This is not medical advice. General information for self-tracking only. If you are under 18, pregnant or breastfeeding, have ever had an eating disorder or a difficult relationship with food, or have diabetes, heart disease, kidney disease or another medical condition, talk to a doctor or a registered dietitian before you change what you eat. The numbers behind MyPlate's own targets are on the health sources page. Whether to take hormone therapy, and any bleeding, new symptom or weight change you cannot explain, belongs with your own doctor.

Does menopause cause weight gain?

On the scale, mostly not, and the best evidence for that is uncomfortable if you have just gained five kilos. The Study of Women's Health Across the Nation (SWAN) followed 3,064 women aged 42 to 52 for three years. They gained 2.1 kg on average, and a change in menopausal status was not associated with the gain.1 A 2019 meta-analysis of 201 cross-sectional and 11 longitudinal studies put postmenopausal women about 1 kg heavier than premenopausal women, and its authors attributed the difference in total fat predominantly to age, with menopause adding no significant influence of its own.2 A writing group from the International Menopause Society reached the same place in 2012: "weight gain per se cannot be attributed to the menopause transition".3

Not every cohort agrees. In a four-year study from Pennington Biomedical of 156 women, body fat and weight rose significantly only in the 51 who became postmenopausal.4 But the larger studies lean the other way, and none of them says the gain is imaginary. Midlife weight gain is real. The argument is over whether menopause is what drives it.

Fat gain doubles while the scale holds its line

This is the finding I would put in front of anyone tracking through this. A 2019 SWAN analysis measured body composition with DXA scans, year after year, and lined each woman up by the date of her final period. Fat and lean mass were both rising before the transition. When it began, the rate of fat gain doubled and lean mass started to fall. Both continued until about two years after the final period, and then both flattened out.5

Weight showed none of it. It climbed in a straight line before the transition with no acceleration when the transition began, because the sum of fat and lean was rising at the same rate as before.5 A woman could watch a trend line that looks just as it did at 44 while her body is changing in a way it was not at 44. This was an observational cohort, adjusted for age at the final period, race, study site and hormone therapy, so it describes a pattern and not a proven cause.

The place it shows up is the waist. In the Michigan arm of SWAN, 543 women gained 3.4 kg of fat, lost about 0.23 kg of skeletal muscle and added about 5.7 cm around the waist over six years, measured with bioelectrical impedance, which is a cruder tool than DXA.6 The 2019 meta-analysis, which played down menopause for total fat, still found waist circumference 4.63 cm larger and leg fat lower after menopause, and its authors read that as a possible change in where fat goes.2

Does your metabolism slow down in menopause?

A little at most, on the evidence I could find, and the studies do not line up neatly. The largest data set on energy expenditure across the lifespan found it stable from 20 to 60 once adjusted for fat-free mass, which leaves little room for a collapse at 50, though the abstract does not split out menopausal status.7 The post on counting calories after 60 goes through that study and what happens later.

The Pennington study did find a difference, in a subset of 34 women measured in a whole-room calorimeter. Sleeping energy expenditure fell 7.9% in women who became postmenopausal, against 5.3% in those who did not, and fat oxidation fell by 32%.4 A Canadian study (MONET) followed 102 lean women for five years and found resting expenditure stable in those who became postmenopausal, and rising in those still in the transition.8 Those two results do not agree, and both are small.

The cleanest test of the hormone itself did not use menopausal women at all. Researchers in Colorado shut down ovarian hormones with a drug for five months in women averaging about 35, and randomised them to estradiol patches or placebo. Resting expenditure fell by 54 calories a day on placebo and did not fall on estradiol. Total daily expenditure, though, fell in both groups (128 and 96 calories) with no significant difference between them.9 A drug-induced shutdown in younger women is not menopause, but it gives a sense of scale. The hormone effect on resting burn looks like tens of calories a day.

People move less, and eat less, and are hungrier

In the MONET women, total expenditure fell after menopause mostly because activity fell, with more sedentary time during the transition.8 The Pennington women, wearing accelerometers, showed activity dropping about two years before menopause and staying low.4 In SWAN, one step up a five-point sports and exercise scale went with 0.32 kg less weight, which is a modest association, and an observational one.1 I cannot tell you from these whether hot flushes, bad sleep, joint pain or a busy decade explains the drop.

