HRT & weight gain / weight loss

HRT & weight gain / weight loss | Felice Gersh, MD

Рет қаралды 13,527

Күн бұрын

Concerns about weight gain are one of the leading reasons that some women are wary of using hormone replacement therapy (HRT).
Hormones play a critical role in the body's ability to create and store energy, which translates into building, storing, and burning fat. And not just fat, but muscle, too.
Some of the questions I address in this talk:
* Can HRT cause weight gain and if so, what type of weight?
* Why do women in menopause tend to gain weight?
* What is weight redistribution?
* Can HRT cause weight loss?
* Can adding androgens to traditional HRT improve weight profile?
Watch for my latest Instagram lives at
/ dr.felicegersh
I am a full time practicing doctor. I see patients in my office in Irvine, CA and worldwide via telemedicine. If you need more healthcare assistance than I can provide in a video series, please contact my office:
integrativemgi.com/
---- Contents of this video --------------------------
00:00 - menopause and weight gain
01:48 - fluid retention
04:10 - insulin resistance
05:42 - thyroid
06:53 - appetite regulation
10:06 - healthy fat storage
10:50 - gut dysbiosis
11:59 - mitochondria
14:04 - problems with oral estradiol
15:04 - dose matters
18:06 - static progesterone
21:38 - it's all about body composition

Пікірлер: 119

@gina888warhol1 20 күн бұрын

Listen to this lady!!!!! ❤ She is one of a few on KZfaq that is honest and factual and not after your $$$

@Lifes_Frosting 2 ай бұрын

I'm 57 1/2 still perimenopausal not on HRT YET but will be soon. If you're gaining weight, visceral fat, here's what will reverse it QUICKLY!! Stop eating all processed foods. Eliminate anything with wheat and added sugar. Eat 1 gram of protein for every pound of body weight. Eat healthy fats like avocado, olive oil, nuts and seeds. Weight train 4 or 5 days a week with 1/2 hour to 45 minutes of cardio. When I say weight train I mean lift as heavy as you possibly can (without injury) and try to increase the weight as you get stronger. There are many videos on KZfaq about how to build muscle. Muscle knows no age. You will see huge changes in your body within a few weeks if you stick to it. If you change your diet as I suggested, your cravings will go away. I've done this myself and it works. I now have a lean body with lots of beautiful feminine muscle and my hourglass figure back. Understand that a woman cannot get big like a man if she lifts heavy weight unless she's taking male hormones to do so. You only see that in women professional body builders. Trust me and start today. You'll be so happy that you did!

@kirstybreen1295 Ай бұрын

talk me through the eliminating wheat aspect....

@muchasalud2011 Ай бұрын

I am keto carnivore for over 5 yrs. I'm 65 yrs old and have no visceral fat. A reasonable amount of subcutaneous fat is very healthy for women. Seeds and nuts are high in oxalic acid (info: Sally K Norton) plus extremely high in omega 6 which is already plentiful in modern human diet. I feel my best avoiding all plant foods.

@bluejean-1968 Ай бұрын

I ate all the "healthy fats" and "grass-fed beef" and developed insulin resistance. Now, I eat a WFPB, very low-fat diet and even my eyesight is improving. There is no one size fits all dietl. I am so tired of seeing that. You must find the diet that works for you.

@StrideOrDie71 Ай бұрын

@@bluejean-1968Everything she said is 100% valid, even if it doesn’t apply to you. Interesting you blame your IR on meat and healthy fats, since those two things aren’t any lists for IR causes. How did you tie the two together?

@Julia29853 Ай бұрын

For weight training are just dumbells ok? And like arms three times a week and legs ( squats lunges etc) three times a week? Just trying to figure out a simple program that i will stick to since i find weight training excruciatingly boring haha but have been doing it because i know i need to.

