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5 Tips to Combat Perimenopause Weight Gain

by Jennifer Sweenie
Last Updated: April 30, 2024

As women approach their midlife years, they tend to experience a range of physical and emotional changes, including perimenopause weight gain. This weight gain has many causes, including hormonal shifts, disrupted sleep, and muscle loss. 

Feel like you again with these five tips to combat perimenopause weight gain.

Feel like you again with these five tips to combat perimenopause weight gain.

In addition to possible rapid weight gain, women may experience other symptoms such as hot flashes, mood swings, and a decreased sex drive. Changes in body composition during this time are frustrating. They, along with other symptoms, can be extremely bothersome and debilitating for women. However, healthy aging throughout perimenopause and menopause is possible by addressing certain lifestyle factors.

Before we get into how to fight perimenopause weight gain, let’s first look at what perimenopause is. We'll also see why it leads to weight gain and the risks associated with it. 

What Is Perimenopause?

Perimenopause is a transitional phase that marks the beginning of the end of a woman's reproductive years and the onset of menopause. During this period, which may last several years, the ovaries begin to produce less estrogen and progesterone. This leads to irregular periods and a whole host of other possible physical and mental health symptoms. Many midlife women experience unexpected weight gain. This is caused by a drop in estrogen levels and subsequent hormonal fluctuations.

Perimenopause typically begins in a woman's early to mid-40s, but it can start earlier or later. It is not the same as menopause, which is defined as the absence of periods for 12 consecutive months. 

Common Symptoms of Perimenopause

The symptoms of perimenopause vary from woman to woman, but several common ones, according to the National Institutes of Health, include:

  • Higher abdominal fat, or “menopause belly” 
  • Irregular periods (either a longer or shorter cycle) 
  • Vasomotor symptoms such as hot flashes and night sweats 
  • Changes in mood, such as irritability or depression 
  • Decreased sex drive 
  • Vaginal dryness 
  • Sleep disturbances 
  • Fatigue 
  • Memory problems, brain fog, or difficulty concentrating 
  • Joint and muscle pain 
  • Headaches 
  • Itchy skin 
  • Thinning hair 
  • Urinary tract infections

It's important to note that not all women will experience these symptoms, though many do. And some women may experience them to a greater or lesser degree than others. Symptoms associated with perimenopause may come and go throughout the years leading up to the onset of full menopause.

What Causes Perimenopause Weight Gain?

Perimenopause can lead to weight gain for a number of reasons. First, as the ovaries produce less estrogen, the body becomes less responsive to the hormone insulin. Estrogen improves insulin sensitivity. This resistance to insulin can lead to higher levels of insulin and sugar in the blood, resulting in an increase in appetite and cravings for sugary and carbohydrate-rich foods. Additionally, as women and men age, they lose lean body mass. Having less muscle slows down metabolism, which can make it easier to gain weight. 

Disrupted sleep due to perimenopause can also contribute to weight gain. Many women experience sleep disturbances during this time, which can lead to fatigue and a decrease in physical activity. Genetics and a sedentary lifestyle in middle age may also be at play in menopausal weight gain, according to the University of Chicago Medicine.

Lastly, an increase in stress levels can also be a factor. Many women feel stress during perimenopause. This is due to the physical, emotional, and mental changes happening. Stress can lead to overeating and can also cause the body to produce more stress hormones and store more fat, particularly around the belly.

What Are the Risks of Perimenopause Weight Gain?

Some risks of perimenopause weight gain include an increased risk for certain health conditions. Hormonal changes can lead to an increase in visceral fat. Visceral fat is the fat that accumulates around the organs in the abdomen. A higher waist circumference in menopausal women is a risk factor for cardiovascular and metabolic diseases. It is associated with an increased risk of heart disease, metabolic syndrome, type 2 diabetes, and certain types of cancer. Excess weight can also lead to joint pain and decreased mobility. A higher body mass index (BMI) in women is also tied to an increased risk for certain cancers, such as breast, colon, and endometrial. 

5 Tips to Combat Perimenopause Weight Gain

Women can take several steps to manage their weight and reduce the buildup of visceral fat and perimenopause weight gain. Here are our top 5 tips:

  1. Engage in regular physical activity: Exercise is an important part of weight management and can help reduce the risk of developing health problems associated with visceral fat. Primally aligned movement is an excellent way to incorporate exercise into your routine.
  2. Follow a healthy diet: A primally-aligned diet rich in vegetables, animal proteins, healthy fats, and low-sugar fruit can help manage weight and reduce the risk of health problems. Avoiding processed and sugary foods is paramount to combatting perimenopause weight gain.
  3. Get enough sleep: Sleep is essential for maintaining a healthy weight and hormone balance. Women should aim for 8-10 hours of sleep per night.
  4. Manage stress: Chronic stress can contribute to weight gain and other health problems. Find healthy ways to manage stress, such as yoga, meditation, daily affirmations, or deep breathing exercises.
  5. Speak with your healthcare provider:  Seeking guidance from a women's health specialist or a practitioner certified by the North American Menopause Society is a great option if you're suffering from debilitating perimenopause symptoms. If you have a hormonal imbalance, your healthcare provider can help you develop a personalized plan for managing your perimenopause symptoms. Hormone replacement therapy is one treatment option, that may reduce other related health problems. Hormone replacement therapy helps manage perimenopause symptoms by adding estrogen and/or progesterone to the body's declining hormone levels. However, menopausal hormone therapy isn't suitable for everyone. You should discuss it with your provider to see if it's right for you.


Perimenopausal weight gain is a common symptom associated with hormonal changes that occur as a woman's body prepares for menopause. 

Premenopausal women who are experiencing weight gain and suspect it may be due to hormonal changes can benefit from a primal lifestyle.

A myPrimalCoach is a great addition to your healthcare team. They can help you implement new healthy lifestyle changes to keep perimenopause weight gain at bay.

These changes may include:

  • Starting a new exercise program
  • Using stress management tools
  •  Finding a healthy, primally-aligned calorie deficit.

Take action and reach your weight loss goals and optimal health with your myPrimalCoach today. 

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