GLP-1 and Menopause: Nutrition Tips for Women in Perimenopause and Beyond

Woman in her fifties preparing a breakfast of yogurt with berries, eggs and leafy greens in a bright kitchen

Quick answer: Menopause and GLP-1 medications both change how your body handles food, muscle and fat. During the menopause transition, women tend to gain more fat around the middle and start losing lean muscle, while GLP-1 medications reduce appetite, so you eat less overall. The practical priorities are the same at every stage: get enough protein at each meal, do strength training at least twice a week, meet your calcium and vitamin D needs, choose fibre-rich whole foods, and talk with your provider about menopause symptoms and treatment options, including hormone therapy if it's appropriate for you. Supplements can fill specific gaps, but no supplement treats menopause or replaces a balanced diet.

Why menopause and GLP-1 medications overlap

Many women start a GLP-1 medication in their 40s and 50s, which is also when perimenopause and menopause begin. That timing matters, because the menopause transition brings its own changes in body composition and metabolism.

What happens to your body during the menopause transition

The long-running Study of Women's Health Across the Nation (SWAN) followed women through midlife. It found that at the start of the menopause transition, the rate of fat gain roughly doubled and lean mass began to decline. Both trends continued until about two years after the final menstrual period and then levelled off.1

An American Heart Association scientific statement adds that LDL cholesterol and apolipoprotein B rise in response to menopause itself, not only to ageing, and that women after menopause tend to gain central (visceral) fat. This shift is linked to higher cardiovascular risk, even in women at a normal body weight.2

What GLP-1 medications add to the picture

GLP-1 medications reduce appetite and slow stomach emptying, so most people eat noticeably less. Eating less is part of how they work, but smaller meals also leave less room for protein, calcium, fibre and other nutrients. When a lower intake meets the muscle loss that menopause already brings, protein and strength training matter even more. For a deeper look, see our guide to GLP-1 and muscle health in women.

Does menopause hormone therapy affect GLP-1 results?

Early research suggests it might, but the evidence is still limited.

  • A Mayo Clinic study of 106 postmenopausal women taking semaglutide found an average 16% total body weight loss after 12 months in women using hormone therapy, compared with 12% in women who weren't. Only 16 women in the study used hormone therapy, and the design was retrospective, so it can't show cause and effect.3
  • A second Mayo Clinic study of 120 postmenopausal women taking tirzepatide, presented at the Endocrine Society's ENDO 2025 meeting, reported 17% average weight loss with hormone therapy compared with 14% without, over a median of 18 months. These were early conference results.4

Hormone therapy isn't a weight-loss treatment, and these studies don't mean every woman should start it. According to The Menopause Society's 2022 position statement, the benefits of hormone therapy outweigh the risks for most healthy women with bothersome hot flashes who are under 60 or within 10 years of menopause, as long as there's no reason they shouldn't take it.5 Whether it's right for you depends on your health history, so it's worth asking your provider.

Food-first nutrition priorities for midlife women on GLP-1

1. Put protein first at every meal

Protein helps you keep muscle while you lose weight. The PROT-AGE expert group recommends that older adults aim for at least 1.0–1.2 g of protein per kilogram of body weight per day, and at least 1.2 g/kg for active adults. People with severe kidney disease are an exception and may need to eat less.6 Those targets were written for adults over 65, so ask your provider or dietitian what fits you.

  • Start each meal with the protein: eggs, Greek yogurt, fish, chicken, tofu, tempeh, lentils or cottage cheese.
  • Spread protein across the day rather than saving it for dinner, because large portions may be hard to finish on a GLP-1.
  • If appetite is very low, protein-rich snacks such as a small yogurt, a boiled egg or edamame can help.

