Peri-Menopause is an inflammatory phase of the woman's life-cycle.
Sex, Myths and Menopause – I saw this well-publicised documentary made by the UK’s Celebrity Journalist Davina McCall, a couple of years ago now. She didn’t realise she was in peri-menopause and like millions of women, she was confused about her hot flushes, depression, and brain fog.
With so much noise online about “high protein diets”, it’s worth taking a more evidence-informed look at protein and menopause – especially if you’re noticing menopause belly fat, fatigue, and changes in appetite or digestion.
Whilst she did a great job of busting taboos about menopause, and primarily promoting HRT for women (something that is between a woman and her Doctor), there was a lot missing from her documentary.
After a decade of studying the inflammatory effects of menopause as well as coaching thousands of women on the MyMT™ programmes using lifestyle science evidence specific to this life-stage, I was waiting to hear about ‘inflammaging’ – the science of inflammatory changes that occur with age, and which accelerate as women transition from peri-menopause to post-menopause.
Like many documentaries and books I’ve read about menopause written by celebrities, journalists and even doctors, they are almost always missing the discussion about changes to the cardiovascular system, as well as the liver and gut changes that occur with age.
And this is an important point. Because with the world going mad about very high protein diets for midlife women, poor gut and liver health can affect the uptake of proteins, especially if women aren’t sleeping. A very high protein intake may also worsen bloating and flatulence for some women, which is why “protein for menopause” is not only about quantity – it’s about tolerance and context too. Angela, below, discovered this the hard way as well.
Peri-menopause is known as a systemic (all-over) inflammatory phase of the life-course [McCarthy & Raval, 2022], so focusing on reducing inflammatory changes through specific lifestyle solutions is an integral part of your self-care during menopause.
And please take note, if you are already overweight or obese (a waist circumference over 84cm for women), then I’m also referring to the inflammatory changes occurring in your fat cells.
Fat cells have a secret life.
If women have a lot of deeper visceral fat, then the fat cells are storing and producing oestrogens that are sourced via the diet, medications, chemicals and plastics (known as xeno-estrogens).
All oestrogens are recycled in the gut and for many overweight or obese women, these excess and recycled oestrogens may be metabolised differently, if they also have a fatty liver. This is why there has also been interest in the mode of delivery of transdermal HRT (skin patch), which bypasses the liver.
Does a high protein diet cause weight gain in already overweight women?
Weight gain in menopausal and post-menopausal women is an important topic.
In New Zealand alone there has been an increase in overweight and obese status in women over the past few years and yes, menopausal and post-menopausal women contribute to these stats. New Zealand has the third highest adult obesity rate in the OECD, and our rates continue to increase. (MoH, 2025).
The NZ Ministry of Health reports a significant increase from 2019/20 to 2022/24 for women (31.9% to 35.9%) and stats are similar in other western countries as well.
Canada stats are similar. During the 2022-2024 period, 34.8% of women over the age of 45 years were classified as having obesity (BMI of 30.0 or higher), while an estimated 30% were in the overweight range (BMI 25.0-29.9). Combined, nearly two-thirds of women in this age group are classified as overweight or obese.
Why do women put on weight during menopause?
It’s the question that I had to ask myself when I put on 15kg, and yes, I was on HRT. I had no idea at the time that the menopause transition increases susceptibility to weight gain and obesity for so many women. But it’s not just to do with our hormones.
It was my studies that led me to explore the role of the liver and gut health on menopause-related weight gain.
There are also changes occurring in our muscles, especially in the size and density of muscles. For some women, this may increase the risk of more rapid muscle loss (called sarcopenia). More importantly, with muscle loss, there may also be changes to the mitochondria in skeletal muscle (the organelles that help to ‘burn fat’). Add this to the inflammatory changes that may be occurring within the mitochondria, which are also ageing, then fat-burning metabolism can change during menopause.
Muscle tissue is replete with oestrogen receptors. So, when oestrogen is declining, it makes sense that there are also changes to muscle tissue as women move through menopause. This is why there seems to be such an emphasis on very high protein diets and resistance training.
The question is however, for overweight and obese women, who may also have a fatty liver and/or a fatty pancreas, how high is too high for protein intake?
I mention these organs, because it is the gut, liver and pancreas, which are doing a lot of work to turn-over protein in foods in order for the amino-acids to be utilised in muscle.
