Mounjaro and menopause: everything you need to know

Menopause can bring changes to your body that you weren’t expecting. You may notice weight gain or your body shape changing, even though the way you eat and live has stayed the same. At least 50% of women gain weight during this stage of life, with weight often settling around the stomach and upper body.

If that feels frustrating, confusing or knocks your confidence, you’re not alone. And most importantly, it doesn’t mean you’ve done anything wrong.

Not everyone wants or needs to lose weight during menopause. But if you do want support managing your weight and you’re considering Mounjaro, you most likely have many questions. In this guide, we’ll explain how Mounjaro works during menopause, what you can expect, and what you need to know if you’re also taking hormone replacement therapy (HRT).

Weight and appetite changes during menopause

Women’s Health Concern calls perimenopause a “perfect storm” for weight gain. Lower oestrogen means more fat gets stored deep inside your tummy (visceral fat), and as muscle mass decreases with age, your body naturally burns less energy. Broken sleep, low mood, and sore joints don’t help either, and emotional eating is very common. Our guide to weight gain in menopause explains more.

So, at a time of such change, what matters most is your health and how you feel, not getting your body to look a certain way.

Can you take Mounjaro during menopause?

Yes, as long as your clinician agrees it’s suitable. According to the patient leaflet, Mounjaro is licensed for adults whose body mass index (BMI) is 30 or over, or 27 to 30 where weight is affecting their health.

Its active ingredient, tirzepatide, acts on receptors for two gut hormones, including glucagon-like peptide-1 (GLP-1). This reduces your appetite and keeps you fuller for longer.

A 2026 review found early hints that weight loss, and possibly GLP-1 medicines, may help with hot flushes, though the research is thin. But it's important to note that Mounjaro does not treat menopause symptoms, so it should not be used in place of HRT, which the HSE says can ease mood swings, night sweats, and hot flushes.

Is there a “best” GLP-1 for menopause?

A 2025 review called GLP-1s the leading weight loss medicines and a useful option around menopause. Even so, there’s no one GLP-1 for menopause that’s right for everyone.

Whether you want to take a GLP-1 during perimenopause or menopause, the right medicine is the one that suits you specifically, determined through clinical assessment. Our clinicians look at your medical history, other medicines, and preferences before suggesting one.

Can you take Mounjaro alongside HRT?

Yes, and some people do. They do, however, play different roles:

• HRT puts back the oestrogen and progesterone that fall as menopause approaches. It relieves symptoms and helps protect against weak bones (osteoporosis).
• Mounjaro targets your appetite, which helps with weight management.

The HSE says there’s little evidence that most types of HRT cause weight gain.

When undergoing consultation for Mounjaro, make sure to tell your clinician that you take HRT, plus any other medicines. If there’s still a chance you could get pregnant and are taking contraceptives, it's important to note that Mounjaro may make the pill less effective. The Faculty of Sexual & Reproductive Healthcare (FSRH) recommends adding a non-oral method, like condoms, especially for four weeks after starting and after each dose increase.

For more information, read our guide to the impact of Mounjaro on fertility.

Does HRT make Mounjaro work better?

Possibly, but it’s too early to determine. A 2026 study looked back at the records of postmenopausal women who’d used tirzepatide for at least a year. 40 of them also using hormone therapy lost 19.2% of their body weight on average, against 14% for the 80 who weren’t. But because it looked back at records, the study can’t say for certain that the hormone therapy specifically caused the difference.

Whether HRT is right for you depends on your symptoms, risks, and medical needs, not on weight loss.

Muscle and bone health matter even more during menopause

Losing weight can benefit your health, but during menopause, preserving what your body needs along the way matters too. Paying attention to your muscle and bone health can help you stay strong, mobile and active as you get older, so let’s look at how to support both while taking Mounjaro.

Protecting your muscle while losing weight

As with diet and exercise, some weight lost on tirzepatide is lean mass, including muscle. A SURMOUNT-1 trial analysis using body scans found about three-quarters was fat and a quarter lean mass, with a similar split at every age, including 50-64.

You already lose some muscle with age, so preserving it matters. Strength work helps you feel more confident on your feet as you get older, and muscle helps with keeping weight off.

A few ways to look after your muscle include:

• eating a form of protein at every meal
• combining it with strength exercise, as protein alone will not build muscle
• doing muscle-strengthening activities on two or more days a week

Don’t forget about bone health

Oestrogen is essential for healthy bones, and when it falls after menopause, bone density can drop quickly. That makes bone health a priority now.

GLP-1 medicines may affect bones too. In a small 2025 study of semaglutide and tirzepatide, bone density fell at the spine and hips, and people who lost more weight lost more at the hip. However, a 2026 review suggests the effects may vary between GLP-1 medicines.

To support your bones:

• get 800 milligrams (mg) of calcium a day from foods like yoghurt, leafy greens, and tofu
• consider a daily 10 microgram vitamin D supplement, especially in autumn and winter
• mix weight-bearing exercise, like brisk walking, with resistance exercise, weight lifting
• ask whether you need a bone density scan before weight loss treatment, as bone researchers suggest

What about heart health?