@r-anne7375 2 ай бұрын

I take estrogen, 0.05 patch and cyclic 100 mg. progesterone. My sister won't take hormones. We are in our sixties. She has not gained weight or had hair loss issues, but I have. As soon as I started taking hormones 4 yrs ago, I started gaining weight. I exercise daily and she doesn't. It's very frustrating and makes me feel like I want to go off of HRT. I hear all the science, but I see what I see.

@crh251 2 ай бұрын

My guess is maybe it’s not enough estrogen. Do you know what your level is? It should be close to 100 or more. The .05 patch of estradiol is still very low.

@nishachauhan2343 2 ай бұрын

That's interesting. I'm curious what age you started taking HRT? Peri or post menopause?

@r-anne7375 2 ай бұрын

@@nishachauhan2343 I was 59 when I went into menopause and I waited about two years to start HRT. So it was post menopause. I experienced hot flashes and sleepless nights along with other symptoms that led me to try HRT. It takes care of a lot of symptoms, but weight gain comes along with it.

@olderandwiser127 2 ай бұрын

I've had the same experience. I am currently off hormones but, for various reasons, considering trying again; I am very hesitant. I am listening to this doc and a few others that are pro hormone replacement plus those against (Elizabeth Bright); not sure what to do at this point.

@r-anne7375 Ай бұрын

@@nishachauhan2343 Went into menopause at 59 closer to 60, waited to take hormones for a couple of yrs. Couldn't sleep and having hot flashes so I asked my Gyno if I could try HRT. It took care of the symptoms, but I also gained weight. So bloated.

@Nellie7777777 2 ай бұрын

You are phenomenal. Please always make these video's.

@examinethismomentblog3935 25 күн бұрын

I had a hysterectomy in my 30’s and only have one ovary. About 4 years ago I had no strength, energy was so low, and had lots of bone pain. I was put on biest and progesterone and np thyroid it is a low dose proactive (I do not have thyroid issues) which I was weary about taking honestly. I'm thankful I do have less bone pain and more energy too. I take lots of supplements (Vit A, D, E, K). However since that time I have gained weight and have been now dealing with severe duodenitis 😢🙏 I have lowered hrt to almost none and need my gut to heal as it is affecting my mouth and teeth too now sadly. I have been gluten-free and dairy-free for years and can not eat nuts. I'm just trying to make sense of all that I dealing with physically. I appreciate your information.

@j.c.7555 2 ай бұрын

You are a very special person I wish I would have found someone like you years ago. I need to research to get a doctor that knows at least half of what you know about this subject. Thank you so so much!❤️😘❤️

@nishachauhan2343 2 ай бұрын

Thank you!

@iss8504 2 ай бұрын

Thank you

@anne-louisegoldie 2 ай бұрын

Super helpful, thank you 😊xx

@lightfaeries7 Ай бұрын

Best presentation i ve seen. 😊. Thank you

@Aki-wq6xh 2 ай бұрын

You are the best and your approach works the best for me compared to many other KZfaq doctors

@magenem21 Ай бұрын

I’ve recently found your videos and I’m so grateful. I’m certain that I am under dosed on estradiol. I can use this information to advocate for myself. Thanks!

@fr514 25 күн бұрын

This is really interesting, and clear, and aligns with other OB GYNS I follow on here.

@rayrayrayrayray79 Ай бұрын

THANK YOU! This is so helpful. Thank you for sharing your knowledge.

@neophytewraith Ай бұрын

Thank you so much for this video! It cleared so much up!

@alisongoerner7457 2 ай бұрын

Fantastic info! Just started Estriol patches, along with progesterone pills at night, and am feeling so much better! Glad I made the choice to do the patches!

@muchasalud2011 Ай бұрын

Estriol does nothing. You want Estradiol.

@ivalani 2 ай бұрын

I was on bio identical micronized oral progesterone and 2 different doses of estradiol patches - had to go to the lower from 0.375 of 0.25 as bloating, breast tenderness, uncontrollable appetite and weight gain indicated the previous dose was too high. I continued gaining weight and added anxiety to the list of “benefits” from HRT. After almost 6 months I quit and my weight returned to normal within 3 weeks and my mood and appetite stabilized. HRT is not for me.

