Perimenopause is a natural stage in a woman’s life, but it often comes with unexpected challenges—one of the most frustrating being weight gain. Many women find that, despite eating healthily and staying active, they start gaining weight, particularly around the abdomen. This isn’t just a result of aging or lifestyle changes; hormonal fluctuations play a key role.

Understanding hormonal weight gain in perimenopause can help women make informed choices about their health and well-being. By learning how to work with your hormones during perimenopause, it’s possible to manage weight effectively without restrictive diets or excessive calorie counting.
Hormonal Changes in Perimenopause and Their Impact on Weight
Perimenopause typically begins in a woman’s 40s but can start as early as the late 30s. During this time, hormone levels fluctuate significantly, leading to a range of symptoms—including weight gain. Three primary hormones are involved in this process:
Oestrogen
Progesterone
Cortisol
Each of these hormones affects metabolism, fat storage, and appetite regulation in different ways.
Oestrogen and Weight Gain
Oestrogen plays a crucial role in metabolism, body fat distribution, and insulin sensitivity. During perimenopause, oestrogen levels fluctuate and eventually decline, which can contribute to weight gain in several ways:
Increased Fat Storage: When oestrogen levels drop, the body shifts fat storage from the hips and thighs to the abdomen. This is why many women notice an increase in belly fat during perimenopause.
Insulin Resistance: Oestrogen helps regulate insulin, the hormone responsible for blood sugar control. As oestrogen declines, the body may become more insulin-resistant, leading to higher blood sugar levels and increased fat storage.
Slower Metabolism: Oestrogen influences muscle mass, and as levels drop, women may lose muscle, which slows metabolism and makes weight gain more likely.
The Role of Progesterone
Progesterone, another key female hormone, also declines during perimenopause. While its impact on weight is not as direct as oestrogen’s, low progesterone levels can lead to:
Water Retention: Many women feel bloated or notice puffiness due to decreased progesterone.
Mood Changes and Cravings: Lower progesterone can contribute to anxiety and low mood, which may lead to emotional eating and weight gain.
Perimenopause and Cortisol: The Stress-Weight Connection
Cortisol, the body's primary stress hormone, plays a significant role in hormonal weight gain in perimenopause. During this phase, many women experience increased stress due to hormonal fluctuations, work, family responsibilities, and disrupted sleep. Chronic stress leads to persistently high cortisol levels, which can:
Increase Belly Fat: Elevated cortisol promotes fat storage in the abdominal area.
Trigger Sugar Cravings: High cortisol levels can increase cravings for sugary and high-carb foods, leading to overeating.
Disrupt Sleep: Poor sleep quality due to fluctuating hormones can raise cortisol levels, creating a cycle of stress and weight gain.
How to Reduce Cortisol Naturally in Perimenopause
Managing stress is key to preventing hormonal weight gain in perimenopause. Here are some strategies to reduce cortisol naturally:
Prioritise Restorative Sleep: Aim for 7-9 hours of quality sleep per night. Create a relaxing bedtime routine, limit screen time before bed, and maintain a consistent sleep schedule.
Practice Mindfulness and Relaxation Techniques: Activities like yoga, meditation, and deep breathing exercises can help lower cortisol levels.
Incorporate Gentle Movement: Intense exercise can sometimes raise cortisol, so balance high-intensity workouts with activities like walking, swimming, or Pilates.
Nourish Your Body with Whole Foods: Eating a balanced diet that includes protein, healthy fats, and fibre can help stabilise blood sugar and prevent stress-related cravings.
Support Your Adrenals: Adaptogenic herbs like ashwagandha and rhodiola can help regulate cortisol levels and support adrenal function.
How to Balance Hormones Naturally in Perimenopause
To manage hormonal weight gain in perimenopause, it’s essential to adopt lifestyle habits that balance hormones naturally. This means focusing on nutrition, movement, stress management, and self-care.
1. Optimise Nutrition for Hormonal Balance
Eating the right foods can support oestrogen and weight gain while keeping insulin and cortisol in check. Here’s what to focus on:
Increase Fiber-Rich Foods: Fiber helps regulate blood sugar and supports gut health, which is crucial for hormone balance. Include flaxseeds, chia seeds, vegetables, and legumes in your diet.
Prioritise Protein: Protein helps maintain muscle mass and keeps you feeling full. Opt for high-quality sources like eggs, fish, poultry, and plant-based proteins like lentils and quinoa.
Embrace Healthy Fats: Omega-3 fats found in salmon, walnuts, and flaxseeds help support hormone production and reduce inflammation.
Reduce Processed Foods and Sugar: Processed foods can cause blood sugar spikes, leading to increased insulin and fat storage. Choose whole, nutrient-dense foods instead.
Support Liver Function: The liver helps metabolise hormones, so eating cruciferous vegetables (broccoli, cauliflower, Brussels sprouts) can aid in oestrogen balance.
2. Exercise Smartly
Exercise is essential for maintaining a healthy metabolism and managing weight. However, over-exercising or relying on high-intensity workouts can increase perimenopause and cortisol levels. Instead, focus on:
Strength Training: Helps maintain muscle mass and supports metabolism.
Walking and Low-Impact Cardio: Reduces stress without raising cortisol.
Yoga and Pilates: Promote relaxation and core strength.
3. Prioritise Gut Health
Gut health plays a critical role in hormone regulation. A well-functioning gut helps metabolise oestrogen and prevents it from accumulating in the body. To support gut health:
Eat fermented foods like sauerkraut, kimchi, and yogurt.
Include prebiotic foods like garlic, onions, and asparagus.
Stay hydrated and consume plenty of fibre.
4. Support Your Thyroid
The thyroid regulates metabolism, and many women in perimenopause experience thyroid imbalances. Ensure you get enough iodine (found in seaweed), selenium (found in Brazil nuts), and zinc (found in pumpkin seeds) to support thyroid function.
Final Thoughts: Managing Hormonal Weight Gain in Perimenopause
Weight gain during perimenopause isn’t inevitable, but it does require a different approach than simply cutting calories or exercising more. Understanding how oestrogen and weight gain, perimenopause and cortisol, and other hormonal shifts impact your body can empower you to make changes that truly work.
By focusing on balancing hormones naturally, reducing stress, and nourishing your body with the right foods, you can feel your best during perimenopause—and beyond. Instead of battling against your body, learn to support it with the tools it needs to thrive.
If you're struggling with perimenopausal weight gain and need personalised guidance, working with a registered nutritional therapist can help you find a sustainable, enjoyable way of eating that supports your body and well-being. Click here to book in for a free no obligation chat.
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