Can HRT cause you to gain or lose weight? Here's what…

Can HRT cause you to gain or lose weight? Here's what the experts say

Hormone replacement therapy (HRT) is in the news after it was announced that one of the treatments will be available without a prescription for the first time in the UK. Boots is set to sell a medicine for menopausal women over the counter as well as online.

The high street pharmacy will offer a pack of 24 Gina 10 microgram vaginal tablets for £29.99. The drug - that treats one symptom of menopause , vaginal atrophy - was reclassified from prescription-only to a pharmacy medicine by the Medicines and Healthcare products Regulatory Agency (MHRA) this year.

The medicine treats vaginal atrophy by replacing reduced oestrogen levels. The condition leads to the thinning, drying and inflammation of the vaginal wall.

Reduced oestrogen levels during the menopause has also been linked to weight gain - particularly around the belly. NHS Inform says although many women believe taking HRT will make them put on weight, there is no evidence that this is the case.

And many actually find they lose weight by using HRT as it shifts the metabolism back into a pre-menopausal state. Studies have backed this up too.

What is Hormone replacement therapy (HRT)

HRT is a treatment used to relieve symptoms of the menopause. It replaces the female hormones that are at a lower level during the menopause.

Oestrogen and progesterone are female hormones that play important roles in a woman’s body. Falling levels cause a range of physical and emotional symptoms, including hot flushes, mood swings and vaginal dryness.

Does HRT lead to weight loss?

A decline in oestrogen can also accelerate fat accumulation, according to Dr JoAnn Pinkerton, executive director of the North American Menopause Society. “Changes over time in how women look – such as noticing more abdominal fat, having increases in waist size, pants no longer fitting in the waist or increases in breast size – all may be signs,” she said.

However, a study from 2018, involving more than 1,000 postmenopausal women aged 50 to 80, found that those who were currently taking hormones had significantly lower levels of tummy fat than women who had never used them. The findings, published in the Journal of Clinical Endocrinology and Metabolism, came from a large study of heart disease in Switzerland.

Study lead Dr Georgios Papadakis, of Lausanne University Hospital, Switzerland, said when it was published: “Up until now, there was not a large study focused on the fat in the abdomen, which is the most known detrimental fat in the body. The new conclusion of the study is that menopausal hormone therapy prevents the increase of [this] type of fat in postmenopausal women.”

However, the study found the beneficial effects on weight gain were not permanent and once hormone replacement stopped, the women regained their abdominal fat. Dr Pinkerton said this finding was important for doctors when reviewing hormone replacement with their patients.

She added: “Discussions about stopping hormone therapy should include a discussion of increased gain of abdominal fat and the associated health risks.”

How to get started on HRT

NHS Inform says you should speak to your local GP practice if you're interested in starting HRT. You can usually start the treatment as soon as you start experiencing menopausal symptoms and will not usually need to have any tests first.

NHS Inform adds: “However, a blood test to measure your hormone levels may be carried out if you're aged 40 to 45. Blood tests may also be carried out to help diagnose suspected premature menopause if you’re under 40 and have menopausal symptoms.”

Your GP can explain the different types of HRT available and help you choose one that's suitable for you.

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