2. Cover calcium and vitamin D

Bone loss speeds up after menopause. The NIH Office of Dietary Supplements sets the calcium RDA at 1,000 mg per day for women aged 19–50 and 1,200 mg per day for women aged 51–70, to help limit bone loss after menopause.7 Dairy, calcium-fortified plant milks, tofu made with calcium, canned salmon or sardines with bones, and leafy greens such as kale and bok choy all help. Read more in our article on GLP-1 and bone health for women over 40.

3. Choose fibre-rich, heart-friendly foods

Because LDL cholesterol tends to rise around menopause,2 the overall pattern of what you eat matters. Build meals around vegetables, fruit, legumes, whole grains, nuts, seeds and fish, and use olive oil or other unsaturated fats in place of butter where you can. Fibre also helps with the constipation some people notice on GLP-1 medications. Increase it slowly and drink enough fluids.

4. Make every small meal count

When portions shrink, nutrient density becomes the goal. A plate with a palm-sized portion of protein, a generous portion of vegetables and a small portion of whole grains or legumes covers more nutrients than the same amount of ultra-processed food. Our guide to key vitamins and minerals for women on GLP-1 covers this in more detail.

5. Watch alcohol and late, heavy meals

Many women find that alcohol and large late-evening meals worsen hot flashes, sleep and digestive comfort. That's common experience rather than proven science, so pay attention to your own triggers.

Movement: strength training is the priority

Adults should aim for at least 150 minutes of moderate activity a week, such as brisk walking, plus muscle-strengthening activity on at least two days a week that works all the major muscle groups.8 For midlife women on a GLP-1, strength training does two jobs at once: it helps protect the muscle that menopause and weight loss can both reduce, and it supports bone health. Start with bodyweight exercises, resistance bands or light weights, and progress gradually.

What about soy and herbal supplements for hot flashes?

Many products marketed for menopause contain soy, herbs or plant extracts. The Menopause Society's 2023 nonhormone therapy position statement reviewed the evidence and does not recommend soy products or supplements and herbal remedies for treating hot flashes. Options it does recommend include cognitive behavioural therapy, clinical hypnosis, weight loss and several prescription medications.9

Soy foods such as tofu, tempeh, edamame and soy milk are still nutritious sources of protein and, when fortified, calcium. They just shouldn't be relied on to treat symptoms. Herbs can also interact with medications. For example, a published case report describes dong quai raising INR (a measure of how long blood takes to clot) in a woman taking the blood thinner warfarin.10 If you take any prescription medication, check new supplements with your pharmacist or provider first.

Where Beauty Secret® 20+ fits

Beauty Secret® 20+ (Sachet) is a powdered natural health product for adult women, made by Real House Canada (NPN 80073784). Its authorized uses are to help maintain good health, as a source of antioxidants, and as a source of fungal polysaccharides with immunomodulating properties.

What it is: each 10 g serving contains chaga (Inonotus obliquus) mycelia 3,600 mg, soy seed powder 2,000 mg, vitamin C 100 mg, vitamin D3 400 IU (10 mcg), vitamin E 40.5 mg AT, CoQ10 30 mg and astaxanthin 5 mg, plus dong quai, red peony, garcinia and kale. Some women like it as a simple daily routine alongside a balanced diet.

What it isn't:

  • It is not a menopause treatment and is not intended for hot flashes, night sweats or other menopause symptoms.
  • It is not a weight-loss product, doesn't work like a GLP-1 medication and isn't required alongside one.
  • It is not a meaningful source of protein or calcium, so it can't replace protein-rich foods or calcium sources.
  • It hasn't been studied in women taking GLP-1 medications or hormone therapy.

Because it contains dong quai and other botanicals, check with your provider or pharmacist before using it, especially if you take blood thinners, hormone therapy or other prescription medications, or if you're pregnant or breastfeeding. Product availability and labelling vary by country. Learn more about Beauty Secret® 20+.