Some amino acids do go directly to both skeletal and cardiac muscle. These are the branched-chain amino acids (BCAAs), which are leucine, isoleucine, and valine and these proteins largely bypass initial metabolism in the liver and are primarily taken up and catabolized by extrahepatic tissues, particularly skeletal muscle and cardiac muscle. [Paulusma et al., 2022].
This is why, for women wanting to manage their weight, or to lose weight, then it’s important to understand differences in protein requirements to offset muscle tissue breakdown and to maintain metabolism, depending on how much exercise women are doing. This is what I also focus on in the MyMT™ programmes – protein intake shouldn’t be the same for everyone!
Muscles are at the heart of your metabolism, as is the liver and gut.
That’s why I enjoyed reading the proposed study into protein requirements during the menopause transition [Simpson et al., 2023].
Based on analysis of nutritional changes during the menopause transition, the authors of the study identified enhanced bodily protein breakdown as a trigger for weight gain during and after menopause.
This mechanism is known as the Protein Leverage Effect. (Simpson et al, 2023].
It arises when progressive net bodily protein losses induce increased appetite for protein. If there is not a corresponding increase in the dietary protein concentration, the predicted consequence is excess non-protein food intake.
In other words, part of the purpose of the slightly increased protein intake during and after menopause is not only with the reduction of muscle loss in mind, but also because protein is filling.
Protein and menopause belly fat: how much protein is “enough” during perimenopause and menopause?
The research suggests to get protein intake up to around 20% of total daily intake and for the average woman, this equates to around 1.0 to 1.4 gms/kg/day of healthy, low fat protein.
For overweight and obese women, in my own 12 week Transform Me programmes I do focus on whether women are having too much or too little protein.
I suggest starting around 1.0gm of protein per kg of body weight per day (1.0gm/kg/day) and move this up to 1.2 or 1.4 gm/kg/body weight as they add in their exercise.
This should account for around 20%-25% of total daily intake, a percentage that the research suggests as well.
I know that numerous Exercise Professionals and others working in the menopause space, encourage around 30%-40% of the total daily intake of food from protein. However, for women who are overweight and not doing a lot of heavy exercise, then too much protein can stress the kidneys and the liver. [Lonnie, Hooker et al, 2018; Osuna-Padilla et al., 2018]. New research also suggests that a very high protein intake, may also contribute to hardening of the arteries, especially in those over 55 years of age. [Huang et al., 2026].
Excess protein converts to excess energy and greater storage in fat cells as well as places stress on an already over-burdened liver.
This is why I also have a focus on liver health and improved oestrogen clearance for women who are overweight.
Conversely, for those women who are having too little protein in their diet, then this may also contribute to a more rapid rate of muscle breakdown. This is what we are trying to prevent during the menopause transition.
When we lose muscle, then this changes our metabolism and we don’t tend to ‘burn-fat’ as efficiently and this loss of muscle may have implications for sarcopenia and osteoporosis further into post-menopause.
“A failure to change the composition of the diet by the introduction of additional protein and removal of excess processed carbohydrates and/or excess fat, may result in an increased energy intake and storage and therefore, increased body weight during menopause.” [Simpson et al, 2022].
Minimum daily protein intake for women
What does the minimum daily protein intake look like for an 80kg overweight woman?
Not all women who are 80kg are overweight obviously, because this total weight includes both muscle and fat tissue as well as bone.
But for women who have increased belly-fat and the deep visceral fat that may lead to a condition called Metabolic Syndrome, then 80 grams of protein spread throughout the day might look like this:
Of course, when we focus on our protein intake (not too much and not too little), then we also have to look at our intake of carbohydrates and fats so that we don’t overeat!
This is important in terms of weight loss management, so for those of you who may be on a high fat diet (e.g. Keto) and you are now increasing protein intake, then please be aware that you need to remove some of this fat!
A high protein diet combined with a high fat diet can spell disaster for your ageing liver and gut health as well as your weight.
It’s why my focus in the MyMT™ Transform Me programme is on 15-20% total fat intake so that women can lose the deep visceral, storage fat and stop gaining.
It’s this deeper visceral fat that sends women into cardiovascular and metabolic chaos, leading them towards poorer post-menopause health.
For overweight and obese women in their menopause and post-menopause transition, weight loss matters to our cardiovascular and metabolic health as we age.
Dr Wendy Sweet (PhD), MyMT™ Founder/ Member: Australasian & British Society of Lifestyle Medicine.
