title: Understanding weight gain at menopause.
abstract: OBJECTIVE
  The aim of this review was to summarize the literature regarding the impact of the menopause transition on body weight and body composition.
  
  
  METHODS
  We conducted a search of the literature using Medline (Ovid, 1946-present) and PubMed (1966-2012) for English-language studies that included the following search terms: 'menopause', 'midlife', 'hormone therapy' or 'estrogen' combined with 'obesity', 'body weight' or 'body composition'.
  
  
  RESULTS
  Whereas weight gain per se cannot be attributed to the menopause transition, the change in the hormonal milieu at menopause is associated with an increase in total body fat and an increase in abdominal fat. Weight excess at midlife is not only associated with a heightened risk of cardiovascular and metabolic disease, but also impacts adversely on health-related quality of life and sexual function. Animal and human studies indicate that this tendency towards central abdominal fat accumulation is ameliorated by estrogen therapy. Studies mostly indicate a reduction in overall fat mass with estrogen and estrogen-progestin therapy, improved insulin sensitivity and a lower rate of development of type 2 diabetes.
  
  
  CONCLUSIONS
  The hormonal changes across the perimenopause substantially contribute to increased abdominal obesity which leads to additional physical and psychological morbidity. There is strong evidence that estrogen therapy may partly prevent this menopause-related change in body composition and the associated metabolic sequelae. However, further studies are required to identify the women most likely to gain metabolic benefit from menopausal hormone therapy in order to develop evidence-based clinical recommendations.
authors.affiliation: Women's Health Research Program, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: S R
authors.initials: SR
authors.lastname: Davis
authors.forename: C
authors.initials: C
authors.lastname: Castelo-Branco
authors.forename: P
authors.initials: P
authors.lastname: Chedraui
authors.forename: M A
authors.initials: MA
authors.lastname: Lumsden
authors.forename: R E
authors.initials: RE
authors.lastname: Nappi
authors.forename: D
authors.initials: D
authors.lastname: Shah
authors.forename: P
authors.initials: P
authors.lastname: Villaseca
mesh_terms: D050153:Abdominal Fat; D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D000818:Animals; D001823:Body Composition; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control; D015914:Estrogen Replacement Therapy; D005260:Female; D012739:Gonadal Steroid Hormones / Q000502:physiology; D006801:Humans; D007333:Insulin Resistance; D016239:MEDLINE; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D056128:Obesity, Abdominal / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D011788:Quality of Life; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology; D015430:Weight Gain
chemical_list: D012739:Gonadal Steroid Hormones