How to Raise Your Metabolism During Perimenopause

When you think about all of the various discomforts menopause can bring, no body part seems to come out unscathed—from foggy, forgetful brains down to achy, restless legs.

But one of the areas women struggle with most during the perimenopausal and menopausal periods is a changing metabolism. This often results in packing on pounds that don’t seem to budge—especially around the midsection. 

Sound familiar? You’re definitely not alone. “Weight gain and even the inability to maintain weight are probably the most common and frustrating complaints I see in practice in the perimenopause and menopause population,” says Alyssa Dweck, M.D., M.D., FACOG, an OB-GYN focusing on menopause and sexual health.

Metabolic disruption during menopause isn’t just about a bigger number on the scale and a squishier belly. It can increase the risk of chronic health conditions, including cardiovascular disease and type 2 diabetes (1, 2).

Here’s how menopause can mess with metabolism—and how to get it back under control.

About the Experts

Alyssa Dweck, M.D., FACOG, an OB-GYN focusing on menopause and sexual health. She’s the Chief Medical Officer at Bonafide Health and a practicing gynecologist at Well by Messer in New York City.

Jennifer Roelands, M.D., a double board-certified OB-GYN and integrative medicine physician specializing in functional medicine and menopause at her practice, Precision Health, in California.

Paige Kuhlmann, M.D., a urologist and urogynecologist specializing in female sexual health at Tower Urology and Cedars-Sinai Medical Center in Los Angeles.

How Menopause Impacts Metabolism

Estrogen works with the thyroid to maintain a healthy metabolism. As estrogen levels plummet, thyroid hormones can’t work as effectively.

Estrogen also helps to regulate insulin—a hormone secreted in the pancreas that helps the body break down food into glucose, determining whether we use it as fuel or store it as fat. 

“Women will notice what they used to do to lose weight just isn’t working because they become more insulin-resistant,” Roelands says. 

She compares insulin to a bouncer at a club. If the bouncer lets glucose enter the cell, it gets turned into energy. But if the bouncer turns that glucose away, it gets stored as fat. 

“Insulin resistance is basically when the bouncer is ignoring the manager, who’s saying, ‘You need to let people in,’” she says. “Estrogen is that manager.”

So when estrogen levels decline, that “manager” starts doing its job less effectively.

Estrogen also helps control two other metabolism hormones: ghrelin and leptin. These hormones tell the body whether it’s full or hungry. When they aren’t working properly, it can lead to overeating.  

Cortisol—a stress hormone that can cause weight gain—tends to rise as estrogen levels fall. When cortisol levels are high, the body can store fat in anticipation of energy needed for a fight or flight. And that fat tends to accumulate in the abdomen for women, Roelands says. Belly fat is particularly concerning, as it often hides deep visceral fat surrounding other organs underneath those outer layers (3, 4).

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Physical Activities to Boost Menopause Metabolism

Research has found regular physical activity, both pre- and post-menopause, can effectively mitigate many of its symptoms, including metabolic disruptions and weight gain (5, 6).

A combo of cardio and strength training is key, Roelands says. Just pick exercises in those two categories you like doing so that you can stick to them. 

Aerobic exercise

Exercise burns calories, and it becomes more crucial during menopause because the “use it or store it” system regulated by insulin and estrogen gets out of whack. Exercise can lower blood glucose levels for up to 24 hours after a workout, making the body more sensitive (versus resistant) to insulin (7). 

Consistency is key. Aim for the recommended 150 minutes of moderate cardio every week (8).

Resistance training

“With age and thus with menopause comes significant muscle loss,” Dweck says. “Muscle is our metabolic tissue. Less muscle means lower metabolism.”  

Muscle also doesn’t require as much insulin to use up glucose stores, which would otherwise be turned into fat. When muscles contract during strength training and other exercises, they yank whatever glucose they need without needing insulin (and by extension, estrogen) as a middleman (7).

Because women are steadily losing muscle during this time, the emphasis needs to be on building muscle, not toning. That means committing to regular strength training and lifting heavier weights, Roelands says. 

Dweck recommends doing some form of resistance or strength training two to three times a week.

Tai chi

Tai chi is an ancient Chinese practice that combines slow, gentle movements with breathwork. Sometimes referred to as “meditation in motion,” tai chi can benefit both the body and the mind. Research has found tai chi may benefit menopausal women by reducing insulin resistance and improving mood and sleep (9, 10).

