Did you know that women over 40 make up the largest group of GLP-1 drug users? According to a 2025 analysis of insurance claims by FAIR Health, nearly one in five GLP-1 users are women ages 40-64, and many take the medication for weight loss instead of diabetes treatment (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 accompany this stage of life.
During perimenopause and menopause, shifts in estrogen can slow metabolism, increase belly fat, reduce muscle mass, and alter appetite signals, all of which affect how your body responds to your weight loss efforts (3). Therefore, women who are experiencing perimenopause, menopause, or who are postmenopausal may explore the use of a GLP-1 to help with weight management and overall health.
“When used strategically, GLP-1s during perimenopause and menopause can help you reach your weight loss goals. However, diet and lifestyle are key to helping minimize muscle and bone loss and support long-term metabolic health (2),” says MyFitnessPal Dietitian Katherine Basbaum, RD.
Read on to learn how to reach your health and nutrition goals as you navigate 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 (‘menopausal belly’) and worsening insulin resistance, making weight management more challenging (3). This is why GLP-1 medication can be beneficial at this stage of life.
The benefits of using a GLP-1 medication during perimenopause and menopause include:
- A reduction in appetite, overall caloric intake and ‘food noise’ due to slower gastric emptying by mimicking gut hormones.
- A GLP-1 can help with the ‘menopausal belly’ by reducing visceral fat, the deep abdominal fat associated with estrogen decline, which can increase the risk of chronic disease. This happens by helping to reduce insulin resistance along with overall calorie intake (4).
- An improvement in cardiometabolic health by reducing cholesterol levels, which can rise with a drop in estrogen. (14)
- A potential reduction in hot flashes and night sweats, which may be associated with improvements in metabolic health (5).
- Combining GLP-1s with hormone therapy (HT) can improve outcomes, with studies showing up to 35% more weight loss than GLP-1s alone (6).
“While GLP-1 medications appear to be equally effective for weight loss in both perimenopausal and postmenopausal individuals, they are not without side effects, such as digestive disturbances and muscle loss. Talk to your doctor first to discuss the risk versus benefit to see if a menopausal GLP-1 is right for you,” explains Basbaum.
GLP-1 and Menopause: Symptoms and Side Effects You Should Know
While menopause already brings its own side effects due to a drop in estrogen, from gastrointestinal disturbances to fatigue, dizziness and muscle loss, GLP-1 drugs can add to these. “Taking a GLP-1 medication can increase gastrointestinal distress, including nausea and heartburn, while accelerating muscle loss during weight loss. A drastic reduction in caloric intake along with rapid weight loss can also decrease bone density, which is a major concern for menopausal and menopausal women (7),” shares Basbaum.
It can be difficult to determine which symptom is related to menopause and which symptom may be associated with GLP-1 use. Some common overlapping side effects include:
- Gastrointestinal and digestive problems: Nausea, vomiting, diarrhea, and constipation affect up to 40% of GLP-1 users initially, often subsiding 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 bone density decreases as estrogen levels drop. The weight loss from a GLP-1 can further accelerate muscle loss and bone density if not paired with adequate protein intake and resistance training, according to 2025 analyzes showing mixed anabolic effects (4).
- Fatigue and dizziness: While hormone-related fatigue can be common during menopause, a reduction in calories and potential dehydration associated with GLP-1 use can exacerbate these symptoms (8).
GLP-1 and Perimenopause and Menopause: How to best support your body
If you’re 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 making sure you’re 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 protect against muscle loss while on a GLP-1 for weight loss. “During perimenopause, aim for a protein goal of about 1.2-1.4 grams of protein per kg of body weight per day, increasing to 1.2 to 1.6 g per kg during menopause and postmenopause (9),” says Basbaum. Adding strength training 2-3 weekly can help protect against muscle loss and a decrease in bone density. (15)
Combating side effects
- Eat smaller, more frequent meals to relieve GLP-1-related nausea, which can intensify menopausal fatigue if you skip meals or eat too much at one time. (8)
- Limit trigger 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 nutritious meals
Build balanced meals by focusing on filling your plate with lean protein, colorful fruits and vegetables, whole grains, and healthy fats. This balance will help support your energy levels and muscle mass, while the high-fiber foods can help 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, may also help protect bone density during a reduction in body weight and estrogen ( 2Trusted Source , 8Trusted Source , 11Trusted Source ).
Combination 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 that postmenopausal women on hormone therapy experienced significantly greater weight loss (12% to 16% more) and maintained better body composition, suggesting that this combination may help protect against muscle loss (6).
Track your progress and make adjustments
Tracking your meals, exercise, and symptoms such as hot flashes, GI upset, or energy levels can help you understand how your nutrition and medications are affecting you during menopause. Logging your food intake with MyFitnessPal can also make it easy to see exactly how many macro and micronutrients you’re getting each day to ensure you’re meeting your menopause nutrition goals.
Frequently Asked Questions (Frequently Asked Questions)
How does menopause affect my weight and body?
As estrogen declines, metabolism slows and fat gain shifts toward 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 can exacerbate menopause-related sarcopenia and bone density loss. For this reason, focusing on your daily protein needs, along with strength training two to three times a week, is critical to protecting long-term muscle and bone health (5). Always consult your health care provider to find out what is right for you.
What side effects can I expect from taking GLP-1 while in menopause?
Many side effects you may experience on a GLP-1 medication during menopause are common side effects of GLP-1 use in general, which include nausea, constipation, and fatigue. However, during menopause, you may be more prone to increased muscle loss as you lose weight. On the other hand, GLP-1s can help manage menopausal symptoms by dampening 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?
To feel your best and limit side effects from GLP-1s during menopause, try to focus on protein- and fiber-rich meals and snacks throughout the day to preserve muscle, support gut health, and counteract menopause-related metabolic changes. Small, frequent meals are often best for managing decreased appetite and GI side effects. Try to limit or avoid fatty, 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 an effective tool for managing weight and insulin resistance during menopause, but they are not a quick fix. Think of them as part of a larger lifestyle change, one that works best when combined with nutritious foods, physical activity and healthy lifestyle habits.
Tracking your food intake, medications, activity and symptoms in MyFitnessPal can support your GLP-1 and menopause journey by allowing you to understand how your body responds to your food and exercise choices. As you understand the patterns that help you feel your best, you can create consistent lifestyle habits that allow you to reach and maintain your health and weight loss goals.