· Weight gain is a common side effect of menopause.
· Scientists found that women who took hormone therapy and the weight loss drug tirzepatide lost more weight than those who took tirzepatide alone.
· Data show that hormone therapy can support weight loss and other treatments as well.
Weight gain is common at menopause, and some data suggests that women gain an average of a pound a year during this stage of life. If you’re struggling, going through it, or on the other side, it’s natural to be curious about what you can do to combat menopausal weight gain.
Although there is an arsenal of weight loss strategies to choose from, new research shows that postmenopausal women on the weight loss drug tirzepatide will be more successful if they are paired with hormone therapy.
The study, which was published in The Lancet Obstetrics, Gynecology, & Women’s Healthanalyzed data from 120 postmenopausal women with overweight or obesity who took the weight loss drug tirzepatide (the main ingredient in Mounjaro and Zepbound) for 12 months or more. The study found that women who used hormone therapy—which uses estrogen and progesterone to relieve menopausal symptoms like hot flashes—lost 35% more weight than those who just took tirzepatide.
Meet the experts: Jessica Shepherd, MD, an ob/gyn in Texas and author of the book, Generation M: Living Well in Perimenopause and Menopause; Lauren Streicher, MD, clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine and host of Dr. Streicher’s Insights: Menopause, Midlife, and more podcasts;Christoph Buettner, MD, Ph.D., chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School
Specifically, women in the hormone therapy group lost about 19.2% of their body weight compared to 14% in the group that did not use hormone therapy. A high percentage of women in the hormone therapy group lost between 20% and 30% of their total body weight. So, what is behind this? Here’s what doctors want you to know.
Can hormone therapy support more weight loss in menopause?
There are some important things to point out. One is that teaching is not prove that hormone therapy causes more weight loss—it just found a link. Another is the possibility that women who take hormone therapy are also more likely to follow behaviors that can lead to weight loss. But it’s just not clear at the moment.
Still, there are some things about hormone therapy that can support weight loss. “Estrogen has a profound effect on energy balance, [fat] distribution, and insulin sensitivity,” says Christoph Buettner, MD, Ph.D., head of the division of endocrinology at Rutgers Robert Wood Johnson Medical School. After menopause, the loss of natural estrogen causes more fat, a reduced insulin sensitivity, and changes in appetite, he explained.
“Menopausal hormone therapy can partially reverse these changes and reduce central abdominal fat accumulation, and potentially increase brain signaling related to energy balance,” says Dr. Buettner. When you combine that with a powerful weight loss medication like tirzepatide, which reduces appetite and improves glucose metabolism, these effects can build on each other, he says.
The link between the two may be indirect as well, he said Lauren Streicher, MD, clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine and host of Dr. Streicher’s Inside Information: Menopause, Midlife, and More podcast.Hormone therapy is an effective treatment for some of the unpleasant symptoms of menopause, including insomnia and hot flashes, she points out. It can affect other areas of health that support weight loss. “Treating hot flashes facilitates weight loss,” says Dr. Streicher. Hormone therapy in menopause can also improve quality of life and support better sleep (usually by preventing nighttime hot flashes), which then increases the likelihood that women will exercise regularly and make healthier food choices, researchers show in the study.
Overall, “these findings suggest that hormone therapy may enhance the therapeutic effects of tirzepatide in this population,” said Jessica Shepherd, MD, an ob/gyn in Texas and author of the book, Generation M: Living Well in Perimenopause and Menopause.
Can other weight loss treatments produce the same results?
The doctor says it is possible. “There are benefits to using hormone therapy with GLP-1s,” says Dr. Shepherd. This class of medications includes popular weight loss medications such as semaglutide (Ozempic, Wegovy).
Case in point: A small 2024 study of 106 postmenopausal women was published in a journal Menopause found that those who took semaglutide and hormone therapy were more likely to lose 5% to 10% of their total body weight after 12 months compared to those who only took semaglutide.
Potential side effects
Every medication has potential side effects, and tirzepatide and hormone therapy are no exception.
Here are the biggest potential side effects to consider when using tirzepatide, per the US Food and Drug Administration (FDA):
- nausea
- rear
- vomit
- Constipated
- indigestion
- Abdominal pain
- Injection site reaction
- fatigue
- Belching
- Hair loss
- acid reflux
Each form of hormone therapy is slightly different, but here are the biggest potential problems, according to the American College of Obstetricians & Gynecologists (ACOG):
- Spotting or bleeding that usually stops within six months
- Temporary chest pain
- puffed-up
- Headache
But Dr. Shepherd says you’re fine taking both of these medications at once, based on the data we have. (Dr. Buettner points out that the safety data on this combination is limited, though.)
Of course, if you have tried to lose weight and have been unsuccessful, it is important to contact a health professional. They can help dig deeper into your health and recommend a personalized plan from there. “Overall, these findings highlight the importance of considering hormonal status when evaluating response to weight loss therapies and also suggest that a more personalized approach can improve results in postmenopausal women,” says Dr. Buettner.
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