Obesity in perimenopause - current treatment options based on pathogenetic factors

Area of Science:

• Endocrinology
• Women's Health
• Metabolic Disorders

Background:

• Aging global population increases concern for post-menopausal women's health.
• Obesity prevalence is rising among post-menopausal women, posing a public health challenge.
• Mechanisms driving menopause-associated weight gain are not fully understood.

Purpose of the Study:

• Review literature on hormonal factors and pathomechanisms of perimenopausal obesity.
• Identify pathogenic factors to guide treatment selection for obesity in this demographic.
• Explore potential therapeutic strategies, including menopausal hormone therapy (MHT).

Main Methods:

• Literature review of hormonal changes and pathomechanisms during perimenopause.
• Analysis of factors contributing to obesity, metabolic alterations, and cardiovascular risks.
• Examination of current and emerging obesity treatment strategies.

Main Results:

• Menopause-induced hormonal changes (e.g., hypoestrogenaemia, leptin resistance) implicated in obesity onset.
• Weight gain associated with increased adipose tissue and decreased lean body mass.
• Standard obesity treatments show efficacy; MHT shows potential for visceral obesity but lacks official recommendation.

Conclusions:

• Hormonal fluctuations and reduced energy expenditure drive metabolic changes and obesity risk in perimenopausal women.
• Individualized behavioral management, pharmacotherapy, and bariatric surgery are current treatment mainstays.
• Further research is needed to validate MHT as a causal treatment for perimenopausal obesity, particularly visceral fat accumulation.