Hormone replacement therapy (HRT) can lead to weight gain in some individuals, although the amount of weight gain varies considerably between patients. There are several factors that contribute to potential weight gain on HRT:
- Estrogen effects: Estrogen can increase subcutaneous fat stores, resulting in a more feminine fat distribution with more fat deposited on the hips, buttocks and thighs. Estrogen may also decrease muscle mass. These effects lead some individuals to gain a modest amount of weight on feminizing HRT regimens.
- Progesterone effects: Some progestins used in HRT, especially medroxyprogesterone acetate, may increase appetite and lead to fluid retention, both of which can promote mild weight gain. This seems most pronounced with depot medroxyprogesterone shots used in feminizing HRT regimens.
- Anti-androgen effects: The anti-androgens used in feminizing HRT, such as spironolactone and cyproterone acetate, are potassium-sparing diuretics. They can cause salt and water retention early in treatment, leading to temporary weight gain of a few pounds. This evens out over time on a steady HRT regimen.
- Lifestyle changes: Starting HRT represents a major life change for most transgender women. Some changes like decreased muscle mass may slow metabolism. HRT can also increase appetite. If calorie intake remains high while activity decreases, weight gain can occur. Making proactive lifestyle modifications can help minimize HRT-related weight gain.
- Normalization of weight: Transgender women with severe gender dysphoria may restrict caloric intake before HRT intentionally or unintentionally due to depression and body image distress. As gender dysphoria alleviates with feminizing physical changes from HRT, appetite and weight often normalize. This includes some weight gain, but is healthy overall.
So in summary, while feminizing HRT often leads to modest weight gain, this is usually beneficial for transgender women. It results from normalizing hormone balance, improvements in mood and self-image, and desired feminizing fat distribution changes. However, it's important to be mindful of making positive lifestyle choices as well while on HRT. Getting regular exercise, practicing mindful eating habits and seeking support can all help transgender women achieve their goals for HRT.
At Hormone Harmony Clinic, we specialize in transgender hormone therapy and are dedicated to helping our patients through their transition journeys in a caring and affirming manner. Our board-certified providers work closely with each patient to develop customized HRT regimens based on their specific needs and transition goals. We monitor progress carefully and make adjustments over time to optimize results while minimizing side effects.
We also provide counseling and resources related to proper nutrition, fitness and developing a strong support system - all of which are vital for transgender individuals to thrive, including being able to achieve comfortable and sustainable weight management on HRT. At Hormone Harmony Clinic, your wellbeing is our top priority. We are here to empower you to become your true self. Contact us today to take the first step!