Eating more does not seem to be the explanation. The MONET women's food diaries showed energy intake falling across the transition, while their ratings of hunger and desire to eat went up and stayed up afterwards.10 Food diaries under-record, as the section after next shows, so I would not lean on the falling intake too hard. The rising hunger is harder to explain away. If you feel hungrier than you did and your log says you are eating less than you were, that matches what these women reported.

Does counting calories to lose weight still work after menopause?

Yes, in the trials that have tested something close to it, though the support was far more than an app gives you. A year-long trial randomised 439 sedentary postmenopausal women with overweight or obesity, mean age 58. The diet group lost 8.5% of body weight, the aerobic exercise group 2.4%, diet plus exercise 10.8%, and controls 0.8%.11 The diet arm had a target of 1,200 to 2,000 calories a day depending on weight, and women recorded everything they ate for at least six months and got their food journals back with feedback from a dietitian, alongside group sessions. Their questionnaire-reported calories did not change significantly against controls, which the authors put down to the questionnaire being a weak tool for that.11

The closest thing to a prevention test is the Women's Healthy Lifestyle Project, which enrolled 535 premenopausal women aged 44 to 50 and ran for five years. After 4.5 years, 55% of the intervention group were at or below their starting weight against 26% of controls. Mean change was 0.1 kg down against 2.4 kg up, and waist fell 2.9 cm against 0.5 cm.12 The 1,300-calorie eating pattern and the 1,000 to 1,500 calories a week of activity were that trial's prescription, delivered over years by a research team. I would not lift the number out and use it as your target.

Two results argue against going hard. The TEMPO trial randomised 101 postmenopausal women with obesity to moderate restriction or to four months of severe restriction on meal replacements. The severe group lost more weight and fat, but also lost more hip bone density, and the authors advised caution, particularly with osteopenia or osteoporosis.13 And in a retrospective look at women aged 50 to 70 on a calorie-restricted programme, 32% of the weight lost was lean mass, on protein averaging just 0.62 g per kg. Those eating more protein lost less lean mass, though that is an association.14 Why a deficit costs lean mass and what to do about it at this age is the main subject of the post on counting calories after 60, and the question of how much protein is in why macro calculators disagree.

Food logs often run low at this age

One doubly labelled water study checked what 87 sedentary postmenopausal women with overweight or obesity reported eating against what they measurably burned. Fifty of them, 57.5%, reported less than 80% of their expenditure. Those who under-reported had more fat mass and higher perceived stress.15 It had no younger comparison group, so it cannot say menopause makes logging worse. Even so, if your log says you are in a deficit and four weeks of weight says otherwise, the log is the first suspect, and where the error usually comes from is in how accurate calorie tracking apps are.

Does hormone therapy change the numbers?

Less than either side tends to claim, at least for weight. A Cochrane review of 22 randomised trials found no significant difference in weight gain between oestrogen users and non-users (0.66 kg, 95% CI -0.62 to 1.93) or combined therapy and non-users (-0.47 kg, 95% CI -1.63 to 0.69). Its search stopped in 1998, and there were too few data to pool fat mass or waist-hip ratio.16 So the fear that hormone therapy itself puts weight on was not supported, on old evidence. The opposite hope, that it protects muscle, has not held up well either: a 2019 meta-analysis of 12 trials found users lost 0.06 kg less lean mass, not significant, with the evidence graded low.17

Fat may behave differently. The International Menopause Society writing group said studies mostly show less fat mass on therapy and that estrogen may partly prevent the shift to abdominal fat, while noting more work was needed on who benefits.3 In the Colorado experiment, abdominal fat grew on placebo and not on estradiol.18 The North American Menopause Society's 2022 statement describes hormone therapy as the most effective treatment for hot flushes and genitourinary symptoms and says it prevents bone loss and fracture, with a favourable benefit-risk balance for women without contraindications who are under 60 or within 10 years of menopause, and a less favourable one later. Weight is not among the uses its abstract lists.19 I am a developer, and this decision sits between you and your doctor. I would make it on symptoms and risk, and not on what it might do for a calorie target.

Can losing weight help hot flushes?

If you are carrying excess weight and flushes bother you, possibly. In a six-month trial of 338 women with overweight or obesity and urinary incontinence, the 154 bothered by flushes at baseline did better on an intensive weight-loss programme than on health education (odds ratio for improving one category 2.25, 95% CI 1.20 to 4.21).20 In the Women's Health Initiative dietary trial, women who lost 10% or more of their weight in a year were more likely to stop having symptoms than those who stayed at the same weight (odds ratio 1.56, 95% CI 1.21 to 2.02), an observational comparison within the trial.21 The first trial enrolled only women with overweight or obesity, and the weight loss in the second was not randomised, so I would not read either as a reason to diet if your weight is healthy.

