What happens to the body during menopause?
Menopause marks the end of the fertile period of life and occurs when the ovaries gradually reduce their production of sex hormones, particularly oestrogen and progesterone. The process happens gradually over several years and is usually divided into three different stages.
Perimenopause
Perimenopause is the period that many people associate with menopause. During this stage, hormone production begins to fluctuate more than before, which can lead to irregular periods and the symptoms commonly associated with menopause.
Menopause
Menopause is the final menstrual period. It is not actually a stage, but a point in time that is determined retrospectively, once 12 months have passed without a period. At this point, oestrogen production from the ovaries has decreased significantly. For most women, menopause occurs between the ages of 45 and 55.
Postmenopause
Postmenopause is the period after menopause, when hormone levels have stabilised at a new, lower level. Many of the symptoms that occur during hormonal changes may decrease over time, but some effects of lower oestrogen levels remain even after menopause.
Common symptoms during menopause
Hormonal changes can affect the body in many different ways. Some women experience few problems, while others have symptoms that affect everyday life and quality of life to a greater extent.
Common symptoms include:
- Hot flushes and night sweats
- Sleep problems and tiredness
- Mood swings or low mood
- Increased sensitivity to stress
- Dry mucous membranes
- Urinary incontinence or frequent urges to urinate
- Joint pain and stiffness
- Reduced energy and recovery
Lack of sleep, tiredness and increased sensitivity to stress can also affect eating habits, physical activity and recovery, which can indirectly make it more difficult to maintain a stable weight.
How does menopause affect weight and body composition?
As oestrogen levels fall, the body's metabolism and fat distribution change. Before menopause, fat is more often stored around the hips, thighs and buttocks, while after menopause, fat is stored to a greater extent around the abdomen and internal organs.
At the same time, muscle mass gradually decreases with age, a process that may become more pronounced during menopause. Because muscle tissue contributes to the body's energy expenditure, this can make it easier to gain weight and more difficult to maintain a lower weight over time.
However, research shows that menopause itself does not necessarily cause dramatic weight gain. For many women, weight gain occurs gradually over several decades. What changes most during menopause is body composition, with an increased proportion of abdominal fat and a reduced proportion of muscle mass. Abdominal fat is more metabolically active than subcutaneous fat and is linked to an increased risk of conditions including type 2 diabetes, cardiovascular disease and fatty liver disease.
The importance of oestrogen for metabolism
Oestrogen affects much more than reproduction. The hormone and its receptors are involved in several of the body's systems for energy metabolism, hunger regulation and metabolic health. Oestrogen contributes to good insulin sensitivity, regulation of hunger and fullness, preservation of muscle mass and favourable fat distribution. The hormone also plays an important role in bone density and cardiovascular health.
As oestrogen levels fall, the risk of conditions such as type 2 diabetes, cardiovascular disease and osteoporosis increases. In people living with overweight or obesity, these risks are already elevated, meaning that the hormonal changes during menopause may have a greater impact.
At the same time, menopause is also a period when healthy lifestyle habits can make a significant difference. Regular strength training, a nutritious diet, good sleep and, when needed, medical treatment can contribute to better weight management, preservation of muscle mass and improved metabolic health throughout the transition and beyond.
Diet for lasting weight loss during menopause
During menopause, the body's hormonal balance, muscle mass and energy requirements change. The quality of your diet therefore becomes particularly important. A nutritious diet with sufficient protein, healthy fats, fibre, vegetables, fruit and berries, as well as calcium and vitamin D, can contribute to better fullness, preservation of muscle mass and stronger bones.
Sufficient protein intake is particularly important during weight loss, as it helps preserve muscle mass and supports recovery after physical activity. Good sources of protein include fish, eggs, poultry, pulses, dairy products and quark.
After menopause, the risk of reduced bone density increases. It is therefore important to get enough calcium and vitamin D, preferably in combination with regular exercise, to support bone health over time.
Physical activity and recovery during menopause
Regular physical activity is one of the most effective measures for promoting health and wellbeing during and after menopause. Strength training, cardiovascular exercise and activities such as yoga all have important functions and complement each other by affecting body composition, metabolism, cardiovascular health and quality of life in different ways.
Strength training helps preserve muscle mass and physical function, which is particularly important because muscle mass naturally decreases with age and falling oestrogen levels. During weight loss, the body usually loses both fat mass and muscle mass, but regular strength training can help preserve muscle and promote a more favourable body composition. Exercise also stimulates the bones and can help maintain bone density, which is important as the risk of osteoporosis increases after menopause.
