Perimenopause and Weight Gain

How to Lose Weight During Perimenopause

Dr. Jolene BrightenPublished: Last Reviewed: Perimenopause/ Menopause, Weight Loss Leave a Comment

Weight gain is a common symptom that women experience during perimenopause. Even when diet, exercise, and other lifestyle factors remain the same, the number on the scale and the waist measurement can creep up. This change can feel frustrating, unexpected, and impossible to change. 

However, the root of perimenopause weight gain may be in the natural hormonal changes during this time. Instead of focusing on weight, it’s time to focus on hormonal health with targeted lifestyle strategies and supplements, which we’ll discuss in this article).

Can you lose weight during perimenopause? Yes, but not by pushing harder and going through extreme caloric restriction! 

Before we get to the action steps, let’s cover hormonal changes during perimenopause and the science behind perimenopause weight loss. If you want to learn how to lose weight during perimenopause, you are in the right place! 

Does Perimenopause Cause Weight Gain?

To answer the question “does perimenopause cause weight gain?”we first need to understand perimenopause. 

Perimenopause describes the hormone fluctuations and eventual decline of ovarian hormones before menopause. Perimenopause may last for seven to 10 years prior to menopause, which is one year after your last period. After that, you are considered post-menopausal. 

During perimenopause, you may experience symptoms related to fluctuating hormones and the body adapting to lower levels of estrogen and progesterone. Perimenopause symptoms may include: 

While this article focuses on weight, many of the same interventions that support perimenopause and weight loss will also benefit other symptoms. 

Age alone may be responsible for some weight gain, including a loss of lean body mass accompanied by an increase in fat deposits. As we enter our thirties we begin losing muscle mass, which progresses with age. However, the hormonal changes of perimenopause can accelerate the changes in body composition

In a sample of almost 500 women in perimenopause and post-menopause, 69% experienced weight gain during perimenopause. These women were more likely to experience weight gain if they had a sedentary lifestyle, negative body image, and increased stress. Yes, stress is a huge player in body composition and as we enter our perimenopausal years, we become less resilient to the effects of stress.

In addition, it’s important to note that not all weight gain is equal. An even distribution of extra weight is preferable over gaining weight in the stomach, as visceral adiposity brings additional health risks.Visceral adiposity is the term that refers to fat that is distributed around our organs and is linked to significant cardiometabolic issues, like diabetes and heart disease.

perimenopause symptoms

Hormonal Changes During Perimenopause

Perimenopause is a time of progesterone decline as the ovaries don’t produce a sufficient amount of the hormone and then begin to ovulate irregularly. Without ovulation, there is no progesterone, which can leave you feeling anxious and sleepless. And friend, no sleep can be a root cause struggle in the weight gain department. . 

As hormones decline over the perimenopause years, there can also be large hormonal swings. You may experience times of estrogen dominance, where estrogen levels are elevated compared to progesterone. 

Both high and low levels of estrogen can contribute to weight gain. High estrogen promotes increased fat, and fat produces more estrogen. Since progesterone works to balance estrogen levels, low progesterone compounds this imbalance. 

Estrogen is insulin-sensitizing, making insulin work better and improving energy metabolism. As estrogen levels decline in late perimenopause and eventually settle at much lower levels, you may become more insulin resistant, impacting weight, including abdominal weight, and metabolic health. 

In addition, increased stress during this life phase of many transitions may lead to increased cortisol, a stress hormone that can lead toweight gain. Ffluctuations in sex hormones are associated with thyroid imbalances, which also affect weight and the metabolic rate. 

Read more about the connections between hormonal imbalances and weight loss here

The Impact of Lower Estrogen Levels on Perimenopause

In addition to weight gain and increased visceral fat, low estrogen levels contribute to many body changes and perimenopausal symptoms, including sarcopenia (loss of muscle mass and strength), lower libido, and mood swings. 


Sarcopenia is the loss of muscle mass associated with aging. Estrogen supports strong muscles and bones. As levels decline, so can muscle mass and bone density

Lean body mass (muscle) is vital for a lean and strong body and helps to preserve metabolic health. Maintaining and improving muscle mass during perimenopause and beyond helps prevent falls, fractures, and osteoporosis later in life. 

Lower Libido

Low estrogen may contribute to a decreased libido during perimenopause. Other factors to consider are stress, low testosterone, and low oxytocin.

As I talk about in Is This Normal, pleasure and orgasms all support health and longevity. If you’re struggling here it’s important to be aware and take action. Your desire and enjoyment of sex is a real vital sign so if you need some guidance around this, in addition to balancing hormones, check out these tips for improving your libido

Mood Swings

Your brain develops in response to estrogen; as estrogen levels decline, it can affect your neurotransmitter levels and mood. In early perimenopause, when your progesterone is fluctuating, you might experience more mood swings and irritability. 