Changes around your middle during menopause can feel frustrating, especially when your body starts to look or feel different despite your usual habits. But a “menopause belly” isn’t something to monitor simply because of how it looks or how your clothes fit.

As oestrogen levels fall during menopause, fat is more likely to be stored around the abdomen. At the same time, changes in cholesterol and blood pressure can increase your risk of heart and circulatory problems.

That’s why it’s worth keeping an eye on changes around your waist first and foremost for your health, rather than your appearance. Looking after your heart is far more important than fitting into a certain clothes size.

For more information, read our guide to why the menopause belly happens and what you can do about it.

Mounjaro side effects to be aware of during menopause

Like any medication, Mounjaro can cause side effects. The most common ones are digestive, such as nausea, vomiting or diarrhoea. Most people find Mounjaro side effects mild and manageable as the body adjusts to the medication. Even so, there are certain side effects to be aware of, as they might overlap with menopause symptoms.

Hair thinning and hair loss

Thinning hair is one of the less acknowledged symptoms of menopause, yet it can happen due to changes in the hair follicle. This type of shedding is known as diffuse effluvium. On top of this, losing a lot of weight rapidly can trigger telogen effluvium, another type of temporary hair loss.

Mood and emotional wellbeing

According to the HSE, menopause can cause low mood, anxiety, and mood swings.

While there's no established link between tirzepatide and low mood, a few people have anecdotally reported feeling "flatter than usual". This might be because of blood sugar fluctuations (which can cause feelings akin to anxiety), lifestyle changes, or even adapting to a changing body. Even though none of these is directly caused by the medication, they are important to note if you're considering Mounjaro during menopause, a time when you're already more prone to changes in mood.

If you start Mounjaro and your mood shifts in a way that feels new, worse, or out of character, let your clinician or GP know.

Digestive symptoms

Menopause can bring changes to your digestion too. As oestrogen and progesterone levels decline, this can affect the gut, including changes to the gut microbiome, which may contribute to symptoms such as bloating, constipation, and changes in bowel habits.

As mentioned, digestive symptoms are also among the most common side effects of Mounjaro. So, if you’re going through menopause and taking Mounjaro, it can sometimes be difficult to tell what’s behind the changes you’re experiencing.

“Menopause can already feel like a time when your body is changing in lots of different ways, so starting Mounjaro on top of that may naturally bring questions. The important thing is that you don’t have to work everything out on your own. Keep your healthcare team informed about any medicines you’re taking, including HRT, and let them know if you experience new or difficult side effects. That way, your treatment can continue to be reviewed with your overall health and wellbeing in mind.”

Ayesha BashirPrescribing Pharmacist

You don’t have to simply put up with uncomfortable symptoms. Keeping track of when they happen and speaking to your healthcare team if they’re persistent, severe or worrying can help you get the right support.

And if you're a myBMI patient, our treatment plans include ongoing clinical support with side effects, including free treatments for your symptoms if deemed appropriate.

How to take Mounjaro safely during menopause

As menopause brings its own changes to your body, it's particularly important to look after yourself along the way if you're taking Mounjaro. Luckily, it doesn’t have to feel complicated. Here are a few things to consider:

• Stick to your prescribed dose. Your clinician will guide you through all dose changes.
• Tell your clinician about every medicine you take, HRT included.
• Make sure you consume adequate protein and calcium-rich foods like yoghurt on the menu, even when you’re not particularly hungry.
• Stay active, focusing on strength and resistance exercise, to protect your muscles and bones.
• Stay hydrated, especially if you’ve been sick or have diarrhoea.
• Speak to your doctor before stopping or adjusting your treatment.

What about microdosing GLP-1s during menopause or perimenopause?

Some people refer to deliberately taking much smaller doses than prescribed as "microdosing GLP-1s". This topic has had plenty of attention online. However, there’s no peer-reviewed evidence it works or is safe. So, there’s no proof that "microdosing" cuts side effects, and you should always stick with your prescribed dose. Your myBMI clinical team will take your side effects into consideration when guiding you through your dose changes.

Looking after your whole health, not just the number on the scales

Your weight is only one part of your health. How strong you feel, your bone health, energy, sleep, nutrition, and emotional wellbeing all matter too, especially while your body is going through the changes of menopause.

There can be a lot of pressure to stay slim or look a certain way as you get older. But a body that changes during menopause isn’t a body that needs fixing. What matters is looking after your health and feeling comfortable and supported in the choices you make.

If weight changes are affecting your health or how you feel, and you’d like some extra support, you don’t have to manage them alone. If you’re eligible, Mounjaro may be one option to help you manage your weight alongside healthy, sustainable habits. But treatment is a personal choice, and there should never be pressure to lose weight simply because your body has changed.

If you need support managing your weight, our clinicians can help you decide whether Mounjaro could work for you.

Sources

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