What the evidence does not settle

Whether menopause adds total fat beyond ageing is unresolved. The SWAN DXA analysis says the rate doubles and the meta-analysis says age explains it, though most of the meta-analysis was cross-sectional, comparing different women, and SWAN followed the same women through.52 I find the longitudinal version more convincing, and that is a judgement. Both agree fat is moving to the middle.

Whether resting expenditure falls because of menopause is also open, given that the two small cohorts disagree.48

I could not find a study of what the daily scale does during irregular perimenopausal cycles. My own post on the menstrual cycle tells you to compare one cycle with the next, and that advice stops working when cycles stop being regular. A PubMed search turned up nothing I could use, so what I say below about long averages is my reasoning and not a result. Nor did I find a randomised trial of a calorie counter app in perimenopausal women. The trials above used journals and human counsellors, and their samples were not broad: the year-long diet trial was 85% non-Hispanic white.11 The activity link in one SWAN analysis was not statistically significant in its Chinese participants.22

What calorie tracking can see through menopause, and what it cannot

A calorie tracker sees what you log and, if you record it, your weight. It cannot see fat moving to your waist or lean mass falling, which is what the SWAN work says changes most. MyPlate has nowhere to record a waist measurement, a final period or a hot flush, and it does not know you are in menopause. Its target uses the Mifflin-St Jeor equation, which takes your age, sex, height and weight and nothing about hormones, multiplied by an activity band. A scan is an estimate as well, so the log carries its own error.

The arithmetic does show which input to care about. Take a woman of 52, 165 cm and 70 kg. On the moderate activity band, the app estimates maintenance at 2,030 calories and sets a weight-loss target of 1,726. On the lowest band those become 1,801 and 1,531. Age the same woman five years and maintenance on the lowest band drops by 34 calories. So if your activity has really fallen a band, that moves the number about seven times as far as those five years do. The lowest band is a multiplier of 1.375, and the app has nothing below it, so a truly sedentary day may still be over-estimated.

None of those numbers update on their own. The app stores your age as you entered it, and logging a weight does not recompute the target, so a target set at 48 is still the target at 53 until you run setup again. Your weight trend over several weeks is what tells you whether the number is right, as the maintenance calories post explains.

How to use calorie tracking through menopause

Add a tape measure. Once a month, measure at the narrowest point of your waist at the end of a normal breath out, which is how the year-long trial did it,11 and write it next to your weight. It is crude. All the Pennington women gained fat under the skin of the abdomen with age, and only those who became postmenopausal gained visceral fat, and a tape cannot tell those apart.4 But it is the cheapest thing you can do that responds to a change the scale may miss. The monthly interval is my suggestion, not a trial finding.

Read weight as long averages. Four weeks is the minimum the plateau post uses, and with irregular cycles I would look at several months before concluding anything, for the reasoning given above.

Re-run your target when your life changes, and pick the activity band for the last few months, not the person you were at 45. Then decide what you want. If your weight is healthy and your waist is growing, a bigger deficit is not obviously the answer, because the problem may be composition and not total weight. Holding your weight at maintenance while you eat your protein and train your muscles is a reasonable thing to try.

If you do want to lose, keep it moderate. MyPlate's goal is a 15% deficit and it will not set a target below 1,200 calories a day for women, the top of the low-calorie range in the NIH guidelines (1,000 to 1,200 for women).23 Do not go lower without a clinician, and the TEMPO bone result is a further reason not to.13 For that example woman on the lowest band, the 28% protein share comes to about 107 g a day, or roughly 1.5 g per kg, which is well above the 0.62 g per kg in the study above.14

Log the hungry days too. That is when entries go missing, and rising appetite is one of the changes the MONET women reported.10 Short nights may matter here as well, and what the research shows on that is in the post on sleep and calorie tracking.

Lift something, if you can do so safely, while accepting that the evidence here is thinner than the fitness internet suggests. In the Colorado experiment, an exploratory resistance training arm of 12 women did not show the fat-free mass loss seen on placebo. The paper later carried an erratum I could not get access to, so I am giving you the direction and leaving out the numbers.18 In a small trial of 28 women around 66 with low bone mass, supervised high-intensity lifting and impact work twice a week improved spine and hip bone density and caused no injuries.24 Across midlife women, more vigorous activity generally went with lower body fat and a smaller waist, though cross-sectionally, and not significantly in the Chinese women in the sample.22 With osteoporosis or low bone mass, talk to your doctor first. LIFTMOR's training was supervised for a reason.