When estrogen levels are low, depression is more common. In fact, perimenopause correlates with an increased vulnerability to depression for those with a history and new-onset depression for some women. 

Can You Lose Weight During Perimenopause?

It might seem like your hormones are turning against you and weight loss during perimenopause is impossible. In truth, it is possible; it just might take a different approach. 

Because of the hormonal changes that occur from your late 30s through your early 50s, the weight management strategies that worked when you were younger may no longer work. The “eat less, exercise more” messages are bad advice, especially in perimenopause. 

The Science Behind Perimenopausal Weight Loss

Overly restrictive dieting and excessive exercise stress the perimenopause hormonal system, which is already in a state of transition and adjustment. In fact, this is a good way to cause cortisol to climb and your weight loss efforts to feel completely thwarted. Instead of extreme measures, getting back to proper nourishment and movement is key.

In addition, focusing on the exercise science has shown to be most beneficial can help you achieve the changes you’re after quicker. 

Prioritize Movement and Exercise

Physical activity during the perimenopausal transition helps preserve lean body mass and improve metabolic health, not to mention the benefits for stress management, hormone levels, and mood. 

The right type, frequency and intensity of exercise supports weight loss and helps prevent weight gain, but you want to be smart about training. Too much exercise and too much endurance or cardio exercise may work against your goals in some cases. 

If you don’t already have a strength training routine, now is the time to get one. Start slow with body weight exercises, yoga, and Pilates. Then add in some weight training.

Why Strength Training is Good for Perimenopause

We begin losing muscle mass in our thirties and it becomes even more apparent as we enter our forties. To combat this, we need to strength train and eat protein (more on that soon).

Building muscle mass and keeping it is expensive, which means it requires more energy. That’s part of why you’ll hear people say building muscle improves your metabolism or the number of calories you burn. In one study it was found that postmenopausal women burned less calories doing the same exercise as a premenopausal woman, which they believe was due to muscle mass. This makes the case to build muscle sooner, rather than later. But allow me to also explain why women need to strength train.

Engaging in strength training and building muscle mass is key to metabolic and hormone health, as well as longevity. It has the additional bonus of also helping with body composition. In a recent meta-analysis, found that 30 to 60 minutes of strength training weekly was associated with a 10 to 20 percent reduction in risk for cancer, heart disease, and mortality. 

Improving muscle mass also improves bone health and reduces the risk for injury. In addition, strength training may also reduce the risk of Alzheimer's. In fact, one study found that low muscle mass was associated with faster future cognitive decline in people over the age of 65. 

Why HIIT Training is Good for Perimenopause

High intensity interval training is one way to optimize insulin and blood sugar levels, while also improving muscle mass. As estrogen levels begin to decline in late perimenopause and continue into menopause, insulin resistance can become more problematic. The result can be weight gain. In addition to building muscle, cardio training can also optimize your hormones and body composition. 

While research shows that people who engage in both cardio and strength training have the best outcomes in terms of reduced mortality, cardiovascular disease, cholesterol, and blood pressure, I often tell my premenopausal patients that if you have to choose one, make it strength training. The reason for this is that muscle needs continuous stimulation to maintain and you can achieve getting your heart rate up, although not as high, with strength training. I’m not saying skip the cardio. What I am saying is life sometimes leaves us short on time and if you have to choose—choose maintaining your muscle.

Stay Hydrated

Staying hydrated has a direct effect on your physical performance during exercise. And the better your tolerance for exercise, the more you can stay with it in the moment and recover better.

Drinking water, especially cold water, stimulates thermogenesis, which is heat production. In one small study, drinking water at 71 degrees fahrenheit resulted in a 30% average increase in metabolic rate. While this sounds really awesome, keep in mind that this is unlikely to be enough of a change to shift your body composition. 

In addition to these benefits, making water your beverage of choice means less liquid calories. Things like soda, teas with added sugar, and other beverages can be a sneaky, yet significant way your calorie intake climbs.

When it comes to hormones, estrogen helps your cells and body tissues hold onto water and stay hydrated. You may notice more dryness in perimenopause, including dry skin, vaginal dryness, and even itchy ears. In later perimenopause, as estrogen declines, your ability to stay hydrated may feel more challenging. I recommend to my patients that they start the day with lemon water with a bit of salt and consider adding an electrolyte beverage to their routine on the days they work out. Here’s the electrolytes I use because they’ve got the right balance and taste good.

