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Did you know that women over 40 make up the largest group of GLP-1 medication users? According to a 2025 analysis of insurance claims by FAIR Health, nearly one in five GLP-1 users are women between the ages of 40-64 years and many are taking the medication for weight loss rather than diabetes management (1). Much of this increase is driven by the growing link between GLP-1 and menopause, as more women look to these medications to help manage the weight gain and metabolic shifts that often come with this life stage.
During perimenopause and menopause, shifts in estrogen can slow metabolism, increase belly fat, reduce muscle mass, and change appetite signals, all of which affect how your body responds to your weight loss efforts (3). Which is why women experiencing perimenopause, menopause, or who are postmenopausal may explore using a GLP-1 to help with weight management and overall health.
“When used strategically, GLP-1s during perimenopause and menopause can help you to reach your weight loss goals. However, diet and lifestyle are key in helping to minimize muscle and bone loss and support long-term metabolic health (2),” states MyFitnessPal dietitian Katherine Basbaum, RD.
Read on to learn how to reach your health goals and nutrition goals when navigating perimenopause, menopause, and GLP‑1 therapy.
GLP-1 and Menopause: The Potential Benefits for Women
So how does a GLP-1 help with menopause-related weight gain? During perimenopause and menopause, declining estrogen levels can directly contribute to increased food cravings, increased visceral fat (‘menopause belly’), and worsening insulin resistance, making weight management more challenging (3). That’s why GLP-1 medications may be beneficial during this stage of life.
The benefits of using a GLP-1 medication during perimenopause and menopause include:
- A reduction in appetite, overall calorie intake, and ‘food noise’ due to slowed gastric emptying by mimicking gut hormones.
- A GLP-1 can help with ‘menopause belly’ by reducing visceral fat, the deep abdominal fat linked to estrogen decline which can increase risk of chronic disease. This occurs by helping to reduce insulin resistance along with overall calorie intake (4).
- An improvement in cardiometabolic health by reducing cholesterol levels, which can increase with a decline in estrogen. (14)
- A potential reduction in hot flashes and night sweats which may be linked to improvements in metabolic health (5).
- Combining GLP-1s with hormone therapy (HT) may improve outcomes, with studies showing up to 35% more weight loss than GLP-1s alone (6).
“While GLP-1 medications appear equally effective for weight loss in both perimenopausal and postmenopausal individuals, they are not without side effects, such as digestive upset and muscle loss. Speak to your healthcare provider first to discuss the risk versus benefit to see if a GLP-1 during menopause is right for you,” explains Basbaum.
GLP-1 and Menopause: Symptoms and Side Effects You Should Know
While menopause already brings on side effects of its own due to a decline in estrogen, from gastrointestinal upset to fatigue, dizziness, and muscle loss, GLP-1 medications may add to these. ‘Taking a GLP-1 medication can increase gastrointestinal upset including nausea and heartburn while accelerating muscle loss during weight loss. A drastic reduction in calorie intake along with rapid weight loss can also decrease bone density, which is a big concern for perimenopausal and menopausal women (7),” shares Basbaum.
It can be hard to determine which symptom is related to menopause and which symptom may be linked to GLP-1 usage. Some common overlapping side effects include:
- Gastrointestinal and Digestive Issues: Nausea, vomiting, diarrhea, and constipation affect up to 40% of GLP-1 users initially, often easing after 4–8 weeks, but menopause-related gut sensitivity or bloating can increase discomfort (8).
- Reduced Muscle and Bone Density: Menopause can increase muscle loss while decreasing bone density as estrogen levels drop. The weight loss from a GLP-1 may further accelerate muscle loss and bone mass density if not paired with adequate protein intake and resistance training, per 2025 analyses showing mixed anabolic effects (4).
- Fatigue and Dizziness: With hormone-related fatigue can be common during menopause, a reduction in calories and potential dehydration associated with GLP-1 usage can compound these symptoms (8).
GLP-1 and Perimenopause & Menopause: How to Support Your Body Best
If you are wondering how to best support your body on a GLP-1 during menopause or perimenopause, you’ve come to the right place. While using a GLP-1 for weight loss comes with its own unique needs, the combination of a GLP-1 and menopause adds an extra layer when it comes to nutrition and lifestyle. By ensuring you are giving your body what it needs, you can lose weight and keep it off long term while improving your overall well-being.