@mickey6416 Ай бұрын

This has exactly happened to me. I cycled off three times and the weight fell off within 2 weeks. Same dosage. I was never able to build myself up to .5mg.

@onewomansjourney760 Ай бұрын

The Progesterone caused this most likely. Not estrogen. Also, if you were on synthetic fake hormones, yes you will experience alot of symptoms. There are various methods like patch, troche, gels, creams & even inserted vaginally.

@hazeldellis Ай бұрын

Fascinating. I lost loads of weight on HRT but I use gels and creams

@denise3432 Ай бұрын

Same.

@giannas1096 Ай бұрын

Same with me gained weight on HRT but haven’t been able to get it off.

@lori.rampton 10 сағат бұрын

I just recently started HRT at 63 with oral 2mg estradiol, 200 mg progesterone and testosterone cream. Been in menopause for 5 years. I feel good. I have gained 20 lbs in those years. Now 175 lb and 5’6 with Osteopenia. Otherwise I am pretty healthy. My hormone doctor recommended the oral estradiol for the heart benefit that he said the patches and creams don’t deliver. I started weight training and upped my protein and taking AlgaeCal for calcium. But now you have me concerned about the estrone conversion from my oral estradiol. I was told to expect an initial weight from fluid but in time that would dissipate with the testosterone, I think. I have always had dense breasts with no breast cancer in family. Should I be on estradiol patch or cream instead? Why would women in their 60’s want to cycle again and if so, to what age?

@dorothynewhouse1160 20 күн бұрын

I had a complete hysterectomy when I was 30 I have no ovaries I'm 53 now diabetic on ozempic and just starting HRT therapy I was given Estradiol patch 0.75 I haven't started it yet because I didn't want to gain more weight I'm 202 lbs and 5"5

@TheDatingDetoxCoach 2 ай бұрын

If you have high estrone will taking estradiol block those receptor cites and help modulate it? I think need some but my practitioner is reluctant because she's only testing total estrogen 🤯

@wendywyatt8563 2 ай бұрын

Thank you so much for making this videos. You state you need a level of over 50, 100 or 150 is ok too. Blood level of what?? Estradiol, luteinizing hormone, what?

@123STEP23 16 күн бұрын

Estradiol level

@fenellacorden375 25 күн бұрын

Felice.. I’ve just learnt so much by you thank you. I’ve just started hrt and 60 yrs old.. I’ve been taking it for a week now and all I’m getting is bloating started bleeding and feel like I’m a teenager again. I’m on a gel as there are no patches available right now.. my doctor has put me on a dosage of 0.75 estrodial and take it in the evenings around 9pm along with progesterone .. from listening to to you should I be upping this amount and leaving the progesterone.. would love your advice.

@cleanqueen75 Ай бұрын

I didn’t have high cholesterol till I went into menopause.

@meme-rx4vb Ай бұрын

Can you please clearly give optimal dose and when to take for both estradiol and progesterone?? I take the profesterone daily but you say this is incorrect?

@lightladyq665 2 ай бұрын

Can I still cycle progesterone as a recently menopausal woman on daily E with endometriosis? Or is having E opposed without P for 2 weeks each month a bad idea?

@silentvoice4970 13 күн бұрын

I just started Estrogen Gel & Projesterone tablet. I'm looking for info on that. In Australia there are very few options available.

@leslieharari8755 2 ай бұрын

Your explanations are so clear! I am newly on cyclic (physiologic) at age 66 rather than static bhrt and I so appreciate your videos!! My estrogen blood test on day 12 was 185. I feel great and am putting on some great muscle, but the estradiol has definitely given me some hips and a little belly. I am a thin , very active person. Could it be too much estradiol causing this? I am one of those weird people who got thinner and thinner as perimenopause and menopause arrived and would be happy to have some extra weight if it were not at the belly and hips! (or more accurately, love handles)!!!!!

