From the Guidelines
Postmenopausal women experiencing weight gain should have their thyroid hormones evaluated, as changes in thyroid function can contribute to weight gain, although the provided evidence does not directly address this issue [@\1@, @\2@].
Relevant Hormones
- Thyroid hormones: Although not directly mentioned in the provided studies, thyroid hormones, such as TSH, free T4, and free T3, play a crucial role in regulating metabolism and weight.
- Estrogen and progesterone: The studies primarily focus on the use of menopausal hormone therapy for the prevention of chronic conditions, rather than weight gain [@\1@, @\2@].
Evaluation and Management
In the context of real-life clinical medicine, when evaluating a postmenopausal woman experiencing weight gain, it is essential to consider basic human physiology and the potential impact of hormonal changes on metabolism and weight. While the provided evidence does not directly address the evaluation of hormones in postmenopausal women with weight gain, it emphasizes the importance of individualized care and consideration of personal risk factors [@\1@]. Therefore, a thorough evaluation, including assessment of thyroid function, is necessary to determine the underlying cause of weight gain and guide appropriate management.
From the Research
Hormones to Evaluate in Postmenopausal Women Experiencing Weight Gain
The following hormones should be evaluated in postmenopausal women experiencing weight gain:
- Estrogen: Studies have shown that the change in hormonal milieu at menopause is associated with an increase in total body fat and abdominal fat 1. Estrogen therapy has been found to ameliorate central abdominal fat accumulation and improve insulin sensitivity 1, 2.
- Ghrelin: Frequent intentional weight loss has been associated with higher ghrelin levels in postmenopausal women, which may stimulate appetite and favor weight gain 3.
- Glucose: Lower glucose levels have been observed in postmenopausal women with a history of frequent intentional weight loss 3.
- Androgens: Lower androgen concentrations, including androstenedione, testosterone, and free testosterone, have been found in postmenopausal women with a history of frequent intentional weight loss 3.
- Insulin: Lower insulin levels have been observed in postmenopausal women with a history of frequent intentional weight loss, although the association was not statistically significant 3.
- Leptin: No independent associations between leptin concentrations and weight cycling have been observed in postmenopausal women 3.
Rationale for Hormone Evaluation
Evaluating these hormones can help healthcare providers understand the underlying mechanisms contributing to weight gain in postmenopausal women and develop targeted treatment strategies. For example, estrogen therapy may be considered to improve body composition and insulin sensitivity 1, 2. Additionally, lifestyle interventions such as diet and exercise may be recommended to manage weight and improve hormonal profiles 4, 5.