Prioritize Protein and Strength Training to Protect Your Muscles
Prioritizing protein and incorporating regular strength training can help to protect against muscle loss while on a GLP-1 for weight loss. ‘During perimenopause, aim for a protein goal of around 1.2–1.4 grams of protein per kilogram of body weight per day, and increase to 1.2 to 1.6 grams per kilogram during menopause and postmenopause (9),’ states Basbaum. Adding strength training 2–3 weekly can help to protect against muscle loss and a decline in bone density. (15)
Combat Side Effects
- Eat smaller, more frequent meals to ease GLP-1–related nausea, which can intensify menopausal fatigue if you skip meals or overeat at once. (8)
- Limit triggering foods like spicy foods, caffeine, and alcohol that commonly worsen hot flashes, night sweats, and medication‑related reflux or heartburn. (16)
- Hydrate and add electrolytes to reduce the risk of constipation, dizziness, and low energy as GLP-1s reduce appetite and fluid intake (8), especially important in midlife when dehydration worsens (17).
Eat Nutrient-Dense Meals
Build balanced meals by focusing on filling your plate with lean protein, colorful fruits and veggies, whole grains, and healthy fats. This balance will help to support your energy levels & muscle mass while the fiber-rich foods may help to offset common gastrointestinal symptoms from both menopause and GLP-1 therapy. Adding foods rich in vitamin K, magnesium, and vitamin D such as dark green leafy vegetables, fatty fish, and nuts can also help to protect bone density during a reduction in body weight and estrogen (2, 8, 11).
Combined Therapy: Pair GLP-1s with Hormone Replacement Therapy (HRT)
Combining GLP-1 medications with menopausal hormone therapy may improve side effects and weight outcomes in some women. A recent study found postmenopausal women on hormone therapy experienced significantly greater weight loss (12% to 16% more) and maintained better body composition, suggesting this combination may help to protect against muscle loss (6).
Track Your Progress and Make Adjustments
Tracking your meals, exercise, and symptoms such as hot flashes, GI disturbances, or energy levels can help you to understand how your nutrition and medications are impacting you during menopause. Logging your food intake with MyFitnessPal may also make it easy to see exactly how many macro and micronutrients you are getting each day to ensure you are meeting your nutrition goals during menopause.
Frequently Asked Questions (FAQs)
How does menopause affect my weight and body?
As estrogen declines, metabolism slows and fat gain shifts towards the abdomen (visceral fat), while reducing lean body mass, skeletal muscle, and bone density. This can lead to changes in overall body composition that can increase cardiometabolic risk factors such as heart disease and type 2 diabetes (12).
Is GLP-1 safe to use during menopause?
While GLP-1 medications appear to be safe to use during menopause, it is important to note that muscle loss from rapid weight reduction may compound menopause-related sarcopenia and bone density losses. For this reason, focusing on your daily protein needs along with strength training two to three times weekly is critical to protect long term muscle and bone health (5). Always consult with your healthcare provider to determine what’s right for you.
What side effects can I expect from taking GLP-1 while on menopause?
Many side effects you may experience on a GLP-1 medication during menopause are common side effects of GLP-1 usage in general, which include nausea, constipation, and fatigue. However, during menopause, you may be more at risk for an increased loss of muscle as you lose weight. On the flip side, GLP-1s may help to manage menopausal symptoms by curbing intense cravings and “food noise,” reducing insulin resistance and visceral fat, and potentially easing hot flashes through metabolic improvements and weight loss (4).
What should I include and avoid in my diet?
In order to feel your best and to limit side effects from GLP-1s during menopause, try focusing on protein and fiber rich meals and snacks throughout the day to preserve muscle, support gut health, and counteract menopause-related metabolic shifts. Small, frequent meals are often best to manage reduced appetite and GI side effects. Try to limit or avoid greasy, ultra-processed, or fried foods along with added sugars to prevent GI upset, inflammation and worsening insulin resistance.(3, 8)
Bottom Line
GLP-1 medications can be a powerful tool for managing weight and insulin resistance during menopause, but they’re not a quick fix. Think of them as part of a bigger lifestyle shift, one that works best when paired with nutrient-rich foods, physical activity, and healthy lifestyle habits.
Tracking your food intake, medications, activity, and symptoms in MyFitnessPal may support your GLP-1 and menopause journey by allowing you to understand how your body responds to your food and movement choices. As you understand the patterns that help you to feel your best, you can create consistent lifestyle habits that allow you to reach and maintain your health and weight loss goals.