Yoga

Like tai chi, yoga combines movement and breathwork, and its benefits are far-reaching. A new systematic review of older research about yoga and menopause has found a regular yoga practice can significantly improve many symptoms of menopause that are tied to metabolism, including sleep quality, BMI, and blood pressure (11).

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Diet Changes to Support Menopause Metabolism

It may sound obvious, but you won’t be able to boost your metabolism or lose weight if your diet is in bad shape. 

While there’s no single diet all experts agree is the best, but Dweck recommends one in particular for menopause.

“The Mediterranean diet is particularly helpful for weight management,” she says. “This dietary regimen is naturally low-glycemic, high in antioxidants, and high in fiber, all contributing to good weight management.”

She likes that it limits salt, which benefits cardiovascular health, and focuses on flavoring with spices instead. It also favors olive oil—good for cardiovascular health and minimizing inflammation. Lean protein and whole grains are also part of the plate.

Protein

Most women need to increase their protein intake during menopause to help the body build muscle that’s being lost. 

“There’s no perfect menopause diet,” Roelands adds. “But we do know women do better with a little bit lower carbs and more protein than when they were younger.”

Probiotics

Some research into women entering menopause after a partial hysterectomy found that menopause can alter the microbiome in the gut, which is associated with decreased metabolic rate and increased amounts of fat and insulin resistance (12). Roelands is also a big fan of probiotics for gut health. 

Fiber

Roelands recommends aiming for at least 25 grams of fiber per day. Food sources like veggies and whole grains are best, she adds, but a fiber supplement is OK if needed. 

Fiber keeps you feeling full for longer, which may reduce overeating. Fiber also helps keep you regular, serves as a prebiotic for good bacteria in the gut, and helps keep bad cholesterol levels down. 

Green tea

Matcha is wildly popular, and green tea extract is a common ingredient in weight-loss products, but the research isn’t yet conclusive on its effectiveness. A small study of obese postmenopausal women found supplementing with green tea extract for 60 days reduced their waist circumference, burned fat, and reduced inflammation and insulin sensitivity. Other research has found any weight loss from green tea to be minimal (13, 14).

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Hormone Support for Metabolism During Perimenopause

While replacing the estrogen the body used to make on its own may alleviate many symptoms of menopause, it isn’t guaranteed to make that menopause belly disappear.

“To be clear, menopause hormone therapy is not indicated for weight loss or even weight control,” Dweck says. “However, there are indirect effects of hormonal support that may help.”

Hot flashes, night sweats, and increased anxiety during perimenopause and menopause can do a number on sleep. As a result, we may have zero energy to work out and turn to frequent snacking (and usually high-sugar, high-calorie foods) for a boost. 

“Hormone replacement therapy provides your body with the natural support it needs to maintain a good balance of fat and muscle in your body composition,” Paige Kuhlmann, M.D., a urologist and urogynecologist specializing in female sexual health Kuhlmann says.

Just don’t expect HRT to be a magic bullet for weight loss. “You’re not going to lose 20 pounds just by starting estrogen,” Roelands says. “You’re just going to stop the cascade of dominoes happening with the other hormones.”

Other Lifestyle Changes 

Improving your diet and prioritizing exercise are important, but optimizing other health components can also help your metabolism. 

Sleep

Plummeting estrogen and progesterone levels often disrupt sleep via night sweats, restless legs, or racing thoughts. Poor sleep or not enough sleep messes with metabolism by increasing appetite, tanking energy levels, and slowing down fat-burning (15, 16).

Stress Management

“With age and menopause might come significant stress,” Dweck says. “Chronic stress leads to constant cortisol release from the adrenal glands. Chronic cortisol release leads to visceral fat deposition and fat around the middle. Thus, stress reduction through exercise, meditation, and yoga can help with weight maintenance.”  

How to Increase Metabolism After Menopause

Boosting your metabolism after menopause will likely take a multipronged approach to diet, exercise, hormonal support, and other healthy lifestyle practices. 

“In addition to hormone replacement, the same things recommended for people of every age—healthy eating, exercising, good sleep hygiene, stress reduction—become even more important during menopause for weight management,” Kuhlmann says.