A new study published in The Lancet Obstetrics, Gynaecology, & Women’s Health suggests hormone replacement therapy may be linked to better weight loss after menopause in women taking Mounjaro (tirzepatide) a glucagon-like peptide-1 (GLP-1) receptor agonist. In this article we investigate the specifics of the study and examine its findings.
Weight gain is one of the most common side effects related to menopause, affecting at least 50% of women. Falling oestrogen levels are linked with changes in body fat distribution, causing fat to increase around the abdomen rather than in the thighs, buttocks and hips. The wider effects of menopause in combination with the effects of natural aging can trigger changes in the body, causing weight gain and difficulty with weight management.
The study, published in The Lancet Obstetrics, Gynaecology, & Women’s Health, looked at postmenopausal women who were overweight or obese, and who had taken tirzepatide for at least 12 months. The researchers identified 120 women in total, 40 who were using menopausal hormone therapy and 80 who were not. The mean age of the group was 56.4 years old.
The headline result of the observational study states that the women who used menopausal hormone therapy lost about 35% more weight taking tirzepatide than those without hormone therapy. The researchers suggest that hormone therapy might enhance the therapeutic effects of tirzepatide in this population.
The authors state because the study is not a randomised control trial, they cannot say hormone therapy caused additional weight loss. They suggest the menopause symptom relief experienced by women using hormone therapy may support better weight management outcomes.
Women using hormone therapy using hormone therapy may experience improved sleep and quality of life, making it easier for them to stay engaged with healthier diets, physical activity and other lifestyle changes that support weight loss.
While more studies are needed the authors state that preclinical data suggest a potential synergy, with oestrogen appearing to enhance the appetite-suppressing effects of GLP-1 medicine. In theory, that could help explain why some women on hormone therapy appeared to respond better to tirzepatide.
While this study does not prove cause and effect, it does show menopause status and hormone therapy use may matter more than clinicians once appreciated.
The authors said the study points towards more personalised approaches, where menopause status and hormone therapy use are considered when counselling midlife women and designing treatment plans for obesity with GLP-1 medicines.
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