in particular. High intensity cardio can raise cortisol, which makes you hold on to fat.

Try swapping the cardio for weights (heavy lifting, not just weight bearing) and have a couple of days off each week.

Interesting, thank you. I need it for my MH tbh, it calms me down (when drivers aren't trying to run me over...)- why is everything so counterproductive :"D

This might relieve or depress but I have been on HRT for nearly five years. I piled the weight on and nothing seemed to shift it. I am extremely active.

However, since the start of the year I have steadily lost weight without doing anything different. I only really noticed at the start of the summer. I’m on track to get back to my very slim pre HRT weight.

@HRHHRT I'm not posting this to be at all boastful but this is roughly what I'd eat in a day. I feel a bit exposed putting this out there but hope it may help.

Breakfast- usually 200gms 2% greek yoghurt, mixed seeds, blueberries and/ or raspberries.
Sometimes porridge- 30gms dry weight oats and about 300mls semi milk. Topped with fruit.
Occasionally a boiled egg or two, and 2 oat cakes.

Lunch- homemade veg soup, or cottage cheese salad, or tinned sardines on 1 slice toast, or scrambled eggs, or cold meat - eg sliced turkey or chicken with green salad. At least 1 portion of fruit.

Dinner- fish 3 x a week (sea bass, salmon, cod etc) often with mixed roast veg, and greens (broccoli, kale, etc.) Or chicken thighs roasted, homemade shepherds pie, stir fry, meat casserole, or a chickpea and sweet potato curry.
Fruit and sometimes more yogurt- about 100mgs.
On busy days it'll be fish fingers and peas/ carrots/ broccoli.

I eat 1 or 2 squares of 80% dark choc a day.

Occasionally I will have pudding but what would be a half portion- last night it was homemade apple crumble and yogurt.

I could always eat twice what's on my plate but having been a podgy young teen and the misery of that, I don't want to go there.

I also think you should experiment with reducing your estrogen dose as 100mgs is top whack and you may feel better on less.

Your private consultant sounds useless. I have a private consultant and they are absolutely lovely and would answer any questions.