Be sure to drink enough water, use sea salt when cooking, and add an electrolyte supplement when sweating. I know it seems simple, but it’s essential. 

perimenopause and diet

Maintain a Healthy Diet

There are foods you can add into your diet that will help promote your ideal body composition. Diet is one of the areas where making some changes will have profound results, and I’m not talking about extreme calorie restriction or following a fad weight loss challenge. Focus on whole, real food, eating plenty of plants, and balancing your blood sugar. 

If you’re in need of recipes to help you get started, you can grab my free Hormone Balancing Starter Kit, which also includes a meal plan to give you a framework.

Focus on these categories of food:

High protein foods.

If you aren’t eating enough protein, you can’t build muscle — it’s that simple. In addition to building and maintaining muscle mass, protein helps you balance blood sugar, provides the building blocks for neurotransmitters, and so much more. 

Choose protein from plant and animal sources, including wild fish, shellfish, eggs, grass-fed beef, bison, grass-fed dairy, organic chicken, organic turkey, beans, lentils, nuts, and seeds. Include protein at every meal. 

The goal should be 1-1.5 grams of protein per kilogram of body weight per day. As we age, higher protein intake can help support the health of our muscle tissue and prevent us from rapidly losing this important metabolic tissue.

Healthy fats

Including healthy fats improves satiety from meals or in other words, helps you feel full longer. Including quality fats ensures you’re less likely to overeat and experience sugar cravings. Healthy fats may also slow the release of sugars and carbohydrates, which could help maintain healthy blood sugar levels — the antidote to insulin resistance. 

I steer my patients toward avocados, cold pressed olive oil, hemp seeds, goat cheese, organic Greek yogurt, coconut, Brazil nuts, walnuts, sardines, wild salmon, eggs, and olives. Many of these foods also contain protein, so it’s a two-for-one! 

High fiber

Gut microbiome variety is associated with a lower rate of belly fat. And the way to a healthy gut microbiome is fiber.  

Studies have shown that people who consume soluble fiber have more microbial diversity and less incidences of belly fat. In fact, in one study it was found that for every 10 grams of soluble fiber consumed, belly fat weight gain is reduced by 3.7% over five years.

A high-fiber diet is essential in perimenopause and beyond for supporting the gut microbiome and blood sugar regulation, both of which promote a healthy metabolism and weight loss. 

Whole plant foods contain fiber, including fruit, vegetables, beans, whole grains, nuts, and seeds. Make these the cornerstone of your diet with a half plate of veggies with most meals and a quarter plate of starchier options. 

Practice Intermittent Fasting

I’m not talking about the “don’t eat for a couple of days” method, although that does work well for some individuals. Instead, aiming to give yourself 12-16 hours from dinner to breakfast can help shift not just your weight, but many longevity markers. Women who practice intermittent fasting have better metabolic markers like fasting insulin levels and optimal blood sugar. In fact, in one randomized control trial, it was found that insulin resistance was reduced by 19% in obese women who practiced intermittent fasting for a period of 6 months. They also have lower visceral adiposity. 

Longer fasts may have health benefits for some people, but I caution people from jumping into any more extreme variation of fasting. While you may be someone who benefits from longer or more modified fasts, this is something you should talk with a healthcare provider about so they can best guide you before jumping in. 

You can read more about the benefits of intermittent fasting here.

Reduce Stress

Easier said than done, but in the weight loss arena, it’s a must. Cortisol issues can arise in perimenopause, which are only compounded by stress. Cortisol is a stress hormone produced by the adrenal glands. When it rises for long periods of time, this can contribute to weight gain, difficulty losing weight, and belly fat or visceral adiposity.

Here are a few ways to combat stress:

Practice Mindfulness and Meditation: Engaging in regular mindfulness exercises and meditation can help reduce stress and cortisol levels by promoting relaxation and increasing self-awareness. 

Establish a Supportive Social Network: Whether through family, friends, or joining social groups or communities, having people you can count on can help reduce stress.

Engage in Relaxation Techniques: Deep breathing exercises, progressive muscle relaxation, or listening to calming music, can activate the body's parasympathetic nervous system (the “rest and digest”) and help build resiliency against stress. 

Best Perimenopause Supplements for Weight Loss

In addition to lifting weights and eating well, targeted supplements may support weight loss in perimenopause. 

For more on perimenopause supplements, check out this article. I’ll cover some specific to weight loss next. 


A balanced gut microbiome means improved insulin sensitivity, vaginal health, better digestion, and more. Gut health is key for hormonal health and provides a solid foundation in perimenopause. 