FAQs: Protein and Menopause
Increasing protein intake may help support muscle maintenance and metabolism during menopause, but it does not automatically reduce menopause belly fat. For overweight or obese women, very high protein diets can contribute to bloating, liver stress, and further weight gain if protein intake exceeds what the body can effectively metabolise. Protein intake needs to be individualised and considered alongside liver health, gut health, sleep, and overall energy intake.
For the average women, not doing excessive amounts of resistance training, longevity research suggests that during and after menopause, protein intake of around 1.0–1.4 grams per kilogram of body weight per day, equating to approximately 20–25% of total daily energy intake, may help offset muscle loss and support metabolism. Intake should be adjusted gradually, particularly for women who are overweight or beginning an exercise programme.
Yes. For women who are overweight or obese, excess protein can convert to excess energy, contributing to fat storage and placing additional stress on the liver and kidneys. Very high protein intakes (particularly 30–40% of total daily intake) may worsen metabolic health if not matched with appropriate exercise and reductions in dietary fat or refined carbohydrates.
During the menopause transition, women may experience increased systemic inflammation, changes in muscle mitochondria, and enhanced protein breakdown. This can increase appetite for protein (known as the Protein Leverage Effect) while also making the body less efficient at processing excess intake, particularly if liver or gut health is compromised.
Yes. Declining oestrogen affects skeletal muscle, which contains oestrogen receptors. Loss of muscle mass (sarcopenia) during menopause can reduce metabolic rate and fat-burning capacity. Adequate — but not excessive — protein intake is important to help preserve muscle and support long-term metabolic and bone health. But all protein is utilised in the body in the presence of carbohydrates too.
Absolutely. The gut, liver, and pancreas play a central role in protein digestion and amino acid metabolism. Poor gut health, fatty liver, or sleep disruption can reduce protein uptake and utilisation, meaning higher protein intake does not necessarily translate to better outcomes and may instead increase digestive symptoms and fat storage.
No. High-protein diets may be appropriate for lean, physically active women engaging in resistance training, but they are not suitable for all menopausal women. For those who are overweight, insulin resistant, or have fatty liver disease, excessively high protein intake can worsen metabolic stress and weight gain. New research suggests that a very high protein intake, may also contribute to hardening of the arteries, especially in those over 55 years of age. [Huang et al., 2026].
Protein is essential during menopause – but more is not always better. The goal is enough protein to preserve muscle and support metabolism, without exceeding the body’s ability to process it, particularly in women with existing weight gain, liver stress, or metabolic dysfunction.
References:
Jull J, Stacey D, Beach S, Dumas A, Strychar I, Ufholz LA, Prince S, Abdulnour J, Prud’homme D. Lifestyle interventions targeting body weight changes during the menopause transition: a systematic review. J Obes. 2014; 824310.
Kapoor E, Collazo-Clavell ML, Faubion SS. Weight Gain in Women at Midlife: A Concise Review of the Pathophysiology and Strategies for Management. Mayo Clin Proc. 2017 Oct;92(10):1552-1558.
Kodoth V, Scaccia S, Aggarwal B. Adverse Changes in Body Composition During the Menopausal Transition and Relation to Cardiovascular Risk: A Contemporary Review. Womens Health Rep (New Rochelle). 2022 Jun 13;3(1):573-581.
Lonnie M, Hooker E, Brunstrom JM, Corfe BM, Green MA, Watson AW, Williams EA, Stevenson EJ, Penson S, Johnstone AM. Protein for Life: Review of Optimal Protein Intake, Sustainable Dietary Sources and the Effect on Appetite in Ageing Adults. Nutrients. 2018 Mar 16;10(3):360. doi: 10.3390/nu10030360.
Osuna-Padilla IA, Leal-Escobar G, Garza-García CA, Rodríguez-Castellanos FE. Dietary Acid Load: mechanisms and evidence of its health repercussions. Nefrologia (Engl Ed). 2019 Jul-Aug;39(4):343-354.
Paulusma CC, Lamers WH, Broer S, van de Graaf SFJ. Amino acid metabolism, transport and signalling in the liver revisited. Biochem Pharmacol. 2022 Jul;201:115074. doi: 10.1016/j.bcp.2022.115074.
Simpson SJ, Raubenheimer D, Black KI, Conigrave AD. Weight gain during the menopause transition: Evidence for a mechanism dependent on protein leverage. BJOG. 2023 Jan;130(1):4-10.
Stachowiak G, Pertyński T, Pertyńska-Marczewska M. Metabolic disorders in menopause. Prz Menopauzalny. 2015 Mar;14(1):59-64. doi: 10.5114/pm.2015.50000. Epub 2015 Mar 25.