If tracking is making you anxious, or a waist measurement or a number on a screen has started deciding how you feel about yourself, stop and talk to a doctor or a registered dietitian. What the research says about who that is most likely to be is in can calorie tracking cause an eating disorder.

Common questions

Does menopause make you gain weight?

Mostly not on the scale, according to the larger studies. A SWAN analysis of 3,064 women found a 2.1 kg average gain over three years that was not associated with a change in menopausal status, and a 2019 meta-analysis attributed the difference in total fat mainly to age.12 One smaller cohort did find gain only in women who became postmenopausal.4 What changes more clearly is body composition and where fat is stored.

Why is my waist growing when my weight has not changed?

That fits the pattern long studies describe, though only a clinician can tell you what is happening in your case. In SWAN, the rate of fat gain doubled at the start of the menopause transition while lean mass began to fall, and the total kept rising at the same rate as before, so the scale showed no acceleration.5 A 2019 meta-analysis that credited age for total fat still found central fat higher and leg fat lower after menopause.2

Does your metabolism slow down in menopause?

Probably only a little, and the studies disagree. One cohort found sleeping expenditure fell 7.9% in women who became postmenopausal against 5.3% in those who did not, another found resting expenditure stable, and in an experiment suppressing ovarian hormones in younger women resting burn fell by 54 calories a day.489 Falling physical activity seems to account for more of the drop in total daily expenditure.8

How many calories should I eat during menopause?

There is no menopause-specific number that I could find. A calorie calculator app gives a first guess from your age, sex, height, weight and activity, and your weight trend over several weeks corrects it. If you are counting calories to lose weight, keep the deficit moderate. MyPlate uses 15% and will not set a target below 1,200 calories a day for women, and you should not go lower without a clinician.23 A trial of severe restriction in postmenopausal women found more hip bone loss.13

Does hormone therapy cause weight gain?

The trial evidence does not show that it does. A Cochrane review of 22 randomised trials found no significant difference in weight gain against non-users, although its search ended in 1998.16 Hormone therapy is prescribed for symptoms such as hot flushes and for preventing bone loss, and weight is not among the uses listed in the abstract of the 2022 North American Menopause Society statement.19 The decision belongs with your doctor.

What is the best food tracker for weight loss during menopause?

I did not find a trial that tested any app in perimenopausal women, so nobody can honestly name a best one. Look for a food tracker for weight loss you will still be using in six months, that shows protein as well as calories, and that lets you edit your activity level as your life changes. MyPlate does those things, but it has no field for waist or symptoms, it has no barcode scanner and a scan is an estimate, so keep your tape measure notes separately.

Track the weight and the waist

Through menopause, a scale on its usual line can hide fat rising faster and lean mass falling, and calorie tracking on its own will not show you that either.5 The trials say a moderate deficit still works when you need one, and that crash dieting has a cost in bone.1113 So log the food, watch the long average, add a tape measure and keep your muscles working. Be suspicious of anyone who sells you a menopause-specific calorie number. I looked for the evidence behind one and could not find it.

