Weight Gain Around Menopause Is Linked to Lack of Sleep

Weight gain is often an unexpected and unwelcome result of menopause. But it’s also typically misunderstood.

Weight Gain Is a Common Complaint at Menopause

It’s common for women to experience weight gain during the menopause transition, especially around the abdomen (common enough to have earned the nickname “the menopot”). But determining the cause has been a challenge, especially since it’s hard to separate the hormonal transition of menopause from simultaneous aging.

How Metabolism Changes With Lack of Sleep

To eliminate the variable of natural aging, the researchers studied 21 women who were premenopausal, meaning their hormone levels were not naturally reduced.

They brought the women to the lab and allowed them two nights of typical sleep. Then for the next three nights, they continually interrupted the women’s sleep, repeatedly waking them with an alarm.

“We chose an experimental model of sleep interruption that is consistent with the type of sleep disruption experienced most commonly in menopause — increased nighttime awakenings caused by hot flashes but no change in overall sleep time and duration,” Dr. Grant says.

In addition to this sleep disturbance, in 9 of the women the researchers also temporarily suppressed estrogen levels with a drug called leuprolide to mimic the effects of menopause.

Results Show That Use of Fat Is Affected by Sleep Disruption

Compared with the normal sleep nights, the participants’ bodies burned less fat after the disturbed sleep. Similar results occurred when the women had their estrogen levels suppressed.

“We found that both low estrogen and sleep interruption — even while getting an adequate amount of sleep overall — decreased the amount of fat used by the body for energy, which over time may lead to greater fat storage and ultimately weight gain,” Grant says.

As the researchers conclude in their study report: “These findings are important for understanding weight gain during menopause, which is characterized by estrogen withdrawal and often accompanied by sleep disturbances.”

Menopausal Weight Gain Is a Problematic Health Risk

“So it is a bidirectional loop: Declining hormone levels lead to temperature instability with disrupted sleep and frequent night awakenings, which lead to lower leptin — telling you that you are full — and higher ghrelin, then triggering hunger,” Dr. Pinkerton says. “In addition, low estrogen and poor sleep promote storage of abdominal, or belly, fat, which we know now worsens menopausal symptoms.”

Improving Midlife Sleep May Be Key to Keeping Weight Off

Menopausal women should try to improve the quality of their sleep, experts say.

Low-dose menopausal hormone therapy may also help with sleep, Pinkerton notes. “Menopause specialists can be found through the Menopause Society’s provider directory,” she says. “Connecting with experts can provide personalized guidance and reassurance during this transition.”