Signs to discuss with your healthcare provider

  • Hot flashes, night sweats or sleep problems that affect your daily life
  • Irregular, very heavy or unexpected bleeding, including any bleeding after menopause
  • Ongoing nausea, vomiting or difficulty eating enough protein
  • Noticeable loss of strength, frequent falls or a fracture from a minor fall
  • Unusual fatigue, hair shedding, dizziness or low mood
  • Questions about hormone therapy, bone density testing or cholesterol checks
  • Any plan to start, stop or combine supplements with your medications

Frequently asked questions

Can I take a GLP-1 medication during perimenopause or menopause?

Many women do, and GLP-1 medications are prescribed based on weight and health conditions rather than menopause status. Your provider will consider your full health history, including any other medications or hormone therapy.

Does hormone therapy make GLP-1 medications work better?

Two small observational studies from Mayo Clinic found somewhat greater weight loss in postmenopausal women using hormone therapy with semaglutide or tirzepatide.3,4 These findings are early and don't prove cause and effect, so hormone therapy should be considered for its own benefits and risks.

How much protein do women in menopause need on a GLP-1?

Expert guidance for older adults suggests at least 1.0–1.2 g per kilogram of body weight per day, or more for active adults, unless you have kidney disease.6 Your provider or dietitian can help you set a personal target.

Will soy or herbal supplements help with hot flashes?

The Menopause Society does not recommend soy products or herbal supplements for treating hot flashes, because the evidence doesn't support them.9 Talk to your provider about treatments with stronger evidence.

Why am I gaining weight around my middle during menopause?

During the menopause transition, fat gain speeds up and tends to shift toward the abdomen, while lean muscle declines.1,2 Strength training, enough protein and a fibre-rich eating pattern all help, whether or not you take a GLP-1 medication.

Bottom line

Menopause and GLP-1 medications both make muscle, bone and nutrition harder to protect. Put protein first at every meal, strength train at least twice a week, cover calcium and vitamin D, and build your plate around fibre-rich whole foods. Talk with your provider about menopause symptoms and whether hormone therapy is right for you. Supplements such as Beauty Secret® 20+ can be part of a daily wellness routine within their approved uses, but they don't treat menopause or replace a balanced diet.

Medical disclaimer: This article is for general education only and is not medical advice. It does not replace advice from your doctor, pharmacist or registered dietitian. Always consult your healthcare provider before starting, stopping or changing any medication, hormone therapy or supplement. Product availability and labelling vary by country.

Sources

  1. Greendale GA, Sternfeld B, Huang M, et al. Changes in body composition and weight during the menopause transition. JCI Insight. 2019;4(5):e124865. insight.jci.org/articles/view/124865
  2. El Khoudary SR, Aggarwal B, Beckie TM, et al. Menopause transition and cardiovascular disease risk: implications for timing of early prevention. A scientific statement from the American Heart Association. Circulation. 2020. Summary: American College of Cardiology
  3. Hurtado MD, Tama E, Fansa S, et al. Weight loss response to semaglutide in postmenopausal women with and without hormone therapy use. Menopause. 2024. doi:10.1097/GME.0000000000002310. Summary: Healio
  4. Endocrine Society. ENDO 2025 press release on tirzepatide and menopause hormone therapy (Castaneda R, Hurtado Andrade MD, et al.). July 12, 2025. endocrine.org
  5. The North American Menopause Society. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022. PubMed 35797481
  6. Bauer J, Biolo G, Cederholm T, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013;14(8):542–559. doi:10.1016/j.jamda.2013.05.021
  7. NIH Office of Dietary Supplements. Calcium: Fact Sheet for Health Professionals. ods.od.nih.gov
  8. U.S. Centers for Disease Control and Prevention. Adult Activity: An Overview. cdc.gov
  9. The North American Menopause Society. The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause. 2023. doi:10.1097/GME.0000000000002200. Press release (PDF)
  10. Page RL 2nd, Lawrence JD. Potentiation of warfarin by dong quai. Pharmacotherapy. 1999;19(7):870–876. PubMed 10417036

Article précédent

Retour au blog