Cardiovascular exercise also has positive effects on the cardiovascular system, blood pressure and the body's ability to use energy. Regular cardiovascular exercise can improve fitness, increase energy expenditure and contribute to better blood sugar regulation and insulin sensitivity. Because the risk of cardiovascular disease increases after menopause, cardiovascular exercise is an important part of a long-term strategy for good health.
Yoga and other mobility exercises can be valuable additions to both strength and cardiovascular training. In addition to improving balance, mobility and body control, yoga can help reduce stress, improve recovery and improve sleep quality. As many women experience increased sensitivity to stress, sleep problems and joint stiffness during menopause, these effects can be particularly valuable.
For the best effect, a combination of strength training, cardiovascular exercise, everyday physical activity and activities that promote recovery is recommended. Together, these can help preserve muscle mass, reduce abdominal fat, strengthen bones and improve both metabolic health and quality of life throughout menopause and beyond.
Medical support for weight loss during menopause
For some women, lifestyle changes may be sufficient to achieve and maintain a healthy weight during menopause. For others, hormonal changes, combined with biological mechanisms that affect hunger, fullness and energy balance, can make weight loss more challenging.
In these cases, medical treatment can complement diet, physical activity and other lifestyle habits. Modern weight loss medicines, such as GLP-1-based treatments, work by affecting the body's systems for appetite regulation, fullness and blood sugar control. Treatment can contribute to reduced appetite, increased feelings of fullness and lower energy intake over time, which makes long-term weight loss easier for many patients.
In large clinical trials, treatment with semaglutide has shown an average weight loss of around 15 per cent of body weight after approximately 68 weeks of treatment. For tirzepatide, studies have shown an average weight loss of up to around 20 per cent or more after approximately 72 weeks. All of the studies combined medication with advice on diet, physical activity and other lifestyle changes.
Weight loss achieved through lifestyle changes and medication can also contribute to reduced abdominal fat and improvements in several metabolic risk factors, such as blood sugar, blood pressure and blood lipids.
At Yazen, treatment is preceded by an individual medical assessment by a registered doctor. Medication is combined with support from the healthcare team around diet, physical activity and sustainable lifestyle habits, with the aim of creating long-term conditions for improved health and weight management.
Frequently asked questions about losing weight during menopause
Why does it feel more difficult to maintain my weight during menopause?
Research shows that menopause itself does not cause significant weight gain. Weight usually begins to increase slowly before menopause and then continues at approximately the same rate throughout the menopausal transition. As oestrogen levels fall, the body's fat distribution changes, meaning that a greater proportion of fat tends to be stored around the abdomen and internal organs rather than the hips and thighs. At the same time, muscle mass naturally decreases with age, which can contribute to lower energy expenditure over time.
Many women also experience sleep problems, tiredness and increased sensitivity to stress during menopause. These factors can affect appetite, recovery and physical activity, which can further contribute to changes in body weight and body composition.
What type of exercise is best during menopause?
There is no single type of exercise that is best for everyone during menopause. For most women, a combination of strength training, cardiovascular exercise and regular everyday movement provides the greatest health benefits.
Strength training is particularly important because it helps preserve muscle mass, bone density and physical function as oestrogen levels fall. Cardiovascular exercise also contributes to better cardiovascular health, fitness and blood sugar regulation.
Yoga and other mobility exercises can also be valuable. In addition to improving balance, mobility and body control, yoga can help reduce stress and improve recovery, which is particularly relevant as many women experience sleep problems and increased sensitivity to stress during menopause.
The most important thing is to find a form of exercise that feels sustainable and can be maintained over time. Regular movement is often more important for health than occasional intensive exercise sessions.
How can modern weight loss medicines help?
For some women, weight loss can become more challenging during menopause due to hormonal changes, changes in body composition and increased hunger or appetite. If lifestyle changes do not have the desired effect, medical treatment may be an option in some cases.
Modern weight loss medicines, such as GLP-1-based treatments, work by affecting the body's systems for hunger, fullness and blood sugar regulation. Treatment can contribute to reduced appetite, increased feelings of fullness and reduced food cravings, which for many people makes it easier to create and maintain an energy deficit over time.
The medicines do not replace healthy lifestyle habits, but can provide support to make long-term changes to diet, physical activity and weight management easier. For many patients, treatment combined with lifestyle changes also contributes to reduced abdominal fat and improvements in metabolic risk factors such as blood sugar, blood pressure and blood lipids.
All medication should be preceded by an individual medical assessment to determine whether the treatment is appropriate based on the person's health, risk factors and treatment goals.
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