@Aki-wq6xh 2 ай бұрын

I hear you. I have piled on like ten pounds since I started HRT BUT I look so much better - my skin, my face volume- even my gum according to my dentist!!!

@michellemustari498 2 ай бұрын

What doctor are you working with that's prescribing the cycling of your hormones and I've been working with somebody but they're not easy to work with trying to find a new practitioner that understands how to do this are you on the Wiley protocol or something else

@nishachauhan2343 2 ай бұрын

@@Aki-wq6xh Ack, reading about all these women gaining weight on HRT is helpful, and scary. I just started, but may discontinue. Thanks for sharing that you gained weight.

@bluejean-1968 Ай бұрын

Be sure not to use a 20% concentrate progesterone cream. The body can only absorb at 3% or 5%. If you use a cream that is too concentrated, you won't absorb it and you will get estrogen dominant.

@bigfoot116 Ай бұрын

I got prescribed estradiol .025 mg 2x per week patch and progesterone 100 mg by mouth nightly . I am pre menopause. Does this fall in line with the advice you give?

@dmrodrig72 23 күн бұрын

I understand what you are saying. And really appreciate the knowledge you share. The only problem I encounter is in my country most of my friends are on pellets . I don’t know if that is what you reccomend. I would love to be able to consult with you but I do not think is on my possibilities and it is somewhat frustrating. I am right now in the end of a FMCA coaching certification in functional medicine I would love to be able to help me and help others in my country all women who are suffering even if they are in some kind of hormones. Without even being capable of knowing if it’s right for them.

@dmrodrig72 23 күн бұрын

I am so scared of taking or going on hormones because I have finally managed four years ago to loose a ton of weight and put back the Insuline resistance through low carb and fasting and It feels like too much to risk on my end right now but if I could debug this in the right way I would be willing to try

@dmrodrig72 23 күн бұрын

And by the way I am 52 and still menstruate although starting to get irregular

@ednaarroyo5088 8 күн бұрын

I have a question regarding a 53-year-old woman who is experiencing spotting /light bleeding during her "period" cycle. Would a 12-day cycle of 0.01 mg estradiol and 200 mg progesterone be more effective than a 30-day cycle in managing this issue?

@evaeva0 2 ай бұрын

In my country only cyclical oral or continuous combined intramuscolar hrt is available. Would any of these better than nothing?

@justYouJesus1God 9 күн бұрын

I am using the Dottie patch.05 and Progesterone 100 MG but I don't really get sleep, my hair still falls out, I haven't lost weight probably gained a few pounds. How much more should I go up to be able to get a good night's sleep? Do I need to up my estrogen or up my progesterone to 200 mg. That's what I don't know the doctor was hesitant to even give me the patch and so she probably figured when I said .05 she's like okay but I really haven't noticed it doing anything

@justYouJesus1God 9 күн бұрын

So how much are we supposed to take then of estradiol 1.0 would that make me bleed? And then progesterone you're saying that it'll counteract with the estrogen. Are we not supposed to take that every day. I still can't sleep, am I taking adequate estradiol on the Dottie patch? That doctor I have does not know anything and maybe she agreed to the 05 because she doesn't know anything I don't know either

@MarjanKeirk 27 күн бұрын

What about surgical menopause? On patch estrodot and utrogestan and T cream

@helenstewart3417 24 күн бұрын

66 yrs old on Oestridal and Utrogestan. Only on it a month. Feel good on it BUT is it better to do it naturally? 11 yrs post meno btw

@lf9341 7 күн бұрын

I'm on 0.375 patch and progesterone iud. Estrodial gave me melasma, so I don't want to take anymore. Should we be taking testosterone? Some doctors are all about it, but not mine.