Studies have shown that probiotic supplementation can help with body composition. In one study, women who took a probiotic supplement strain Lactobacillus rhamnosus lost 50% more weight over a 3 month period than the women who took placebo.

Lactobacillus rhamnosus has many benefits in women’s health, which is why we’ve included it as part of our Women’s Probiotic supplement formulation. 


After menopause, you won’t make any estrogen or progesterone in the ovaries, but you will make some estrogen (estrone) in the adrenal glands. This makes adrenal health even more important. 

Rhodiola is one of my favorite adaptogenic herbs for adrenal support, helping the body adapt to stress. In addition, animal studies suggest rhodiola may help improve muscle growth with exercise. Other animal studies show it may help reduce visceral adiposity or belly fat.

While studies are limited in the weight loss department, there are many benefits to Rhodiola that make it an herb worth considering.


Omega-3s are essential for lowering inflammation associated with perimenopause. Inflammation is one reason the body holds onto weight.

These fatty acids have been found to be beneficial in aiding in weight loss.  

You’ll find these fatty acids in cold water fish, fish oil, and algae supplements. Omega-3 supplements specifically may help alleviate some of the vasomotor symptoms like hot flashes associated with perimenopause. 

Our Omega Plus has a balance of EPA and DHA to support both the brain and the body!

Green Tea Extract

Green tea extract contains EGCG, a powerful antioxidant that may positively affect the microbiome, possibly leading to better blood sugar balance and insulin sensitivity — a key factor for weight loss.

EGCG and the caffeine found in green tea may help to improve metabolism. One study found that after 12 weeks of consuming more than 500 mg of green tea daily there was significant weight loss among obese participants. 

Our Myoinositol Plus contains green tea extract, along with chromium and inositol to support healthy blood sugar.

You can also get the protective benefits from drinking green tea or matcha. 

Best Perimenopause Supplements for Weight Loss


Branched-chain amino acids, BCAAs, are critical amino acids for protein synthesis in the muscles. BCAA’s include leucine, isoleucine, and valine. A BCAA supplement, along with strength training, may improve body composition. 

BCAAs are found in high amounts in animal proteins. If you eat a vegetarian diet or are looking for more support, a supplement may be a good option.

With so many supplement choices, my go-to best perimenopause supplements for weight loss are: 

  • Balance Women’s Hormone Support – A comprehensive female hormone support formula containing vitamins, minerals, and phytonutrients to support estrogen metabolism and clearance. This formula may be particularly beneficial during early perimenopause when estrogen levels widely fluctuate. In addition, it provides your ovaries with the support they need to keep producing progesterone for as long as they can.
  • Women’s Probiotic – Contains specific probiotic bacteria strains known to promote women’s health and hormone balance. I formulated this to contain three science backed spore based organisms, along with the specific Lactobacillus species women need. In addition, you’ll find a SIBO-friendly prebiotic, which means you’re less likely to bloat, and an antioxidant to support urinary tract health. A robust microbiome and improved hormone balance may support weight loss during perimenopause. 
  • Adrenal Support – Contains a synergistic formula of critical nutrients and adaptogenic herbs, including rhodiola, that promote adrenal health. Adrenal health and cortisol balance is essential in supporting healthy body composition. In addition, your adrenal health can help your body in creating the optimal levels of estrogen and progesterone.. 


If you are in your 40s and noticing weight gain, there are many tools to support a healthy metabolism and your ideal  body composition through the significant hormonal changes of perimenopause. Eating whole, nourishing meals that balance blood sugar and hormones while prioritizing strength training can have a significant impact on your metabolic health. Throw in a few essential supplements, and you’ll have a solid foundation of health for years to come.

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About The Author

Dr. Jolene Brighten

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Dr. Jolene Brighten, NMD, is a women’s hormone expert and prominent leader in women’s medicine. As a licensed naturopathic physician who is board certified in naturopathic endocrinology, she takes an integrative approach in her clinical practice. A fierce patient advocate and completely dedicated to uncovering the root cause of hormonal imbalances, Dr. Brighten empowers women worldwide to take control of their health and their hormones. She is the best selling author of Beyond the Pill and Healing Your Body Naturally After Childbirth. Dr. Brighten is an international speaker, clinical educator, medical advisor within the tech community, and considered a leading authority on women’s health. She is a member of the MindBodyGreen Collective and a faculty member for the American Academy of Anti Aging Medicine. Her work has been featured in the New York Post, Forbes, Cosmopolitan, Huffington Post, Bustle, The Guardian, Sports Illustrated, Elle, and ABC News. Read more about me here.