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6 Factors That Cause Menopause Belly & Why You Should Finally Embrace It

Charlie Jordan Brookins

Menopause is a huge milestone in a woman’s life journey. This is a time when women are bidding adieu to their last menstrual cycle, no longer under the chains of PMS and menstrual migraines, and saving tons of money that would have otherwise gone to tampons and sanitary pads. At the same time, a lot of life changes are happening at home. Children are likely going off to school or leaving the nest to start their own careers, leaving more opportunities to focus on yourself. You’re also wiser and more experienced from the trials and tribulations of life. All in all, who says your best years are behind you?

“The most confident, and the most sexually free and liberated I’ve seen women be is in mid-life,” says Leigh Ann Dooley, MD, MPH, a behavioral health medical director at Charlie Norwood Veterans Affairs Medical Center. “This is a time when women know who they are and are coming into their own.”

Of course, when you’re talking about menopause, you can’t ignore the elephant in the room. Menopause can cause a number of uncomfortable symptoms, such as hot flashes, vaginal dryness, brain fog, and irritability. People may experience these symptoms sooner when they go through perimenopause. “Many women are experiencing symptoms younger than 40 and that’s a specific premature menopause or premature ovarian insufficiency, but the average woman starts having symptoms in their mid-to-late forties into their early to mid-50s,” says Risa Kagan, MD, an OBGYN and expert in menopausal care at Sutter Health.

Unlike other symptoms, there is one that’s pretty hard to conceal: menopot. Women often gain weight in their stomach, especially below the belly button. “On average, women gain 5 to 8 percent of their baseline body weight during this time,” says Susan Reed, MD, an OBGYN and vice chair for research at the University of Washington. This can typically look like 1.5 pounds per year between the ages of 45 to 55.

It’s normal to feel self-conscious about how you look, especially when there are so many products and workout “hacks” geared toward losing weight as fast as possible. But remember, there’s nothing wrong with your body and these changes — it’s all biology. Instead of focusing on the negatives, our experts say it’s a great opportunity to get reconnected with your changing body.

What causes the menopausal middle?

The sudden weight gain comes from changes in hormone levels. Estrogen and progesterone levels decline during perimenopause and menopause, explains Michele Griffith, MD, an internist at 21stMD Direct Primary Care. The drop in estrogen slows down your metabolism, making it harder to burn calories. Beyond hormones, there are five other factors that may add a few inches to the waistline as you get older.

Muscle loss

People naturally lose muscle mass as they age. By age 30, you are losing 3 to 8 percent of muscle and the loss of estrogen accelerates the process. Muscles use up a lot of energy, so when you lose muscles your body stores the excess calories into fat.


Despite exercise counteracting a lot of menopausal symptoms, a third of women are less physically active in the years leading up to the event. With a slower metabolism, sitting for too long makes it more difficult to burn off calories.


Hormonal changes can cause insomnia during menopause. If you are sleep deprived, you are more likely to overeat. That’s because the lack of sleep increases the appetite-promoting hormone ghrelin and decreases levels of the appetite-suppressing hormone leptin. Insufficient sleep also affects your decision-making skills, weakening the control to resist junk food and binge-eating splurges.


Menopause can affect your mental health. “Falling estrogen and progesterone levels can trigger mood swings that make you less able to cope with things you’d normally let roll off your back,” Jennifer Payne, MD, a psychiatrist and director of the Women’s Mood Disorders Center at Johns Hopkins wrote for John Hopkins Health. The increase in mood swings can make you more easily affected from stressful events, meaning cortisol levels are constantly elevated in the body. One of the consequences of constant stress and high cortisol levels is the slowing down of metabolism as well as an increase in fatty and sugary cravings.


If your relatives have extra weight around their abdomen you are more likely to gain it as well. One reason is because of certain genes that predispose a person to weight gain. A 2020 study in Nature Metabolism found the reprimo gene, which is involved in regulating temperature, is altered with the fluctuating estrogen levels that occur during menopause. This leads to increased weight gain, likely because a lower core temperature makes your body unable to burn fats.

How to accept your menopausal middle

All of these new physical “disruptors” and changes can take an emotional toll. The media constantly bombards women to think thinness is beauty, and having unexpected weight gain can understandably impact a person’s self-esteem. “Living in Western culture, youth is valued so highly. For some women whose youthfulness has been a big part of their identity, this season can begin to challenge who they are,” explains Dooley.

Instead of dwelling over your middle, Griffith says women should look at this time as a moment of celebration. “You can wear white at any time and as you please without ever worrying about whether ‘your friend’ is due or will make an untimely appearance. Embrace this time in your life! The body is dynamic and constantly changing, which is the beauty of life. Every person is different genetically and you must discover what works best for you.” Here are six things to focus on rather than your menopausal middle.

Self Acceptance & Self-Love

During this often turbulent time of unpredictable changes and emotional and physical highs and lows, there’s also an opportunity to love yourself. This is a time to lean into and not be ashamed of biology or look back at what once was, but instead embrace who you are becoming. “Women enter menopause in different ways. Many enter with a sense of freedom. [It’s] a chance to get reacquainted with your body, get to know yourself again,” adds Dooley.


Society has conditioned women to think they need to take care of others before themselves. Women often neglect their own health unless they absolutely have to, explains Dooley. This time in a woman’s life shifts the focus back to them. “Every day is an opportunity to care for ourselves.” For example, women can prioritize spending money buying fruits and vegetables, getting daily exercise, and practicing breathwork and meditation.


Griffith encourages looking inwards and doing practices that nourish your well-being. “Protect your emotional health. Do something on a regular basis that restores your soul. You may not be able to control certain things in your environment, but you can control your response. Your response is where your power lies,” she explains.

Strength Training

Exercise for your health, not to reach a target weight. Rather than spending time obsessing over the numbers on a scale, use this time to find an exercise regimen that you enjoy. You are never too old to try a new sport or activity and not only will you find like-minded people but you also counteract the declining muscle mass and metabolism impacting your middle. Not to mention that toned muscles are great for your confidence and energy level. “Incorporate resistance training into your activity that strengthens and helps to maintain muscle mass at least 3 days a week for 20 minutes,” suggests Griffith.


Sleep continues to be at the top of every healthy living to-do list. Aim for the recommended hours of sleep and make sure to keep your room dark and the electronics away from the bedroom. “This allows the brain and body to completely restore,” Griffith says. 

Share & Support

This is a perfect season to lean into your support network and share your story. What is your community? Who are your people? Share healthy recipes. Start a book or walking club. “Feeling like the only one is so damaging,” notes Dooley. “So many people — I wish I could give them a prescription that just says ‘friend’ on it.”

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