@engelneen1686 Ай бұрын

I was on the highest patch dose and my dr said I needed to go to the oral pill in order to increase my dose. I checked and the patches are only in lower doses.

@stephaniehenault9360 Ай бұрын

Is it enough 50mcg estradiol in patches

@kimdavis1091 2 ай бұрын

Dr Gersh do you have a video for HRT for women who have had a full hysterectomy? Thank you I had mine at 42…..

@mariapetrarca6925 Ай бұрын

Same here. Had mine at 46. I'm curious.

@crh251 2 ай бұрын

I gained all my weight in perimenopause at the age of 50. I put on 30 pounds quickly. Most of it around my waist. I was not on any hormones until I turned 58. I’m 60 now and am on the highest patch of 0.1. My progesterone which is daily is 200 mgs. My estradiol level is 96. My progesterone is 5.5, but I recently went up to 200 mgs. so I’ll be tested again. Last June I found out my visceral fat was 2.4 pounds. It would be nice to know how to regulate them both so I can begin to finally lose the weight I gained in perimenopause.

@muchasalud2011 Ай бұрын

Try keto carnivore. Get off all carbs.

@crh251 Ай бұрын

@@muchasalud2011, I’ve been doing that, but I think because I have Hashimotos, it’s a struggle losing the weight. I’ll keep trying!

@giannas1096 Ай бұрын

Me too, gained weight on HRT and now can’t get it off.

@crh251 Ай бұрын

@@giannas1096, I gained the weight before HRT.

@mistyowens1036 Ай бұрын

What if you had a thyroidectomy and hysterectomy?

@Aki-wq6xh 2 ай бұрын

I have early menopause. Given my relatively young age (late 30s) is HRT with E2 + Real Progesterone still better than the pill? That’s my preference but some people think I need higher dose of hormones that’s in the pill 😢 I know you can’t give personal advice but may I hear your thoughts?😊

@cozinha8945 2 ай бұрын

I'm curious too

@rachelhambone1159 Ай бұрын

I'm not absolutely sure about this, but I feel like I heard somewhere that the hormones in birth control are not the body identical Estradiol and Micronized Progesterone.

@michellemustari498 17 күн бұрын

If you had an ablation done on the uterus and you're doing the cycle of hormones I haven't gotten a period even though I'm doing the cycle is that normal

@marynow123 Ай бұрын

As soon as I went on hrt in post menopause I gained weight. Within a few months of starting hrt my a1c went up to pre diabetic and my triglycerides went to over200! Before hrt my a1c was at 5 and my triglycerides were 80. Why is hrt doing this to me? Does it mean I need a lot more hormones? And why do some people not gain weight from hrt?

@giannas1096 Ай бұрын

Me too.

@leslielucci3182 2 ай бұрын

Does anyone know of a good doctor for this in the Long Island, NY area?

@mojavewolf1 2 ай бұрын

So you’re saying using hormones is bad ?

@leighdavidov9383 2 ай бұрын

What about Estriol as in the Bi-est compound?

@robynritchie971 2 ай бұрын

Hi! I take a Biest/testosterone troche. I had thought troches were considered transdermal. However, it sounds like taking it this way turns it into estrone? I have been struggling with gerd since starting hrt. Would this be the cause? Would it be better to use a cream? I am losing weight so I’m not worried about that. Any help would be greatly appreciated!😀

@57athina 2 ай бұрын

I took bio identical hormones at menopause for 5 years and then stopped 10 years ago. Now at 66 is it too late to start again? Some doctors say yes others say no.

@leslieharari8755 2 ай бұрын

No it's not too late! Dr. Gersh mentions this in some of her videos. I also stopped and then started back a few months before turning 66 and I do like how I am feeling. It took me a few months to be able to tolerate the hormones, i.e. progesterone made me so sleepy, etc. but it's been a year and I feel great.

