GLP-1s and the Menopause: What you need to know
Going through perimenopause and menopause brings significant changes to your body, and many women find themselves struggling with weight gain and metabolic changes they’ve never experienced before. If you’re considering or currently using GLP-1 medications during this time, here’s what you should know.
In this post:
- How Menopause Changes Your Body
- What happens during this transition
- Why Nutrition and Strength Training Become Essential
- How GLP-1s Can Help During Menopause
- Important Considerations with HRT
How Menopause Changes Your Body
The hormonal shifts during perimenopause and menopause – particularly declining oestrogen levels – create a perfect storm of metabolic changes that can feel frustrating and overwhelming.
What happens during this transition:
- Your metabolism slows down as you lose lean muscle mass
- Visceral fat (the deep abdominal fat around your organs) increases significantly
- Your risk of heart disease rises
- Glucose control can become more challenging, increasing diabetes risk
- Bone density starts to decline
Weight gain during menopause is normal (but that doesn’t make It easy)
If you’ve been gaining weight during perimenopause or menopause, you’re definitely not alone. Research shows that at least 50% of women experience weight gain during this time, with evidence from the SWAN study and The Healthy Women’s study indicating an average gain of about 1.5kg per year during the perimenopause transition.
By the time menopause is reached, many women have gained around 10kg on average. Most of this weight settles around the abdomen and upper body, which isn’t just about appearance – it’s about health.
Here’s why the location matters: visceral fat increases from 5-8% of total body fat in the premenopausal state to 15-20% of total body fat in the postmenopausal state. This central fat distribution carries higher cardiometabolic risks compared to weight distributed elsewhere on the body.
At the same time, your metabolic rate slows as lean muscle mass reduces, making it even harder to maintain your weight. Your bones also become more fragile due to declining bone density, making strong supporting muscles more important than ever.
Why Nutrition and Strength Training Become Essential
Good nutrition and an active lifestyle are crucial, whether or not you’re using hormone replacement therapy (HRT).
With the increased risks of cardiovascular disease and reduced bone density, focusing on nutrition becomes even more important. If you’re taking GLP-1 medications and eating less overall, it’s vital to make every bite count nutritionally.
Strength training is particularly important during this time. The British Menopause Society calls resistance or strength exercises “almost non-negotiable” for menopausal women. You’re facing a double challenge: losing muscle mass due to hormonal changes and potentially losing more through weight loss.
Building and preserving muscle strength helps protect your metabolism and reduces your risk of falls, which can be particularly serious when bone density is declining.
Simple exercises like squats, box press-ups, ankle taps, and bicep curls are ideal starting points. The Body Coach has excellent YouTube content specifically designed for women going through menopause.
Check it out:
How GLP-1s Can Help During Menopause
The hormonal changes during perimenopause and menopause can make weight management feel like an uphill battle. This is where GLP-1 medications can be particularly valuable tools.
GLP-1s can help with both weight management and glucose control during this challenging time. The weight loss achieved can reduce the risk of other metabolic problems associated with being overweight. For example, Wegovy is licensed specifically to reduce cardiovascular risk in people with raised BMI – something that becomes increasingly relevant during menopause.
The key is using GLP-1s as part of a comprehensive approach that includes good nutrition and strength training, not as a standalone solution.
Important Considerations with HRT
If you’re taking hormone replacement therapy alongside GLP-1 medications, there are some important interactions to be aware of.
GLP-1s can affect how well your body absorbs HRT that’s taken orally. If you’re currently taking oral oestrogen, your healthcare provider might recommend switching to a patch-based (transdermal) formulation while you’re on GLP-1 treatment.
The same applies to oral progesterone. Since progesterone is crucial for protecting your endometrium (womb lining) from increased cancer risk, it’s important to ensure adequate absorption. Given that obesity is also a risk factor for endometrial cancer, proper protection becomes even more critical.
The British Menopause Society recommends using non-oral progestogen for 4 weeks after starting GLP-1 treatment and for 4 weeks after any dose increase. Practically speaking, this might mean considering options like an intrauterine device that releases progestogen.
The Bottom Line :
- Menopause brings complex changes that affect your metabolism, body composition, and health risks. While these changes can feel overwhelming, GLP-1 medications can be valuable tools when used thoughtfully alongside proper nutrition and strength training.
- The key is understanding that successful management during this time requires a comprehensive approach. GLP-1s can help with the weight and metabolic challenges, but they work best when combined with lifestyle strategies that address the unique needs of your changing body.
- If you’re considering GLP-1 treatment during perimenopause or menopause, discuss your full health picture with your healthcare provider, including any HRT you’re taking and your approach to nutrition and exercise. This ensures you get the most benefit while managing any potential interactions safely.
