Weight Management Strategies in Menopause: Hormonal and Lifestyle Considerations

Menopause is the permanent cessation of menstruation that occurs due to a decline in ovarian hormone production. It is associated with lifestyle and hormonal changes that increase the risk of obesity, diabetes mellitus, and cardiovascular diseases. Weight gain is a common complaint by women during this period, and weight management is a significant challenge for them. Evidence on lifestyle interventions to manage weight addressing this specific population is lacking. Furthermore, the benefits of hormonal therapy in managing weight are controversial. The aim of this review is to discuss lifestyle and hormonal considerations in weight management during menopause. Menopausal hormonal changes alongside increasing age and decreased energy expenditure lead to an increase in women's total body weight, specifically an increase in abdominal subcutaneous and visceral adipose tissue deposition. Physical exercise showed significant improvements in metabolic functions, BMI, body weight, and body fat percentage in postmenopausal women. Furthermore, nutritional changes, such as introducing the Mediterranean diet, can have positive effects on weight management. Although evidence showed measurable positive effects of hormonal replacement therapy (HRT) on weight management, HRT is still not recommended in menopausal weight management strategies due to its high risks. Individualized, evidence-based strategies that consider hormonal, behavioral, and social factors are essential to support women through menopause transition.