Sources

  1. Sternfeld B, Wang H, Quesenberry CP Jr, et al. (2004). Physical activity and changes in weight and waist circumference in midlife women: findings from the Study of Women's Health Across the Nation. American Journal of Epidemiology, 160(9):912-922. Read on PubMed →
  2. Ambikairajah A, Walsh E, Tabatabaei-Jafari H, Cherbuin N (2019). Fat mass changes during menopause: a metaanalysis. American Journal of Obstetrics and Gynecology, 221(5):393-409. Read on PubMed →
  3. Davis SR, Castelo-Branco C, Chedraui P, et al. (2012). Understanding weight gain at menopause. Climacteric, 15(5):419-429. Read on PubMed →
  4. Lovejoy JC, Champagne CM, de Jonge L, Xie H, Smith SR (2008). Increased visceral fat and decreased energy expenditure during the menopausal transition. International Journal of Obesity, 32(6):949-958. Read on PubMed →
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  6. Sowers M, Zheng H, Tomey K, et al. (2007). Changes in body composition in women over six years at midlife: ovarian and chronological aging. Journal of Clinical Endocrinology and Metabolism, 92(3):895-901. Read on PubMed →
  7. Pontzer H, Yamada Y, Sagayama H, et al. (2021). Daily energy expenditure through the human life course. Science, 373(6556):808-812. Read on PubMed →
  8. Duval K, Prud'homme D, Rabasa-Lhoret R, et al. (2013). Effects of the menopausal transition on energy expenditure: a MONET Group Study. European Journal of Clinical Nutrition, 67(4):407-411. Read on PubMed →
  9. Melanson EL, Gavin KM, Shea KL, et al. (2015). Regulation of energy expenditure by estradiol in premenopausal women. Journal of Applied Physiology, 119(9):975-981. Read on PubMed →
  10. Duval K, Prud'homme D, Rabasa-Lhoret R, et al. (2014). Effects of the menopausal transition on dietary intake and appetite: a MONET Group Study. European Journal of Clinical Nutrition, 68(2):271-276. Read on PubMed →
  11. Foster-Schubert KE, Alfano CM, Duggan CR, et al. (2012). Effect of diet and exercise, alone or combined, on weight and body composition in overweight-to-obese postmenopausal women. Obesity, 20(8):1628-1638. Read on PubMed →
  12. Simkin-Silverman LR, Wing RR, Boraz MA, Kuller LH (2003). Lifestyle intervention can prevent weight gain during menopause: results from a 5-year randomized clinical trial. Annals of Behavioral Medicine, 26(3):212-220. Read on PubMed →
  13. Seimon RV, Wild-Taylor AL, Keating SE, et al. (2019). Effect of weight loss via severe vs moderate energy restriction on lean mass and body composition among postmenopausal women with obesity: the TEMPO Diet randomized clinical trial. JAMA Network Open, 2(10):e1913733. Read on PubMed →
  14. Bopp MJ, Houston DK, Lenchik L, et al. (2008). Lean mass loss is associated with low protein intake during dietary-induced weight loss in postmenopausal women. Journal of the American Dietetic Association, 108(7):1216-1220. Read on PubMed →
  15. Karelis AD, Lavoie ME, Fontaine J, et al. (2010). Anthropometric, metabolic, dietary and psychosocial profiles of underreporters of energy intake: a doubly labeled water study among overweight/obese postmenopausal women--a Montreal Ottawa New Emerging Team study. European Journal of Clinical Nutrition, 64(1):68-74. Read on PubMed →
  16. Norman RJ, Flight IH, Rees MC (2000). Oestrogen and progestogen hormone replacement therapy for peri-menopausal and post-menopausal women: weight and body fat distribution. Cochrane Database of Systematic Reviews, (2):CD001018. Read on PubMed →
  17. Javed AA, Mayhew AJ, Shea AK, Raina P (2019). Association between hormone therapy and muscle mass in postmenopausal women: a systematic review and meta-analysis. JAMA Network Open, 2(8):e1910154. Read on PubMed →
  18. Shea KL, Gavin KM, Melanson EL, et al. (2015). Body composition and bone mineral density after ovarian hormone suppression with or without estradiol treatment. Menopause, 22(10):1045-1052. Read on PubMed →
  19. The 2022 Hormone Therapy Position Statement of The North American Menopause Society Advisory Panel (2022). The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 29(7):767-794. Read on PubMed →
  20. Huang AJ, Subak LL, Wing R, et al. (2010). An intensive behavioral weight loss intervention and hot flushes in women. Archives of Internal Medicine, 170(13):1161-1167. Read on PubMed →
  21. Kroenke CH, Caan BJ, Stefanick ML, et al. (2012). Effects of a dietary intervention and weight change on vasomotor symptoms in the Women's Health Initiative. Menopause, 19(9):980-988. Read on PubMed →
  22. Sternfeld B, Bhat AK, Wang H, Sharp T, Quesenberry CP Jr (2005). Menopause, physical activity, and body composition/fat distribution in midlife women. Medicine and Science in Sports and Exercise, 37(7):1195-1202. Read on PubMed →
  23. National Heart, Lung, and Blood Institute, NIH (1998). Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. NIH Publication 98-4083. Read the guidelines →
  24. Watson SL, Weeks BK, Weis LJ, Horan SA, Beck BR (2015). Heavy resistance training is safe and improves bone, function, and stature in postmenopausal women with low to very low bone mass: novel early findings from the LIFTMOR trial. Osteoporosis International, 26(12):2889-2894. Read on PubMed →

The formulas and limits behind MyPlate's own numbers, with their citations, are on the health sources page.