Weight Loss

What Happens To My Hormones in Perimenopause And How Does That Impact Weight?

Does it ever seem like your hormones are holding you back from enjoying your life? Are you of a certain age, and noticing that no matter what you try, you keep putting on weight? This could be because of perimenopause. 

Perimenopause is a period in women’s lives that can leave them feeling sad, helpless, confused, tired, and uninterested in certain activities. Unfortunately it can also be a time of expanding waistlines. Hormones, perimenopause, and weight gain can become a bit of a nightmare. (3)

A perimenopause makeover is sometimes needed during this time, to help women feel feminine, fit, and fabulous again. We’ll look into that too, but first, let’s look at the different menstrual stages in every woman’s lifetime.

A Timeline: The Life Cycle of Menstrual Cycles

The monthly menstrual cycle dominates a woman’s health throughout her reproductive years. The difference between perimenopause and premenopause can be complex, so here are some facts on the terminology:

  1. Perimenopause means “around menopause.” ‘Peri’ means around; therefore, perimenopause surrounds the time of menopause, and particularly for the 12 months leading up to menopause.
  2. Premenopause does technically mean “before menopause.” However, healthcare professionals prefer to use the term perimenopause to refer to the years before menopause, when hormone levels are changing but menstruation still occurs.
  3. Premenopause is a confusing term. A toddler, a teenager, or a young mother of three could all be called premenopausal. Yet in each of these younger women, very different endocrine activities are taking place.
  4. People sometimes use the terms premenopause and perimenopause interchangeably, but premenopause is not a scientifically accepted term.
  5. Menopause occurs when there have been no periods for 12 months. It is more like a moment of transition rather than a stage.
  6. When menstruation has not occurred for 12 months, early postmenopause begins.
  7. Around 3–6 years after menopause most females enter late postmenopause, though this can vary widely. (1,2,3)

From the age of the onset of periods, right through until the process of the ovaries shutting down, is a phenomenon that involves the entire cascade of a woman’s reproductive functioning, from her brain to throughout her whole body.

And all the way throughout, major physiological events usually have some effect on almost every aspect of a woman’s body and life.

Perimenopause is one stage where weight can fluctuate, and in this article, we will examine why.

Hormones, Perimenopause, And Weight

Women enter perimenopause at various ages. In their 40s, some women may begin to notice signs of menopause, such as irregular menstruation. Others, however, notice changes as early as their mid-30s. (4)

During perimenopause, the level of estrogen — the main female hormone — in the body rises and falls unevenly. Menstrual cycles may become longer or shorter, and menstrual cycles in which ovaries do not release an egg (ovulate) begin. Menopause-like symptoms, such as hot flashes, sleep problems, and vaginal dryness, may also occur. (4)

During perimenopause when estrogen levels begin to fluctuate, the body begins to look for an estrogen replacement, which it finds in fat (an estrogen source) which produces estrone, the weakest of the three types of estrogen, which also include estradiol and estriol. (5,6)

Estrogen normally inhibits the action of hunger signals, preventing events of excessive calorie consumption. But during the menopausal transition – because of fluctuating levels – its effectiveness to modulate hunger hormones is reduced. This means women experience more intense hunger signals, encouraging increased food intake which promotes weight gain. (8)

Plus, the continuous depletion of the follicular ovarian pool during the menopausal transition also relatively increases androgen levels. This hormonal imbalance alters energy homeostasis by regulating hunger and satiety signals. (8)

The body then deposits fat very readily, particularly in the midsection, and this is why belly fat becomes proportionally more of a problem with low estrogen levels at  perimenopause. The low estrogen levels, along with high androgen levels, lead to the redistribution of fat present in the gluteal and femoral regions to abdominal regions of the body, favoring abdominal obesity. (8)

Effectively this obesity is all primarily driven by hormonal imbalance, and its effect on energy balance. (8)

But what can be done? Food and nutritional supplements can’t replace estradiol, the strongest of the three forms of estrogen. The only way to get it back is with hormone replacement therapy. And doctors will often offer the lowest possible dose because hormone treatment can have adverse effects. (1)

It’s all quite distressing, and distress can sometimes lead to indulging in unhealthy eating behavior, causing even more weight gain.

Yet by calming ourselves down, and by gaining some knowledge, shaping our waists during perimenopause can be easier than we think.

FAQ’s On Tailoring Hormones To Prevent Weight Gain

Should I get my hormone levels checked?

It depends. Erratic fluctuations that can quite commonly happen hourly during perimenopause (especially estrogen) may cause a too high or a too low level reading, which would be inaccurate. Usually, a woman’s symptoms are a better measure of her hormones. Seeing a hormone specialist in person for a whole-body approach is a great start. (1)

What should I do to shift the extra weight I am gaining?

Any movement is great, and so is regular vigorous exercise. Find a combination of activities you like and do them faithfully. Simple, scientifically proven methods for burning off excess pounds and inches while simultaneously restoring energy levels can be found online, with programs like this one from Rhythmichealth.

Should I diet?

Yo-yo dieting will not work in the long term. An eating plan that encompasses eating real food and not processed food, cutting portion sizes, reducing alcohol, coffee, and soda consumption, drinking more water, and of course quitting smoking if needed, is the best route to take. Rather than focusing on what you can’t eat, educate yourself on what you can. (7)

I feel very stressed about my weight gain. Is this normal?

Worry is frequently seen in perimenopause and if your entire day is full of high stress, your body may constantly pump out cortisol. Studies have shown a direct relationship between cortisol levels and calorie intake. False hunger signals can lead to a desire for high-calorie foods, leading to overeating and weight gain. But yes, this happens to many women and it can be a frustrating cycle. (9,10)

What can I do to stop this cycle?

Our bodies and minds are united. And so are hormones, perimenopause, and weight. Choosing positive thoughts turns on the relaxation response in our nervous system, coaxing our bodies into peace, with less cortisol release. Exercise, meditation, deep breathing exercises, massage, movement, talk therapy, counseling, making nutritious food at home, happy relationships, lots of sleep – these all help. 

There is no personalized hormone therapy that can be devised to ‘correct’ imbalances – rather a lifestyle change, powerful knowledge, and expert advice to follow up on any progress is favored. (9,10)


  1. https://www.medicalnewstoday.com/articles/318660#treating-the-symptoms 
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC346633/ 
  3. https://www.bionity.com/en/encyclopedia/Menopause.html 
  4. https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666 
  5. https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P00559 
  6. https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/estrone 
  7. https://www.webmd.com/menopause/news/20000209/natural-alternatives-hormone-therapy 
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947726/ 
  9. https://www.npr.org/sections/health-shots/2020/01/16/796682276/for-some-women-nearing-menopause-depression-and-anxiety-can-spike 
  10. https://www.premierhealth.com/your-health/articles/women-wisdom-wellness-/beware-high-levels-of-cortisol-the-stress-hormone 

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