@57athina 2 ай бұрын

@@leslieharari8755 thank you much for your reply. I wish I have stuck with it but the cost and then I felt I’d been through the worst of it but now I feel I need it again. Too much conflicting information.

@kenike007 2 ай бұрын

I've watched other videos and the answer is No! You can go back on them...they are a major benefit. I'm doing so myself at 72 ,but I need to play with the dosage.

@kidges3132 Ай бұрын

If you’re within 10 years of having hrt you can take it

@michellejessey8654 28 күн бұрын

My estrogen is high on my period in peri. Terrible

@giannas1096 Ай бұрын

Some menopausal aged women I know take no HRT and don’t gain weight. How is this possible?

@StrideOrDie71 Ай бұрын

Genetics, I’m guessing.

@madisonmartinezz 2 ай бұрын

Hello 🌲 Pay attention to video editing also. This is quite low, edit in good style. Because it is very important in your video.

@emilybrowno 2 ай бұрын

Agree at heart. 💙

@jessicamillerr 2 ай бұрын

Definitely yes. 🍈

@laurendavisa 2 ай бұрын

Yes, video editing is definitely low. 🥜

@Julia29853 Ай бұрын

Please explain in better English. This makes No sense. Video editing low? Are you saying it is low QUALITY?

@lostgirlproductions 25 күн бұрын

@@Julia29853 they're probably all bots

@brendadaviswilson9243 26 күн бұрын

Just be patient the menopause process doesn’t occur overnight so addressing the hormonal imbalance won’t resolve overnight either. You and your physician may need to adjust doses as you go

@Nellie7777777 2 ай бұрын

Can we eat carbs now if we use HRT? I was 18 yr whole food plant based. Im being told this is the worse diet now peri and meno. So confusing. Please make a video on a good diet for this transition. Thank you mamm

@iss8504 2 ай бұрын

You maybe can but you have to be careful. I ended up having to do keto and 48 hour fasts twice weekly to control my weight. I am 54 and post menopausal. On the patch. My gut is so messed up from menopause that i suddenly couldn't tolerate a lot of vegetables. Bloating, gerd, etc. So i only eat fermented veggies like kimchee and meat. It's insane but i feel like my former pre menopausal self again. I avoid beans, grains and starchy vegetables. Eating maybe 10 g of total carbs, which is very low. Grains are inflammatory. I ended up with autoimmune issues but they resolved once i took the grains out. This is even on hrt so its not a panacea.

@michellemustari498 2 ай бұрын

I can tell you one thing get off the plant-based diet and get on eating meat you need the hormones from Meet the fat in order to make your hormones you're going to kill yourself just eating a plant-based diet there's so many people that have been on this that have complained about it ruining their health

@sarahwinzeler24 2 ай бұрын

No. Even with hormone supplementation, i couldn't lose the weight. I switched from keto to carnivore to be rid of the inflammation and lose weight. I feel fantastic now! Zero sugar cravings for this sugar addict. I enjoy Dr. Ken Berry the most of all of the doctors that teach about keto/carnivore. Best wishes. Dr. Felice Gersh, thank you! You're fabulous ❤

@cleanqueen75 2 ай бұрын

I’m 67 and I have been on bio-identical hormones for 12 years now. I take progesterone cream, testosterone cream and one click of 2mg/gm of estradiol. I also take 15mg of Lyrothyronine. In the last 5 years years I’ve gained weight especially in my belly and butt. I go to a dietitian and she thinks I don’t eat enough protein. I do weight training and cardio 5 days a week. About once a year my hormone doctor checks my saliva and then of course bloodwork every 6 months. I always thought too much estradiol is what makes you can weight?

@muchasalud2011 Ай бұрын

keto carnivore or at a least very low carb. You must eat animal foods. Your body cannot make hormones from plant sterols; it's a biological fact. Some excellent resources: Dr. Elizabeth Bright, Dr. Zoe Harcombe, Dr. Ben Bikman, Dr. Ken Berry, Dr. Brett Scher.